Optimal Course of Statins for Patients With Aneurysmal Subarachnoid Hemorrhage: Is Longer Treatment Better? A Meta-Analysis of Randomized Controlled Trials

Statins are used in clinical practice to prevent from complications such as cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH). However, the efficacy and safety of statins are still controversial due to insufficient evidence from randomized controlled trials and inconsistent results of the existing studies. This meta-analysis aimed to systematically review the latest evidence on the time window and complications of statins in aSAH. The randomized controlled trials in the databases of The Cochrane Library, PubMed, Web of Science, Embase, CNKI, and Wanfang from January 2005 to April 2021 were searched and analyzed systematically. Data analysis was performed using Stata version 16.0. The fixed-effects model (M-H method) with effect size risk ratio (RR) was used for subgroups with homogeneity, and the random-effects model (D-L method) with effect size odds ratio (OR) was used for subgroups with heterogeneity. The primary outcomes were poor neurological prognosis and all-cause mortality, and the secondary outcomes were cerebral vasospasm (CVS) and statin-related complications. This study was registered with PROSPERO (International Prospective Register of Systematic Reviews; CRD42021247376). Nine studies comprising 1,464 patients were included. The Jadad score of the patients was 5–7. Meta-analysis showed that poor neurological prognosis was reduced in patients who took oral statins for 14 days (RR, 0.73 [0.55–0.97]; I2 = 0%). Surprisingly, the continuous use of statins for 21 days had no significant effect on neurological prognosis (RR, 1.04 [0.89–1.23]; I2 = 17%). Statins reduced CVS (OR, 0.51 [0.36–0.71]; I2 = 0%) but increased bacteremia (OR, 1.38 [1.01–1.89]; I2 = 0%). In conclusion, a short treatment course of statins over 2 weeks may improve neurological prognosis. Statins were associated with reduced CVS. Based on the pathophysiological characteristics of CVS and the evaluation of prognosis, 2 weeks could be the optimal time window for statin treatment in aSAH, although bacteremia may increase

Regional Differences in Disability and Its Influencing Factors among Middle-aged and Elderly People in East, Central and West Major Regions in China

Background The aging of our population and the intensification of major chronic disease problems will inevitably lead to an increase in the number of disabled people, resulting in increased pressure on social care and a heavier burden on the government and families for the elderly. At the same time, the unbalanced allocation of health resources will pose even more serious challenge to the medical treatment and nursing care of the disabled population. Objective To explore the differences of disability rate, disability degree and influencing factors among middle-aged and elderly people in eastern, central and western regions of China. Methods Data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) were analyzed from 2022-10-05 to 2023-01-13, and 19 170 middle-aged and elderly people aged 45 years and above were selected as the study subjects. Activities of daily living (ADL) and instrumental activities of daily living (IADL) scales were used to determine disability. The situation and degree of disability in middle-aged and elderly people were considered as dependent variables, and independent variables were selected from three aspects of general demographic characteristics, health evaluation and lifestyle according to CHARLS data questionnaire. Binary and multivariate Logistic regression analyses were conducted to analyze the factors affecting the disability and degree of disability of middle-aged and elderly people in eastern, central and western regions of China. Results Comparison of the rate and degree of disability among middle-aged and elderly people in eastern, central and western regions showed statistically significant differences (χ2=143.014, P<0.001; χ2=136.356, P<0.001) . Mild disability predominated among middle-aged and elderly people in eastern, central and western regions; the difference was statistically significant when comparing the age composition of middle-aged and elderly people with mild and severe disability in eastern, central and western regions (P<0.05) . There were commonalities and characteristics in the influencing factors of disability and disability degree in the three regions. Age, education level and self-rated health status were the common influencing factors of disability in middle-aged and elderly people in eastern, central and western regions (P<0.05) . Gender and physical disability were the independent influencing factors for the development of disability in middle-aged and elderly people in eastern China (P<0.05) . The risk of disability in middle-aged and elderly people in females was 86.0% higher than that in males (OR=1.860, 95%CI=1.036 to 3.338) . Marital status and combining with chronic disease were the independent influencing factors for disability in middle-aged and elderly people (P<0.05) . Residence, brain damage/intellectual impairment were the independent influencing factors for disability among middle-aged and elderly people in western China (P<0.05) . Conclusion In order to solve and improve the differences of disability status among the middle aged and old people in the eastern, central and western regions of China, individualized prevention and intervention strategies for different regions should be developed according to the differences of influencing factors, regional medical services and rehabilitation guidance should be provided, and a cross-regional allocation mechanism of medical and health resources should be established to promote regional healthy and sustainable development

Correlation of Regional Differences in the Prevalence and Types of Chronic Diseases among Middle-aged and Elderly People with Health Resources Allocation in China

Background China is gradually entering an ageing society and the health of the middle-aged and elderly is a growing concern, with chronic diseases such as hypertension, diabetes, coronary heart disease and stroke becoming major health threats. At the same time, the uneven distribution of health resources has led to regional differences in medical level and service quality. Objective To explore the correlation between the prevalence of chronic diseases, regional differences in the types of diseases and health care resources among middle-aged and elderly people in China. Methods A total of 19 520 middle-aged and older adults ≥45 years of age were selected by cleaning, organizing and statistically analyzing the data from the China Health and Retirement Longitudinal Study (CHARLS) 2018 from October 2022 to March 2023, and 2018 statistics from the China Health Statistics Yearbook (2011-2020) were selected as the corresponding data related to health resources. Multiple linear regression analysis was used to analyze the correlation between Theil index of the number of beds, number of health technicians [practicing (assistant) physicians, registered nurses, rural doctors and health workers], financial expenditures (total health expenditure), number of health institutions (hospitals, primary care institutions, professional public health institutions) and the prevalence of chronic diseases in middle-aged and elderly people in each province. Results There were significant differences in the prevalence of chronic diseases (χ2=57.900, P<0.001) and the number of chronic diseases (χ2=11.138, P=0.004) among the middle-aged and elderly people living in the eastern, central and western regions. Among the 14 types of chronic diseases, there were significant differences in the prevalence of chronic lung disease (χ2=30.906, P<0.001), liver disease (χ2=17.871, P<0.001), cerebrovascular disease (χ2=18.313, P<0.001), kidney disease (χ2=24.383, P<0.001), digestive system diseases (χ2=16.973, P<0.001), memory-related diseases (χ2=6.898, P=0.032) and asthma (χ2=22.055, P<0.001) in middle-aged and elderly people living in the eastern, central and western regions of China. The results of the multiple linear regression analysis showed that the overall prevalence of chronic diseases in middle-aged and elderly people was correlated with hospitals, primary care institutions, practicing (assistant) physicians, registered nurses, rural doctors and the equity of health financial expenditures in middle-aged and elderly people (P<0.05) . Conclusion There are regional differences in the prevalence of chronic diseases among the middle-aged and elderly populations in the eastern, central and western parts of China, and there are also certain differences in the investment in health care and the allocation of health care resources in different regions. Regional health management of major chronic diseases should be strengthened, the ability of disease prevention and health management in primary care should be improved, medical and health personnel should be strengthened, the regional health resources allocation balance should be improved, so as to shorten the regional differences in the prevalence of chronic diseases among middle-aged and elderly people in the eastern, central and western China

From verified model to executable program: the PAT approach

CSP# is a formal modeling language that emphasizes the design of communication in concurrent systems. PAT framework provides a model checking environment for the simulation and verification of CSP# models. Although the desired properties can be formally verified at the design level, it is not always straightforward to ensure the correctness of the system’s implementation conforms to the behaviors of the formal design model. To avoid human error and enhance productivity, it would be beneficial to have a tool support to automatically generate the executable programs from their corresponding formal models. In this paper, we propose such a solution for translating verified CSP# models into C# programs in the PAT framework. We encoded the CSP# operators in a C# library-“PAT.Runtime”, where the event synchronization is based on the “Monitor” class in C#. The precondition and choice layers are built on top of the CSP event synchronization to support language-specific features. We further developed a code generation tool to automatically transform CSP# models into multi-threaded C# programs. We proved that the generated C# program and original CSP# model are equivalent on the trace semantics. This equivalence guarantees that the verified properties of the CSP# models are preserved in the generated C# programs. Furthermore, based on the existing implementation of choice operator, we improved the synchronization mechanism by pruning the unnecessary communications among the choice operators. The experiment results showed that the improved mechanism notably outperforms the standard JCSP library.Accepted versio

Novel DNA methylation loci and genes showing pleiotropic association with Alzheimer’s dementia: a network Mendelian randomization analysis

Previous genome-wide association studies (GWAS) have identified potential genetic variants involved in the risk of Alzheimer’s dementia, but their underlying biological interpretation remains largely unclear. In addition, the effects of DNA methylation and gene expression on Alzheimer’s dementia are not well understood. A network summary data-based Mendelian randomization (SMR) analysis was performed integrating cis- DNA methylation quantitative trait loci (mQTL) /cis- gene expression QTL (eQTL) data in the brain and blood, as well as GWAS summarized data for Alzheimer’s dementia to evaluate the pleiotropic associations of DNA methylation and gene expression with Alzheimer’s dementia and to explore the complex mechanisms underpinning Alzheimer’s dementia. After correction for multiple testing (false discovery rate [FDR] P 0.01), we identified dozens of DNA methylation sites and genes showing pleiotropic associations with Alzheimer’s dementia. We found 22 and 16 potentially causal pathways of Alzheimer’s dementia (i.e., SNP→DNA methylation→Gene expression→Alzheimer’s dementia) in the brain and blood, respectively. Approximately two-thirds of the identified DNA methylation sites had an influence on gene expression and the expression of almost all the identified genes was regulated by DNA methylation. Our network SMR analysis provided evidence supporting the pleiotropic association of some novel DNA methylation sites and genes with Alzheimer’s dementia and revealed possible causal pathways underlying the pathogenesis of Alzheimer’s dementia. Our findings shed light on the role of DNA methylation in gene expression and in the development of Alzheimer’s dementia

Dietary Schizochytrium Microalgae Affect the Fatty Acid Profile of Goat Milk: Quantification of Docosahexaenoic Acid (DHA) and Its Distribution at Sn-2 Position

The objective of this study was to detect the influence of dietary Schizochytrium microalgae on milk composition, milk fatty acids, and milk sn-2 fatty acids in goat’s milk. Firstly, we could see that the fat content increased in low microalgae supplementation goat’s milk (LM, 15 g/day) and the lactose content decreased in medium microalgae supplementation goat’s milk (MM, 25 g/day) compared with control goat’s milk (C, 0 g/day). Moreover, the absolute concentration of the docosahexaenoic acid (DHA) of LM, MM, and high microalgae supplementation (HM, 35 g/day) goat’s milk was 29.485, 32.351, and 24.817 mg/100 g raw milk, respectively, which were all higher than that in the control goat’s milk with 4.668 mg/100 g raw milk. In addition, the sn-2 DHA content increased in MM and HM goat’s milk. However, the decreasing trend of the sn-2 DHA content was observed in LM goat’s milk. As for other fatty acids, the oleic acid (C18:1n9c) and linolenic acid (C18:3n3) content decreased and increased, respectively, in all experimental goat milk. Finally, an interesting phenomenon was found, which was that docosanoic acid (C22:0) and tetracosenic acid (C24:1) were only detected in test goat’s milk. Consequently, the phenomena of this study demonstrated that dietary Schizochytrium microalgae have an obvious effect on the fatty acid and sn-2 fatty acid profile of goat’s milk, and they provide an effective method to improve the content of goat’s milk DHA in practical production

Theory-Guided Design of a Method to Obtain Competitive Balance between U(VI) Adsorption and Swaying Zwitterion-Induced Fouling Resistance on Natural Hemp Fibers

The competitive balance between uranium (VI) (U(VI)) adsorption and fouling resistance is of great significance in guaranteeing the full potential of U(VI) adsorbents in seawater, and it is faced with insufficient research. To fill the gap in this field, a molecular dynamics (MD) simulation was employed to explore the influence and to guide the design of mass-produced natural hemp fibers (HFs). Sulfobetaine (SB)- and carboxybetaine (CB)-type zwitterions containing soft side chains were constructed beside amidoxime (AO) groups on HFs (HFAS and HFAC) to form a hydration layer based on the terminal hydrophilic groups. The soft side chains were swayed by waves to form a hydration-layer area with fouling resistance and to simultaneously expel water molecules surrounding the AO groups. HFAS exhibited greater antifouling properties than that of HFAO and HFAC. The U(VI) adsorption capacity of HFAS was almost 10 times higher than that of HFAO, and the max mass rate of U:V was 4.3 after 35 days of immersion in marine water. This paper offers a theory-guided design of a method to the competitive balance between zwitterion-induced fouling resistance and seawater U(VI) adsorption on natural materials

Triglyceride and fatty acid composition of ruminants milk, human milk, and infant formulae

In this study, triglyceride and fatty acid composition of Holstein cow milk, Jersey cow milk, yak milk, goat milk, human milk and 8 infant formulae samples were determined by UPLC-ESI-MS and GC, respectively. In general, the triglyceride and fatty acid composition of various milk samples were specific. Compared with infant formulae, human milk contained more triglycerides composed of unsaturated fatty acids, for example 18:0/18:1/18:2, 15:0/18:1/18:1, 17:0/18:2/18:2. The triglyceride, C52:2 in human milk consisted of more 16:0/18:1/18:1 than in infant formulae. In addition, the proportion of triglyceride 18:1/18:1/18:1 in infant formulae differed greatly among brands, ranging from 0 % to 38.56 %. Triglyceride 4:0/18:0/18:1 was present in bovine milk (> 1 %) but not detected in goat milk. The triglycerides, 12:0/12:0/12:0, 6:0/14:0/18:0, 12:0/14:0/14:0, 10:0/14:0/18;0, and 18:0/14:0/18:0 were present in goat milk (> 1 %), which were different from bovine milk samples. The triglycerides 16:0/16:0/24:0, 16:0/18:0/22:0, 16:0/16:0/23:0, and 16:0/18:0/21:0 contained long chain FAs in yak milk. In addition, the ratio of omega-3 PUFA to omega-6 PUFA in yak milk was about 1–2, which is a characteristic of the fatty acid profile of yak milk. This study could provide a theoretical foundation for optimizing the composition of dairy products