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There is no consensus on the prevalence of sarcopenia or its impact on mortality in end‐stage renal disease patients undergoing dialysis. This review aimed to summarize the diagnostic criteria of sarcopenia and its prevalence and impact on the mortality of end‐stage renal disease patients undergoing dialysis. Embase, MEDLINE, PubMed, and Cochrane Library were searched from inception to 8 May 2021 to retrieve eligible studies that assessed muscle mass by commonly used instruments, such as dual‐energy X‐ray absorptiometry, bioelectrical impedance analysis, magnetic resonance imaging, and body composition monitor. Two assessment tools matched to study designs were employed to evaluate study quality. Pooled sarcopenia prevalence was calculated with 95% confidence interval (CI), and heterogeneity was estimated using the I2 test. Associations of sarcopenia with mortality were expressed as hazard ratio (HR) and 95% CI. The search identified 3272 studies, and 30 studies (6162 participants, mean age from 47.5 to 77.5 years) were analysed in this review. The risk of bias in the included studies was low to moderate. Twenty‐two studies defined sarcopenia based on low muscle mass (LMM) plus low muscle strength and/or low physical performance, while eight studies used LMM alone. Muscle mass was assessed by different instruments, and a wide range of cut‐off points were used to define LMM. Overall, sarcopenia prevalence was 28.5% (95% CI 22.9–34.1%) and varied from 25.9% (I2 = 94.9%, 95% CI 20.4–31.3%; combined criteria) to 34.6% (I2 = 98.1%, 95% CI 20.9–48.2%; LMM alone) (P = 0.247 between subgroups). The statistically significant differences were not found in the subgroups of diagnostic criteria (P > 0.05) and dialysis modality (P > 0.05). Additionally, the sarcopenia prevalence could not be affected by average age [regression coefficient 0.004 (95% CI: −0.005 to 0.012), P = 0.406] and dialysis duration [regression coefficient 0.002 (95% CI −0.002 to 0.005), P = 0.327] in the meta‐regression. The pooled analyses showed that combined criteria of sarcopenia were related to a higher mortality risk [HR 1.82 (I2 = 26.3%, 95% CI 1.38–2.39)], as was LMM [HR 1.61 (I2 = 26.0%, 95% CI 1.31–1.99)] and low muscle strength [HR 2.04 (I2 = 80.4%, 95% CI 1.19–3.5)]. Although there are substantial differences in diagnostic criteria, sarcopenia is highly prevalent in dialysis patients and is linked to increased mortality. The standardization of sarcopenia diagnostic criteria would be beneficial, and future longitudinal studies are needed to investigate the prevalence and prognostic value of sarcopenia in dialysis patients.

Previous studies have explored the association between malnutrition and frailty, but no study has investigated whether the Geriatric Nutritional Risk Index (GNRI), a simple and objective nutritional risk screening tool, is associated with the frailty of older adults. The study aimed to examine the relationship between nutrition-related risk, as assessed by the GNRI, and frailty among older hospitalized patients. A cross-sectional study was conducted in the West China Hospital of Sichuan University with 740 patients aged ≥70 years between March 2016 and Jan 2017. Nutritional and frailty status was evaluated with the GNRI and FRAIL scale, respectively. The adjusted and unadjusted ordinal logistic regression analyses were used to examine the relationship between nutritional risk and frailty. The ability of GNRI in detecting frailty was assessed by receiver operating characteristic (ROC) curve analysis. The prevalence of low, moderate, and severe nutritional risk among frail patients were 30.1%, 27.6%, and 12.5%, respectively. Ordinal logistic regression analysis showed that malnutrition assessed by the GNRI had a significant association with frailty after adjustment of age, sex, polypharmacy, comorbidity, vision impairment, hearing impairment, cognitive impairment, and depression. In the ROC analysis, the area under the curve for GNRI identifying frailty was 0.698 (95% CI: 0.66-0.74; <0.001), and the optimal cut-point value was 97.16 (sensitivity: 64.3%; specificity: 66.9%). Nutrition-related risk screened by the GNRI was independently associated with frailty. The GNRI could be used as a simple tool in detecting nutritional risk and frailty status of older patients.

Backgrounds Delirium is a common neuropsychiatric syndrome in older hospitalized patients. Previous studies have suggested that inflammation and oxidative stress contribute to the pathophysiology of delirium. However, it remains unclear whether neutrophil-lymphocyte ratio (NLR), an indicator of systematic inflammation, is associated with delirium. This study aimed to investigate the value of NLR as an independent risk factor for delirium among older hospitalized patients. Methods We conducted a prospective study of 740 hospitalized patients aged ≥ 70 years in the geriatric ward of West China Hospital of Sichuan University. Neutrophil and lymphocyte counts were collected within 24 h after hospital admission. Delirium was assessed on admission and every 48 h thereafter. We used the receiver operating characteristic analysis to assess the ability of the NLR for predicting delirium. The optimal cut-point value of the NLR was determined based on the highest Youden index (sensitivity + specificity − 1). Patients were categorized according to the cut-point value and quartiles of NLR, respectively. We then used logistic regression to identify the unadjusted and adjusted associations between NLR as a categorical variable and delirium. Results The optimal cut-point value of NLR for predicting delirium was 3.626 (sensitivity: 75.2 %; specificity: 63.4 %; Youden index: 0.386). The incidence of delirium was significantly higher in patients with NLR > 3.626 than NLR ≤ 3.626 (24.5 % vs. 5.8 %; P  < 0.001). Significantly fewer patients in the first quartile of NLR experienced delirium than in the third (4.3 % vs. 20.0 %; P  < 0.001) and fourth quartiles of NLR (4.3 % vs. 24.9 %; P  < 0.001). Results from the multivariable logistic regression models showed that NLR was independently associated with delirium. Conclusions NLR is a simple and practical marker that can predict the development of delirium in older internal medicine patients.

ObjectiveTo identify comorbidities associated with incident heart failure with preserved ejection fraction (HFpEF) and quantify their HRs for early risk stratification and prevention.DesignPROSPERO-registered (CRD42024505533) systematic review and meta-analysis. Primary analysis prioritised unadjusted HRs; exploratory analysis incorporated adjusted HRs.Data sourcesOvid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials through 15 June 2025.Eligibility criteria for selecting studiesCohort studies of adults (≥18 years) without prior HF reporting HRs for incident HFpEF-associated comorbidities. Exclusions: non-English publications, reviews, non-clinical studies and studies without HR data.Data extraction and synthesisTwo reviewers independently extracted data and assessed quality (Newcastle-Ottawa Scale). Random-effects models pooled HRs. Heterogeneity was investigated using Galbraith/Baujat plots, meta-regression and subgroup analyses. Publication bias assessed via funnel plots, Egger’s and Begg’s tests.ResultsAmong 61 eligible studies, 22 reporting unadjusted HRs formed the primary analysis, identifying five comorbidities with significant incident HFpEF risk: atrial fibrillation (AF) (HR 2.92, 95% CI 1.94 to 4.37, I²=86.6%), hypertension (HR 2.28, 95% CI 1.35 to 3.84, I²=96.9%), diabetes (HR 1.88, 95% CI 1.54 to 2.30, I²=58.2%), obesity (HR 1.70, 95% CI 1.45 to 2.00, I²=69.7%) and myocardial infarction (MI) (HR 1.62, 95% CI 1.18 to 2.23, I²=72.1%). Conversely, chronic kidney disease (CKD) (HR 1.44, 95% CI 0.68 to 3.06, I²=86.6%) and cerebrovascular disease (HR 1.72, 95% CI 0.93 to 3.18, I²=77.2%) showed non-significant associations. Exploratory analysis integrating unadjusted HRs from primary studies and adjusted HRs from 39 additional studies confirmed these five comorbidities as significant risk factors, with CKD again demonstrating non-significant association.ConclusionAF, hypertension, diabetes, obesity and MI constitute evidence-based targets for HFpEF risk stratification and preventive management. The CKD-HFpEF association requires validation in larger cohorts.PROSPERO registration numberCRD42024505533.

Background Sarcopenia is the decline in muscle strength and mass attributed to aging. The pathogenesis of sarcopenia may be triggered by oxidative stress and uric acid (UA) has strong antioxidant properties. The aim of this study was to investigate the relationship between UA and sarcopenia in community-dwelling adults of West China using the baseline data of West China Health and Aging Trend (WCHAT) study. Design A cross-sectional study. Methods 4236 adults aged 50 years or older in communities of west China were enrolled in this study. We applied Asian Working Group for Sarcopenia (AWGS) 2019 criteria to define sarcopenia. Muscle mass was measured using skeletal muscle index (SMI) based on bioimpedance analysis (BIA). Handgrip strength (HGS) and gait speed (GS) were recorded, respectively. Different variables like anthropometry measures, life styles, chronic disease and blood test were collected. General linear model was done to investigate the relationship between UA and HGS/GS/SMI, adjusting age, ethnic groups, sleeping quality, education level, cognitive function, smoking history, drinking history, ADL score, and chronic disease. Results Participants were grouped according to UA quartiles by gender. After adjusting for potential confounders, a negative association between serum UA levels and sarcopenia was shown both in men and women. And a significant association between serum UA levels and HGS in women was shown as an inverted J shape. Besides, a positive association between the UA quartiles and SMI was observed, irrespective of gender. Conclusions Our results showed that higher uric acid levels were significantly correlated with higher muscle mass and grip strength among Chinese adults aged over 50. Higher UA serum levels might slow down the progression of sarcopenia.

Key summary points Aim To evaluate the relationship between levels of total testosterone, free testosterone, or sex hormone-binding globulin and frailty in older adults. Findings Total testosterone and free testosterone were significantly associated with frailty in men but not women. However, the association between sex hormone-binding globulin and frailty was not significant. Message Understanding that the association between frailty and androgen has important implications for frailty intervention. Purpose We conducted a systematic review to evaluate the relationship between total testosterone (TT), free testosterone (fT), or sex hormone-binding globulin (SHBG) and frailty in older adults. Methods We systematically searched nine databases (e.g. MEDLINE, Embase, ACP Journal Club, and the Cochrane library et al.) for papers on frailty and androgen levels published up to October 10, 2021. We calculated the odds ratio (OR) for the relationship between testosterone level and frailty by performing meta-analysis. Results The search strategy yielded 311 hits in all databases combined. Eleven (seven cross-sectional studies and four cohort studies) met the inclusion criteria for meta-analysis. Among cross-sectional studies, meta-analysis revealed a significant association between TT and frailty in men (OR = 1.37 [95% CI 1.09, 1.72]) not women (OR = 1.06 [0.84, 1.34]). The fT was also significantly association with frailty in men (OR = 1.55 [1.06, 2.25] not women (OR = 1.35 [0.91, 2.01]). Cohort studies showed the same result in TT (OR = 1.09 [1.02, 1.18]) and fT (OR = 1.15 [1.02, 1.30]) for men. We did not find a significant association between SHBG and frailty. Conclusion The findings of this systematic review and meta-analysis suggest that TT and fT were significantly associated with frailty in older men but not women.

Hydrogen is a renewable energy source with various features, clean, carbon-free, high energy density, which is being recognized internationally as a “future energy.” The US, the EU, Japan, South Korea, China, and other countries or regions are gradually clarifying the development position of hydrogen. The rapid development of the hydrogen energy industry requires more hydrogenation infrastructure to meet the hydrogenation need of hydrogen fuel cell vehicles. Nevertheless, due to the frequent occurrence of hydrogen infrastructure accidents, their safety has become an obstacle to large-scale construction. This paper analyzed five sizes (diameters of 0.068 mm, 0.215 mm, 0.68 mm, 2.15 mm, and 6.8 mm) of hydrogen leakage in the hydrogen fueling station using Quantitative Risk Assessment (QRA) and HyRAM software. The results show that unignited leaks occur most frequently; leaks caused by flanges, valves, instruments, compressors, and filters occur more frequently; and the risk indicator of thermal radiation accident and structure collapse accident caused by overpressure exceeds the Chinese individual acceptable risk standard and the risk indicator of a thermal radiation accident and head impact accident caused by overpressure is below the Chinese standard. On the other hand, we simulated the consequences of hydrogen leak from the 45 MPa hydrogen storage vessels by the physic module of HyRAM and obtained the ranges of plume dispersion, jet fire, radiative heat flux, and unconfined overpressure. We suggest targeted preventive measures and safety distance to provide references for hydrogen fueling stations’ safe construction and operation.

The exponential growth of big data in biology, medical science, and public health is fundamentally transforming the landscape of biomedical research and therapeutic development [...]

Fine-resolution population distribution mapping is necessary for many purposes, which cannot be met by aggregated census data due to privacy. Many approaches utilize ancillary data that are related to population density, such as nighttime light imagery and land use, to redistribute the population from census to finer-scale units. However, most of the ancillary data used in the previous studies of population modeling are environmental data, which can only provide a limited capacity to aid population redistribution. Social sensing data with geographic information, such as point-of-interest (POI), are emerging as a new type of ancillary data for urban studies. This study, as a nascent attempt, combined POI and multisensor remote sensing data into new ancillary data to aid population redistribution from census to grid cells at a resolution of 250 m in Zhejiang, China. The accuracy of the results was assessed by comparing them with WorldPop. Results showed that our approach redistributed the population with fewer errors than WorldPop, especially at the extremes of population density. The approach developed in this study—incorporating POI with multisensor remotely sensed data in redistributing the population onto finer-scale spatial units—possessed considerable potential in the era of big data, where a substantial volume of social sensing data is increasingly being collected and becoming available.

Myeloid-derived suppressor cells (MDSCs) suppress antitumor immune activities and facilitate cancer progression. Although the concept of immunosuppressive MDSCs is well established, the mechanism that MDSCs regulate non-small cell lung cancer (NSCLC) progression through the paracrine signals is still lacking. Here, we reported that the infiltration of MDSCs within NSCLC tissues was associated with the progression of cancer status, and was positively correlated with the Patient-derived xenograft model establishment, and poor patient prognosis. Intratumoral MDSCs directly promoted NSCLC metastasis and highly expressed chemokines that promote NSCLC cells invasion, including CCL11. CCL11 was capable of activating the AKT and ERK signaling pathways to promote NSCLC metastasis through the epithelial-mesenchymal transition (EMT) process. Moreover, high expression of CCL11 was associated with a poor prognosis in lung cancer as well as other types of cancer. Our findings underscore that MDSCs produce CCL11 to promote NSCLC metastasis via activation of ERK and AKT signaling and induction of EMT, suggesting that the MDSCs-CCL11-ERK/AKT-EMT axis contains potential targets for NSCLC metastasis treatment.