A technique to quantify very low activities in regions of interest with a collimatorless detector

We present a new method to measure sub-microcurie activities of photon-emitting radionuclides in organs and lesions of small animals in vivo. Our technique, named the collimator-less likelihood fit, combines a very high sensitivity collimatorless detector with a Monte Carlo-based likelihood fit in order to estimate the activities in previously segmented regions of interest along with their uncertainties. This is done directly from the photon projections in our collimatorless detector and from the region of interest segmentation provided by an x-ray computed tomography scan. We have extensively validated our approach with 225Ac experimentally in spherical phantoms and mouse phantoms, and also numerically with simulations of a realistic mouse anatomy. Our method yields statistically unbiased results with uncertainties smaller than 20% for activities as low as ~111 Bq (3 nCi) and for exposures under 30 minutes. We demonstrate that our method yields more robust recovery coefficients when compared to SPECT imaging with a commercial pre-clinical scanner, specially at very low activities. Thus, our technique is complementary to traditional SPECT/CT imaging since it provides a more accurate and precise organ and tumor dosimetry, with a more limited spatial information. Finally, our technique is specially significant in extremely low-activity scenarios when SPECT/CT imaging is simply not viable.

Suppression of microRNA-320 Induces Cerebral Protection Against Ischemia/Reperfusion Injury by Targeting HMGB1/NF-kappaB Axis

MicroRNAs have been shown to potentially function in cerebral ischemia/reperfusion (IR) injury. This study aimed to examine the expression of microRNA-320 (miR-320) in cerebral IR injury and its involvement in cerebral mitochondrial function, oxidative stress, and inflammatory responses by targeting the HMGB1/NF-kappaB axis. Sprague-Dawley rats were subjected to middle cerebral artery occlusion to simulate cerebral IR injury. The cerebral expression of miR-320 was assessed using qRT-PCR. Neurological function, cerebral infarct volume, mitochondrial function, oxidative stress, and inflammatory cytokines were evaluated using relevant methods, including staining, fluorometry, and ELISA. HMGB1 expression was analyzed through Western blotting. The levels of miR-320, HMGB1, neurological deficits, and cerebral infarction were significantly higher after IR induction. Intracerebral overexpression of miR-320 resulted in substantial neurological deficits, increased infarct volume, elevated levels of 8-isoprostane, NF-kappaBp65, TNF-alpha, IL-1beta, ICAM-1, VCAM-1, and HMGB1 expression. It also promoted the loss of mitochondrial membrane potential and ROS levels while reducing MnSOD and GSH levels. Downregulation of miR-320 and inhibition of HMGB1 activity significantly reversed the outcomes of cerebral IR injury. MiR-320 plays a negative role in regulating cerebral inflammatory/oxidative reactions induced by IR injury by enhancing HMGB1 activity and modulating mitochondrial function.

STING-Dependent Sensing of Self-DNA Driving Pyroptosis Contributes to Radiation-Induced Lung Injury

PURPOSE/OBJECTIVE(S)

Radiation therapy (RT) is indispensable for managing thoracic carcinomas. However, its application is limited by radiation-induced lung injury (RILI), one of the most common and fatal complications of thoracic RT. Nonetheless, the exact molecular mechanisms of RILI remain poorly understood.

MATERIALS/METHODS

To elucidate the underlying mechanisms, various knockout (KO) mouse strains were subjected to 16 Gy whole-thoracic RT. RILI was assessed by qRT-PCR, ELISA, histology, western blot, immunohistochemistry, and CT examination. To perform further mechanistic studies on the signaling cascade during the RILI process, pulldown, CHIP, and rescue assays were conducted.

RESULTS

We found that the cGAS-STING pathway was significantly upregulated after irradiation exposure in both the mouse models and clinical lung tissues. Knocking down either cGAS or STING led to attenuated inflammation and fibrosis in mouse lung tissues. NLRP3 is hardwired to the upstream DNA-sensing cGAS-STING pathway to trigger of the inflammasome and amplification of the inflammatory response. STING deficiency suppressed the expressions of the NLRP3 inflammasome and pyroptosis-pertinent components containing IL-1β, IL-18, and cleaved caspase-1. Mechanistically, interferon regulatory factor 3, the essential transcription factor downstream of cGAS-STING, promoted the pyroptosis by transcriptionally activating NLRP3. Moreover, we found that RT triggered the release of self-dsDNA in the bronchoalveolar space, which is essential for the activation of cGAS-STING and the downstream NLRP3-mediated pyroptosis. Of note, Pulmozyme, an old drug for the management of cystic fibrosis, was revealed to have the potential to mitigate RILI by degrading extracellular dsDNA and then inhibiting the cGAS-STING-NLRP3 signaling pathway.

CONCLUSION

These results delineated the crucial function of cGAS-STING as a key mediator of RILI, and described a mechanism of pyroptosis linking cGAS-STING activation with the amplification of initial RILI. These findings indicate that the dsDNA-cGAS-STING-NLRP3 axis might be potentially amenable to therapeutic targeting for RILI.

Safety and Efficacy of Hypofractionated Radiotherapy Combined with Tyrosine Kinase Inhibitors in Patients with Lung Metastases after Liver Transplantation for Hepatocellular Carcinoma

PURPOSE/OBJECTIVE(S)

We evaluated the safety and efficacy of hypofractionated radiotherapy (HFRT) combined with tyrosine kinase inhibitors (TKIs) in patients with pulmonary metastases after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).

MATERIALS/METHODS

Twenty-five patients with lung metastases after OLT for HCC who underwent HFRT using helical tomotherapy concomitantly with TKIs (sorafenib or lenvatinib) were retrospectively. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall survival (OS), local control rate (LCR), objective response rate (ORR), and treatment-related side effects.

RESULTS

The median follow-up time was 35.5 months, with a median interval from OLT to lung metastasis of 15.3 months. The median PFS and OS were 9.9 and 32.7 months, respectively. The 1-, 2-, and 3-year PFS and OS rates were 36.0%, 16.0%, and 12.0%, and 84.0%, 52.0%, and 20.0%, respectively. The LCR of pulmonary metastases at 1 year was 100%, whereas the two-year LCR was 76.9%. The 1- and 2- year ORRs were 95.2% and 69.2%, respectively, with no grade > 2 adverse events. Radiation pneumonitis was observed in 17 patients (68.0%). Grade 1 pneumonitis occurred in 15 patients (60.0%), and grade 2 pneumonitis occurred in 2 patients (8.0%).

CONCLUSION

The combination therapy of HFRT with TKIs is a feasible, safe, and promising approach in the treatment of pulmonary metastases for HCC after OLT.

Salvage Radiotherapy Improves Survival in Patients with Metastatic Liver Cancer after Immunotherapy Oligoprogression

PURPOSE/OBJECTIVE(S)

Immune checkpoint inhibitors (ICIs) have ameliorated the survival outcome of liver cancer, a majority of patients receiving ICIs have eventually developed progression. Local therapy, especially radiotherapy (RT), is increasingly being considered in the setting of oligoprogression to delay the need to change systemic therapy. The aim of this study was to evaluate the efficacy and safety of RT as a salvage treatment in patients with oligoprogression after ICIs.

MATERIALS/METHODS

This retrospective study was performed to evaluate the use of salvage radiotherapy in oligoprogressive metastatic liver cancer patients. Patients with metastatic liver cancer who had previous stability or response after ≥ 6 mo of ICIs were eligible if they developed progression of five of fewer metastases.

RESULTS

Overall, 178 patients treated between August 2018 and March 2022 were included. The patients were followed for a median of 17.2 months. The overall response rate (ORR) and disease control rate (DCR) were 38.2% and 57.8%, respectively. The median progression-free survival (PFS) and overall survival (OS) were 6.5 (95% CI:5.116-7.884) and 17.3 (95% CI:11.166-23.434) months. In multivariate analysis, factors associated with OS included tumor size, tumor number, and radiated tumor site (intrahepatic vs. extrahepatic). The most frequent AEs were fatigue, decreased appetite, rash, fever, and nausea. The above-mentioned AEs were reversible and manageable.

CONCLUSION

Salvage radiotherapy has a potential activity and is tolerable for oligoprogression after ICIs with appropriate radiated tumor site and patient selection. A prospective randomized trial is ongoing to validate this finding (ChiCTR2200060664).

Stereotactic Body Radiotherapy Combined with Sintilimab in Patients with Recurrent or Oligometastatic Hepatocellular Carcinoma: A Phase II Clinical Trial

PURPOSE/OBJECTIVE(S)

The anti-tumor activity and tolerability of stereotactic body radiotherapy (SBRT) and PD-1 inhibitors have been illustrated in retrospective studies, but the results vary across a broad range. This study aimed to assess the clinical efficacy of SBRT combined with sintilimab in patients with recurrent or oligometastatic hepatocellular carcinoma (HCC).

MATERIALS/METHODS

This trial involved patients with recurrent or oligometastatic HCC intravenously treated with SBRT plus sintilimab every 3 weeks for 12 months or until disease progression. The primary endpoint was progression-free survival (PFS).

RESULTS

Twenty-five patients were enrolled from August 14, 2019, to August 23, 2021. The median treatment duration was 10.2 months. SBRT was delivered at a median dose of 54 in six fractions. The median follow-up time was 21.9 months, and 32 targeted lesions among 25 patients were evaluated for treatment response according to the Response Evaluation Criteria in Solid Tumors version 1.1. The median PFS was 19.7 months, with PFS rates of 68% and 45.3% at 12 and 24 months, respectively. The median overall survival (OS) was not reached, with OS rates of 91.5% and 83.2% at 12 and 24 months, respectively. The 1- and 2-year local control rate were 100% and 90.9%, respectively. The confirmed objective response rate and disease control rate was 96%, and 96%, respectively. Most adverse events were graded as 1 or 2, and grade 3 adverse events were observed in three patients.

CONCLUSION

SBRT plus sintilimab is an effective, well-tolerated treatment regimen for patients with recurrent or oligometastatic HCC.

Low Dietary Diversity for Recommended Food Groups Increases the Risk of Obesity among Children: Evidence from a Chinese Longitudinal Study

The association between dietary diversity and childhood obesity remains unclear; therefore, this longitudinal study was conducted to analyze the effect of dietary diversity on childhood obesity. One year after the first investigation, a follow-up was completed in 2010. A total of 4538 participants were included for analysis. Dietary diversity scores were calculated based on the consumption of nine recommended food groups which were categorized in accordance with the 2013 United Nations Food and Agriculture Organization guidelines. After a one-year follow-up, the low-score group underwent a significantly more considerable change in weight, body mass index, and body fat percentage than the high-score group (4.62 vs. 4.06 kg, 0.76 vs. 0.51 kg/m², and 1.99% vs. 1.13%, respectively). Furthermore, in the low-score group, the odds ratios for overweight, obese, and overweight and obese were 1.76 (95% CI: 1.17, 2.65), 0.99 (95% CI: 0.67, 1.46), and 1.35 (95% CI: 1.01, 1.81), and the relative risks were 1.81 (95% CI: 1.03, 3.19), 2.31 (95% CI: 0.81, 6.59), and 1.98 (95% CI: 1.20,3.28), respectively. Low dietary diversity for the recommended food groups was associated with a high weight, high body mass index, and high body fat, which was associated with an increased risk of being overweight or obese in Chinese children.

Dehydration and rehydration affect brain regional density and homogeneity among young male adults, determined via magnetic resonance imaging: A pilot self-control trial

The effects of dehydration and rehydration on brain regional density and homogeneity are unknown and have been infrequently studied. In this pilot self-control study, twelve participants aged 18-25 years were recruited and the brain was scanned using magnetic resonance imaging for three tests under different hydration statuses. In three tests, urine osmolality was determined to assess hydration status. Test 1 was conducted after 12 h of overnight fasting. Test 2 was conducted in a dehydration state induced by 36 h of water deprivation. Test 3 was conducted in a rehydration state, which was induced by 1.5 L of purified water supplementation. Compared with test 1, participants under the dehydration state in test 2 had higher cerebrospinal fluid density (p < 0.001). Compared with test 2, participants under the rehydration state in test 3 showed an extensive increase in gray matter density in widespread brain regions, mainly involving the left middle temporal gyrus, cuneus, right thalamus, left rolandic opercula, Brodmann area 39, right precentral, left postcentral gyrus, and cingulate gyrus (p < 0.001); a higher white matter density in the temporal lobe, sub-lobar, and sub-gyral areas; and a lower cerebrospinal fluid density (p < 0.001). The multimodal, multiscale neuroimaging marker of the human brain connection—the regional homogeneity (ReHo) index—was used for evaluating the connectivity of nodes in the brain. Compared with test 1, participants in test 2 had a lower ReHo value in the right amygdala, left occiput median, right lingual, opercula part of right inferior frontal gyrus, and right precuneus (p < 0.01). Compared with test 2, participants in test 3 had a higher ReHo value in the right amygdala, right lingual, opercula part of the right inferior frontal gyrus, and right precuneus (p < 0.01). Dehydration state increased cerebrospinal fluid density, decreased brain regional homogeneity. Rehydration state increased brain gray matter and white matter density widespreadly, and increased brain regional homogeneity.

Acute Water Supplementation Improved the Body Composition of Young Female Adults After Water Restriction of 12 h in Baoding, China: A Randomized Controlled Trial (RCT)

Insufficient intake of water may influence the balance of water in the human body. In this study, we explore the impacts of water supplementation on body composition indices among young adults after 12 h of water restriction, with the aim to determine the optimum volume of water for improving body water composition. A randomized controlled trial study was conducted among 64 young men and women in Baoding, China. After fasting overnight for 12 h, anthropometric measurements and urine and blood samples were collected as a baseline test at 8:00 a.m. of Day 2. Body composition was determined by measuring the ECW (extracellular water), ICW (intracellular water), and TBW (total body water) through bioelectrical impedance analysis (BIA). The participants were randomly divided into four groups, including water supplementation (WS) groups 1, 2, and 3, with 500, 200, and 100 mL of water, respectively, and a no water supplementation (NW) group. After 90 min, they were reassessed in a rehydration test (at 10:00 a.m. of Day 2). Repeated measurement ANOVA was used to assess the impact of water supplementation on body composition. Comparing the baseline and rehydration tests, interactions between time and volume were not significant among the men (all p > 0.05). Among women, a significant interaction was only found in ECW (p = 0.043), with TBW tending toward being significant (p = 0.055). Comparing the baseline and rehydration tests, the ECW in WS group 1, WS group 3, and the NW group all decreased (p = 0.028, p = 0.001, and p = 0.029), with reductions of 0.1, 0.3, and 0.2 kg, respectively; however, no significant decrease was observed in WS group 2 (p = 0.329). Furthermore, comparing the WS groups with the NW group in the rehydration test, the differences were not significant (p = 1.000, p = 1.000, and p = 0.288, respectively). Between men and women within groups, all of the body composition indices differed significantly, both at baseline and rehydration tests (all p < 0.05). Water supplementation led to changes in the distribution of the water content in young female adults in this study-but not men-after 12 h of water restriction, with no decrease in ECW. Finally, we found that 200 mL was the minimum volume capable of improving the water content distribution in participants in this study.

Trial Registration

[www.chictr.org.cn], identifier [ChiCTR-IOR-17011568].

The Association Between Family Environment and Adolescent Alcohol Drinking Behavior: A Cross-Sectional Study of Six Chinese Cities

Objective

Adolescents' alcohol consumption has lifetime adverse physical and mental health effects. Family environment factors have a significant influence in shaping adolescents' beliefs and habits. We conducted the multicenter cross-sectional study aiming to investigate the association between family environment factors and adolescent drinking behavior in China.

Methods

The study investigated 27,762 middle school students from Beijing, Shanghai, Guangzhou, Jinan, Chengdu, and Harbin. A logistic regression model was used to explore the association between family environmental factors and adolescent drinking behavior. Participants were asked to self-report previous experiences of drinking and getting drunk to access their drinking status. Factors of family environment related to alcohol consumption included: parents' educational level, family economic status, family composition, the number of times parents drank alcohol in the past 30 days, and parents' attitudes toward their drinking behavior. The logistic regression model was used to adjust the demographic confounders, including gender, age, city, location, and smoking status, and to explore the association between family environmental factors and adolescent alcohol drinking behaviors.

Results

Compared with students whose parents prohibited drinking, students who were approved drinking were more likely to drink in this year (OR = 16.544, 95%CI:15.265–17.929, P < 0.001; Full adjustment: OR = 13.111, 95% CI: 12.031–14.288, P < 0.001), drink in this month (OR = 7.791, 95% CI: 7.077–8.565, P < 0.001; Full adjustment: OR = 6.010, 95% CI: 5.439–6.641, P < 0.001). In addition, Low family economic status, not living with the mother, parents' ambivalent attitudes toward their children's drinking and parental drinking were risk factors for drinking among middle school students.

Conclusion

The family environment, especially parents' attitudes, is associated with students' drinking and drunken behavior. Mobilizing the power of parents may play a positive role in the effective prevention and control of adolescent drinking.

Young Adults with Higher Salt Intake Have Inferior Hydration Status: A Cross-Sectional Study

The body’s water and sodium balances are tightly regulated and monitored by the brain. Few studies have explored the relationship between water and salt intake, and whether sodium intake with different levels of fluid intake leads to changes in hydration status remains unknown. The aim of the present study was to determine the patterns of water intake and hydration status among young adults with different levels of daily salt intakes. Participants’ total drinking fluids and water from food were determined by a 7-day 24-h fluid intake questionnaire for 7 days (from Day 1 to Day 7) and duplicate portion method (Day 5, Day 6 and Day 7). Urine of 24 h for 3 days (Day 5, Day 6 and Day 7) was collected and tested for the osmolality, the urine-specific gravity (USG), the concentrations of electrolytes, pH, creatinine, uric acid and the urea. The fasting blood samples for 1 day (Day 6) were collected and measured for the osmolality and the concentrations of electrolytes. The salt intakes of the participants were evaluated from the concentrations of Na of 24 h urine of 3 days (Day 5, Day 6 and Day 7). Participants were divided into four groups according to the quartile of salt intake, including the low salt intake (LS₁), LS₂, high salt intake (HS₁) and HS₂ groups. In total, 156 participants (including 80 male and 76 female young adults) completed the study. The salt intakes were 7.6, 10.9, 14.7 and 22.4 g among participants in the four groups (LS₁, LS₂, HS₁ and HS₂ groups, respectively), which differed significantly in all groups (F = 252.020; all p < 0.05). Compared to the LS₁ and LS₂ groups, the HS₂ group had 310–381, 250–358 and 382–655 mL more amounts of water from the total water intake (TWI), total drinking fluids and water from food (all p < 0.05), respectively. Participants in the HS₂ group had 384–403, 129–228 and 81–114 mL more in the water, water from dishes and staple foods, respectively, than those in the groups of LS₁ and LS₂ (p < 0.05). The HS₂ group excreted 386–793 mL more urine than those in the groups of LS₁ and LS₂ (p < 0.05). However, regarding urine osmolality, the percentage of participants with optimal hydration status decreased from 41.0% in LS₁ and LS₂ to 25.6% in the HS₂ group (p < 0.05). Participants with higher salt intake had higher TWI, total drinking fluids and water from food. Nevertheless, they had inferior hydration status. A reduction in salt intake should be encouraged among young adults to maintain optimal hydration status.

The Relationships between Water Intake and Hydration Biomarkers and the Applications for Assessing Adequate Total Water Intake among Young Adults in Hebei, China

Water is an essential nutrient for humans. A cross-sectional study was conducted among 159 young adults aged 18–23 years in Hebei, China. The total drinking fluids and water from food were obtained by 7-day 24 h fluid intake questionnaires and the duplicate portion method, respectively. Pearson’s correlation coefficients were performed to determine the relationship between fluid intake and 24 h urinary biomarkers and plasma biomarkers. A multivariable partial least squares (PLS) model was used to identify the key predictors in modeling the total water intake (TWI) with 24 h urine biomarkers. Logistic regressions of the TWI against binary variables were performed, and the receiver operating characteristic curve (ROC) was analyzed to determine the cutoff value of the TWI for the optimal hydration status and dehydration without adjustments to favor either the sensitivity or specificity. In total, 156 participants (80 males and 76 females) completed the study. Strong relationships were found between the total drinking fluids, TWI, and 24 h urine biomarkers among young adults, especially for the 24 h urine volume (r = 0.784, p < 0.001; r = 0.747, p < 0.001) and osmolality (r = −0.589, p < 0.001; r = −0.477, p < 0.001), respectively. As for the FMU and plasma biomarkers, no strong relationships were found. The percentages of the variance in TWI explained by the PLS model with 13 urinary biomarkers were 66.9%. The optimal TWI values for assessing the optimal hydration and dehydration were 2892 mL and 2482 mL for young males, respectively, and 2139 mL and 1507 mL for young females, respectively. Strong relationships were found between the TWI, total drinking fluids, and 24 h urine biomarkers, but not with the FMU and plasma biomarkers, among young adults, including males and females. The 24 h urine biomarkers were more sensitive than the first morning urinary biomarkers in reflecting the fluid intake. The TWI was a reliable index for assessing the hydration statuses for young adults in free-living conditions.

[Research progress on building of disease control and prevention system of the international experience]

Through literature search in regular database and official websites of relevant countries, this paper combs and summarizes the main characteristics of disease prevention and control systems in five countries, the United States, Germany, South Korea, Australia and Japan, and the European Union at key levels including legal construction, organizational structure, financing, personnel construction and international cooperation, in order to provide decision support for the construction of disease prevention and control system in China in the future.

POS1040 IMPLEMENTATION OF THE OMERACT PSAMRIS IN A PHASE IIB, RANDOMISED PLACEBO-CONTROLLED STUDY OF ABATACEPT IN PSORIATIC ARTHRITIS

Background:

The semi-quantitative Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) was developed for the evaluation of inflammatory and destructive changes in PsA,1 but has limited trial usage.

Objectives:

To retrospectively utilise the PsAMRIS in a multi-dose, randomised Phase IIb study of abatacept in patients with PsA who have inadequate response to DMARDs (NCT00534313).2

Methods:

Patients were randomised to abatacept (3, 10 or 30/10 mg/kg [the 30-mg/kg group switched to 10 mg/kg after the first two doses]) or placebo and treated for 169 days, after which all patients received abatacept 10 mg/kg through to Day 365. MRI scans of one hand or foot from 123 patients with PsA collected at baseline and on Days 85, 169 and 365 were centrally evaluated by two readers blinded to chronological order and treatment arm. Synovitis, bone oedema, tenosynovitis, periarticular inflammation, bone erosion, bone proliferation and joint space narrowing were assessed as per OMERACT PsAMRIS; a novel total inflammation score was calculated from the sum of synovitis, bone oedema, tenosynovitis and periarticular inflammation. Variables were analysed using all cases (hand or foot) and by hand and foot cases separately.

Results:

At Day 169, the abatacept 30/10 mg/kg or 10 mg/kg group showed the most decrease (improvement) in each inflammatory assessment (Figure 1). The Day 169 change from baseline severity in synovitis and tenosynovitis in the abatacept 30/10 mg/kg and 10 mg/kg groups, respectively, were significantly reduced (improved) compared with placebo (estimated differences of –0.966 [p=0.039] and –1.652 [p=0.014], respectively) (Table 1). Patients originally randomised to placebo and then switched to abatacept 10 mg/kg at Day 169 showed significant improvements in synovitis, tenosynovitis and total inflammation from Day 169 to Day 365 (Table 1, Figure 1). The structural outcomes joint space narrowing and bone erosion remained stable within each treatment group, showing little change from baseline to Days 85, 169 and 365. After separating hand and foot analyses (72 hand and 51 foot cases), only hand tenosynovitis in the 10-mg/kg group and foot synovitis in the 3-mg/kg group were significantly reduced (improved) at Day 169 compared with placebo (differences of –2.331 [p=0.017] and –1.689 [p=0.010], respectively). In general, more comparisons in the hand analysis were statistically significant versus in the foot analysis.

Conclusion:

This analysis confirmed the efficacy of abatacept 10 and 30/10 mg/kg when assessed with the OMERACT PsAMRIS. The inflammatory pathologies, synovitis and tenosynovitis, appeared to be the most responsive MRI outcomes. Analysing hand and foot cases together yielded results consistent with the primary clinical efficacy endpoint (ACR20 response rate), as the abatacept 10- and 30/10-mg/kg groups showed significant differences versus placebo at Day 169;2 reduced sample size in separate hand and foot assessments may have prevented finding significant results corresponding to the combined analysis. These results also demonstrate the responsiveness of the PsAMRIS in PsA randomised clinical trials.

References:

[1]Glinatsi D, et al. J Rheumatol 2015;42:2473–2479.

[2]Mease P, et al. Arthritis Rheum 2011;63:939–948.

Table 1.

MRI variables showing significant treatment effectsa

Between groups at Day 169MRI scoreComparatorComparatorDifferenceSEp valueSynovitisPlaceboAbatacept 30/10 mg/kg–0.9660.4610.039TenosynovitisPlaceboAbatacept 10 mg/kg–1.6520.6620.014Placebo group before/after switchbMRI scoreTreatment, Day 169Treatment, Day 365DifferenceSEp valueSynovitisPlaceboAbatacept 10 mg/kg–1.0180.4580.029TenosynovitisPlaceboAbatacept 10 mg/kg–0.9400.3900.018Total inflammationPlaceboAbatacept 10 mg/kg–2.2751.0670.036

aBased on change from baseline at the stated time points (unadjusted p values).

bPatients were switched to abatacept 10 mg/kg after Day 169.

Acknowledgements:

Professional medical writing and editorial assistance was provided by Rob Coover, MPH, at Caudex and was funded by Bristol Myers Squibb.

Disclosure of Interests:

Mikkel Østergaard Speakers bureau: AbbVie, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, Sanofi, UCB, Consultant of: AbbVie, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, UCB, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Merck, Novartis, Paul Bird Speakers bureau: AbbVie, Bristol Myers Squibb, Eli Lilly, Novartis, Pfizer, UCB, Grant/research support from: Gilead, Chahin Pachai Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Shuyan Du Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Chun Wu Employee of: Bristol Myers Squibb, Jessica Landis Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Thomas Fuerst Employee of: Bioclinica, Inc., a contract research service providing radiology central reading services to pharmaceutical, biotech and medical device companies, Harris A Ahmad Employee of: Bristol Myers Squibb, Sean Connolly Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Philip G Conaghan Speakers bureau: AbbVie, Novartis, Consultant of: AstraZeneca, Bristol Myers Squibb, Eli Lilly, EMD Serono, Flexion Therapeutics, Galapagos, Gilead, Novartis, Pfizer.

The Influence of Fluid Intake Behavior on Cognition and Mood among College Students in Baoding, China

INTRODUCTION

Water is a critical nutrient, and it is important for the maintenance of the physiological function of the human body [<xref ref-type="bibr" rid="ref1">1</xref>-<xref ref-type="bibr" rid="ref3">3</xref>]. In addition to fluid amounts, fluid intake frequency is also important for hydration status [<xref ref-type="bibr" rid="ref4">4</xref>, <xref ref-type="bibr" rid="ref5">5</xref>]. At present, only few guidelines mention fluid intake behavior that recommend drinking water frequently while in small quantities, however, there is no scientific evidence to support it. Therefore, it is necessary to explore the appropriate fluid intake behavior.

OBJECTIVE

The objective of this study is to evaluate the influence of different fluid intake behavior on cognition and mood, to provide scientific basis for proposing the appropriate fluid intake behavior.

METHODS

A double-blinded randomized controlled trial was designed and implemented among college students aged 18-23 years in Baoding, China. Subjects were randomly assigned into each of 3 groups using a random number generated by computer software: the subjects consuming plain water 200 mL/2 h, that is, 1,600 mL during whole day (group 1), 100 mL/2 h, that is, 800 mL during whole day (group 2), and 110 mL/1 h, that is, 1,650 mL during whole day (group 3), respectively. Subjects were asked to fast from 11:00 p.m., without consuming any foods or drinks the day before the intervention. From 8:00 a.m. to 10:00 p.m. of the first study day, subjects consumed water according to the instructions and repeated it from 8:00 a.m. to 4:00 p.m. of the second study day. Cognition, mood, and urine osmolality were collected twice at 10:00 a.m. (time 1) and 4:00 p.m. (time 2) of the second study day (shown in Fig. <xref ref-type="fig" rid="f01">1</xref>).

RESULTS

A total of 92 subjects (46 males, 46 females) completed this study. It was found that the increasing fluid intake amounts lead to an increase in urine output and a decrease in urine osmolality (p < 0.05). Use the mixed models to compare measurements for groups 1 and 2, which showed that when compared with those drinking 800 mL per day, people who drank 1,600 mL per day scored higher in vigor (11.8 vs. 9.1, p < 0.05) and portrait memory test (22.6 vs. 20.8, p < 0.05) but lower in total mood disturbance (90.8 vs. 97.8, p < 0.05). By comparing groups 1 and 3, the results indicated that compared with drinking 8 times per day, people who drank 15 times per day scored lower in portrait memory test (21.8 vs. 22.6, p < 0.05) and hunger (3.3 vs. 3.6, p < 0.05).

CONCLUSIONS

Reasonable fluid intake behavior may be beneficial to improve the cognition and mood of college students. The fluid intake behavior, which is consuming water 200 mL each time and 8 times per day, is recommended. More studies are needed to advise people to have health-beneficial fluid intake behavior.

Effects of Water Restriction and Water Replenishment on the Content of Body Water with Bioelectrical Impedance among Young Adults in Baoding, China: A Randomized Controlled Trial (RCT)

Insufficient water intake may affect body composition. The purpose of this research was to explore the effects of water restriction and replenishment on body composition and to evaluate the optimum amount of water that improves body composition. A total of 76 young adults aged 18-23 years old (40 males and 36 females) in Baoding, China, were recruited in this randomized controlled trial, with a 100% completion rate. After fasting overnight for 12 h, at 8:00 a.m. of day 2, a baseline test, including anthropometric indices and collection of urine and blood samples, was explored. Participants were then subjected to water restriction for 24 h, and three meals with ≤75% water content were provided. At 8:00 AM of day 3, the same indices were determined as a dehydration test. Then, participants were randomly assigned into four groups: three water replenishment groups (WR groups 1, 2, and 3 given 1000, 500, and 200 mL of purified water, respectively) and one non-replenishment group (NR group, with no water). After 90 min, the same measurements were performed as a rehydration test. Compared with the baseline test, during the dehydration test, the intracellular water to total body water ratio (ICW/TBW) increased; and extracellular water (ECW), ECW/TBW (extracellular water to total body water ratio), and TBW decreased (all p < 0.05). For males, significant differences were found in ECW, ECW/ICW (extracellular water to intracellular water ratio), ICW/TBW, and ECW/TBW (all p < 0.05); for females, significant reductions were found in ICW, ECW, TBW, ECW/ICW, ICW/TBW, and ECW/TBW (all p < 0.05). Furthermore, significant differences were found in ICW, ECW, ICW/TBW, ECW/TBW, ECW/ICW, TBW, and TBW/BW between males and females during the baseline and dehydration test (all p < 0.05). Comparing the dehydration test with the rehydration test, there were significant interactions between time × volume in ICW and TBW (F = 3.002, p = 0.036; F = 2.907, p = 0.040); in males, these were only found in ICW (F = 3.061, p = 0.040); in females, they were found in ICW and TBW (F = 3.002, p = 0.036; F = 2.907, p = 0.040). The ICW levels in WR groups 1 and 2 were all higher than in the NR group (all p < 0.05); the TBW was higher in WR group 1 than in the NR group (p < 0.05). No significant differences were found between WR groups 1 and 2, either in males or in females (all p > 0.05). In the rehydration test, significant differences in body composition were found between males and females among the four groups (all p < 0.05). Water restriction had adverse effects on body composition, and females were more susceptible to water restriction than males. Water replenishment improved the water content of body composition, alleviating the adverse effects of water restriction on ICW and TBW. After water restriction for 36 h, the optimum volume of water to improve body composition among young male adults was 1000 mL, but this was not the case for females.

The comparison of water intake patterns and hydration biomarkers among young adults with different hydration statuses in Hebei, China

Background

Water is essential for maintaining the functions of human body properly. Studies have shown that the amounts and contributions of fluids were associated with health and hydration status. The objectives of the study was that to explore the differences of water intake pattern and hydration biomarkers among young males and females in different hydration statuses.

Methods

A cross-sectional study was implemented among 159 young adults aged 18–23 years in Hebei, China. The total drinking fluids and water from food were obtained by 7-day 24-h fluid intake questionnaire and duplicate portion method, respectively. The osmolality and electrolyte concentrations of the 24 h urine and plasma were tested. Differences in optimal hydration (OH), middle hydration (MH) and hypohydration (HH) groups, divided by the osmolality of 24 h urine, were compared.

Results

Totally, 156 participants (80 males and 76 females) completed the study. OH group had highest proportions of participants met the recommendations of total water intake (TWI) and total drinking fluids of China (34.5%, 36.2%), while HH group had lowest (7.7%, 0.0%). OH group had higher amounts of TWI, total drinking fluids, water and lower amounts of sugar-sweetened-beverages (SSBs) (P < 0.05). The percentage of total drinking fluids in TWI decreased from 54.1% in OH group to 42.6% in HH group (P < 0.05). OH group had higher and lower contributions of water and SSBs to total drinking fluids (P < 0.05); produced 551–950 mL more, excreted significantly less quantity of solutes of urine (P < 0.05). No significant differences were found in plasma osmolality among the three groups (P > 0.05). Among both males and females, the amounts of TWI and water were higher in OH group than others (P < 0.05). Males had 4.3% lower, 5.4% and 1.1% higher contributions of milk and milk products, SSBs and alcohol to total drinking fluids than females (P < 0.05); males had higher volume of urine than females only in MH group (P < 0.05). There were no significant differences of plasma osmolality between males and females in the same group (P > 0.05).

Conclusions

Young adults with optimal hydration status had better water intake pattern and less concentrated urine. Females maybe have better water intake pattern than males.

Trial registration Chinese clinical trial registry. Name of the registry: Relationship of drinking water and urination. Trial registration number: ChiCTR-ROC-17010320. Date of registration: 01/04/2017. URL of trial registry record: http://www.chictr.org.cn/edit.aspx?pid=17601&htm=4.

Effects of the Amount and Frequency of Fluid Intake on Cognitive Performance and Mood among Young Adults in Baoding, Hebei, China: A Randomized Controlled Trial

Water is a critical nutrient that is important for the maintenance of the physiological function of the human body. This article aimed to investigate the effects of the amount and frequency of fluid intake on cognitive performance and mood. A double-blinded randomized controlled trial was designed and implemented on college students aged 18–23 years in Baoding, China. Participants were randomly assigned into one of three groups: the recommended behavior group (RB group) who drank 200 mL of water every 2 h, the half amount group (HA group) who drank 100 mL of water every 2 h, and the high frequency group (HF group) who drank 110 mL of water every 1 h. The intervention lasted 2 days. Urine osmolality, cognitive performance, and mood of participants in each group were compared using the one-way analysis of variance (ANOVA). A total of 92 participants (46 females, 46 males) completed this study with a completion rate of 95.8%. The urine osmolality of the HA group was higher than that of the RB group and the HF group at two time points (p < 0.05). At time point 1, the scores in the portrait memory test and vigor were statistically different (F = 20.45, p < 0.001; F = 5.46, p = 0.006). It was found that the scores for the portrait memory test in the RB group were lower than those in the HA group and the HF group (p = 0.007; p < 0.001), while the scores of the HF group were higher than those of the HA group (p < 0.001). The scores for vigor in the RB group were significantly higher than those of the HA group (p = 0.006), and they were also significantly higher than those of the HF group (p = 0.004). At time point 2, only the scores for vigor were statistically different (F = 3.80, p = 0.026). It was found that the scores for vigor in the RB group were higher than those in the HA group and HF group (p = 0.018; p = 0.019). Both the amount and frequency of fluid intake may affect urine osmolality and vigor, but these factors have limited impacts on cognitive performance. Rational fluid intake behavior may be beneficial to improve the hydration status and mood of young adults. More research is needed, especially experimental research, to allow causal conclusions to be drawn.

[The role of CT coronary angiography in improving the positive rate of coronary angiography in patients with low-or moderate-risk non-ST segment elevation myocardial infarction]

Objective: To investigate whether CT coronary angiography (CTA) can safely and effectively reduce the number of invasive coronary angiography (ICA) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) whose Grace score is low-or moderate-risk, and increase ICA positive rate. Methods: One hundred and two NSTEMI patients, including 61 males and 41 females, aged 38-80 (58±12) years, were prospectively included and treated in Henan Provincial People's Hospital from February 2017 to February 2018. By using random number method, the patients were divided into control group (51 cases) and experimental group (51 cases). Patients in the control group were arranged for elective ICA examination according to the risk stratification. If further intervention or surgical treatment was required, the ICA examination was positive; in the experimental group, the CTA examination was completed through the green channel first. If the CTA showed that the main coronary artery and its main branches were severe or extreme stenosis, further ICA examination was arranged; otherwise, a secondary prophylactic drug treatment was developed and the patients were then discharged and followed up for 1 year. ICA number, ICA positive rate, length of hospital stay, hospital cost, hospital anxiety and depression score (HADS), major cardiovascular events (MACE) within 1 year, and other serious adverse events related to examination or surgery were compared between the two groups. Results: A total of 37 patients in the experimental group underwent ICA, and the positive rate of ICA was 94.59% (35/37), which was significantly higher than that of the control group [62.75% (32/51)] (P<0.05). The average length of hospital stay and the HADS score before ICA in the experimental group were significantly lower than those in the control group [(3.8±2.2) d vs (4.8±2.4) d; 8.8±4.5 vs 11.4±6.8] (all P<0.05). There was no significant difference in the cumulative incidence of MACE (3 cases vs 5 cases, P=0.423) and other serious adverse events (8 cases vs 10 cases, P=0.548) within 1 year between the two groups. Conclusion: CTA significantly reduces the number of ICA and the average length of hospital stay, and increases the positive rate of ICA in NSTEMI patients whose Grace score is low-or moderate-risk. There is no increase in cardiovascular risks within 1 year.

Different Amounts of Water Supplementation Improved Cognitive Performance and Mood among Young Adults after 12 h Water Restriction in Baoding, China: A Randomized Controlled Trial (RCT)

Water is indispensable to keeping the functions of the human body working properly, including that of the brain. The purpose of this research was to explore the impacts of water supplementation on cognitive performance and mood, and to determine the optimum amount of water to alleviate detriments of dehydration after 12 h water restriction. A randomized controlled trial was implemented among 64 young adults from Baoding, China. Fasting overnight for 12 h, and at 8:00 a.m. on day 2, osmolality of first morning urine and blood, cognitive performance, and mood were assessed as the dehydration test. Then, participants were randomly separated into four groups: water supplementation groups (WS groups 1, 2, and 3 with 500, 200, and 100 mL purified water, respectively) and no water supplementation group (NW group). Participants in WS groups were instructed to drink the water within 10 min, while those in NW group drank no water. After 90 min, the same measurements were taken as the rehydration test. There was significant interaction between TIME and VOLUME in thirst when comparing dehydration with rehydration tests (F = 6.172, p = 0.001). Significant thirst reductions were found in WS group 1 and WS group 2 (p = 0.003; p = 0.041), and a significant increase was found in the NW group (p = 0.039). In the rehydration test, significant interactions between TIME and VOLUME were found in scores of anger, fatigue, and TMD (total mood disturbance) (F = 3.815, p = 0.014; F = 10.429, p < 0.001; F = 5.246, p < 0.001), compared to the dehydration test. Scores of anger were only decreased in WS group 2 (p = 0.025), and scores of fatigue and TMD decreased in WS group 1 and WS group 2 (all p < 0.05). Significant interaction between TIME and VOLUME was only found for operation span test scores (F = 2.816, p = 0.047), with scores being only higher in WS group 1 in the rehydration test compared to the dehydration test (p = 0.003). Comparing WS group 1 and WS group 2, scores of thirst, fatigue, and TMD did not differ significantly (p > 0.05). Water supplementation improved working memory and attenuated anger, fatigue, and TMD. A small amount of water (200 mL) was sufficient to attenuate thirst, anger, fatigue, and TMD of young adults, but the larger volume (500 mL) appeared to be necessary to improve working memory. The amount of 500 mL was the optimum volume to improve the cognitive performance and mood among young adults.

Cost-utility and cost-benefit analyses of school-based obesity prevention program

BACKGROUND

Economic evaluation of school-based obesity interventions could provide support for public health decision of obesity prevention. This study is to perform cost-utility and cost-benefit assessment of three school-based childhood obesity interventions including nutrition education intervention (NE), physical activity intervention (PA) and comprehensive intervention (both NE and PA, CNP) with secondary data analysis of one randomized controlled trial.

METHODS

The standard cost-effectiveness analysis methods were employed from a societal perspective to the health outcome and costs that are attributable to the intervention. NE, PA and CNP were carried out separately for 2 semesters for childhood obesity interventions in primary schools. The additional quality-adjusted life years (QALYs) resulting from the interventions were measured as the health outcome. A cost-utility ratio (CUR) and A cost-benefit ratio (CBR) was calculated as the ratio of implementation costs to the total medical and productivity loss costs averted by the interventions.

RESULTS

The CUR and CBR were ¥11,505.9 ($1646.0) per QALY and ¥1.2 benefit per ¥1 cost respectively, and the net saving was ¥73,659.6 ($10,537.9). The CUR and CBR for nutrition education and physical activity interventions were ¥21,316.4 ($3049.6) per QALY and ¥0.7 benefit per ¥1 cost, ¥28,417.1 ($4065.4) per QALY and ¥0.4 benefit per ¥1 cost, respectively (in 2019 RMB). Compared with PA intervention, the ICERs were ¥10,335.2 ($1478.6) and 4626.3 ($661.8) for CNP and NE respectively. The CBR was ¥1.2, 0.7, and 0.4 benefits per ¥1 cost for CNP, NE, and PA interventions, respectively. Net estimated savings were achieved only through CNP intervention, amounting to ¥73,659.6 ($10,537.9).

CONCLUSIONS

Comprehensive school-based obesity intervention is a beneficial investment that is both cost-effective and cost saving. Compared with PA intervention, both CNP and NE intervention were more cost-effective.

Leading dietary determinants identified using machine learning techniques and a healthy diet score for changes in cardiometabolic risk factors in children: a longitudinal analysis

BACKGROUND

Identifying leading dietary determinants for cardiometabolic risk (CMR) factors is urgent for prioritizing interventions in children. We aimed to identify leading dietary determinants for the change in CMR and create a healthy diet score (HDS) to predict CMR in children.

METHODS

We included 5676 children aged 6-13 years in the final analysis with physical examinations, blood tests, and diets assessed at baseline and one year later. CMR score (CMRS) was computed by summing Z-scores of waist circumference, an average of systolic and diastolic blood pressure (SBP and DBP), fasting glucose, high-density lipoprotein cholesterol (HDL-C, multiplying by - 1), and triglycerides. Machine learning was used to identify leading dietary determinants for CMR and an HDS was then computed.

RESULTS

The nine leading predictors for CMRS were refined grains, seafood, fried foods, sugar-sweetened beverages, wheat, red meat other than pork, rice, fungi and algae, and roots and tubers with the contribution ranging from 3.9 to 19.6% of the total variance. Diets high in seafood, rice, and red meat other than pork but low in other six food groups were associated with a favorable change in CMRS. The HDS was computed based on these nine dietary factors. Children with HDS ≥8 had a higher decrease in CMRS (β (95% CI): - 1.02 (- 1.31, - 0.73)), BMI (- 0.08 (- 0.16, - 0.00)), SBP (- 0.46 (- 0.58, - 0.34)), DBP (- 0.46 (- 0.58, - 0.34)), mean arterial pressure (- 0.50 (- 0.62, - 0.38)), fasting glucose (- 0.22 (- 0.32, - 0.11)), insulin (- 0.52 (- 0.71, - 0.32)), and HOMA-IR (- 0.55 (- 0.73, - 0.36)) compared to those with HDS ≦3. Improved HDS during follow-up was associated with favorable changes in CMRS, BMI, percent body fat, SBP, DBP, mean arterial pressure, HDL-C, fasting glucose, insulin, and HOMA-IR.

CONCLUSION

Diets high in seafood, rice, and red meat other than pork and low in refined grains, fried foods, sugar-sweetened beverages, and wheat are leading healthy dietary factors for metabolic health in children. HDS is strongly predictive of CMR factors.

Drinking patterns and hydration biomarkers among young adults with different levels of habitual total drinking fluids intake in Baoding, Hebei Province, China: a cross-sectional study

BACKGROUND

The purposes were to investigate the drinking patterns and hydration biomarkers among young adults with different levels of habitual total drinking fluids intake.

METHODS

A cross-sectional study was conducted among 159 young adults aged 18-23 years in Baoding, China. Total drinking fluids and water from food were assessed by 7-day 24-h fluid intake questionnaire and duplicate portion method, respectively. The osmolality and electrolyte concentrations of the 24 h urine and fasting blood samples were tested. Differences in LD1 (low drinker), LD2, LD3 and HD (high drinker) groups, stratified according to the quartiles of total drinking fluids, were compared using one-way ANOVA, Kruskal-Wallis H test and chi-square test.

RESULTS

A total of 156 participants (80 males and 76 females) completed the study. HD group had greater amounts of TWI (Total Water Intake), water from food, higher and lower contributions of total drinking fluids and water from food to TWI, respectively, than LD1, LD2 and LD3 groups (p < 0.05). Participants in HD group had higher amounts of water and water from dishes than participants in LD1, LD2 and LD3 groups (p < 0.05). No significant differences were found in the contributions of different fluids to total drinking fluids within the four groups (p > 0.05). The osmolality of urine was 59-143 mOsm/kg higher in LD1 than that in LD2, LD3 and HD group (p < 0.05). The percentage of participants in optimal hydration status increased from 12.8% in LD1 group to 56.4% in HD group (p < 0.05). HD and LD3 groups had 386~793 higher volumes of urine than that of LD1 and LD2 groups (p < 0.05). Differences were found in the concentrations of electrolytes among the four groups (p < 0.05). No significant differences were found in the plasma biomarkers (p > 0.05), with the exception of higher concentration of Mg in LD3 and HD groups than that in LD1 and LD2 groups (p < 0.05).

CONCLUSIONS

Participants with higher total drinking fluids had better drinking pattern and hydration status. Interventions should be undertaken to advise adults to have adequate total drinking fluids, in order to keep in optimal hydration status.

TRIAL REGISTRATION

The registration number was ChiCTR-ROC-17010320, which was registered on the Chinese clinical trial registry.

Effect of multidimensional lifestyle interventions on metabolic risk reduction in children: a cluster randomised controlled trial

Few clinical trials have investigated lifestyle intervention effect on metabolic health in children. The study aimed to examine the effect of diet and physical activity intervention on the reduction of clustered metabolic risk score (CMRS) in children and moderators and mediators of the intervention effect. A multicentre, clustered randomised controlled trial was conducted with examination conducted at baseline and after intervention over one year. 7110 children (49.7% girls) with a mean of 9.06 (95% CI: 9.03, 9.09) years were included in the analysis. In Beijing, each three schools were randomly assigned to diet-only, physical activity-only intervention and control groups. In five other urban cities, each 15 schools were randomly assigned to comprehensive intervention and control groups. CMRS was computed by summing the Z scores of % fat mass, systolic blood pressure, fasting glucose, ratio of cholesterol to high-density lipoprotein, and triglyceride. Compared with controls (n = 2808), children in the comprehensive intervention group (n = 2848) had more reduction in CMRS (multivariate-adjusted mean difference (95% CI): -0.49 (-0.85, -0.14)). The body mass index (BMI) reduction explained 7.3% (95% CI 2.8%-18.1%) of the total intervention effect. The intervention was more effective in children with higher birthweight, lower parental BMI, or complete parental data. Diet-only or physical activity-only intervention had non-significant effects on CMRS reduction. Our multidimensional comprehensive intervention resulted in significant reduction in CMRS in primary school children and this effect was modified by birthweight, parental BMI, and parental involvement. A minority of metabolic risk reduction was mediated through BMI. Clinical Trial Registry number and website: ChiCTR-PRC-09000402, URL: http://www.chictr.org.cn.

Independent and Interactive Associations of Fitness and Fatness With Changes in Cardiometabolic Risk in Children: A Longitudinal Analysis

Background: Findings for associations between cardiorespiratory fitness (CRF) and cardiometabolic risk (CMR) factors are inconsistent, and the interactive association between CRF and fatness with CMR factors is unclear in children. Our study aimed to examine whether CRF and fatness are independently and interactively associated with CMR factors. Methods: We included 5,869 children aged 6-13 years in the analysis. Physical examinations, blood tests, and CRF were measured at baseline and 1 year later. Cardiometabolic risk score (CMRS) was computed by summing Z scores of waist circumference (WC), averaged systolic and diastolic blood pressure, glucose, high-density lipoprotein cholesterol (HDL-C, multiplied by -1), and triglycerides. Results: There was a high correlation between fatness and CRF in both boys and girls. High baseline CRF was independently associated with favorable changes in CMRS, BMI, WC, percent body fat (PBF), total cholesterol, LDL-C, and HDL-C (all P < 0.025). Improved CRF was independently associated with favorable changes in CMRS, BMI, WC, PBF, total cholesterol, LDL-C, HDL-C, triglycerides, and fasting glucose (all P < 0.0321). Baseline BMI was positively associated with changes in CMRS, WC, blood pressure, triglycerides, insulin, and HOMA-IR (all P < 0.0462). Low PBF at baseline was associated with favorable changes in CMRS, BMI, WC, blood pressure, HDL-C, triglycerides, insulin, and HOMA-IR (all P < 0.0423). The percentage of the total effect of baseline CRF on changes in CMRS, triglycerides, HDL-C, PBF, and WC mediated by baseline BMI was 66.0, 61.6, 40.3, 20.7, and 9.2%, respectively. Baseline CRF was a significant mediator for the association between baseline BMI and changes in CMRS (mediated by 4.3%), triglycerides (5.1%), and HDL-C (12.0%). An inverse association was found between baseline CRF and CMRS in children with high baseline BMI/PBF only. Improved CRF was associated with decreased BMI and WC in children with low baseline CRF. Conclusions: Fatness and CRF are each independently associated with changes in CMR factors. Fatness is a major mediator for the association between CRF and CMR factors, whereas the association between fatness and CMR factors is also mediated by CRF. The beneficial effect of high CRF on CMR factors was more evident in obese or unfit children.

miR-126 suppresses neuronal apoptosis in rats after cardiopulmonary resuscitation via regulating p38MAPK

In this study, we aimed to evaluate the effect of microRNA-126 (miR-126) on neuronal apoptosis in cardiopulmonary resuscitation rats and to explore the related molecular mechanism. The expression of miR-126 in brain tissues of rats after cardiopulmonary resuscitation was measured by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR). The basic parameters of cardiopulmonary resuscitation were recorded by miR-126 mimic injection in rats after cardiopulmonary resuscitation. Hematoxylin-eosin staining was used to observe the pathological changes of hippocampus. Immunohistochemistry was used to observe the expression of p38 and caspase-3 protein. Furthermore, the expression of p38 mitogen-activated protein kinase (p38MAPK), Jun N-terminal kinase (JNK), and extracellular signal-regulated kinase 1/2 (ERK1/2) in rat hippocampus was detected by RT-qPCR and Western blot. In order to confirm whether miR-126 takes part in the p38MAPK pathway in the hippocampus of rats after cardiopulmonary resuscitation, the p38MAPK pathway inhibitor (SB203580) and activator (anisomycin) were added. The results showed overexpression of miR-126 could significantly increase the neurological function score and improve the pathological morphology of hippocampus in rats after cardiopulmonary resuscitation. miR-126 overexpression also could reduce the neuronal apoptosis, p38, and caspase-3 expression in the hippocampus. Moreover, the p38MAPK and JNK expression was downregulated and ERK1/2 expression was upregulated after miR-126 mimic injection (p < 0.05). The results of inhibition of p38MAPK pathway were consistent with those of overexpression of miR-126 (p > 0.05). This study indicated miR-126 could significantly reduce neuronal apoptosis of hippocampus in rats after cardiopulmonary resuscitation, which might be involved in the regulation of p38MAPK pathway.

Identification of E2F8 as a Transcriptional Regulator of Gluconeogenesis in Primary Mouse Hepatocytes

The dysregulation of hepatic gluconeogenesis is a major factor in the pathogenesis of type 2 diabetes mellitus (T2DM). Hepatic gluconeogenesis is known to be tightly regulated at the transcription/expression level. The aim of this study was to evaluate the role of the E2F8 transcription factor in glucose metabolism. Here, we found that hepatic expression levels of E2F8 were increased in db/db and high-fat-diet-induced obese mice. Adenovirus-mediated overexpression of E2F8 in primary mouse hepatocytes upregulated expression of gluconeogenic genes, including those for PGC-1α, PEPCK, and G6Pase, subsequently increasing cellular glucose output. We demonstrated that E2F8 overexpression impairs insulin sensitivity in vitro. Furthermore, knockdown of E2F8 expression increased insulin sensitivity in primary hepatocytes. In summary, these findings indicated that E2F8 is involved in gluconeogenesis and insulin resistance and may represent a new therapeutic target in T2DM prevention.

Final results for the neutron -asymmetry parameter A0 from the UCNA experiment

The UCNA experiment was designed to measure the neutron β-asymmetry parameter A0 using polarized ultracold neutrons (UCN). UCN produced via downscattering in solid deuterium were polarized via transport through a 7 T magnetic field, and then directed to a 1 T solenoidal electron spectrometer, where the decay electrons were detected in electron detector packages located on the two ends of the spectrometer. A value for A0 was then extracted from the asymmetry in the numbers of counts in the two detector packages. We summarize all of the results from the UCNA experiment, obtained during run periods in 2007, 2008–2009, 2010, and 2011–2013, which ultimately culminated in a 0.67% precision result for A0.

Advances and gaps in recommendations for adequate water intake in China

Water is essential for life survival and development. It plays a pivotal role in metabolic function, modulates normal osmotic pressure, maintains the electrolyte balance, and regulates body temperature. Adequate water intake is necessary for optimal hydration-both excessive and insufficient water consumption can have adverse effects on health. Water requirements among people vary based on various factors such as gender, age, physical activity, dietary factors, ambient temperature, and renal concentrating capacity. In recent years, water intake guidelines have been developed in some countries and by some organisations. Even in China, it is important to develop such guidelines considering specific dietary habits, height of people, and environmental factors. In 2013, guidelines for adequate water intake were developed in China, but the scope was somewhat limited; there are still specific challenges in formulating such recommendations. Future water-related studies should focus on surveying water intake among infants and toddlers, older adults, and pregnant and lactating women. Moreover, additional studies should be conducted to elucidate water intake among adults and adolescents in different regions and seasons, and the association between water intake and related diseases should also be investigated. It is imperative to transform the results of scientific research into action plans for water-related health education so as to inform and evaluate pertinent public health programmes.