[Association between vitamin D level and grip strength in adults aged 50 and older in Shanghai]

Objective: To understand the association between vitamin D level and grip strength in people aged ≥50 years in Shanghai. Methods: Data were obtained from the WHO's Study on Global Ageing and Adult Health in Shanghai during 2018-2019. Logistic regression model was used to analyze the association between vitamin D level and grip strength, and a stratified analysis was conducted for different gender, age and dairy product intake groups. Restricted cubic spline was used to evaluate the dose-response association between vitamin D level and low grip strength. Results: A total of 4 391 participants were included in the study, including 2 054 men (46.8%), with an average age of (67.02±8.81) years. And 1 421 individuals (32.4%) had low grip strength; 1 533 individuals (34.9%) had vitamin D deficiency, and 401 individuals (9.1%) had vitamin D deficiency. After adjusted for confounding factors, the logistic regression results analysis showed that individuals with vitamin D deficiency had a higher risk for low grip strength (OR=1.41, 95%CI: 1.09-1.83). In men, after adjusting for confounding factors, vitamin D deficiency was positively associated with the risk for low grip strength (OR=1.67, 95%CI: 1.12-2.50), but there was no significant association between vitamin D level and grip strength in women (OR=1.30, 95%CI: 0.97-1.74). In age group 60-69 years and ≥80 years, there was significant association between vitamin D deficiency and low grip strength after adjusting for confounding factors (OR=1.57, 95%CI: 1.05-2.35; OR=2.40, 95%CI: 1.08-5.31). In people who had daily intake of dairy product <250 ml, there was positive association between vitamin D deficiency and low grip strength, but there was no significant association in people who had daily dairy product ≥250 ml after adjusting for confounding factors. The restrictive cubic spline demonstrated that risk of low grip strength might decreased with the increase of vitamin D levels, however, the difference was not significant (P>0.05). Conclusions: This study demonstrated that there is association between vitamin D level and grip strength. People with vitamin D deficiency have higher risk for low grip strength.

[Association between dietary pattern and frailty among people aged 50 years and over in Shanghai]

Objective: To investigate dietary patterns of individuals aged ≥50 in Shanghai and analyze their association with frailty. Methods: Using data from the third wave of the Study on Global Ageing and Adult Health in Shanghai conducted between 2018 and 2019. We collected the frequency and average intake of food by the food frequency questionnaire. Factor analysis was used to extract dietary patterns, and a frailty index was constructed using the ratio of the cumulative total score of health deficits to 35 health-related variables considered. We used an ordinal multinomial logistic regression model to analyze the association between dietary patterns and frailty. Results: A total of 3 274 participants aged (67.9±9.2) years were included in the study, including 1 971 (60.2%) men and 1 303 (39.8%) women. We extracted four dietary patterns: high-protein-nuts pattern, potato-bean-vegetable-fruit pattern, poultry-meat pattern, and high-oil-salt pattern. After adjusting for confounding factors, the logistic regression analysis showed that compared with the high-oil-salt pattern, the high-protein-nuts pattern was negatively associated with the risk of higher frailty (OR=0.743, 95%CI: 0.580-0.951). We did not find an association between dietary patterns and frailty between the different gender groups. In the age group 50-64, the high-protein-nuts and potato-bean-vegetable-fruit patterns were negatively correlated with a higher degree of frailty than the high-oil-salt pattern. In the low-level physical activity group, the high-protein-nuts pattern was negatively correlated with a higher degree of frailty than the high-oil-salt pattern (OR=0.509, 95%CI: 0.361-0.720). However, we found no significant effect of the high-protein nuts pattern, potato-bean-vegetable-fruit pattern, and poultry-meat pattern on the risk of higher frailty compared to the high-oil-salt pattern in the moderate to high level of physical activity group. Conclusions: Compared to the high-oil-salt pattern, dietary patterns with a higher intake of high-protein nuts, potatoes, legumes, and fruits and vegetables might be associated with a lower risk of higher frailty in residents aged 50-64 years of age than with a high oil and salt pattern. At the same time, it may have a more significant protective effect in people with lower physical activity levels. It is suggested that a diet rich in high-protein foods, nuts, potatoes, beans, vegetables, and fruits may help reduce and delay the risk of frailty.

Multiple Origins of Bioluminescence in Beetles and Evolution of Luciferase Function

Bioluminescence in beetles has long fascinated biologists, with diverse applications in biotechnology. To date, however, our understanding of its evolutionary origin and functional variation mechanisms remains poor. To address these questions, we obtained high-quality reference genomes of luminous and nonluminous beetles in 6 Elateroidea families. We then reconstructed a robust phylogenetic relationship for all luminous families and related nonluminous families. Comparative genomic analyses and biochemical functional experiments suggested that gene evolution within Elateroidea played a crucial role in the origin of bioluminescence, with multiple parallel origins observed in the luminous beetle families. While most luciferase-like proteins exhibited a conserved nonluminous amino acid pattern (TLA346 to 348) in the luciferin-binding sites, luciferases in the different luminous beetle families showed divergent luminous patterns at these sites (TSA/CCA/CSA/LVA). Comparisons of the structural and enzymatic properties of ancestral, extant, and site-directed mutant luciferases further reinforced the important role of these sites in the trade-off between acyl-CoA synthetase and luciferase activities. Furthermore, the evolution of bioluminescent color demonstrated a tendency toward hypsochromic shifts and variations among the luminous families. Taken together, our results revealed multiple parallel origins of bioluminescence and functional divergence within the beetle bioluminescent system.

Active learning prediction and experimental confirmation of atomic structure and thermophysical properties for liquid Hf_{76}W_{24} refractory alloy

The determination of liquid atomic structure and thermophysical properties is essential for investigating the physical characteristics and phase transitions of refractory alloys. However, due to the stringent experimental requirements and underdeveloped interatomic potentials, acquiring such information through experimentation or simulation remains challenging. Here, an active learning method incorporating a deep neural network was established to generate the interatomic potential of the Hf_{76}W_{24} refractory alloy. Then the achieved potential was applied to investigate the liquid atomic structure and thermophysical properties of this alloy over a wide temperature range. The simulation results revealed the distinctive bonding preferences among atoms, that is, Hf atoms exhibited a strong tendency for conspecific bonding, while W atoms preferred to form an interspecific bonding. The analysis of short-range order (SRO) in the liquid alloy revealed a significant proportion of icosahedral (ICO) and distorted ICO structures, which even exceeded 30% in the undercooled state. As temperature decreased, SRO structures demonstrated an increase in larger coordination number (CN) clusters and a decrease in smaller CNs. The alterations of the atomic structure indicated that the liquid alloy becomes more ordered, densely packed, and energetically favorable with decreasing temperature, consistent with the obtained fact: Both density and surface tension increase linearly. The simulated thermophysical properties were close to experimental values with minor deviations of 2.8% for density and 3.4% for surface tension. The consistency of the thermophysical properties further attested to the accuracy and reliability of active learning simulation.

Two new species of the Longitarsusviolentus group from China (Coleoptera, Chrysomelidae, Galerucinae, Alticini)

Two new species of Longitarsus Latreille, 1829 from China are described: L.pekingensis Liang, Konstantinov & Ge, sp. nov. (Beijing) and L.xinjiangensis Liang, Konstantinov & Ge, sp. nov. (Xinjiang). Images of dorsal and lateral habitus, pronotum, head, and male and female genitalia are provided. The records of Longitarsusviolentus Weise, 1893 and Longitarsusweisei Guillebeau, 1895 in China are discussed. Holotypes of L.marguzoricus Konstantinov in Konstantinov & Lopatin, 2000 and L.violentoides Konstantinov in Konstantinov & Lopatin, 2000 are illustrated with images of pronotum and median lobe of aedeagus. A key to species of L.violentus species group is provided.

Description of three new species of Benedictus (Coleoptera, Chrysomelidae, Galerucinae, Alticini) from China, with comments on their biology and modified ethanol traps for collecting flea beetles

The diversity and biology of the moss and leaf litter-inhabiting flea beetles are still poorly known. In this study, three new species of Benedictus are described from China: Benedictusfuanensis Ruan & Konstantinov, sp. nov., Benedictusquadrimaculatus Ruan & Konstantinov, sp. nov., and Benedictuswangi Ruan & Konstantinov, sp. nov. Comments on their biology are given. Benedictusquadrimaculatus has a highly unusual morphological feature not reported before in flea beetles: black spots on the abdominal tergites that are visible through the elytra. Traditional and modified ethanol traps were tested and proven useful for collecting leaf litter- and moss-inhabiting flea beetles. Based on our tests, eight traps could collect one specimen each day in the testing sites in Fujian Province; three traps could collect one specimen each day in the testing sites in Guangdong Province.

[Comparison of efficacy and safety of transurethral thulium laser vapoenucleation of prostate and transurethral thulium laser enucleation of prostate in the treatment of benign prostatic hyperplasia]

Objective: To compare early outcomes between transurethral thulium laser vapoenucleation of prostate and transurethral thulium laser enucleation of prostate for the treatment of benign prostatic hyperplasia (BPH). Methods: Retrospective analysis was conducted on the clinical data of 1 638 BPH patients admitted to the Department of Urology of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to December 2021. There were 916 patients underwent transurethral thulium laser vapoenucleation of prostate (ThuVEP group) and 722 patients underwent transurethral thulium laser enucleation of prostate (ThuLEP group). The operation time, eliminated tissue weight, surgical complications, duration of post-operative catheter implantation were compared between the two groups. The improvement of International Prostate Symptom Score (IPSS), Quality of Life Index (QoL), maximum uroflow rate (Qmax) and post-void residual urine volume (PVR) at 1 month after operation was compared between the two groups. Results: There were no significant differences in age, preoperative and 1-month postoperative prostate volume, IPSS score, QoL score, Qmax, and PVR between the ThuVEP and ThuLEP group (all P>0.05). There were no significant differences in perioperative indicators such as operation time, cutting or enucleation time, tissue crushing time, tissue weight, hemoglobin change, catheter indwelling time, and postoperative hospital stay between ThuVEP group and ThuLEP group (all P>0.05). The incidence of minor gross hematuria after extubation in the ThuVEP group was 7.8% (56/916), which was lower than 9.4% (65/722) in the ThuLEP group (P=0.026); the incidence of temporary incontinence at 1 month after surgery was 5.2% (38/916) in ThuVEP group, lower than 11.9% (86/722) in ThuLEP group (P<0.001). A total of 3 patients (0.4%) in ThuLEP group required operative intervention for severe post-operation bleeding, but none of ThuVEP group suffered from this kind of surgical complications. Conclusions: ThuVEP has similar efficacy with ThuLEP for the treatment of BPH. ThuVEP can significantly reduce the incidence of post-operation temporary urine incontinence, and has much superiority in stanching bleeding.

A110 INCIDENCE AND PREDICTORS OF ASYMPTOMATIC ABNORMALITIES IN BIOCHEMICAL AND RADIOLOGIC PANCREATIC MARKERS FOLLOWING UNCOMPLICATED ERCP

Background

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is common. Its diagnosis relies on characteristic abdominal pain in addition to biochemical and/or radiographic evidence of pancreatic inflammation.

Purpose

Little is known regarding the frequency with which asymptomatic alterations in biochemical and/or imaging parameters occur following uncomplicated ERCP. We sought to assess the incidence and predictors of such alterations following uncomplicated ERCP.

Method

This study was an analysis of a prospectively maintained ERCP registry. All inpatients ³ 18 years old who underwent ERCP between 2018/09/01 and 2022/02/28 were identified. Patients with acute pancreatitis or abdominal pain following ERCP were excluded, as were patients with lipase levels ≥3x the upper limit of normal (ULN) within 7 days preceding ERCP. Primary outcomes were (1) asymptomatic lipase elevation within 48 hours of uncomplicated ERCP or (2) asymptomatic cross-sectional imaging findings of pancreatic inflammation within 14 days of ERCP.Descriptive statistics were presented as means with accompanying standard deviations (SD) and percentages by lipase categories and PEP, or by imaging categories. Multiple logistic regression was used to examine the associations of exposure variables with PEP or imaging findings.

Result(s)

A total of 646 patients were analyzed in the biochemical cohort, and 187 patients were analyzed in the radiologic cohort. In the biochemical cohort, 478 patients (74.0%) had no elevations in pancreatic enzymes, while 81 (12.5%) had elevations up to 2x ULN, 26 (4.0%) had elevations between 2-3x ULN, and 61 (9.4%) had elevations >3x ULN. In the radiologic cohort, 148 (79.1%) had no abnormalities on cross-sectional imaging within 14 days of ERCP, while 39 (20.9%) had one or more imaging finding typically associated with acute pancreatitis. Among these, 22 (11.8%) had peri-pancreatic fluid collections and 2.1-9.6% of patients had pancreatic findings that included edema, enlargement, inflammation, or fat-stranding. On multivariable analysis, predictors of lipasemia >3x ULN included balloon sphincteroplasty (odds ratio, OR, 2.29, 95% confidence intervals, CI, 1.08 to 4.85) and the placement of a common bile duct stent (OR 4.19, 95% CI 1.37 to 12.77), whereas cannulation of the pancreatic duct or performance of a pancreatogram were not significantly associated (OR 0.75, 95% CI 0.24 to 2.35 and OR 1.07, 95% CI 0.18 to 6.26, respectively).

Conclusion(s)

Over 25% of patients will have asymptomatic elevations in pancreatic enzymes following ERCP, while over 20% will have asymptomatic cross-sectional imaging findings suggestive of pancreatic inflammation. Clinical symptoms should guide post-ERCP care rather than biochemical or imaging parameters.

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Disclosure of Interest

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[Bushen Huoxue Fang improves recurrent miscarriage in mice by down-regulating the JAK2/STAT3 pathway]

OBJECTIVE

To investigate the efficacy of Bushen Huoxue Fang (BSHXF, a traditional Chinese medicine formula) for improving recurrent spontaneous abortion (RSA) in mice and the role of tyrosine kinase (JAK2) and transcriptional activator (STAT3) signaling pathway in its therapeutic mechanism.

METHODS

Female CBA/J mice were caged with male DBA/2 mice to establish RSA mouse models, which were randomly divided into model group, dydrogesterone group and BSHXF group, with the female mice caged with male BALB/c mice as the control group (n=6). From the first day of pregnancy, the mice were subjected to daily intragastric administration of BSHXF, dydrogesterone, or distilled water (in control and model groups) for 12 days. After the treatments, serum levels of antithrombin III (AT-III), activated protein C (APC), tissue plasminogen activator (t-PA), progesterone, human chorionic gonadotropin (HCG), and estradiol (E2) were detected in each group using ELISA. HE staining was used to observe the morphological changes of the endometrium of the mice. Western blotting was performed to determine the expressions of p-JAK2, p-Stat3 and Bcl-2 in the placenta of the mice.

RESULTS

Compared with the control mice, the mouse models of RSA showed a significantly increased embryo loss rate with decreased serum levels of AT-III, T-PA, progesterone, APC and HCG, increased placental expressions of p-JAK2, p-STAT3 and Bax, and decreased expression of Bcl-2 (P < 0.05). Treatments with BSHXF and dydrogesterone both increased serum levels of AT-III, t-PA and HCG in the mouse models; Serum APC level was significantly reduced in BSHXF group and serum progesterone level was significantly increased in dydrogesterone group (P < 0.05).

CONCLUSION

BSHXF can improve the prethrombotic state and inhibit cell apoptosis by downregulating the JAK2/STAT3 pathway to increase the pregnancy rate in mouse models of RSA.

[Analysis of genotypes on 850 newborns with SLC26A4 single-allele mutation and the phenotypes of those with second variant]

Objective: To clarify the phenotypes of the newborns with SLC26A4 single-allele mutation in deafness genetic screening and second variant; to analyze the SLC26A4 genotype and hearing phenotype. Methods: 850 newborns born in Beijing from April 2015 to December 2019 were included and there were 468 males and 382 females. They received genetic deafness screening for 9 or 15 variants, with the result of SLC26A4 single-allele mutation. Firstly, three step deafness gene sequencing was adopted in this work, i.e., the first step was "SLC26A4 gene whole exons and splice sites" sequencing; the second step was "SLC26A4 gene promoter, FOXI1 gene and KCNJ10 gene whole exons" sequencing; and the third step was detection for "SLC26A4 gene copy number variation". Secondly, we collected the results of newborn hearing screening for all patients with the second mutation found in the three step test, and conducted audiological examinations, such as acoustic immittance, auditory brainstem response and auditory steady state response. Thirdly, for novel/VUS mutations, we searched the international deafness gene database or software, such as DVD, ClinVar and Mutation Taster, to predict the pathogenicity of mutations according to the ACMG guideline. Lastly, we analyzed the relationship between genotype and phenotype of newborns with SLC26A4 single allele mutation. Results: Among 850 cases, the median age of diagnosis was 4 months. In the first step, 850 cases were sequenced. A total of 32 cases (3.76%, 32/850) of a second variants were detected, including 18 cases (2.12%, 18/850) with identified pathogenic variants; 832 cases were sequenced and 8 cases of KCNJ10 gene missense variants were detected among the second step. No missense mutations in the FOXI1 gene and abnormal SLC26A4 gene promoter were detected; the third step sequencing results were all negative. Genotypes and hearing phenotypes included 18 cases combined with the second clear pathogenic variant, 16 cases (16/18) referred newborn hearing screening and 2 cases (2/18) passed in both ears; degree of hearing loss consisted of 18 profound ears (18/36), 13 severe ears (13/36) and 5 moderate ears (5/36); audiogram patterns comprised 17 high frequency drop ears (17/36), 14 flat ears (14/36), 3 undistinguished ears (3/36), and 2 U shaped ears (2/36); 11 cases underwent imaging examination, all of which were bilateral enlarged vestibular aqueduct. As for 22 cases of other genotypes, all passed neonatal hearing screening and the hearing diagnosis was normal, including 9 cases with VUS or possibly novel benign variants, 8 cases with KCNJ10 double gene heterozygous variants, and 5 cases with double heterozygous variants. Conclusions: The probability of individuals with SLC26A4 single-allele variant who merge with a second pathogenic variant is 2.12%, all of which are SNV, which can provide scientific basis for the genetic diagnosis and genetic counseling of SLC26A4 variants. Those who have merged with second pathogenic variant are all diagnosed with sensorineural hearing loss. Patients with KCNJ10 gene mutations do not manifest hearing loss during the infancy, suggesting the need for further follow-up.

Characterization of the Complete Mitochondrial Genome of a Flea Beetle Luperomorpha xanthodera (Coleoptera: Chrysomelidae: Galerucinae) and Phylogenetic Analysis

In this study, the mitochondrial genome of Luperomorpha xanthodera was assembled and annotated, which is a circular DNA molecule including 13 protein-coding genes (PCGs), 22 transfer RNA (tRNA) genes, 2 ribosomal RNA genes (12S rRNA and 16S rRNA), and 1388 bp non-coding regions (A + T rich region), measuring 16,021 bp in length. The nucleotide composition of the mitochondrial genome is 41.3% adenine (A), 38.7% thymine (T), 8.4% guanine (G), and 11.6% cytosine (C). Most of the protein-coding genes presented a typical ATN start codon (ATA, ATT, ATC, ATG), except for ND1, which showed the start codon TTG. Three-quarters of the protein-coding genes showed the complete stop codon TAR (TAA, TAG), except the genes COI, COII, ND4, and ND5, which showed incomplete stop codons (T- or TA-). All the tRNA genes have the typical clover-leaf structure, except tRNASer1 (AGN), which has a missing dihydrouridine arm (DHU). The phylogenetic results determined by both maximum likelihood and Bayesian inference methods consistently supported the monophyly of the subfamily Galerucinae and revealed that the subtribe Luperina and genus Monolepta are polyphyletic groups. Meanwhile, the classification status of the genus Luperomorpha is controversial.

[Frailty trajectories in people aged 50 years and above in China]

Objective: To identify distinct frailty trajectories in a cohort of nationwide community adults aged 50 years and above, and explore the relationship between frailty trajectories and their socioeconomic characteristics and behavioral factors at baseline survey. Methods: Data were from the three waves of "Global Ageing and Adult Health Research" (SAGE) by World Health Organization in China. The frailty index is generated from 32 items. Group-based trajectory modeling using a censored normal model was conducted to identify the patterns in frailty progression over time. Multinomial logistic regression model was used to examine the effect of socioeconomic status and behavioral factors on the frailty trajectories. Results: A total of 4 303 adults aged 50 years and above with complete data from all three rounds of project were included in the final analysis. Three frailty trajectories were identified: low and stable trajectory (LT) (56.8%), moderately increased trajectory (MT) (34.4%) and highly increased trajectory (HT) (8.8%). The results of the multinomial logistic regression analysis showed that the HT group was more likely to be women (OR=1.88, 95%CI:1.22-2.92) and rural residents (OR=1.87, 95%CI:1.29-2.70) compared with the LT group. In terms of household wealth per capita, there was a clear gradient in ORs, the people with lower household wealth were more likely to be classified in the HT group. Conclusion: This study identified three patterns of progression of frailty trajectories in population aged 50 years and above in China and highlighted that interventions should target those vulnerable populations with rapid progression of frailty.

[A prospective cohort study on the association between grip strength and cognitive function in adults aged 50 years and above]

Objective: To evaluate the association between grip strength (GS) and cognitive function in a population-based longitudinal cohort of Chinese adults aged ≥50 years. Methods: The study population of 3 600 adults was from the baseline survey and two rounds of follow up of World Health Organization (WHO) study of global ageing and adult health (SAGE) in five districts of Shanghai (Hongkou, Huangpu, Minhang, Qingpu and Pudong) after excluding individuals with self-report stroke and depression. The effects of baseline GS on cognitive function and its changes were evaluated. Factor analysis was applied to generate an overall cognition score based on verbal recall trials, verbal fluency test, forward digit span test and backward digit span test. Linear mixed effects model was used to examine the predictive capability of baseline GS for changes in cognitive function. Results: A total of 3 600 participants aged (61.2±8.1) years at baseline survey were included in this study, including 1 668 (46.3%) men and 1 932 (53.7%) women. The average of baseline GS and total cognitive function score were (28.19±12.18) kg and (58.93±14.56) respectively. Cognitive function score declined significantly during the follow-up, however, the changes were different among different age groups, education level groups and household income groups. After adjusted for age, education level, marital status, household income, co-morbidity of chronic conditions, drinking status, smoking status, physical activity level, vegetable/fruit intakes and BMI, no relationships between the baseline GS and cognitive score at baseline survey and at 1^st follow-up were observed, however, compared with lower GS quartile group, there was a significant relationship between higher baseline GS level and better cognitive function at 2^nd follow-up. The participants with highest GS quartile had better cognitive performance over time (male: β=1.938,95%CI:0.644-3.231,P=0.003, female: β=2.192,95%CI:0.975-3.409,P<0.001 and those aged 50-64 years: β=1.652,95%CI:0.646-2.659,P=0.001) than those with the lowest quartile. Conclusions: Higher baseline GS was significantly related to better cognitive function with slow decline. Thus, it is an indicator of cognitive function in middle-aged and elderly Chinese.

Complete mitochondrial genome of Pectocera sp. (Elateridae: Dendrometrinae: Oxynopterini) and its phylogenetic implications

The Elateridae family (click beetles) represents a highly diverse lineage that possesses a specialized clicking mechanism to startle predators. At present, however, phylogenetic relationships, especially among recognized subfamilies, remain contentious. Mitochondrial genomes (mitogenomes) can help resolve previously intractable phylogenetic relationships using morphological or limited molecular data. Here, we report the complete mitogenome of Pectocera sp. (Elateridae: Dendrometrinae: Oxynopterini), which was 15,962 bp in length and showed a typical gene number and order as most beetle mitogenomes, including 13 protein-coding genes (PCGs), 22 transfer RNA genes, 2 ribosomal RNA genes, and 1 noncoding control region (AT-rich region). Comparative genomic analyses showed a high degree of feature similarity among Pectocera sp. and other click beetles. Evolutionary analysis of all PCGs based on the nonsynonymous/synonymous substitution rate ratio (ω) indicated that cox1 and atp8 exhibited the lowest and highest evolutionary rates, respectively, and that the evolutionary rates of all PCGs, except for cox3, nad2, and nad3, were lower than the average ω of click beetles. Phylogenetic analyses based on concatenated and coalescent approaches indicated that Pectocera sp. was sister to Campsosternus auratus in the same tribe (Oxynopterini) with high support. This study offers insight into the mitogenomic basis of Pectocera sp. and provides an important data resource for exploring the taxonomy, phylogeny, and evolution of click beetles.

LncRNA ABHD11-AS1 promotes tumor progression in papillary thyroid carcinoma by regulating EPS15L1/EGFR signaling pathway

OBJECTIVES

lncRNA ABHD11 antisense RNA 1 (ABHD11-AS1) acts as an oncogene involved in papillary thyroid carcinoma (PTC) occurrence and progression. ABHD11-AS1 exerts biologic functions by some miRNAs and proteins to regulate multiple targets. Identification of novel mechanism of ABHD11-AS1 could be helpful in therapeutic targeting for PTC treatment.

METHODS

Differentially expressed lncRNAs were selected from TCGA database. qRT-PCR analysis was applied to examine the expression of ABHD11-AS1 in PTC cell lines and tissues. The relationship of ABHD11-AS1 expression and clinicopathological features was analyzed by Kaplan-Meier analysis. Two PTC cell lines (TPC-1 and KTC-1) were transfected with pcDNA 3.1, pcDNA3.1-ABHD11-AS1, si-NC and si-ABHD11-AS1, respectively, to verify the ABHD11-AS1 oncogene-regulating capacity to promote tumor progression. The cell metastasis and proliferation had been evaluated both in vitro and in vivo.

RESULTS

High expression of ABHD11-AS1 was found in PTC tissues (P < 0.01), which was significantly correlated with lymph node metastasis (P < 0.05). ABHD11-AS1 overexpression noticeably promoted cell proliferation, migration, and invasion capabilities, which were obviously decreased upon ABHD11-AS1 knockdown. ABHD11-AS1 positively regulated EGFR/EPS15L1 pathway, as EGFR, EPS15L1, STAT3, and p-STAT3 were activated.

CONCLUSION

ABHD11-AS1 promotes tumor progression in PTC by regulating EPS15L1/EGFR pathway.

[Cross-sectional study of association between dietary pattern and cognitive performance in people aged 50 and above years in Shanghai]

Objective: To investigate the association between dietary pattern and cognitive performance in local residents aged ≥50 years in Shanghai. Methods: Data were obtained from the second round of Study of Global Ageing and Adult Health (SAGE) survey in Shanghai. Dietary patterns were surveyed by factor analysis. Cognitive tests were conducted to assess subjects' cognitive performance, including verbal recall, verbal fluency and digit test. Multiple linear regression analysis was used to evaluate the relationship between dietary patterns and cognition performance. Results: A total of 4 132 subjects with complete dietary and cognitive performance test data were included. Factor analysis was used to obtain three dietary patterns: including plant-based pattern, high animal-food pattern, high salt-oil pattern. After controlling for gender, age, education level and other factors, it was found that plant-based pattern (β=0.26,95%CI: 0.17-0.36) and high animal-food pattern (β=0.18, 95%CI:0.06-0.29) were positively associated with total cognitive test score while high salt-oil pattern (β=-0.28, 95%CI:-0.85--0.07) was negatively associated with verbal fluency test score. Conclusion: A dietary pattern with high intake of plant food and appropriate intake of animal food might be associated with better cognitive function of residents aged ≥50 years.

Cambridge hybrid closed-loop algorithm in children and adolescents with type 1 diabetes: a multicentre 6-month randomised controlled trial

BACKGROUND

Closed-loop insulin delivery systems have the potential to address suboptimal glucose control in children and adolescents with type 1 diabetes. We compared safety and efficacy of the Cambridge hybrid closed-loop algorithm with usual care over 6 months in this population.

METHODS

In a multicentre, multinational, parallel randomised controlled trial, participants aged 6-18 years using insulin pump therapy were recruited at seven UK and five US paediatric diabetes centres. Key inclusion criteria were diagnosis of type 1 diabetes for at least 12 months, insulin pump therapy for at least 3 months, and screening HbA1c levels between 53 and 86 mmol/mol (7·0-10·0%). Using block randomisation and central randomisation software, we randomly assigned participants to either closed-loop insulin delivery (closed-loop group) or to usual care with insulin pump therapy (control group) for 6 months. Randomisation was stratified at each centre by local baseline HbA1c. The Cambridge closed-loop algorithm running on a smartphone was used with either (1) a modified Medtronic 640G pump, Medtronic Guardian 3 sensor, and Medtronic prototype phone enclosure (FlorenceM configuration), or (2) a Sooil Dana RS pump and Dexcom G6 sensor (CamAPS FX configuration). The primary endpoint was change in HbA1c at 6 months combining data from both configurations. The primary analysis was done in all randomised patients (intention to treat). Trial registration ClinicalTrials.gov, NCT02925299.

FINDINGS

Of 147 people initially screened, 133 participants (mean age 13·0 years [SD 2·8]; 57% female, 43% male) were randomly assigned to either the closed-loop group (n=65) or the control group (n=68). Mean baseline HbA1c was 8·2% (SD 0·7) in the closed-loop group and 8·3% (0·7) in the control group. At 6 months, HbA1c was lower in the closed-loop group than in the control group (between-group difference -3·5 mmol/mol (95% CI -6·5 to -0·5 [-0·32 percentage points, -0·59 to -0·04]; p=0·023). Closed-loop usage was low with FlorenceM due to failing phone enclosures (median 40% [IQR 26-53]), but consistently high with CamAPS FX (93% [88-96]), impacting efficacy. A total of 155 adverse events occurred after randomisation (67 in the closed-loop group, 88 in the control group), including seven severe hypoglycaemia events (four in the closed-loop group, three in the control group), two diabetic ketoacidosis events (both in the closed-loop group), and two non-treatment-related serious adverse events. There were 23 reportable hyperglycaemia events (11 in the closed-loop group, 12 in the control group), which did not meet criteria for diabetic ketoacidosis.

INTERPRETATION

The Cambridge hybrid closed-loop algorithm had an acceptable safety profile, and improved glycaemic control in children and adolescents with type 1 diabetes. To ensure optimal efficacy of the closed-loop system, usage needs to be consistently high, as demonstrated with CamAPS FX.

FUNDING

National Institute of Diabetes and Digestive and Kidney Diseases.

Functional Morphology of the Thorax of the Click Beetle Campsosternus auratus (Coleoptera, Elateridae), with an Emphasis on Its Jumping Mechanism

Simple Summary

Click beetles are well-known for the specialized thoracic structure, which they can click to thrust themselves into the air and to right themselves. Several aspects of their jumping mechanism were still not entirely clear prior to this study. We utilized traditional dissection, 3D virtual dissection, and high-speed filming techniques to investigate the functional morphology of their thorax. Our results show several new insights into their extraordinary clicking and jumping mechanisms.

Abstract

We investigated and described the thoracic structures, jumping mechanism, and promesothoracic interlocking mechanism of the click beetle Campsosternus auratus (Drury) (Elateridae: Dendrometrinae). Two experiments were conducted to reveal the critical muscles and sclerites involved in the jumping mechanism. They showed that M2 and M4 are essential clicking-related muscles. The prosternal process, the prosternal rest of the mesoventrite, the mesoventral cavity, the base of the elytra, and the posterodorsal evagination of the pronotum are critical clicking-related sclerites. The destruction of any of these muscles and sclerites resulted in the loss of normal clicking and jumping ability. The mesonotum was identified as a highly specialized saddle-shaped biological spring that can store elastic energy and release it abruptly. During the jumping process of C. auratus, M2 contracts to establish and latch the clicking system, and M4 contracts to generate energy. The specialized thoracic biological springs (e.g., the prosternum and mesonotum) and elastic cuticles store and abruptly release the colossal energy, which explosively raises the beetle body in a few milliseconds. The specialized trigger muscle for the release of the clicking was not found; our study supports the theory that the triggering of the clicking is due to the building-up of tension (i.e., elastic energy) in the system.

A novel approach quantifying the periorbital morphology: A comparison of direct, 2-dimensional, and 3-dimensional technologies

BACKGROUND

The measurement of anatomical structures is critical in plastic and reconstructive surgery. However, few detailed and standardized measurements have been widely used in the periorbital region. This study aimed to evaluate the feasibility of a novel detailed and standardized protocol with 2D and 3D technologies, and explore the relationship between them and direct measurements.

METHODS

Fifty healthy Caucasians (100 eyes) between 20 and 68 years old were recruited and captured for 3D photographs by VECTRA M3 3D Imaging System. Subsequently, 24 landmarks were located on each 3D photographs following a standardized protocol, and then 19 linear and 3 angular periorbital variables were measured. Furthermore, two-dimensional (2D) and direct measurements were conducted on each subject and compared with 3D measurements and one another.

RESULTS

The grand r means across all measurements were 0.77, 0.78, and 0.88 for direct vs. 2D values, direct vs. 3D values, and 3D vs. 2D values, respectively. The mean absolute differences were 1 mm (ranging from 0.2 mm to 3.7 mm) between direct and 3D measurements, 1 mm (ranging from 0.04 mm to 2.4 mm) between direct and 2D measurements, and 1 mm and 6.6° (ranging from 0.04 mm or 0.5° to 3 mm or 12.8°) between 2D and 3D measurements.

CONCLUSIONS

This study verified the feasibility of this detailed and standardized landmark localization protocol for assessing the periorbital morphology with 2D and 3D technologies. This protocol may work as a bridge communicating with all studies involving any of the three technologies in the future.

[Association between grip strength, rapid gait speed and cognition in people aged 50 and above in Shanghai during 2009-2010]

Objective: To investigate the association between grip strength, rapid gait speed and cognition in people aged 50 and above in Shanghai. Methods: Cross-sectional data was collected from the World Health Organization (WHO) study on global ageing and adult health (SAGE) wave 1 (2009-2010). A questionnaire survey was conducted among 8 643 participants aged 50 years old and above selected by using multistage random cluster sampling strategies in Shanghai. Factor analysis was applied to evaluate and generate cognitive function overall score.Association between grip strength, rapid gait speed and cognition was examined by a two-level hierarchical linear model. Results: A total of 8 175 participants were included in this study, who were (62.9±9.7) years old, including 3 782 (46.3%) males. The average grip strength and rapid gait speed of participants were (27.46±12.01) kg and (1.44±0.43) m/s respectively. The average scores of verbal recall (VR), verbal fluency (VF), forward digit span (FDS), backward digit span (BDS) and total cognitive scores were (5.72±0.09), (12.67±0.35), (6.84±0.10), (4.32±0.14) and (60.50±0.95) respectively. Grip strength was positively associated with VR, VF, FDS, BDS and overall cognition (standardized β=0.036, 0.079, 0.042, 0.046 and 0.043 respectively, P<0.05), and rapid gait speed was also positively associated with VR, VF and overall cognition (standardized β=0.040, 0.031, 0.039 respectively, P<0.05) after adjusted for age, sex, residence, education level, marital status, household income, co-morbidity of chronic conditions, BMI, drinking, smoking, fruits, vegetables intake and physical activities. Conclusion: Grip strength and rapid gait speed are both positively associated with cognitive function of people aged 50 and above, which would be indicators to evaluate their cognition.

Revision of Chinese Phorocardius species (Coleoptera, Elateridae, Cardiophorinae)

The Chinese species of Phorocardius Fleutiaux, 1931 have been studied and six species are described as new: P. alterlineatus Ruan & Douglas, sp. nov.; P. flavistriolatus Ruan & Douglas, sp. nov.; P. minutus Ruan & Douglas, sp. nov.; P. rufiposterus Ruan & Douglas, sp. nov.; P. yunnanensis Ruan & Douglas, sp. nov.; and P. zhiweii Ruan, Douglas & Qiu, sp. nov. Lectotypes are designated for Cardiophorus comptus Candèze, 1860, Cardiophorus contemptus Candèze, 1860, Phorocardius magnus Fleutiaux, 1931, and Cardiophorus manuleatus Candèze, 1888. The holotype is identified for Cardiophorus yanagiharae Miwa, 1927. Phorocardius florentini (Fleutiaux, 1895) and P. manuleatus (Candèze, 1888) are newly reported from China; P. comptus (Candèze, 1860) is excluded from the Chinese fauna. A key to the 11 Phorocardius species known from China is given. Phorocardius is newly recorded from deep within the Palearctic Region. The procoxal cavities of P. rufiposterus Ruan & Douglas, sp. nov. are closed, which is different from all other species of Phorocardius. An annotated checklist of the 21 Phorocardius species of the world is provided. Additionally, Phorocardius contemptus (Candèze, 1860), comb. nov. is transferred from Cardiophorus to Phorocardius; four species are transferred from Phorocardius to Displatynychus: Displatynychus bombycinus (Candèze, 1895), comb. nov., Displatynychus pakistanicus (Platia & Ahmed, 2016), comb. nov., Displatynychus sobrinus (Laporte, 1840), comb. nov., and Displatynychus tibialis (Platia & Ahmed, 2016), comb. nov.

Stillbirths in China: a nationwide survey

Objective

To estimate a stillbirth rate at 24 or more gestational weeks in 2015–2016 and to explore potentially preventable causes in China.

Design

A multi‐centre cross‐sectional study.

Setting

Ninety‐six hospitals distributed in 24 (of 34) provinces in China.

Population

A total of 75 132 births at 24 completed weeks of gestation or more.

Methods

COX Proportional Hazard Models were performed to examine risk factors for antepartum and intrapartum stillbirths. Population attributable risk percentage was calculated for major risk factors. Correspondence analysis was used to explore region‐specific risk factors for stillbirths.

Main outcome measures

Stillbirth rate and risk factors for stillbirth.

Results

A total of 75 132 births including 949 stillbirths were used for the final analysis, giving a weighted stillbirth rate of 13.2 per 1000 births (95% CI 7.9–18.5). Small for gestational age (SGA) and pre‐eclampsia/eclampsia increased antepartum stillbirths by 26.2% and 11.7%, respectively. Fetal anomalies increased antepartum and intrapartum stillbirths by 17.9% and 7.4%, respectively. Overall, 31.4% of all stillbirths were potentially preventable. Advanced maternal age, pre‐pregnant obesity, chronic hypertension and diabetes mellitus were important risk factors in East China; low education and SGA were major risk factors in Northwest, Southwest, Northeast and South China; and pre‐eclampsia/eclampsia and intrapartum complications were significant risk factors in Central China.

Conclusions

The prevalence of stillbirth was 13.2 per 1000 births in China in 2015–2016. Nearly one‐third of all stillbirths may be preventable. Strategies based on regional characteristics should be considered to reduce further the burden of stillbirths in China.

Tweetable abstract

The stillbirth rate was 13.2 per 1000 births in China in 2015–2016 and nearly one‐third of all stillbirths may be preventable.

The stillbirth rate was 13.2 per 1000 births in China in 2015–2016 and nearly one‐third of all stillbirths may be preventable.

The Biology and Immature Stages of the Moss-Eating Flea Beetle Cangshanaltica fuanensis sp. nov. (Coleoptera, Chrysomelidae, Galerucinae, Alticini), with Description of a Fan-Driven High-Power Berlese Funnel

The biology of the moss and leaf litter inhabiting flea beetles is poorly understood. In this study, a new species of moss-eating flea beetles Cangshanaltica fuanensis sp. nov. is described; the morphology of adult and immature stages is examined and illustrated. Its life history and biology are studied. The remarkable and unique biological features are revealed: (1) females deposit one large egg at a time, egg length equals 0.4-0.5 times the female body length, these are unusual in Chrysomelidae; (2) females have only two ovarioles on each side of the ovary, which has not been reported in other Chrysomelidae species; (3) females lay and hide each egg under a spoon-shaped moss leaf; (4) cannibalism of a second instar larva on an egg was observed. Both adults and larvae feed on moss and are polyphagous; their feces mainly consist of un-digested moss fragments; high humidity is essential for the survival of eggs and larvae and expedites the hatching. In addition, a modified fan-driven Berlese funnel is designed for faster extraction of moss inhabiting flea beetles. This device could also be used for collecting other ground-dwelling arthropods. Its working diagram is illustrated and described.

A141 ENDOSCOPIST PROCEDURAL VOLUME AND COLONOSCOPY OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background

In addition to monitoring adverse events (AEs) and post-colonoscopy colorectal cancers (PCCRC), several indicators are used to assess the overall quality of colonoscopy performance, including adenoma detection rate (ADR) and cecal intubation rate (CIR). It is unclear whether there is an association between an endoscopist’s annual colonoscopy volumes and ADR, CIR, AEs or PCCRC.

Aims

We performed a systematic review and meta-analysis to determine whether there is an association between annual colonoscopy volume and colonoscopy quality indicators, or between annual volume and colonoscopy outcomes.

Methods

A comprehensive electronic search was performed through March of 2019 for any studies assessing the potential association between annual colonoscopy volume and outcomes, or quality indicators, including ADR, CIR, AEs or PCCRC. Pooled odds ratios (OR) were calculated using DerSimonian and Laird random effects models. Subgroup and sensitivity analyses were also performed to assess for any potential methodological or clinical factors associated with outcomes. These included dividing procedural volume into total procedures or screening procedures performed.

Results

Out of an initial 9,235 studies, 27 were included in our systematic review, representing 11,276,244 colonoscopies performed by over 530 endoscopists. There was no association between procedural volume and ADR (OR 1.00, 95% confidence intervals, CI, 0.98 to 1.02 per additional 100 annual total colonoscopy procedures performed by an endoscopist). CIR was improved with each additional 100 annual colonoscopy procedures (OR 1.17, 95% CI 1.08 to 1.28). There was a trend toward decreased overall adverse events per additional 100 annual procedures that did not meet significance (OR 0.95, 95% CI 0.90 to 1.00), although there was a decreased incidence of colonic perforations with increasing colonoscopy volume. Figure 1 - Forest plots demonstrating the odds of A) detecting an adenoma, B) intubating the cecum, and C) incurring an overall or specific adverse event, per additional 100 annual procedures, for total and screening procedures.

Conclusions

In this meta-analysis, higher annual colonoscopy volumes correlated with higher CIR, but not with ADR or PCCRC. Trends toward lower AE rates were also demonstrated with higher volumes. All studies included in this review examined endoscopists performing above respective recommended minimum volume thresholds for their health region. Thus, data are lacking on endoscopists performing very low numbers or very high numbers of colonoscopies annually. Future studies should focus on measuring colonoscopy quality metrics and outcomes among these extreme performers to more clearly determine associations between annual volume and colonoscopy outcomes.

Funding Agencies

Alberta Health Services Digestive Health Strategic Care Network

The jumping mechanism of flea beetles (Coleoptera, Chrysomelidae, Alticini), its application to bionics and preliminary design for a robotic jumping leg

Flea beetles (Coleoptera, Chrysomelidae, Galerucinae, Alticini) are a hyperdiverse group of organisms with approximately 9900 species worldwide. In addition to walking as most insects do, nearly all the species of flea beetles have an ability to jump and this ability is commonly understood as one of the key adaptations responsible for its diversity. Our investigation of flea beetle jumping is based on high-speed filming, micro-CT scans and 3D reconstructions, and provides a mechanical description of the jump. We reveal that the flea beetle jumping mechanism is a catapult in nature and is enabled by a small structure in the hind femur called an 'elastic plate' which powers the explosive jump and protects other structures from potential injury. The explosive catapult jump of flea beetles involves a unique 'high-efficiency mechanism' and 'positive feedback mechanism'. As this catapult mechanism could inspire the design of bionic jumping limbs, we provide a preliminary design for a robotic jumping leg, which could be a resource for the bionics industry.

Revision of the Oriental Chaetocnema species (Coleoptera, Chrysomelidae, Galerucinae, Alticini)

The Oriental species of Chaetocnema Stephens, 1831 are revised. There are 85 valid species, including 19 new species: C. angustifrons sp. nov.; C. appendiculata sp. nov.; C. baoshanica sp. nov.; C. dapitanica sp. nov.; C. glabra sp. nov.; C. greenica sp. nov.; C. jinxiuensis sp. nov.; C. hongkongensis sp. nov.; C. latapronota sp. nov.; C. midimpunctata sp. nov.; C. nigrilata sp. nov.; C. parafusiformis sp. nov.; C. paragreenica sp. nov.; C. paraumesaoi sp. nov.; C. purerulea sp. nov.; C. reteimpunctata sp. nov.; C. sabahensis sp. nov.; C. subbasalis sp. nov.; C. trapezoida sp. nov.                Fifteen new synonyms are proposed: C. assamensis Scherer, 1969 (syn. nov.) = C. hainanensis Chen, 1932; C. birmanica Jacoby, 1892 (syn. nov.) = C. malayana Baly, 1877; C. ebenina Warchalowski, 1973 (syn. nov.) = C. yiei Kimoto, 1970; C. flavipennis Medvedev, 1996 (syn. nov.) = C. granulicollis Jacoby, 1896; C. harita Maulik, 1926 (syn. nov.) = C. westwoodi Baly, 1877; C. himalayana Medvedev, 1993 (syn. nov.) = C. melonae Chen, 1934; C. kwangsiensis Chen, 1939 (syn. nov.) = C. hainanensis Chen, 1932; C. loriae Jacoby, 1905 (syn. nov.) = C. nigrica Motschulsky, 1858; C. nepalensis Scherer, 1969 (syn. nov.) = C. bella Baly, 1877; C. nitens Baly, 1877 (syn. nov.) = C. nigrica Motschulsky, 1858; C. placida Jacoby, 1896 (syn. nov.) = C. bella Baly 1877; C. shanensis Bryant, 1939 (syn. nov.) = C. bella Baly 1877; C. subcostata Jacoby, 1889 (syn. nov.) = C. wallacei Baly, 1877; C. vietnamica Chen Wang, 1980 (syn. nov.) = C. modigliani Jacoby, 1896; C. vietnamica Medvedev, 2009 (syn. nov.) = C. wallacei Baly, 1877.                C. vietnamica Medvedev, 2001 is a new junior homonym of C. vietnamica Chen Wang, 1980.                C. melonae Chen, 1934 status restored and resurrected from synonymy with C. duvivieri Jacoby, 1892 in Medvedev, 2001: 613. Two subspecies are raised to species level: C. taiwanensis Chûjô, 1965 new status for C. tonkinensis taiwanensis Chûjô, 1965 and C. yunnanica Heikertinger, 1951 new status for C. discreta yunnanica Heikertinger, 1951.                Lectotypes are designated for 25 species: C. minuta Jacoby, 1896; C. granulicollis Jacoby, 1896; C. kwangsiensis Chen, 1939; C. longipunctata Maulik, 1926; C. montivaga Maulik, 1926; C. basalis Baly, 1877; C. parvula Baly, 1877; C. nitens Baly, 1877; C. geniculata Jacoby, 1896; C. simplicifrons (Baly, 1876); C. sticta Maulik, 1926; C. sumatrana Jacoby, 1896; C. wallacei Baly, 1877; C. alticola Maulik, 1926; C. belli Jacoby 1904; C. cognata Baly, 1877; C. squarrosa Baly, 1877; C. concinnipennis Baly, 1877; C. malayana Baly, 1877; C. birmanica Jacoby, 1892; C. merguiensis Bryant, 1941; C. pusaensis Maulik, 1926; C. singala Maulik, 1926; C. westwoodi Baly, 1877; C. harita Maulik, 1926.

[Association between edentulism and cognition among people aged 50 and over]

Objective: To investigate the association between edentulism and cognition in people aged 50 and over in China. Methods: Cross-sectional data was collected from the first wave of World Health Organization Study on global AGEing and adult health in China, among people aged 50 and over in China. A comprehensive cognitive test was used to assess cognitive functions, including verbal recall (VR), verbal fluency (VF), forward digit span (FDS) and backward digit span (BDS) among the subjects. Association between edentulism and cognition was examined by a two-level (individual level and community level) linear model. Results: A total of 12 843 individuals aged 50 years and over were included for analysis, with an average age of (63.0±9.3) years. The overall prevalence of edentulism was 11.0%. The edentulous adults had lower mean scores of VR (4.55), VF (10.88), FDS (6.25), BDS (2.96) and overall cognition (49.15) (P<0.001). Edentulism was negatively associated with VR (β=-0.216, 95%CI: -0.370 - -0.062), FDS (β=-0.186, 95%CI: -0.293 - -0.078) and overall cognition (β=-1.703, 95%CI: -3.025 - -0.381) after adjusted for age, sex, residence, education level, marital status, household income, co-morbidity of chronic conditions, BMI, smoking and drinking alcohol. Conclusion: Edentulism was related with lower cognition level in people aged 50 and over in China.

[Association between daily sedentary time and frailty among people aged 50 years and over]

Objective: To investigate the association between daily sedentary time and frailty among people aged 50 years and over. Methods: Cross-sectional data was collected from the first wave of World Health Organization Study on global AGEing and adult health in China. A two-level (individual level and community level) logistic model was performed to identify the association between daily sedentary time and frailty. The dose-response relationship between them was analyzed by restrictive cubic spline curve. Results: A total of 13 175 individuals aged 50 years and over were included for analysis. A positive association between daily sedentary time and frailty was noticed, both in urban (OR=1.22, 95%CI: 1.17-1.27) or rural areas (OR=1.11, 95%CI: 1.05-1.18) under study. The dose-response curve showed that daily sedentary time and frailty might present an approximate linear relationship. Conclusion: Results from this study showed significant association exsited between daily sedentary time and frailty, approximately with a linear dose-response relationship.

[Association between frailty and sleep duration among people aged 50 years and over]

Objective: To investigate the association between sleep duration and frailty among people aged 50 years and over. Methods: Cross-sectional data was collected from the first wave of World Health Organization Study on global AGEing and adult health in China. Frailty index was constructed on the proportion of deficits, out of the 40 variables. A two-level (individual level and community level) linear model was performed to identify the related factors on frailty. All the models were stratified by age, gender, residence (urban/rural). Restricted cubic spline was performed to graphically evaluate the dose-response association between self-reported sleep duration and frailty. Results: A total of 13 175 individuals aged 50 years and over participated in this study. Without adjusting on any confounding factors, shorter or longer sleep duration significantly increased the risk of weakness compared with normal sleep time (OR=2.05, 95%CI: 1.71-2.44; OR=1.35, 95%CI: 1.12-1.63). After adjusting for confounding factors such as gender, age, residence, education, family assets, vegetable, smoking, drinking and physical activity, a positive association between short sleep duration and frailty was noticed compared with normal sleep time (aOR=1.60, 95%CI: 1.27-2.01). The results of stratified analysis on sex, age and urban and rural areas showed that, after adjusting for gender, age, residence, education level, family assets, intake of vegetables and fruits, smoking, drinking and physical activity, only shorter sleep duration was positively correlated with the risk of weakness. In addition, among people aged 65 years and over, adjusted for confounding factors, the risk of weakness increased by 91%, compared with normal sleep time (aOR=1.91, 95%CI: 1.46-2.49). The dose-response curve also showed that the sleep duration and frailty present an approximate "U" shaped relationship. Conclusion: Short sleep duration might be associated with frailty.

[Association between low handgrip strength and air pollution among people aged 50 years and over]

Objective: To examine the association between long-term exposure to ambient PM(2.5) combined with indoor air pollution and handgrip strength among people aged 50 and over. Methods: Data were from the first wave of World Health Organization Study on global AGEing and adult health in China. Ambient annual concentration of PM(2.5) was estimated by using the satellite data we also investigated the use of fuels and chimneys as indoor air pollution. A two-level (individual level and community level) linear model was applied to examine the association between long-term exposure to ambient PM(2.5) combined with indoor air pollution and the handgrip strength. Results: A total of 13 175 individuals aged 50 years and over were included for analysis. The handgrip strength was (26.67±0.54) kg. Ambient PM(2.5) was found to be significantly associated with the risk of decreased handgrip strength. Outdoor PM(2.5) concentration was negatively correlated with handgrip strength (β=-0.23, 95%CI: -0.31 - -0.14) decrease in handgrip strength after adjusting for gender, age, residence, education, household assets, intake of vegetables and fruits, smoking and drinking, physical activity. In rural area, compared to those who used solid fuel, use of clean fuel increased (β=1.41, 95%CI: 0.36-2.46) handgrip strength. But in urban area, we did not find any statistically significant association between the use of clean fuel and handgrip strength (β=0.19, 95%CI: -0.95-1.32). Conclusion: This study found that long-term exposure to ambient PM(2.5) combined with indoor air pollution was significantly associated with low handgrip strength among people aged 50 years and over, this suggested that ambient PM(2.5) might serve as one of the risk factors for low physical function seen in the people aged 50 years and over.

[Project profile: Study on global AGEing and adult health in China]

With accelerating and rapid ageing in China, there is an urgent need to collect reliable, valid and cross-nationally comparable data on health in the elderly to provide basis for richer and empirical analysis on the changing health over one's life course and compression of morbidity. To meet the demands of this growing special population, planning and preparing on related social protection mechanisms (health and pension systems) should also based on evidence-based decision-making process. Based on long-term follow-up, large scale cohort study is indispensible for the etiology of common chronic diseases and disabling conditions. This study aims to introduce the background, project objectives, contents, baseline characteristics, strength and weakness as well as prospect, related to the Study on global AGEing and adult health in China.

A review of the genus Lankaphthona Medvedev, 2001, with comments on the modified phallobase and the unique abdominal appendage of L. binotata (Baly) (Coleoptera, Chrysomelidae, Galerucinae, Alticini)

The flea beetle genus Lankaphthona Medvedev, 2001 is redescribed and a new species L.yunnantarsellasp. nov. Ruan, Konstantinov & Prathapan is described. Longitarsella Medvedev, 2009, syn. nov. and Philotarsa Medvedev, 2009, syn. nov. are newly synonymized with Lankaphthona. Philotarsalaosica Medvedev, 2009, syn. nov. is synonymized with Lankaphthonaphuketensis (Gruev, 1989). The following new combinations are proposed: Lankaphthonabinotata (Baly, 1876), comb. nov.; Lankaphthonacostata (Medvedev, 2016), comb. nov.; Lankaphthonacyanipennis (Medvedev, 2017), comb. nov.; Lankaphthonanigronotata (Jacoby, 1896), comb. nov.; Lankaphthonanotatipennis (Medvedev, 2009), comb. nov.; and Lankaphthonaphuketensis (Gruev, 1989), comb. nov., status restored. A highly specialized spoon-shaped ‘appendage’ is discovered on the first abdominal ventrite of males of Lankaphthonabinotata. Aedeagus of the same species has aberrant sheath-shaped phallobase encircling the median lobe. Morphology and possible function of these structures are discussed. Menispermaceae are newly reported as the host plants of the genus.

Importance of inpatient hypoglycaemia: impact, prediction and prevention

Hypoglycaemia is a key barrier to achieving euglycaemic control in people who are hospitalized. Inpatient hypoglycaemia has been linked to adverse clinical outcomes, including mortality and longer stay in hospital. A number of studies have applied mathematical tools and statistical models to predict inpatient hypoglycaemia and identify factors that may result in hypoglycaemic events. Several different approaches have been tested to prevent inpatient hypoglycaemia. These can be categorized as human intervention, computerized methods or application of medical devices. In this review we provide an overview of the epidemiology of inpatient hypoglycaemia and its impact on patients and hospitals. We also discuss the existing methodology used to predict inpatient hypoglycaemia and the limited number of trials performed to prevent inpatient hypoglycaemia. The review highlights the urgent need for evidence-based methods to reduce inpatient hypoglycaemia.

Geometric morphometric analysis of the pronotum and elytron in stag beetles: insight into its diversity and evolution

Stag beetles (Coleoptera, Scarabaeoidea, Lucanidae) have received extensive attention from researchers in behavioral ecology and evolutionary biology. There have been no previous quantitative analyses, particularly using a geometric morphometric approach based on a large sample of data, to shed light on the morphological diversity and evolution of Lucanidae. Thoracic adaptation and ecological differentiation are intimately related, and the pronotum bears important muscles and supports the locomotion of prothoracic legs. The elytron is an autapomorphy of the Coleoptera. To reconstruct and visualize the patterns of evolutionary diversification and phylogenetic history of shape change, an ancestral groundplan can be reconstructed by mapping geometric morphometric data onto a phylogenetic tree. In this study, the morphologies of the pronotum and elytron in 1303 stag beetles (Lucanidae), including approximately 99.2% of all globally described species, were examined, thus revealing several aspects of morphological diversity and evolution. First, on the basis of geometric morphometric analysis, we found significant morphological differences in the pronotum or elytron between any two Lucanidae subfamilies. And we subsequently reconstructed the ancestral groundplans of the two structures in stag beetles and compared them with those of extant species (through cladistic and geometric morphometric methods). The ancestral groundplan of Lucanidae was found to be most similar to extant Nicagini in both the pronotum and elytron, according to Mahalanobis distances. Furthermore, we analyzed species richness and morphological diversity of stag beetles and the relationships between them and found that the two parameters were not always correlated. Aesalinae was found to be the most diverse subfamily in both the pronotum and elytron, despite its poor species richness, and the diversity of the pronotum or elytron was not superior in Lucaninae, despite its high species richness. Our study provides insights into the morphological variations and evolutionary history of the pronotum and elytron in four subfamilies of stag beetles, and it illuminates the relationship between morphological diversity and species richness. Intriguingly, our analysis indicates that morphological diversity and species richness are not always correlated. These findings may stimulate further studies in this field.

Description of two new species of Dima Charpentier, 1825 from China (Coleoptera: Elateridae: Dendrometrinae)

Dima guizhouensis Ruan, Kundrata Qiu sp. nov. and Dima xiaolongi Ruan, Kundrata Qiu sp. nov. are described from Guizhou and Hunan Provinces in China, respectively. Both species are easily distinguishable from most of their congeners by having a strongly convex pronotum and relatively long elytra with carinate interstria VI. The only superficially similar species is D. tianmuensis Qiu Kundrata in Qiu et al. (2018) from Zhejiang Province. Habitus and main diagnostic characters are figured for both new species, and their systematic placement is discussed. The discovery of these species brings the total number of Dima species in China to 13.

[Subjective well-being feelings and related factors in people aged 50 years or older in Shanghai: Based on Day Reconstruction Method]

Objective: To evaluate the subjective well-being feelings of people aged ≥50 years in Shanghai by using the Day Reconstruction Method (DRM) and explore the related factors. Methods: A cross-sectional survey was conducted from October 2009 to June 2010 among people aged ≥50 years selected through multistage random cluster sampling in Shanghai. DRM was used to assess participants' subjective well-being by net effect and U-index. Univariate and multivariate linear regression models were used to explore the related factors. Results: A total of 8 075 participants were included, with average age of 63.1 years. The mean net effect value was 1.24 (95%CI:1.15-1.33), and the mean U-index was 1.55% (95%CI:1.10%-1.99%). After adjusted for demographic factors, univariate liner regression model indicated that age, education level, marital status, family wealth, residence, self-rated health status, WHODAS score and prevalence of chronic disease were associated with subjective well-being, and multivariate liner regression model indicated that higher WHODAS score was associated with lower net effect value (P<0.05). Conclusion: The subjective well-being feelings of people aged ≥50 years in Shanghai might be associated with age, education level, marital status, family wealth, residence, self-rated health status and WHODAS score. Enhanced social support and appropriate social security system might facilitate the improvement of the subjective well-being of the elderly.

Structure of the Ambrosia Beetle (Coleoptera: Curculionidae) Mycangia Revealed Through Micro-Computed Tomography

Ambrosia beetles (Coleoptera: Curculionidae: Scolytinae and Platypodinae) rely on a symbiosis with fungi for their nutrition. Symbiotic fungi are preserved and transported in specialized storage structures called mycangia. Although pivotal in the symbiosis, mycangia have been notoriously difficult to study, given their minute size and membranous structure. We compared the application of novel visualization methods for the study of mycangia, namely micro-computed tomography (micro-CT) and laser ablation tomography (LATscan) with traditional paraffin sectioning. Micro-CT scanning has shown the greatest promise in new organ discovery, while sectioning remains the only method with sufficient resolution for cellular visualization. All three common types of mycangia (oral, mesonotal, and pronotal) were successfully visualized and presented for different species of ambrosia beetles: Ambrosiodmus minor (Stebbing) 1909, Euplatypus compositus (Say) 1823, Premnobius cavipennis Eichhoff 1878, Scolytoplatypus raja Blandford 1893, Xylosandrus crassiusculus (Motschulsky) 1866 and X. amputatus (Blandford) 1894. A reconstruction of the mycangium and the surrounding musculature in X. amputatus is also presented. The advantages of micro-CT compared to the previously commonly used microtome sectioning include the easy visualization and recording of three-dimensional structures, their position in reference to other internal structures, the ability to distinguish natural aberrations from technical artifacts, and the unprecedented visualizations of the anatomic context of mycangia enabled by the integrated software.

Human tissue kallikrein 1 ameliorates erectile function via modulation of macroautophagy in aged transgenic rats

Previously, we have demonstrated that human tissue kallikrein 1 (hKLK1) improves age-related erectile dysfunction (ED). Autophagy has been implicated in age-related diseases, including ED. However, the molecular mechanisms underlying hKLK1-mediated amelioration of age-related ED via regulation of autophagy remains unknown. To explore the potential mechanism, male wild-type Sprague-Dawley rats (WTR) and transgenic rats harboring human KLK1 (TGR) were bred till 4 or 18 months of age and divided into three groups: young WTR (yWTR) as the control group, aged WTR (aWTR) group, and aged TGR (aTGR) group. The erectile function of each rat was evaluated using cavernous nerve electrostimulation. The ratio of intracavernous pressure/mean arterial pressure (ICP/MAP) and total ICP were also measured. Western blotting, immunohistochemistry, and transmission electron microscopy were performed to detect the levels of autophagy. The expression levels of related signaling pathways were determined by western blotting and immunohistochemistry. We found that hKLK1 improved the impaired erectile function of aged rats. Compared to the yWTR and aTGR groups, the aWTR group showed reduced smooth muscle/collagen ratio, fewer autophagosomes, and lower expression of Beclin 1 and LC3-II, which indicate impaired smooth muscle function and low level of autophagy in the smooth muscle cells. Moreover, the PI3K/Akt/mTOR signaling pathway, which is considered to be a negative regulator of autophagy, was upregulated in the aWTR group. hKLK1 may partially restore erectile function in aged transgenic rats by upregulating protective autophagy via the PI3K/Akt/mTOR pathway. These observations indicate that hKLK1 is a potential gene therapy candidate for age-related ED.

[Incidence of fall related injury in people aged 50 and above and risk factors in 8 provinces in China: a cross-sectional study]

Objective: To estimate the incidence and distribution characteristics of fall related injury in people aged ≥50 years in 8 provinces in China and related physiological, psychological and social risk factors. Methods: Cross-sectional data were collected from adults aged ≥50 years participating in the World Health Organization (WHO) study on global ageing and adult health (SAGE) round 1 in China. Two-level hierarchical logistic model was used to identify the related factors for fall-related injury. All the models were stratified by living area (urban/rural). Results: Estimated incidence of fall related injury (road traffic injury was not included) was 3.2%. Ageing and multiple chronic conditions (OR=2.55, 95%CI: 1.41-4.64) was significantly associated with the incidence of fall related injury in urban area. In rural area, depression (OR=4.33, 95% CI: 2.52-7.42) and multiple chronic conditions (OR=2.46, 95%CI: 1.37-4.41) were associated with the incidence of fall related injury. Conclusions: This study estimated the incidence of fall related injury in adults aged ≥50 years in 8 provinces in China. A significant association between multiple chronic conditions and fall related injury were found in both urban and rural residents. Targeted measures should be taken for the prevention and control of chronic diseases in elderly population.

[Associations of obesity and physical activity with cognition in people aged 50 and above in Shanghai]

Objective: To investigate the associations of obesity and physical activity with cognition in the elderly. Methods: A cross-sectional survey was conducted from October 2009 to June 2010 among people aged ≥50 years selected through multistage random cluster sampling in Shanghai. The subjects' body weight, body height, waist circumference and hip circumference were measured to calculate body mass index (BMI) and waist-hip ratio (WHR), and the data on self-reported physical activity level were collected through questionnaire survey. A comprehensive battery of cognitive tests was conducted to assess subjects' cognitive functions, including verbal recall, forward digit span (FDS), backward digit span (BDS), and verbal fluency (VF). General linear model was used to examine the associations of BMI, WHR and physical activity with cognition. Results: A total of 7 913 participants were included, with a median age of 60 years. Age, sex, education level, income level, BMI, WHR and physical activity level were significantly associated with cognitive scores in univariate analysis. After adjusted for age, sex, education level and income level, BMI was no longer significantly associated with cognitive scores in all cognitive functions (all P>0.01). WHR was significantly associated with VF score (P<0.01). Abdominally obese participants had lower VF score than non-abdominally obese participants (P<0.01). Physical activity level was significantly associated with all cognitive functions (P<0.01). Compared with participants with moderate physical activity level, participants with low physical activity level had lower scores in all cognitive functions (P<0.01). Conclusion: Abdominal obesity and low physical activity level were negatively associated with cognition level in the elderly, suggesting that waist circumference control and physical activity might help maintain cognition in the elderly.

[Pollution characteristics and health risk assessment of heavy metals in PM(2.5) in Lanzhou]

Objective: To understand the pollution characteristics and assess the pollution health risks of heavy metals in atmospheric PM(2.5) in Lanzhou. Methods: According to the regional characteristics of air pollution and industrial distribution characteristics in Lanzhou, atmospheric PM(2.5) was sampled monthly in Chengguan and Xigu Districts from January, 2015 to December, 2016. Detected the concentration of PM(2.5) and 12 kinds of elements (Sb, Al, As, Be, Cd, Cr, Hg, Pb, Mn, Ni, Se and Tl) by weighing method and inductively coupled plasma mass spectrometry. Enrichment factor and geo-accumulation index were used to describe the pollution characteristics, while health risk assessment was conducted using the recommended United States Environmental Protection Agency (USA EPA) model. The health risks of non-carcinogens were evaluated by non-cancer hazard quotient (HQ), the non-carcinogenic risk was considered to be negligible when HQ<1, HQ>1 meant a health risk. With a single contaminant cancer Risk value to evaluate the health risks of carcinogens, when the Risk value between 10(-6) to10(-4) as an acceptable level. Results: The daily average concentrations of PM(2.5) was 83.0 μg/m(3), 77.0 μg/m(3) in Chengguan and Xigu Districts, respectively, during the sampling periods, and the concentration of PM(2.5) in winter/spring was higher than summer/fall in both districts. The concentration of Al in PM(2.5) was the highest and other elements in descending order: Pb, Mn, As, Sb/Cd, Tl in both districts. Enrichment factor results showed that Al and Mn were mainly affected by natural factors, the rest of five elements were all typical man-made pollution elements and according to geo-accumulation index pollution level of Cd was the strongest in the winter. The results of health risk assessment showed that Mn had the highest non-cancer risks (HQ>1) and affected the health of the children seriously. HQ reached up to 2.44 and 1.79 in Chengguan and Xigu Districts, respectively. Pb, As, Sb, Cd had slight health impact (HQ<1), could be negligible. The cancer risks range of As, Cr were 6.33×10(-6) to 6.46×10(-5) between the acceptable level of risk (10(-6) to 10(-4)), which indicated that As and Cd had potential cancer-risks. Conclusions: The pollution level of atmospheric PM(2.5) and the heavy metals in it was still grim;the non-cancer risks caused by multiple metals on children deserved attention. Although the cancer risks of As and Cd were between the acceptable level of risk, the potential cancer risk still shall not be ignored.

Visualisation of insect tracheal systems by lactic acid immersion

The endeavours to reveal the tracheal system of insects and some arachnids has a long history. The traditional way to observe a tracheal system in an insect body is by utilising the glycerin immersion method. In this study, we developed the lactic acid immersion method, which reveals a more complete tracheal system. By mounting various types of live specimens or body parts directly into lactic acid, multiple intact and complex tracheal systems were clearly visualised. The lactic acid immersion contributed to revealing tracheal systems by penetrating body tissue while reserving enough time for observation before the penetration of the tracheae. Preliminary comparisons were conducted between lactic acid and other mediae, including glycerin. It turned out that lactic acid immersion provides better details and more distinct structures. In our test, the optimal time for observing the tracheal system was 10-25 min after the organism was immersed in lactic acid.

Effects of Talaromyces marneffei infection on mortality of HIV/AIDS patients in southern China: a retrospective cohort study

OBJECTIVE

Talaromyces marneffei is an opportunistic infection with high morbidity among human immunodeficiency virus (HIV)/AIDS patients in Southeast Asia and southern China. Its effects on mortality in HIV/AIDS patients has not been clearly elucidated.

METHODS

We conducted a retrospective cohort study of hospitalized HIV-infected individuals at the Fourth People's Hospital of Nanning, Guangxi, China during 2012-2015. Kaplan-Meier analyses were used to calculate the cumulative mortality. Cox proportional hazard models and 1:1 propensity score matching (PSM) were used to evaluate the effects of T. marneffei infection on mortality of HIV/AIDS patients.

RESULTS

In total, 6791 HIV/AIDS patients were included, 1093 of them (16.1%) with documented T. marneffei co-infection. The mortality of T. marneffei-infected patients (25.0 per 100 person-months, 95% CI 21.5-26.7) was the highest among all AIDS-associated complications and was significantly higher than that of T. marneffei-uninfected HIV/AIDS patients (13.8 per 100 person-months, 95% CI 12.5-15.1; adjusted hazard ratio (AHR) 1.80, 95% CI 1.48-2.16). The results using PSM were similar (AHR 4.52 95% CI 2.43-8.42). The mortality of T. marneffei-infected patients was also significantly higher than that of patients without any complications. When stratified by demographic characteristics, T. marneffei infection has higher mortality risk in all stratifications. Co-infection with T. marneffei carries a higher mortality risk in patients at any CD4⁺ T-cell count.

CONCLUSIONS

Talaromyces marneffei infection is commonly found in hospitalized HIV/AIDS patients in southern China and was associated with a higher mortality rate than most HIV-associated complications. These results highlight the need for improved diagnosis, treatment and prevention of infection by this neglected fungal pathogen in southern China.

Bolusing frequency and amount impacts glucose control during hybrid closed-loop

AIM

To compare bolus insulin delivery patterns during closed-loop home studies in adults with suboptimally [HbA1c 58-86 mmol/mol (7.5%-10%)] and well-controlled [58 mmol/mol (< 7.5%)] Type 1 diabetes.

METHODS

Retrospective analysis of daytime and night-time insulin delivery during home use of closed-loop over 4 weeks. Daytime and night-time controller effort, defined as amount of insulin delivered by closed-loop relative to usual basal insulin delivery, and daytime bolus effort, defined as total bolus insulin delivery relative to total daytime insulin delivery were compared between both cohorts. Correlation analysis was performed between individual bolus behaviour (bolus effort and frequency) and daytime controller efforts, and proportion of time spent within and below sensor glucose target range.

RESULTS

Individuals with suboptimally controlled Type 1 diabetes had significantly lower bolus effort (P = 0.038) and daily bolus frequency (P < 0.001) compared with those with well-controlled diabetes. Controller effort during both daytime (P = 0.007) and night-time (P = 0.005) were significantly higher for those with suboptimally controlled Type 1 diabetes. Time when glucose was within the target range (3.9-10.0 mmol/L) during daytime correlated positively with bolus effort (r = 0.37, P = 0.016) and bolus frequency (r = 0.33, P = 0.037). Time when glucose was below the target range during daytime was comparable in both groups (P = 0.36), and did not correlate significantly with bolus effort (r = 0.28, P = 0.066) or bolus frequency (r = -0.21, P = 0.19).

CONCLUSION

More frequent bolusing and higher proportion of insulin delivered as bolus during hybrid closed-loop use correlated positively with time glucose was in target range. This emphasises the need for user input and educational support to benefit from this novel therapeutic modality.

Study of surgical treatment for elderly patients with head and neck cancer

The aim of this study was to evaluate the clinical results of surgery for head and neck cancer (HNC) in elderly patients and to determine whether surgery for elderly HNC patients is safe and what types of surgery result in the most favourable outcomes for this age group. The cases of 637 elderly patients who were diagnosed with HNC and underwent surgical treatment were studied retrospectively. Patient demographic characteristics and treatment data were extracted from the appropriate patient records and analysed. Age did not significantly predict postoperative complications or death rates. Flap reconstruction surgery had no significant association with necrosis, haemorrhage, infection, need for rescue treatment, or length of intensive care unit stay. Age was not a risk factor for surgical treatment of HNC in the elderly patients. Flap reconstruction should not be considered riskier for elderly patients. The treatment choice for elderly patients with HNC should be based on medical assessments but not on age.

Malectin gene polymorphisms promote cerebral palsy via M2-like macrophage polarization

The relationship between gene polymorphisms and the pathogenesis of cerebral palsy (CP) is uncovering recently. Here, we suggested that single nucleotide polymorphisms (SNPs) of MLEC gene might take part in the pathogenesis of CP. We genotyped and analyzed 6 SNP positions of MLEC gene in 916 CP patients and 957 healthy people, which are from the Chinese Han population. The results indicated significant associations between the risk of CP and rs10431386 [allele: P-value = .006, odds ratio (OR) = 1.587, 95% confidence interval (CI) = 1.198-1.967] and rs7964786 [allele: P-value = .005, OR = 1.956, 95% CI = 1.238-2.519] SNP positions of MLEC gene. Further investigations revealed that C alleles of rs10431386 and rs7964786 inhibit the expression of MLEC in blood of CP patients and macrophage cell line. in vitro experiments revealed that MLEC promotes M1 to M2 macrophage polarization. The results of in vitro studies suggest that C alleles of rs10431386 and rs7964786 on MLEC promotes CP by inhibiting M1 to M2 macrophage polarization. Generally, this work suggested the contribution of MLEC gene polymorphisms to the pathogenesis of CP.