Associations between sleep problems and cardiometabolic risk in maintenance hemodialysis patients: A multicenter study.

The incidence of cardiovascular disease is increasing around the world, and it is one of the main causes of death in chronic kidney diseases patients. It is urgent to early identify the factors of cardiometabolic risk. Sleep problems have been recognized as a risk factor for cardiometabolic risk in both healthy people and chronic patients. However, the relationship between sleep problems and cardiometabolic risk has not been clearly explored in hemodialysis patients. This study aimed to investigate the relationship between sleep problems and cardiometabolic risk in 3025 hemodialysis patients by a multicenter study. After adjusting for confounders, binary logistic regression models showed that hemodialysis patients reported sleep duration greater than 7 h were more likely to be with hypertension, hyperglycemia, hypertriglyceridemia, and hypercholesterolemia. Patients reported sleep duration less than 7 h were more likely to be with hypertriglyceridemia and hypercholesterolemia, but the risks of hyperglycemia and Low HDL-cholesterol were decreased. Poor sleep quality was negatively correlated to low HDL cholesterol and hypertriglyceridemia. Moreover, gender-based differences were explained.

Research Progress on the Effects of Support and Support Modification on the FTO Reaction Performance of Fe-Based Catalysts.

In recent years, the non-petroleum production of light olefins has been the research focus of Fischer-Tropsch olefin synthesis (FTO). Iron-based catalysts have attracted much attention because of their low price, high catalytic activity, and wide temperature range. In this paper, traditional modification, hydrophobic modification, and amphiphobic modification of the catalyst are summarized and analyzed. It was found that traditional modification (changing the pore size and surface pH of the catalyst) will reduce the dispersion of Fe, change the active center of the catalyst, and improve the selectivity of light olefins (for example, SiO2: 32%). However, compared with functional methods, these traditional methods lead to poor stability and high carbon dioxide selectivity (for example, SiO2: 34%). Hydrophobic modification can inhibit the adsorption and retention of water molecules on the catalyst and reduce the local water pressure near the iron species in the nuclear layer, thus inhibiting the further formation of CO2 (for example, SiO2: 5%) of the WGSR. Amphiphobic modification can not only inhibit the WGSR, but also reduce the steric hindrance of the catalyst, increase the diffusion rate of olefins, and inhibit the reabsorption of olefins. Follow-up research should focus on these issues.

Could long-term dialysis vintage and abnormal calcium, phosphorus and iPTH control accelerate aging among the maintenance hemodialysis population?

OBJECTIVE: Aging is a complex process of physiological dysregulation of the body system and is common in hemodialysis patients. However, limited studies have investigated the links between dialysis vintage, calcium, phosphorus, and iPTH control and aging. The purpose of the current study was to examine these associations. METHODS: During 2020, a cross-sectional study was conducted in 3025 hemodialysis patients from 27 centers in Anhui Province, China. Biological age was calculated by a formula using chronological age and clinical indicators. The absence of the target range for serum phosphorus (0.87-1.45 mmol/L), corrected calcium (2.1-2.5 mmol/L) and iPTH (130-585 pg/mL) were identified as abnormal calcium, phosphorus, and iPTH control. RESULTS: A total of 1131 hemodialysis patients were included, 59.2% of whom were males (669/1131). The mean (standard deviation) of actual age and biological age were 56.07 (12.79) years and 66.94 (25.88), respectively. The median of dialysis vintage was 4.3 years. After adjusting for the confounders, linear regression models showed patients with abnormal calcium, phosphorus, and iPTH control and on hemodialysis for less than 4.3 years (B = 0.211, p = .002) or on hemodialysis for 4.3 years or more (B = 0.302, p < .001), patients with normal calcium, phosphorus, and iPTH control and on hemodialysis for 4.3 years or more (B = 0.087, p = .013) had a higher biological age. CONCLUSION: Our findings support the hypothesis that long-term hemodialysis and abnormal calcium, phosphorus, and iPTH control may accelerate aging in the hemodialysis population. Further studies are warrant to verify the significance of maintaining normal calcium-phosphorus metabolism in aging.

Investigation on maintenance hemodialysis patients with mineral and bone disorder in Anhui province, China.

BACKGROUND: Chronic kidney disease-mineral bone disorder (CKD-MBD) is a common comorbidity in patients with CKD. The study aims to describe the control rates of serum-corrected calcium (Ca), phosphate (P) and intact parathyroid hormone (iPTH) and its risk factors among maintenance hemodialysis (MHD) patients in Anhui Province of China. METHODS: The study was conducted in 27 hemodialysis centers of Anhui Province between January 1st 2020 and December 31th 2020. Chi-square test was used to compare the control rates of serum-corrected Ca, P and iPTH between the present study and DOPPS 4 or Anhui Province in 2014. Binary logistic regression analysis was used to explore the risk factors of the control rates of serum-corrected Ca, P and iPTH. RESULTS: A total of 3 025 MHD patients were recruited in this study, with a mean age of 54.8 (SD: 12.8) years, and 60.1% were males. According to the Chinese Diagnosis and Treatment Guidelines for CKD-MBD, the control rates of serum-corrected Ca, P and iPTH in the present study were 57.9%, 20.0% and 56.0%, respectively. Based on KDOQI guidelines (2003), the control rates of the above indicators were 43.1%, 35.3% and 22.3%, respectively. The control rates of serum-corrected Ca, P and iPTH in this study were lower than those of DOPPS 4 (P < 0.001). Compared to the results of Anhui Province in 2014, the control rate of corrected Ca was higher (P < 0.001) and the control rate of iPTH was lower (P = 0.005). Age, residential area, BMI, dialysis vintage, albumin and hemoglobin levels were factors of serum-corrected Ca, P and iPTH not within target range. CONCLUSION: The control rates of serum-corrected Ca, P and iPTH in MHD patients in Anhui Province are relatively low. Monitoring and management should be strengthened to improve the prognosis of patients undergoing dialysis.

A multi-center study on the association between serum magnesium levels and allostatic load in hemodialysis patients.

Objective: Serum magnesium (Mg2+) levels are associated with insulin resistance, hypertension, lipid abnormalities, and inflammation. However, limited studies have indicated the relationship between Mg2+ and multiple system indexes. The purpose of this study was to investigate the association between Mg2+ and allostatic load (AL) in hemodialysis patients. Methods: A cross-sectional survey was conducted on hemodialysis patients from different centers in Anhui Province, China, between January and December 2020. A total of 3,025 hemodialysis patients were recruited. Their clinical data were measured before hemodialysis. Information was collected by an online self-reported questionnaire and medical record. Serum Mg2+ was divided into three groups by tertiles. A score of AL greater than or equal to 3 was defined as high AL. A binary logistic regression model was applied to examine the relationship between serum Mg2+ and AL. Results: A total of 1,222 patients undergoing hemodialysis were included, 60% of whom were males (733/1,222). The mean (standard deviation) age of patients was 55.90 (12.75). The median level of serum Mg2+ was 1.22 mmol/L. The rate of high AL levels was 23.4%. Serum Mg2+ was negatively correlated with body mass index, fasting blood glucose (Glu), and C-reactive protein and positively correlated with high-density lipoprotein, low-density lipoprotein, total cholesterol, diastolic blood pressure (DBP), and serum phosphorus. After adjusting for gender, anxiety, diabetes, family residence, lipid-lowering agents, antihypertensive medications, albumin, and Glu, the binary logistic regression model showed that patients with lower levels of serum Mg2+ were more likely have high AL (OR for the T1 group of serum Mg2+:1.945, 95% CI: 1.365-2.773, and OR for the T2 group of serum Mg2+:1.556, 95% CI: 1.099-2.201). Conclusion: Our data support the hypothesis that higher serum Mg2+ concentrations may contribute to lower health risk in hemodialysis populations. Further randomized controlled trials and cohort studies are warranted to verify whether Mg2+ supplementation could be part of routine examinations in hemodialysis populations.

Identifying the dominant impact factors and their contributions to heatwave events over mainland China.

The heatwave frequency and intensity have significantly changed as the climate warms and human activities increase, which poses a potential risk to human society. However, the impact factors that determine the change of heatwave events remain unclear. Here, we estimated the heatwave events based on data from 2474 in-suit gauges during 1960-2018 at daily scale in China. Besides, we explored possible drivers and their contributions to the change of heatwave based on correlation analysis, multiple linear regression (MLR), and random forest (RF) in different subregions of China. The results show that the temporal changes of all heatwave metrics exhibit significant differences between the period 1960-1984 and the period 1985-2019. Spatially, the heatwave frequency and duration significant increase in the southern China (S), eastern arid region (EA), northeastern China (NE), Qinghai-Tibet region (QT) and western arid and semi-arid region (WAS). The occurrence of the first heatwave event in a year tends to be earlier in S, NE, EA, WAS, and QT than before. Based on the regression modelling and RF, human activities play an important role in heatwave intensity in all subregions of China. For heatwave frequency, urbanization generate a dominant influence in NE, EA, and QT, with relative contributions (RC) ranging from 32.8 % to 38.9 %. Long-term climate change exerts the dominant influence in C, N, and S. Moreover, the first day of the yearly heatwave event (HWT) in NE is significantly influenced by climate change, with RC of 33.9 % for temperature variation (TEM). Our findings could provide critical information for understanding the causes of heatwave across different regions of China in the context of rapid urbanization and climate change.

Varying response of vegetation to sea ice dynamics over the Arctic.

Recent reduction of sea ice may have contributed to vegetation growth over the Arctic through albedo feedback effects to atmospheric warming. Understanding the varying response of vegetation to sea ice dynamics is critical for predicting future climate change over the Arctic and middle-high latitudes. Instead of looking at the direct response characteristics, we perform a systematic analysis of the time-lag and time-cumulation responses of vegetation to sea ice dynamics, using a long-term Arctic Normalized Difference Vegetation Index (NDVI) dataset and three sea ice indices (sea ice concentration (SIC), sea ice area (SIA) and sea ice extent (SIE)) from 1982 to 2015. The results show that annual NDVI in the Arctic has exhibited a significant (p < 0.05) increase during 1982 to 2015, while a significant (p < 0.05) decrease is detected for annual SIC, SIA and SIE. The results of a regression analysis on NDVI identify a lag time of 7-months, 8-months and 9-months for vegetation response to SIC, SIA and SIE in February, March and April, respectively, while no evident lag response is observed in summer except for August. For the cumulation response, NDVI in February, March and April shows the largest response to the previous 5, 7 and 9 months of sea ice variations, respectively, while a short cumulation response of 1 to 3 months is found in summer. The differences in the spatial patterns of lagged time are usually not statistically significant in autumn and winter. A shorter lag response (1-3 month) is found in the Yamalia region in June. Further analysis suggests that vegetation response to sea ice dynamics depends on bio - climatic characteristics and soil pH, with vegetation responding faster to sea ice changes in acidic soil. This study provides observational evidences on the varying response of vegetation to sea ice dynamics over the Arctic, which has great implications for predicting vegetation-climate feedback and climate change.