Association between obesity, physical activity, and cognitive decline in Chinese middle and old-aged adults: a mediation analysis.

BACKGROUND AND OBJECTIVES: Epidemiological evidence on obesity and cognitive decline in middle and old-aged individuals is controversial and the effect of physical activity in this chain is sparse and limited. This study aimed to characterize the association between obesity and cognitive decline and the mediating role of physical activity. METHODS: Data from China Health and Retirement Longitudinal Study (CHARLS) were used, including 7,392 participants aged ≥ 45 years between 2011 and 2018. Cognitive function was assessed via episodic memory and mental status. The total score of cognitive function was the sum of the above two dimensions (0-31 points). The Group-based trajectory modeling (GBTM) was applied to identify the potential heterogeneity of longitudinal changes in cognitive function. Multivariable ordinal logistic regression was used to investigate associations between obesity and cognitive trajectories, taking body mass index (BMI) as the indicator of obesity. Mediation analysis was performed to examine the potential causal chain in which physical activity mediates the relationship between BMI and cognitive decline. RESULTS: Of the 7,392 analyzed patients (mean [SD] age, 58.0 [8.5] years; 3,916 [53%] male), the median (interquartile range [IQR]) of BMI was 23.4 (21.1-26.0). Four trajectories were identified by the GBTM model, including the high stable (14.9%), the middle stable (46.0%), the middle decline (29.9%), and the low decline groups (9.2%). After controlling potential confounders, obesity was associated with the low decline groups compared with normal weight (adjusted OR 0.81; 95% CI, 0.70-0.94). Mediation analyses showed that only vigorous physical activity significantly explained 5.94% (95% CI, 0.29-11.60%) of the relationship between obesity and cognitive decline. Sensitivity analyses in different subgroups showed comparable results. CONCLUSION: This study suggests that vigorous physical activity mediates less than 10% of the association between obesity and cognitive decline in middle and old-aged adults. Further studies are warranted to explore the potential factors related to the obesity paradox in the cognitive field.

Potential Biocontrol Microorganisms Causing Attenuated Pathogenicity in Plasmopara viticola.

A phenomenon of pathogenicity attenuation of Plasmopara viticola was consistently observed during its subculture on grape. To clarify the causes of attenuated pathogenicity of P. viticola, culturable microbes were isolated from the P. viticola mass (mycelia, sporangiophores, and sporangia) in each generation and tested for their biocontrol efficacies on grape downy mildew (GDM). The results showed that the incidence of GDM decreased with the increase in the number of subculture times on both vineyard-collected leaves and grape leaves from in vitro-grown seedlings. The number of culturable microbial taxa on the surface of P. viticola decreased, whereas the population densities of four specific strains (i.e., K2, K7, P1, and P5) increased significantly with the increase in subculture times. Compared with the control, the biocontrol efficacies of the bacterial strain K2 reached 87.5%, and those of both fungal strains P1 and P5 reached 100.0%. Based on morphological characteristics and molecular sequences, strains K2, P1, and P5 were identified as Curtobacterium herbarum, Thecaphora amaranthi, and Acremonium sclerotigenum, respectively, and these three strains survived very well and multiplied on the surface of P. viticola. As the number of times P. viticola was subcultured increased, all three of these strains became the predominant strains, leading to greater P. viticola inhibition, attenuated P. viticola pathogenicity, and effective GDM biological control. To the best of our knowledge, this is the first report of C. herbarum and T. amaranthi having biological control activity against GDM.

Application Areas of Intermittent Pneumatic Compression in the Prevention of Deep Vein Thrombosis During Dixon Surgery: A Randomized, Controlled Trial.

PURPOSE: Deep vein thrombosis (DVT) is common in the lithotomy position after laparoscopic surgery. Intermittent pneumatic compression (IPC) plays an important role in DVT prevention. However, few studies have compared the different compression areas of IPC application. It was hypothesized that the location of the compression sleeves could have an impact on the effects of thromboprophylaxis. METHODS: In this randomized, controlled trial performed from August 2020 to March 2021, 164 patients scheduled to undergo laparoscopic Dixon surgery were randomly assigned to one of four groups, based on the bilateral placement of compression sleeves during surgery: feet, calves, thighs, or control (no IPC). Both lower extremities were monitored for DVT on days 1 and 7 after surgery, using ultrasonographic assessment of mean blood velocity, blood flow volume, and diameter of the common femoral veins. Thrombosis-related hematologic analysis was performed. FINDINGS: On day 1 after surgery, IPC of the feet or calves was associated with a reduced prevalence of DVT compared with controls (both: P = 0.024; OR = 0.09; 95% CI, 0.01-0.72), while IPC of the thighs had no significant benefit (P = 0.781; OR = 0.86; 95% CI, 0.29-2.55). The prevalence of DVT in the left extremity was lower with IPC of the feet and calves compared with controls (both, P = 0.048). The mean blood velocity in the common femoral vein was significantly increased after surgery with IPC of the left and right feet (P = 0.006 and 0.007, respectively) and calves (P = 0.011 and P = 0.026, respectively) compared with controls. Similarly, the volume of blood flow in the left common femoral vein was greater with IPC of the feet and calves (P = 0.03 and 0.027, respectively). However, on day 7 after surgery, the between-group differences in the prevalences of DVT and hematologic indicators of thrombosis were not significant. IMPLICATIONS: On day 1 after surgery, IPC application at the feet or calves facilitated venous return and, hence, reduced the prevalence of DVT, especially in the left extremities. However, there were no significant differences in the prevalences of DVT or thrombosis-related hematologic indicators among the four groups on the day 7 after surgery. Chinese Clinical Trial Registration identifier: ChiCTR2000035325.

Latest updates on the serotonergic system in depression and anxiety.

Psychiatric disorders are among the leading causes of global health burden, with depression and anxiety being the most disabling subtypes. The two common disorders, depression and anxiety, usually coexist and are pathologically polygenic with complicated etiologies. Current drug-based therapies include selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, and 5-hydroxytryptamine partial agonists. However, these modalities share common limitations, such as slow onset and low efficacy, which is why potential mechanistic insights for new drug targets are needed. In this review, we summarize recent advances in brain localization, pathology, and therapeutic mechanisms of the serotonergic system in depression and anxiety.

Skin Staining Following Intravenous Iron Extravasation in a Patient With Chronic Kidney Disease: A Case Report.

Rationale: Intravenous iron is commonly use in anemia related to chronic kidney disease. Skin staining due to iron extravasation is a rare adverse reaction that can leave a long-term staining of the skin. Presenting Concerns of the Patients: During iron derisomaltose infusion, patient reported iron extravasation. Five months after the incident, the skin stain related to the extravasation was still present. Diagnosis: A case of skin staining due to iron derisomaltose extravasation was diagnosed. Interventions/Outcomes: She was reviewed by dermatology and laser therapy was offered. Teaching Points: Patients and clinicians need to be aware of this complication, and protocol needs to be put in place to minimize extravasation and its complication.

Justification: L'administration de fer par voie intraveineuse est une procédure courante pour traiter l'anémie liée à l'IRC. La coloration cutanée due à l'extravasation du fer est un effet indésirable rare qui peut perdurer à long terme. Présentation du cas: Une patiente ayant signalé une extravasation du fer au cours d'une perfusion de dérisomaltose ferrique. Cinq mois après l'incident, la coloration de la peau liée à l'extravasation était toujours présente. Diagnostic: Un diagnostic de coloration cutanée due à une extravasation de dérisomaltose ferrique a été posé. Interventions/Résultats: La patiente a été revue en dermatologie et une thérapie au laser lui a été offerte. Enseignements tirés: Les patients et les cliniciens doivent être au fait de cette possible complication. Un protocole doit être mis en place pour minimiser l'extravasation et sa complication.

Exosomal PD-L1 confers chemoresistance and promotes tumorigenic properties in esophageal cancer cells via upregulating STAT3/miR-21.

Chemotherapy resistance remains a major obstacle in the treatment of esophageal cancer. Previous researches have shown that an increase in exosomal PD-L1 expression was positively associated with a more advanced clinical stage, a poorer prognosis as well as drug resistance in patients with esophageal squamous cell carcinoma (ESCC). To explore the role of exosomal PD-L1 in ESCC, we performed bioinformatics analysis as well as several in vitro/in vivo functional experiments in a parental sensitive cell line EC-9706 and its derivative, a paclitaxel-resistant subline EC-9706R, and found that the exosomal PD-L1 from EC-9706R was higher than that from EC-9706. Moreover, exosomes from EC-9706R significantly increased invasion, migration and chemoresistance of EC-9706. Anti-PD-L1 treatment in combination with chemotherapy also led to reduced tumor burden in vivo. Inhibition of the release of exosomes by GW4869 or inhibition of STAT3 phosphorylation by stattic could effectively reverse the resistance to paclitaxel mediated by exosomal PD-L1. Furthermore, we found that PD-L1, miR-21, and multidrug resistance (MDR1) gene are involved in the process of exosomal transfer. Moreover, PD-L1 could enhance miR-21 expression by increasing the enrichment of STAT3 on miR-21 promoter. Our results suggested that exosomal PD-L1 may contribute to drug resistance to paclitaxel by regulating the STAT3/miR-21/PTEN/Akt axis and promote tumorigenic phenotype. This study provides a novel potential therapeutic approach to reverse chemoresistance and tumor progression through exosomal PD-L1 in ESCC patients.

Addressing challenges of an ageing population by rationally forecasting travel behaviours of the elderly: a case study in China.

This research aims to investigate the difference of the travel behaviours of the elderly in different urban areas. On the basis of the results of cluster analysis, the nested logit (NL) model is adopted to investigate the travel decision of the elderly in central urban areas and non-central urban areas. Moreover, it is used to forecast the change of their travel behaviours by implementing the policies of age-friendly society. The results show that the elderly in central urban areas are inclined to decide travel modes in advanced of determining trip chains, while the trip chains are first determined in non-central urban areas. For the central urban areas, the policies mainly affect the choice of travel modes of the elderly, rather than the choice of trip chains. However, for the non-central urban area, the policies simultaneously influence the choice of travel mode and trip chains of the elderly. Based on the results of the forecast, some measures are proposed in this study to meet different travel requirements of the elderly in central urban areas and non-central urban areas.

Effect of Coated Diammonium Phosphate Combined with Paecilomyces variotii Extracts on Soil Available Nutrients, Photosynthesis-Related Enzyme Activities, Endogenous Hormones, and Maize Yield.

Coated diammonium phosphate (CDAP) is intended to release nutrients steadily in response to the demand of crop growth. A novel biostimulant extracted from Paecilomyces variotii has been shown to regulate gene expression in nutrient transport, enhance nitrogen (N) and phosphorus (P) uptake, and improve nutrient use efficiency. The application of CDAP combined with the Paecilomyces variotii extracts (ZNC) in maize is an efficient approach for reducing waste of resources, improving nutrient supply, and maintaining production stability. The effects of CDAP combined with ZNC on photosynthesis, enzyme activities, endogenous hormone content, maize yield, and P use efficiency (PUE) were investigated in this study. In a pot experiment, CDAP and diammonium phosphate (DAP) were tested together with P levels (1.80, 1.44 g pot-1, P2O5) and two ZNC application rates (0, 4.4 µg pot-1), which included the control treatment that had no P fertilizer added. Results showed that the key influencing elements of maize growth and yield were the soil available-P content, endogenous hormone content, and plant photosynthesis in this study. The combination of DAP and ZNC increased the soil available-P content and the auxin content in leaves at the key stage and hence increased the yield and PUE of maize, compared with DAP. The net photosynthetic rate of CDAP combined with ZNC was higher by 23.1% than that of CDAP alone, as well as by 32.0% than that of DAP combined with ZNC. Moreover, the combination of CDAP and ZNC increased the yield and PUE by 8.2% and 15.6 percentage points compared with DAP combined with ZNC while increasing the yield and PUE compared with CDAP. In conclusion, combining CDAP with ZNC as an environmentally friendly fertilizer could improve photosynthesis-related enzyme activity and enhance the net photosynthetic rate, resulting in an increase in maize yield and PUE significantly.