Prevalence and influencing factors of chronic pain in middle-aged and older adults in China: results of a nationally representative survey

BackgroundWith China's rapidly aging population, chronic pain has become a major public health issue. This article aims at determining associations between chronic pain and multiple factors, including demographic characteristics, health status, and health service utilization of middle-aged and older adults in China.MethodsWe selected all the 19,829 respondents who were over 45 years old from the China Health and Aging Tracking Survey 2018 (CHARLS) as our study population. The key information in terms of the body pain, demographic characteristics, health status, behaviors and health services use was extracted and analyzed. Logistic regression model was used to determine the influencing factors of chronic pain.ResultsAnalysis revealed that 60.02% (9,257) of the data from this survey reported physical pain, with pain sites concentrated at the head (40.9%), lower back (62.2%) and knees (47.2%). Pain was positively associated with influencing factors for pain: being a female (OR = 2.10, 95% CI 1.90–2.33, p < 0.001), living in a western region (OR = 1.28, 95% CI 1.16–1.41, p < 0.001), living in a rural area (OR = 1.14, 95% CI 1.06–1.23, p < 0.001), smoked (OR = 1.26, 95% CI 1.14–1.38, p < 0.001), drank alcohol (OR = 1.16, 95% CI 1.06–1.26, p = 0.001), and had poor self-rated health (OR = 6.84, 95% CI 5.41–8.65, p < 0.001), had hearing problems (OR = 1.23, 95% CI 1.11–3.37, p < 0.001), were depressed (OR = 1.56, 95% CI 1.03–1.29, p < 0.001), had arthritis (OR = 2.21, 95% CI 2.02–2.41, p < 0.001), stomach disorders (OR = 1.69, 95% CI 1.55–1.85, p < 0.001), visited a Western medicine hospital (OR = 1.28, 95% CI 1.10–1.50, p = 0.002), and visits to other medical institutions (OR = 1.42, 95%CI 1.22–1.64, p < 0.001). On the other side, as a protective factor for pain, having nighttime sleep ≥7 h (OR = 0.74, 95%CI 0.68–0.80, p < 0.001) was negatively associated with pain.ConclusionPhysical pain affects many older adults. Women, regional, rural residents, smokers, alcohol drinkers, people with poor self-rated health, those having <7 h of sleep at night, those with hearing problems, depression, arthritis, stomach disorders, and people who visits Western hospitals or other medical institutions are at greater risk for pain and deserve the attention of health care providers and policy makers to focus on pain prevention and management in middle-aged and older adults. Future research studies should also focus on the impact of health literacy on pain prevention and management outcomes

Examining the impact of chronic diseases on activities of daily living of middle-aged and older adults aged 45 years and above in China: a nationally representative cohort study

BackgroundChina has by far one of the fastest-aging populations in the world. Increasing age is often accompanied by an increasing prevalence of chronic diseases and impaired Activities of Daily Living (ADL). The aim of this study was to analyze the effects of chronic diseases on ADL in Chinese middle-aged and older adults and to provide a scientific basis for delaying the impairment of ADL and prolonging the self-care life expectancy of middle-aged and older adults.MethodsThis investigation utilized the survey information of 10,096 middle-aged and older adults from the China Health and Aging Tracking Survey (CHARLS) of 2011 as baseline data, then followed up this cohort until 2018, and performed multifactorial analyses using Cox proportional risk models to explore the strength of the associations between chronic diseases and the risk of impaired ADL in middle-aged and older adults.ResultsAmong the middle-aged and older adult population, the presence of hypertension was associated with a 38% higher risk of impaired ADL compared to those without the condition (HR = 1.38,95% CI:1.24–1.54); the involvement of heart disease was associated with a 27% higher risk of impaired ADL compared to those without the condition (HR = 1.27,95% CI:1.10- 1.46); the existence of arthritis was associated with a 38% higher risk of impaired ADL in middle-aged and older adults compared to those without arthritis (HR = 1.38,95% CI:1.25–2.08); additionally, the risk of impaired ADL with one or ≥ 2 chronic diseases was increased by 34% (HR = 1.34, 95% CI:1.18–1.52) and 84% (HR = 1.84, 95% CI:1.63–2.08) in middle-aged and older adult individuals, respectively.ConclusionHypertension is a risk factor for impaired ADL at any age in the subjects of this study. Examining the association between the number of chronic diseases and impairment in activities of daily living, it was revealed that the risk of ADL impairment increased with the number of chronic diseases in both the middle-aged (45–59 years) and older adult (60–74 years) groups

An analysis of socioeconomic factors on multiple chronic conditions and its economic burden: evidence from the National Health Service Survey in Yunnan Province, China

BackgroundThe economic burden of multiple chronic conditions (MCCs) and its socio-economic influencing factors have widely raised public concerns. However, there are few large population-based studies on these problems in China. Our study aims at determining the economic burden of MCCs and associated factors specific to multimorbidity among middle-aged and older individuals.MethodsAs our study population, we extracted all 11,304 participants over 35 years old from the 2018 National Health Service Survey (NHSS) in Yunnan. Economic burden and socio-demographic characteristics were analyzed with descriptive statistics. Chi-square test and generalized estimating equations (GEE) regression models were used to identify influencing factors.ResultsThe prevalence of chronic diseases was 35.93% in 11,304 participants and the prevalence of MCCs increased with age, was 10.12%. Residents who lived in rural areas were more likely to report MCCs than those who lived in urban areas (adjusted OR = 1.347, 97.5% CI: 1.116–1.626). Ethnic minority groups were less likely to report MCCs than those of Han (OR = 0.752, 97.5% CI: 0.601–0.942). Overweight or obese people were more likely to report MCCs than people with normal weight (OR = 1.317, 97.5% CI: 1.099–1.579). The per capita expenses of 2 weeks’ illness, per capita hospitalization expenses, annual household income, annual household expenses, and annual household medical expenses of MCCs were ¥292.90 (±1427.80), ¥4804.22 (±11851.63), ¥51064.77 (±52158.76), ¥41933.50 (±39940.02) and ¥11724.94 (±11642.74), respectively. The per capita expenses of 2 weeks’ illness, per capita hospitalization expenses, annual household income, annual household cost, and annual household medical expenses of hypertensive co-diabetic patients were more compared to those with other three comorbidity modes.ConclusionThe prevalence of MCCs was relatively high among middle-aged and older individuals in Yunnan, China, which bought a heavy economic burden. This encourages policy makers and health providers to pay more attention to the behavioral/lifestyle factors, that contribute to multimorbidity to a great extent. Furthermore, health promotion and education in terms of MCCs need to be prioritized in Yunnan

A Wnt-Frz/Ror-Dsh Pathway Regulates Neurite Outgrowth in Caenorhabditis elegans

One of the challenges to understand the organization of the nervous system has been to determine how axon guidance molecules govern axon outgrowth. Through an unbiased genetic screen, we identified a conserved Wnt pathway which is crucial for anterior-posterior (A/P) outgrowth of neurites from RME head motor neurons in Caenorhabditis elegans. The pathway is composed of the Wnt ligand CWN-2, the Frizzled receptors CFZ-2 and MIG-1, the co-receptor CAM-1/Ror, and the downstream component Dishevelled/DSH-1. Among these, CWN-2 acts as a local attractive cue for neurite outgrowth, and its activity can be partially substituted with other Wnts, suggesting that spatial distribution plays a role in the functional specificity of Wnts. As a co-receptor, CAM-1 functions cell-autonomously in neurons and, together with CFZ-2 and MIG-1, transmits the Wnt signal to downstream effectors. Yeast two-hybrid screening identified DSH-1 as a binding partner for CAM-1, indicating that CAM-1 could facilitate CWN-2/Wnt signaling by its physical association with DSH-1. Our study reveals an important role of a Wnt-Frz/Ror-Dsh pathway in regulating neurite A/P outgrowth

Early Second-Trimester Serum MiRNA Profiling Predicts Gestational Diabetes Mellitus

BACKGROUND: Gestational diabetes mellitus (GDM) is one type of diabetes that presents during pregnancy and significantly increases the risk of a number of adverse consequences for the fetus and mother. The microRNAs (miRNA) have recently been demonstrated to abundantly and stably exist in serum and to be potentially disease-specific. However, no reported study investigates the associations between serum miRNA and GDM. METHODOLOGY/PRINCIPAL FINDINGS: We systematically used the TaqMan Low Density Array followed by individual quantitative reverse transcription polymerase chain reaction assays to screen miRNAs in serum collected at 16-19 gestational weeks. The expression levels of three miRNAs (miR-132, miR-29a and miR-222) were significantly decreased in GDM women with respect to the controls in similar gestational weeks in our discovery evaluation and internal validation, and two miRNAs (miR-29a and miR-222) were also consistently validated in two-centric external validation sample sets. In addition, the knockdown of miR-29a could increase Insulin-induced gene 1 (Insig1) expression level and subsequently the level of Phosphoenolpyruvate Carboxy Kinase2 (PCK2) in HepG2 cell lines. CONCLUSIONS/SIGNIFICANCE: Serum miRNAs are differentially expressed between GDM women and controls and could be candidate biomarkers for predicting GDM. The utility of miR-29a, miR-222 and miR-132 as serum-based non-invasive biomarkers warrants further evaluation and optimization

Fruit-Surface Flavonoid Accumulation in Tomato Is Controlled by a SlMYB12-Regulated Transcriptional Network

The cuticle covering plants' aerial surfaces is a unique structure that plays a key role in organ development and protection against diverse stress conditions. A detailed analysis of the tomato colorless-peel y mutant was carried out in the framework of studying the outer surface of reproductive organs. The y mutant peel lacks the yellow flavonoid pigment naringenin chalcone, which has been suggested to influence the characteristics and function of the cuticular layer. Large-scale metabolic and transcript profiling revealed broad effects on both primary and secondary metabolism, related mostly to the biosynthesis of phenylpropanoids, particularly flavonoids. These were not restricted to the fruit or to a specific stage of its development and indicated that the y mutant phenotype is due to a mutation in a regulatory gene. Indeed, expression analyses specified three R2R3-MYB–type transcription factors that were significantly down-regulated in the y mutant fruit peel. One of these, SlMYB12, was mapped to the genomic region on tomato chromosome 1 previously shown to harbor the y mutation. Identification of an additional mutant allele that co-segregates with the colorless-peel trait, specific down-regulation of SlMYB12 and rescue of the y phenotype by overexpression of SlMYB12 on the mutant background, confirmed that a lesion in this regulator underlies the y phenotype. Hence, this work provides novel insight to the study of fleshy fruit cuticular structure and paves the way for the elucidation of the regulatory network that controls flavonoid accumulation in tomato fruit cuticle

A note on the larva of Chalcophora japonica chinensis (Coleoptera, Buprestidae) based on morphological characters and molecular data

Larvae of Chalcophora japonica chinensis Schaufuss, 1879 were collected from within dead trunks in Hubei Province, China, in February 2019. These specimens created an opportunity to provide the first description of the larval stage of this subspecies; The larva is described and illustrated based on morphological characters and DNA barcoding

The larval, pupal and mitogenomic characteristics of Agrilus adelphinus Kerremans, 1895 (Coleoptera, Buprestidae) from China

In this study, the larva and pupa of Agrilus adelphinus are described and illustrated. DNA barcoding (COI gene) was used to associate the larval and pupal stages with adults based on the maximum-likelihood method. In the resulting phylogenetic tree, species from the same species-group were found to be clustered on a branch with high support value. To better understand A. adelphinus, the complete mitochondrial genome of this species was also sequenced and annotated. Comparing this genome to the known mitogenomes of Agrilus species, the newly sequenced genome is shorter, with 15,732 bp. However, its whole mitogenome composition and gene orientation were consistent with that of most species of Buprestidae. In the mitogenome of A. adelphinus, the ATGATAG sequence was observed between ATP8 and ATP6, which is ATGATAA in other insect mitogenomes. Leu2, Phe, Ile, Gly, and Ser2 were the five most frequently encoded amino acids. The results further prove that DNA barcoding can remove the limitation of traditional taxonomy which cannot identify to species all developmental stages. This study also provides valuable molecular and morphological data for species identification and phylogenetic analyses of the genus Agrilus

Impact of plaques in the left coronary artery on wall shear stress and pressure gradient in coronary side branches

In this study, we investigate plaques located at the left coronary bifurcation. We focus on the effect that the resulting changes in wall shear stress (WSS) and wall pressure stress gradient (WPSG) have on atherosclerotic progress in coronary artery disease. Coronary plaques were simulated and placed at the left main stem and the left anterior descending to produce >50% narrowing of the coronary lumen. Computational fluid dynamics analysis was carried out, simulating realistic physiological conditions that show the in vivo cardiac haemodynamic. WSS and WPSG in the left coronary artery were calculated and compared in the left coronary models, with and without the presence of plaques during cardiac cycles. Our results showed that WSS decreased while WPSG was increased in coronary side branches due to the presence of plaques. There is a direct correlation between coronary plaques and subsequent WSS and WPSG variations based on the bifurcation plaques simulated in the realistic coronary models

Underwater Holothurian Target-Detection Algorithm Based on Improved CenterNet and Scene Feature Fusion

Aiming at the common problems, such as noise pollution, low contrast, and color distortion in underwater images, and the characteristics of holothurian recognition, such as morphological ambiguity, high similarity with the background, and coexistence of special ecological scenes, this paper proposes an underwater holothurian target-detection algorithm (FA-CenterNet), based on improved CenterNet and scene feature fusion. First, to reduce the model’s occupancy of embedded device resources, we use EfficientNet-B3 as the backbone network to reduce the model’s Params and FLOPs. At the same time, EfficientNet-B3 increases the depth and width of the model, which improves the accuracy of the model. Then, we design an effective FPT (feature pyramid transformer) combination module to fully focus and mine the information on holothurian ecological scenarios of different scales and spaces (e.g., holothurian spines, reefs, and waterweeds are often present in the same scenario as holothurians). The co-existing scene information can be used as auxiliary features to detect holothurians, which can improve the detection ability of fuzzy and small-sized holothurians. Finally, we add the AFF module to realize the deep fusion of the shallow-detail and high-level semantic features of holothurians. The results show that the method presented in this paper yields better results on the 2020 CURPC underwater target-detection image dataset with an AP50 of 83.43%, Params of 15.90 M, and FLOPs of 25.12 G compared to other methods. In the underwater holothurian-detection task, this method improves the accuracy of detecting holothurians with fuzzy features, a small size, and dense scene. It also achieves a good balance between detection accuracy, Params, and FLOPs, and is suitable for underwater holothurian detection in most situations