Adaptive Feature Medical Segmentation Network: an adaptable deep learning paradigm for high-performance 3D brain lesion segmentation in medical imaging.

Introduction: In neurological diagnostics, accurate detection and segmentation of brain lesions is crucial. Identifying these lesions is challenging due to its complex morphology, especially when using traditional methods. Conventional methods are either computationally demanding with a marginal impact/enhancement or sacrifice fine details for computational efficiency. Therefore, balancing performance and precision in compute-intensive medical imaging remains a hot research topic. Methods: We introduce a novel encoder-decoder network architecture named the Adaptive Feature Medical Segmentation Network (AFMS-Net) with two encoder variants: the Single Adaptive Encoder Block (SAEB) and the Dual Adaptive Encoder Block (DAEB). A squeeze-and-excite mechanism is employed in SAEB to identify significant data while disregarding peripheral details. This approach is best suited for scenarios requiring quick and efficient segmentation, with an emphasis on identifying key lesion areas. In contrast, the DAEB utilizes an advanced channel spatial attention strategy for fine-grained delineation and multiple-class classifications. Additionally, both architectures incorporate a Segmentation Path (SegPath) module between the encoder and decoder, refining segmentation, enhancing feature extraction, and improving model performance and stability. Results: AFMS-Net demonstrates exceptional performance across several notable datasets, including BRATs 2021, ATLAS 2021, and ISLES 2022. Its design aims to construct a lightweight architecture capable of handling complex segmentation challenges with high precision. Discussion: The proposed AFMS-Net addresses the critical balance issue between performance and computational efficiency in the segmentation of brain lesions. By introducing two tailored encoder variants, the network adapts to varying requirements of speed and feature. This approach not only advances the state-of-the-art in lesion segmentation but also provides a scalable framework for future research in medical image processing.

[Changes in protein requirements of elderly people over 5 years assessed using the indicator amino acid oxidation method].

OBJECTIVE: To evaluate the changes in protein requirements of the elderly during the past five years. METHODS: Based on the previous study of protein requirements of 14 elderly in 2017, 4 of these elderly(70-80 y) were included as study participants and protein requirements were re-evaluated using the indicator amino acid oxidation method. There were seven protein levels: 0.1, 0.3, 0.6, 0.9, 1.2, 1.5 and 1.8 g/(kg·d). Maintenance diets were given for the first two days of each protein level. A stable isotope study was conducted on the day 3, using L-~(13)C-phenylalanine as an indicator on the basis of an amino acid rationed diet, which was orally ingested into the body along with the amino acid rationed diet, and breath and urine samples were collected when the metabolism of L-~(13)C-phenylalanine reached steady state in the body. By measuring the kinetic parameters of labeled amino acids in the samples, a nonlinear mixed-effects model was constructed for the protein intake to be tested and the oxidation rate of labeled amino acids. The mean protein requirement of the study population was determined by the protein intake corresponding to the inflection point of the curve. RESULTS: Based on the production rate of ~(13)CO_2 in exhaled breath of four elderly people at different protein levels, the mean protein requirement was 1.05(95%CI 0.51-1.60) g/(kg·d). The protein recommended nutrient intake was 1.31(95%CI 0.64-2.00) g/(kg·d) was estimated by applying the coefficient of variation of the mean protein requirement to derive the recommended nutrient intake. CONCLUSION: Protein requirements in the elderly have increased over a five-year period and sarcopenia may be the main cause of increased protein requirements.

Determining acute ischemic stroke onset time using machine learning and radiomics features of infarct lesions and whole brain.

Accurate determination of the onset time in acute ischemic stroke (AIS) patients helps to formulate more beneficial treatment plans and plays a vital role in the recovery of patients. Considering that the whole brain may contain some critical information, we combined the Radiomics features of infarct lesions and whole brain to improve the prediction accuracy. First, the radiomics features of infarct lesions and whole brain were separately calculated using apparent diffusion coefficient (ADC), diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) sequences of AIS patients with clear onset time. Then, the least absolute shrinkage and selection operator (Lasso) was used to select features. Four experimental groups were generated according to combination strategies: Features in infarct lesions (IL), features in whole brain (WB), direct combination of them (IW) and Lasso selection again after direct combination (IWS), which were used to evaluate the predictive performance. The results of ten-fold cross-validation showed that IWS achieved the best AUC of 0.904, which improved by 13.5% compared with IL (0.769), by 18.7% compared with WB (0.717) and 4.2% compared with IW (0.862). In conclusion, combining infarct lesions and whole brain features from multiple sequences can further improve the accuracy of AIS onset time.

Association and dose-response relationship of plasma magnesium with metabolic syndrome in Chinese adults older than 45 years.

Purpose: Magnesium (Mg) is an essential nutrient for the maintenance of vital physiological functions. Magnesium deficiency is associated with diseases such as obesity, type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS); however, conclusions have been inconsistent, and there is a particular lack of evidence regarding this association in Chinese population older than 45 years. This study aimed to assess the association between plasma magnesium and the risk of MetS and its components, the dose-response relationship, and the threshold effect relationship in a Chinese population involving older than 45 years. Methods: A total of 2,101 individuals were randomly selected from the China Nutrition and Health Surveillance (CNHS) (2015-2017) by considering monitoring points. We used the joint statement of the International Diabetes Federation (IDF) in 2009 to define participants with MetS. The plasma magnesium was tested by inductively coupled plasma mass spectrometry (ICP-MS). The logistic regression and restricted cubic spline (RCS) models were used to analyze the association and dose-response relationship between plasma Mg and MetS and its components. Results: Compared with the lowest quintile (Q1) for plasma Mg, the odds ratios (ORs) and 95% confidence intervals (95% CI) for MetS, impaired fasting glucose (IFG), hypertension, and triglyceride (TG) elevation at the highest quintile (Q5) were 0.419 (0.301, 0.583), 0.303 (0.221, 0.415), 0.446 (0.322, 0.618), and 0.526 (0.384, 0.720), respectively, with all p < 0.05. However, in the components of decreased high-density lipoprotein cholesterol (HDL-C) and central obesity, no trend toward lowering with higher plasma magnesium was observed (p = 0.717, p = 0.865). These associations were not altered by further adjustment for potential confounding variables, including age, gender, education, nationality, area, residence, body mass index (BMI), and heart rate. The RCS analysis showed that, when plasma magnesium was lower than 0.85 mmol/L, the curve was leveled off, and then, the curve showed a decreasing trend with the increase in plasma magnesium. Conclusion: Therefore, plasma Mg was negatively associated with MetS and its components (including IFG, hypertension, and elevated TG) in people older than 45 years. In addition, plasma Mg greater than or equal to 0.85 mmol/L, which is higher than the commonly used threshold of 0.75 mmol/L, may be protective against MetS and its components (including elevated FPG, elevated blood pressure, and elevated TG). More prospective studies, such as randomized controlled trials, are necessary to confirm the effective impact of Mg on MetS and its components. Plasma Mg levels in the MetS population older than 45 years require attention.

Reevaluation of the protein requirement in Chinese elderly adults without sarcopenia with the indicator amino acid oxidation technique.

It is now generally believed that elderly may have slightly higher dietary protein requirements than those of the young-middle-aged adults. We have previously conducted related studies by the indicator amino acid oxidation (IAAO) technique, but more research data are needed to revise the protein requirements of the elderly. The main objective was to reevaluate the dietary protein requirements of healthy Chinese adults (65-80 years) without sarcopenia by using the IAAO technique. Nine healthy adult men and seven healthy adult women participated in the study, with protein intakes ranging from 0·1 to 1·8 g/(kg·d). Diets that delivered energy at a 1·5 resting energy expenditure were isocaloric. The amounts of phenylalanine and tyrosine needed to remain constant for each protein dosage. By applying a nonlinear mixed-effects model analysis on the F13CO2 data, which revealed a breakpoint in F13CO2 in response to graded protein intakes, the mean protein requirement was calculated. The mean estimated average requirement (EAR) for healthy elderly Chinese adults without sarcopenia was determined to be 0·94 g/(kg·d). The protein recommended nutrient intake (RNI) determined using various derivation approaches ranged from 1·13 to 1·36 g/(kg·d). The EAR for Chinese adults without sarcopenia aged 65-80 years in this study is 6·8 % higher than the current recommended EAR (0·88 g/(kg·d)). The RNI derived using various derivation approaches are all greater than the current RNI (0·98 g/(kg·d)). This trial was registered with the Chinese clinical trial registry as ChiCTR2200061382.

[Protein efficiency ratio of genetically modified pork powder with fat-1 gene].

OBJECTIVE: To evaluate the protein efficiency ratio(PER) of genetically modified pork powder with fat-1 gene(GM group), and thus evaluate whether the nutritional evaluation value of fat-1 gene pork powder has changed. METHODS: Sixty weaned SD rats(60-80 g) were randomly divided into casein group, parental control group and GM group according to sex and weight, 20 rats in each group, half of each sex. The rats in the three groups were fed with corresponding formulated feed containing 10% protein for 28 days. The body weight and food intake of each group were recorded weekly. Blood was collected at the end of the experiment to determine hematology and blood biochemical indexes. The food utilization rate, organ/body weigh indexes, PER and corrected PER were calculated. RESULTS: The weight of rats in all groups increased steadily during the experimental period. Statistically significant differences were found in some hematology and blood biochemical indexes and organ/body weigh indexes. No biologically significant changes were found. The food utilization rate of GM group was higher than that of casein group(P<0.05), which was equivalent to that in the parental control group. The PER of both genetically modified pork powder with fat-1 gene and parental white pork powder were higher than that of casein(P<0.05). CONCLUSION: The PER of genetically modified pork powder with fat-1 gene was equal to that of its parental white pork powder.

Tubular Structure Segmentation via Multi-Scale Reverse Attention Sparse Convolution.

Cerebrovascular and airway structures are tubular structures used for transporting blood and gases, respectively, providing essential support for the normal activities of the human body. Accurately segmenting these tubular structures is the basis of morphology research and pathological detection. Nevertheless, accurately segmenting these structures from images presents great challenges due to their complex morphological and topological characteristics. To address this challenge, this paper proposes a framework UARAI based on the U-Net multi-scale reverse attention network and sparse convolution network. The framework utilizes a multi-scale structure to effectively extract the global and deep detail features of vessels and airways. Further, it enhances the extraction ability of fine-edged features by a joint reverse attention module. In addition, the sparse convolution structure is introduced to improve the features' expression ability without increasing the model's complexity. Finally, the proposed training sample cropping strategy reduces the influence of block boundaries on the accuracy of tubular structure segmentation. The experimental findings demonstrate that the UARAI-based metrics, namely Dice and IoU, achieve impressive scores of 90.31% and 82.33% for cerebrovascular segmentation and 93.34% and 87.51% for airway segmentation, respectively. Compared to commonly employed segmentation techniques, the proposed method exhibits remarkable accuracy and robustness in delineating tubular structures such as cerebrovascular and airway structures. These results hold significant promise in facilitating medical image analysis and clinical diagnosis, offering invaluable support to healthcare professionals.

HyperTDP-Net: A Hyper-densely Connected Compression-and-Decomposition Network Based on Trident Dilated Perception for PET and MRI Image Fusion.

Objective. Since medical images generated by medical devices have low spatial resolution and quality, fusion approaches on medical images can generate a fused image containing a more comprehensive range of different modal features to help physicians accurately diagnose diseases. Conventional methods based on deep learning for medical image fusion usually extract only local features without considering their global features, which often leads to the problem of unclear detail information in the final fused image. Therefore, medical image fusion is a challenging task of great relevance.Approach.This paper proposes a novel end-to-end medical image fusion model for PET and MRI images to achieve information interaction between different pathways, termed as hyper-densely connected compression-and-decomposition network based on trident dilated perception for PET and MRI image fusion (HyperTDP-Net). In particular, in the compression network, a dual residual hyper densely module is constructed to take full advantage of middle layer information. Moreover, we establish the trident dilated perception module to precisely determine the location information of features, and improve the feature representation capability of the network. In addition, we abandon the ordinary mean square error as the content loss function and propose a new content-aware loss consisting of structural similarity loss and gradient loss, so that the fused image not only contains rich texture details but also maintains sufficient structural similarity with the source images.Main results. The experimental dataset used in this paper is derived from multimodal medical images published by Harvard Medical School. Extensive experiments illustrate that our model contains more edge information and texture detail information in the fusion result than the 12 state-of-the-art fusion models and ablation study results demonstrate the effectiveness of three technical innovations.Significance. As medical images continue to be used in clinical diagnosis, our method is expected to be a tool that can effectively improve the accuracy of physician diagnosis and automatic machine detection.

Association of Body Iron Metabolism with Type 2 Diabetes Mellitus in Chinese Women of Childbearing Age: Results from the China Adult Chronic Disease and Nutrition Surveillance (2015).

High iron stores have been reported to be associated with type 2 diabetes mellitus (T2DM). However, evidence for the associations of iron metabolism with T2DM is inconsistent, and whether there is a threshold effect remains controversial. In the present study, we aimed to examine the associations between various iron biomarkers and the risk of T2DM as well as impaired glucose metabolism (IGM) and hyperglycemia in Chinese women of childbearing age. A total of 1145 women were divided into three groups (normal blood glucose metabolism group; IGM group; T2DM group). Biomarkers of iron metabolism (serum ferritin (SF), transferrin, soluble transferrin receptor (sTfR), transferrin saturation, serum iron, total body iron, and sTfR-to-lgferritin index) were measured. After adjusting for various confounding risk factors, SF and sTfR were positively associated with the risk of IGM (fourth vs. first quartile: SF odds ratio (OR) = 1.93 (95% CI 1.17-3.20) and sTfR OR = 3.08 (95% CI 1.84-5.14)) and T2DM (SF OR = 2.39 (95% CI 1.40-4.06) and sTfR OR = 3.84 (95% CI 2.53-5.83)). There was a nonlinear relationship between SF and risk of T2DM and hyperglycemia (p for nonlinearity < 0.01). Our findings suggested that SF and sTfR could be independent predictors of T2DM risk.

Reference Range of Vitamin K Evaluating Indicators in Chinese Childbearing Women.

BACKGROUND: Vitamin K is an essential fat-soluble vitamin for the human body and its functions, such as promoting blood coagulation, bone health and preventing atherosclerosis, have attracted increasing attention. However, there is no recognized indicator and corresponding reference range for evaluating vitamin K status of different populations at present. The aim of this study is to establish a reference range for vitamin K evaluating indicators in healthy women of childbearing age in China. METHODS: The population sample in this study was from the Chinese Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015-2017. A total of 631 healthy women of childbearing age (18-49 years) were included using a series of strict inclusion and exclusion criteria. The concentrations of VK1, MK-4 and MK-7 in serum were detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The other commonly-reported indicators evaluating vitamin K nutritional status, including undercarboxylated osteocalcin (ucOC), osteocalcin (OC), matrix Gla protein (MGP), desphosphorylated undercaboxylated MGP (dp-ucMGP) and protein induced by vitamin K absence II (PIVKA-II), were measured by enzyme-linked immunosorbent assay (ELISA). The reference range was obtained by calculating the 2.5% to 97.5% interval of the vitamin K evaluating indicators in the reference population. RESULTS: The reference ranges of VK1, MK-4 and MK-7 in serum were 0.21-3.07 ng/mL, 0.02-0.24 ng/mL and 0.12-3.54 ng/mL, respectively. The reference ranges of ucOC, %ucOC, dp-ucMGP and PIVKA-II were 1.09-2.51 ng/mL, 5.80-22.78%, 2.69-5.88 ng/mL and 3.98-8.40 ng/mL, respectively. The cut-off values that can be used to evaluate subclinical vitamin K deficiency were as follows: VK1 < 0.21 ng/mL, MK-7 < 0.12 ng/mL, ucOC > 2.51 ng/mL, %ucOC > 22.78%, dp-ucMGP > 5.88 ng/mL and PIVKA-II > 8.40 ng/mL. CONCLUSION: The reference range of VK1, MK-4, MK-7 and vitamin K-related indicators for healthy women of childbearing age established in this study could be used to assess the nutritional and health status of this population.

Study on the Zinc Nutritional Status and Risk Factors of Chinese 6-18-Year-Old Children.

Zinc is an essential micronutrient that is involved in several metabolic processes, especially children's growth and development. Although many previous studies have evaluated the zinc nutritional status of children, there are very few reports on children aged 6-18 years old. Furthermore, there are few reports on children's zinc nutrition status based on the Chinese population. According to WHO data, the prevalence of zinc deficiency in Asian countries is rather high and has resulted in high child mortality. In this study, we aimed to comprehensively assess zinc nutritional status and the prevalence of zinc deficiency among children aged 6-18 years in China based on nationally representative cross-sectional data. Subgroup comparisons were made under possible influencing factors. The potential risk factors of zinc deficiency were also discussed. A total of 64,850 children, equally male and female, were recruited from 150 monitoring sites in 31 provinces through stratified random sampling from China National Nutrition and Health Survey of Children and Lactating Mothers (CNNHS 2016-2017). Median and interquartile intervals were used to represent the overall zinc concentration levels and different subgroups. A Chi-square test was used to compare serum zinc levels and the prevalence of zinc deficiency in children under different group variables. In order to study the influencing factors of zinc deficiency, multiple logistic regression was utilized. It was found that the median concentration of serum Zn was 88.39 µg/dL and the prevalence of Zn deficiency was 9.62%. The possible influence factors for Zn deficiency were sex, anemia, nutritional status, city type and income. By conducting a subgroup analysis of the factors, it was found that males; those with anemia, stunting and low income; and children living in rural areas have a higher risk of Zn deficiency. This study offers a comprehensive analysis of Zn nutritional status among Chinese children, which provides reliable data for policy formulation to improve the zinc nutrition status of children.

[Plasma selenium level and its influencing factors in Chinese child-bearing-aged women in 2015].

OBJECTIVE: To assess the plasma selenium(Se) level of child-bearing-aged women and discuss the influence factor for low-Se level. METHODS: Using the muti-stage stratified and population proportional cluster random sampling method, 1881 child-bearing-aged women aged 18 to 44 years were selected from China Adult Chronic Disease and Nutrition Surveillance(2015) Data. The basic information of the subjects was collected by unified electronic questionnaires and equipments were used for field survey, measurement and record. Plasma Se concentration was detected by inductively coupled plasma mass spectrometry. Plasma low-Se level were assessed using lower limit of plasma/serum Se established by the Mayo Clinic Laboratory and our laboratory, respectively. Influence factors of low-Se level were analyzed by the multivariate logistic regression model. RESULTS: The M(P25, P75) plasma Se concentration for Chinese child-bearing-aged women was 89.52(74.21, 105.03)µg/L. Nationality, location, urban-rural type and education level difference had influence on plasma Se level in this population(P<0.05). According to the lower limit of plasma/serum Se concentration established by the Mayo clinical laboratories(<70 µg/L) and our laboratories(<73.81 µg/L), the low-Se rate were 20.47% and 24.51%, respectively. There were significantly differences in low-Se rate among nationality, location, urban-rural type, education level and marital status(P<0.05). The multivariate logistic regression model showed that location and urban-rural type had significant effects on low-Se rate of child-bearing-aged women(P<0.05). CONCLUSION: The plasma low-Se rate of Chinese women of childbearing age is relatively high and higher prevalence low-Se was found in western and central regions and rural areas in China.

Re-exploration of dietary iodine intake in Chinese adult males using a modified iodine balance study.

There is still controversy about optimal dietary iodine intake as the Universal Salt Iodization policy enforcement in China. A modified iodine balance study was thus conducted to explore the suitable iodine intake in Chinese adult males using the iodine overflow hypothesis. In this study, thirty-eight apparently healthy males (19·1 (sd 0·6) years) were recruited and provided with designed diets. After the 14-d iodine depletion, daily iodine intake gradually increased in the 30-d iodine supplementation, consisting of six stages and each of 5 d. All foods and excreta (urine, faeces) were collected to examine daily iodine intake, iodine excretion and the changes of iodine increment in relation to those values at stage 1. The dose-response associations of iodine intake increment with excretion increment were fitted by the mixed effects models, as well as with retention increment. Daily iodine intake and excretion were 16·3 and 54·3 µg/d at stage 1, and iodine intake increment increased from 11·2 µg/d at stage 2 to 118·0 µg/d at stage 6, while excretion increment elevated from 21·5 to 95·0 µg/d. A zero iodine balance was dynamically achieved as 48·0 µg/d of iodine intake. The estimated average requirement and recommended nutrient intake were severally 48·0 and 67·2 µg/d, which could be corresponded to a daily iodine intake of 0·74 and 1·04 µg/kg per d. The results of our study indicate that roughly half of current iodine intakes recommendation could be enough in Chinese adult males, which would be beneficial for the revision of dietary reference intakes.

Chronic Toxicity of Genetically Modified Maize with Cry1Ab-ma Gene and Its Effect on Serum Metabolites in Rats.

Genetic engineering has inserted the crystallin (Cry) gene of Bacillus thuringiensis into the genes of maize to cultivate a variety of transgenic insect-resistant maizes. At present, genetically modified maize with Cry1Ab-ma gene (maize CM8101) was in the stage of safety verification. In this study, a 1-year chronic toxicity test was carried out to evaluate the safety of maize CM8101. Wistar rats were selected for the experiment. Rats were randomly divided into three groups and fed the corresponding diets: genetically modified maize group (CM8101 group), parental maize group (Zheng58 group), and AIN group. Rat serum and urine were collected at the third, sixth, and twelfth months of the experiment, and viscera were collected at the end of the experiment for detection. Metabolomics was used to analyze the metabolites in the serum of rats at the 12th month. While the CM8101 group rats' diets were supplemented with 60% maize CM8101, no obvious poisoning symptoms were found in rats, and no poisoning death occurred. There were no negative effects on body weight, food intake, blood and urine indices, or organ histopathological examination results. Furthermore, metabolomics results revealed that, when compared to group differences, the gender of rats had a more obvious effect on metabolites. The CM8101 group primarily changed linoleic acid metabolism in female rats, while glyceropholipid metabolism was altered in male rats. In rats, consumption of maize CM8101 did not result in significant metabolic dysfunction.

The Magnesium Status and Suggested Reference Ranges of Plasma Magnesium, Calcium, and Calcium/Magnesium Ratio in Chinese Adults over 45 Years Old.

Magnesium (Mg) is an essential nutrient that participates in various enzymatic reactions and regulates important biological functions. The distribution and reference ranges in China have not been reported in populations more than 45 years old. This study aimed to assess the magnesium status and determine the reference values of plasma Mg, Ca, and Ca/Mg ratios for China's population more than 45 years old. A total of 2101 people were randomly selected from the China Nutrition and Health surveillance (CNHS) (2015-2017), considering the regional types and monitoring points. Then, 337 healthy individuals were further selected by a series of strict inclusion criteria to explore the reference range. The plasma magnesium and calcium were tested by inductively coupled plasma mass spectrometry (ICP-MS). The suggested reference values for plasma Mg, Ca, and Ca/Mg ratios were 0.75-1.14 mmol/L, 2.17-3.64 mmol/L, and 2.36-3.66, respectively. Taking 0.75 mmol/L as the lower cut-off limit, the prevalence of Mg deficiency was 6.66%, and the average level of plasma magnesium was 0.88 mmol/L for populations older than 45 years in China. In conclusion, this study provides the magnesium status and reference ranges for plasma Mg, Ca, and Ca/Mg ratio for Chinese people over 45 years old. The results of the recommended reference ranges in this study were very similar to our published results in women of reproductive age. Thus, the reference range of plasma magnesium in different populations in China was further improved.

Re-exploring the requirement of dietary iodine intake in Chinese female adults based on 'iodine overflow theory'.

PURPOSE: We re-explored the basal iodine requirement based on healthy Chinese female and a new iodine overflow theory was proposed for iodine balance study. METHODS: Thirty-six Chinese healthy female adults (age 20.7 ± 1.1) were recruited for this study, which included 40 days low iodine depletion period and six stages of 30 days supplementation period. Uniform diets with low iodine were provided and the content of iodine in the diet was regulated by dairy products. The total iodine intake from food and the total iodine excretion through 24-h urine and staged feces were completely gathered and monitored. The incremental (Δ) intake and excretion over the range were calculated. RESULTS: The iodine intake and excretion were 13.6 µg/day and 48.6 µg/day at the first stage, respectively. The incremental iodine intakes and excretions were 21.1 µg/day to 120.3 µg/day and 25.8 µg/day to 105.4 µg/day for the supplementation stages, respectively. According to the 'iodine overflow theory', the zero iodine balance (Δ iodine intake = Δ iodine excretion) derived from a mixed effect model indicated a mean iodine intake of 52.2 µg/d (1.0 µg/d kg). The RNI for iodine to healthy Chinese female adult was 73.1 µg/d (1.4 µg/d kg). CONCLUSION: A daily iodine intake of 52.2 µg/d may meet the basal iodine requirement for healthy Chinese female adults, and Chinese female may need more than 20% iodine intake than male based on the 'iodine overflow theory'. The trial was registered at the Chinese Clinical Trial Registry in May 2018 (No: ChiCTR1800016184).

Changes of Iodine Nutritional Status in the Elderly after Replacing Iodized Salt with Non-Iodized Salt for Half a Year.

China has issued the "Reform Plan of the Salt Industry System" in 2016 and it is necessary to attach the importance to the changes of iodine nutritional status of those people who might consume non-iodized salt for a long time. Forty-six elderly subjects were recruited and replaced iodized salt with non-iodized salt for 6 months. Urine iodine concentration (UIC), dietary iodine intake, thyroid function, thyroid B-ultrasound, and plasma iodine were monitored during the follow-up period. The median dietary iodine intakes of the baseline, the 1st, 2nd,3rd, 4th, and 6th month were 255.3 µg/d, 183.6 µg/d, 164.6 µg/d, 179.2 µg/d, 139.4 µg/d, and 146.9 µg/d, respectively. The median UIC of baseline and follow-up was 155.7 (111.0-263.1) µg/L and 69.7(36.7-119.8) µg/L, respectively. The proportion of urinary iodine less than 50 g/L at the baseline and follow-up was 3.0 (0 ~ 8.9)% and 36.0 (33.1 ~ 38.9)%, respectively. Dietary iodine intake had a significant correlation with urine iodine. Six subjects (15.4%) had abnormal thyroid function. Three subjects (7.7%) had first-onset new nodules or enlarged solid nodules and the median UIC of these three subjects during the follow-up period was 39.8 µg/L, which was significantly lower than that of other subject (74.0 µg/L). T4 and T3 had a significant correlation with plasma iodine. The importance of monitoring and evaluating iodine nutrition of people consuming non-iodized salt should be stressed to prevent the potential poor iodine nutrition and iodine deficiency diseases.

Vitamin D Status for Chinese Children and Adolescents in CNNHS 2016-2017.

Vitamin D is very important in maintaining children's bone health because of its regulatory role in calcium and phosphate metabolism. To better understand vitamin D status and related risk factors of children and adolescents in China, this study analyzed the 25-hydroxyvitamin-D (25(OH)D) concentration of children and adolescents aged 6-17 years in China and assessed the risk factors of vitamin D deficiency and insufficiency. We analyzed the data of 25(OH)D concentration collected from the China National Nutrition and Health Survey of Children and Lactating Mothers in 2016-2017 (CNNHS 2016-2017). The age, sex, region type, ethnicities, season, weight and height were recorded, measured by unified questionnaire, equipment and standards. The concentration of 25(OH)D was detected by LC-MS/MS. A total of 64,391 participants from the cross-sectional study of CNNHS in 2016-2017 were included in this study. The median serum 25(OH)D concentration was 17.70 (13.20-22.68) ng/mL, 18.70 (14.10-23.80) ng/mL in boys and 16.60 (12.40-21.40) ng/mL in girls. The total prevalence rate of vitamin D deficiency and insufficiency was 65.98% when the cut-off was 20 ng/mL, 60.42% for boys and 71.99% for girls. According to the results of logistic regression analysis, girls aged above 12 y, living in midlands and northern regions, in spring and winter seasons and with abdominal obesity will have a significantly increased risk of vitamin D deficiency and insufficiency among Chinese children and adolescents. The results showed that vitamin D deficiency and insufficiency are very common among children and adolescents aged 6-17 y in China. They should be encouraged to have more effective sunlight exposure, increased intake of vitamin D from food or supplements in their diet, especially for those aged above 12 y, living in the northern or midlands areas, in spring and winter, and abdominally obese.

The Combination of Whole-Brain Features and Local-Lesion Features in DSC-PWI May Improve Ischemic Stroke Outcome Prediction.

Accurate and reliable outcome predictions can help evaluate the functional recovery of ischemic stroke patients and assist in making treatment plans. Given that recovery factors may be hidden in the whole-brain features, this study aims to validate the role of dynamic radiomics features (DRFs) in the whole brain, DRFs in local ischemic lesions, and their combination in predicting functional outcomes of ischemic stroke patients. First, the DRFs in the whole brain and the DRFs in local lesions of dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) images are calculated. Second, the least absolute shrinkage and selection operator (Lasso) is used to generate four groups of DRFs, including the outstanding DRFs in the whole brain (Lasso (WB)), the outstanding DRFs in local lesions (Lasso (LL)), the combination of them (combined DRFs), and the outstanding DRFs in the combined DRFs (Lasso (combined)). Then, the performance of the four groups of DRFs is evaluated to predict the functional recovery in three months. As a result, Lasso (combined) in the four groups achieves the best AUC score of 0.971, which improves the score by 8.9% compared with Lasso (WB), and by 3.5% compared with Lasso (WB) and combined DRFs. In conclusion, the outstanding combined DRFs generated from the outstanding DRFs in the whole brain and local lesions can predict functional outcomes in ischemic stroke patients better than the single DRFs in the whole brain or local lesions.

The Association of Dietary Magnesium and Prediabetes in Childbearing Chinese Women: Results from China Nutrition and Health Surveillance (2015-2017).

Although several studies have shown the relationship between magnesium and diabetes, there are few studies regarding the association between magnesium status and prediabetes. This study aimed to examine the association between dietary magnesium intake and the risk of prediabetes in childbearing Chinese women (18−44 years). A total of 1981 participants without diabetes were randomly selected from China Nutrition and Health Surveillance (CNHS) in 2015 by considering the regional types and monitoring points, including 1420 normal fasting glucose (NFG) people and 561 prediabetes cases. The Food Frequency Questionnaire (FFQ) and inductively coupled plasma mass spectrometry (ICP-MS) measured dietary and plasma magnesium. The results of this study showed that dietary magnesium intake was inversely associated with fasting plasma glucose. For every 100 mg of magnesium intake, there was a 0.052 mmol/L (95% CI 0.019, 0.085) reduction in fasting plasma glucose (p = 0.002). Compared with the lowest intake quartile (<350.10 mg/day), the third and fourth quartiles (≥405.41 mg/day) reduced the odds risk of prediabetes (OR = 0.63, 95% CI 0.46, 0.88, p = 0.020) by approximately 37%. The dose-response curves for the association between magnesium intake and prediabetes followed an L shape. The odds ratio of prediabetes decreased significantly with increasing dietary Mg intake at less than 410 mg/day, and then the curve leveled off or slightly increased. This study found a negative association between dietary magnesium intake and prediabetes in childbearing Chinese women. The risk of prediabetes was reduced with increasing dietary magnesium intake, and the threshold value was 410 mg/day. This suggests that childbearing women also need to pay attention to their magnesium status.