P5495Sex differences in marital status and risk of cardiovascular disease, cancer, and all-cause mortality: a systematic review and meta-analysis of 7,881,040 individuals

Background

Marital status has been identified as an important social factor associated with mortality. In current epidemiologic research, being unmarried was observed to be a suboptimal health status in the global population. The growing number of unmarried people has health implications, in light of evidence suggesting that it is associated with an increase in the incidence of various diseases and high mortality. Few attempts have been made to produce an overall estimate and sufficiently clarified of the sex difference between unmarried status and mortality risks, this is still a matter of debate.

Purpose

To ascertain whether sex differences exist in the relationship between marital status and cardiovascular disease (CVD), cancer, all-cause mortality in the general population and to explore the potential effect of age, location, the duration of follow-up and publication years on these outcomes.

Methods

A systematic search was performed in PubMed and EMBASE from inception through to April 2018 and review of references. We used the sex-specific RRs (relative risk) to derive the women-to-men ratio of RRs (RRR) and 95% CIs from each study. Subsequently, the RRR for each outcome was pooled with random effects meta-analysis weighted by the inverse of the variances of the log RRRs.

Results

Twenty-one studies with 7,881,040 individuals were included for meta-analysis. Compared with married individuals, being unmarried was significantly associated with all-cause mortality, cancer mortality, CVD mortality and coronary heart disease (CHD) mortality, especially for singles, for both sexes (Figure 1). However, the association with death from all-cause and CVD was significantly stronger in men. Compared with women who were divorced/separated, divorced/separated men had significantly higher risk of all-cause mortality, cancer mortality and CVD mortality. Moreover, never married men had 31% and 9% higher excess risk of stroke mortality and all-cause mortality, respectively, compared with never married women. No sex differences were observed concerning the impact of any unmarried status on CHD mortality.

Conclusions

Being unmarried (widowed, divorced/separated or never married) conferred higher excess risk of stroke mortality and all-cause mortality for men than women. Moreover, divorced/separated men had significantly higher risk of cancer mortality and CVD mortality. Further studies are warranted to clarify the biological, behavioral, and/or social mechanisms involved in sex differences driving these associations.

[Determination of seven urinary metabolites of benzene, toluene and xylene by ultra-high performance liquid chromatography-triple quadrupole mass spectrometry]

Objective: To develop a method using ultra-high performance liquid chromatography-triple quadrupole mass spectrometry to determine the urinary metabolites of benzene, toluene and xylene. The selected metabolites are S-phenylmercapturic acid (S-PMA) , trans, trans-muconic acid (t, t-MA) , 8-hydroxy-2 deoxyguanosine (8-OHdG) , hippuric acid (HA) , 2-methylhippuric acid (2-MHA) , 3-methylhippuric acid (3-MHA) and 4-methylhippuric acid (4-MHA) . Methods: The urine sample was pretreated using methanol to precipitate the proteins. HSS T3 chromatographic column was used to separate the metabolites. The mass spectrometric acquisition was carried out using multiple reaction monitoring (MRM) after ionization with ESI source. External standard method was used for quantification. Results: All the standard curves showed good linear relation, and r of the seven metabolites was all above 0.999. The detection limits and quantitative limits of the seven metabolites were 0.01-500 ng/ml and 0.02-1 000 ng/ml (based on the actual dilution ratio) , respectively. The average spiked recoveries of four loadings ranged from 85.8% to 109.9%. The intra-day and inter-day precisions were 0.2%-4.5% and 0.6%-9.5%, respectively. The samples can be kept for at least 14 days at both 4 ℃ and -20 ℃. Conclusion: This method is simple, rapid and highly sensitive with low cost, and its accuracy, precision and stability can meet the daily test requirements. It can be applied for the determination of urinary S-PMA, t, t-MA, 8-OHdG, HA, 2-MHA, 3-MHA and 4-MHA for the occupational population exposed to benzene, toluene and xylene.

Influence of Shrinkage and Viscosity of Flowable Composite Liners on Cervical Microleakage of Class II Restorations: A Micro-CT Analysis

This study determined the influence of shrinkage and viscosity of flowable composite liners on the cervical microleakage of Class II restorations using micro-CT. Seven composites of varying viscosities were selected and included five giomers (Shofu Beautifil II [BF], Flow Plus F00 and F03 [F00 and F03], Flow F02 and F10 [F02 and F10]) and 2 nano-filled composites (3M-ESPE Filtek Z350 [Z350] and Filtek Z350 Flowable [Z350F]). Polymerization shrinkage (n=7) was assessed with the Acuvol volumetric shrinkage analyzer while complex viscosity was determined with the advanced rheometric expansion system at 25°C. Standardized Class II restorations incorporating 1-mm horizontal layers of different flowable liners and 3-mm oblique layers of BF or Z350 were subjected to a silver nitrate test for 24 hours and examined using micro-CT. Microleakage was determined at 0.1-mm intervals from the buccal to lingual surfaces providing 30 sites per specimen and scored accordingly. Statistical analysis was performed with the one-way ANOVA, Kruskal-Wallis test, and Spearman's rho correlation at a significance level of p<0.05. Mean volumetric shrinkage ranged from 5.33±0.17% to 2.35±0.02% for F02 to Z350, respectively. The flowable materials had significantly higher shrinkage than did their sculptable counterparts (BF and Z350). Complex viscosities ranged from 9.65 to 4.20 (Z350 and F10, respectively) at a frequency of 10 rad/s and from 8.16 to 3.28 (Z350 and F03, respectively) for 100 rad/s. Giomer restorations had significantly less leakage than did those restored with nano-filled composites. No microleakage was observed with restorations lined with F02 or F10. The use of flowable liners reduced cervical microleakage of Class II restorations. Interfacial integrity of Class II restorations was significantly correlated with liner viscosity, filler volume, and shrinkage.

New insights into the plasmonic enhancement for photocatalytic H2 production by Cu–TiO2 upon visible light illumination

Cu nanoparticles were deposited on the surface of commercial TiO₂ nanoparticles (Cu–TiO₂) using different methods aiming at the production of highly efficient visible light photocatalysts.

Vitamin D Status and Prevalent Early Age-Related Macular Degeneration in African Americans and Caucasians: The Atherosclerosis Risk in Communities (ARIC) Study

OBJECTIVES

Vitamin D status has been hypothesized to protect against development of early age-related macular degeneration (AMD) via its anti-inflammatory properties and its possible beneficial influence on blood pressure control. We investigated the association between vitamin D status and prevalent early AMD in a community-based cohort.

DESIGN

This was a cross-sectional study.

SETTING

This was a secondary data analysis of already existing data from the Atherosclerosis Risk in Communities Study (ARIC) cohort collected from 1990 to 1995.

PARTICIPANTS

There were 9,734 (7,779 Caucasians, 1,955 African American) ARIC participants (aged 46 to 70 at visit 2 [1990-1992]) with 25(OH)D data available at visit 2, AMD assessment at visit 3 (1993-1995), and complete covariate data.

MEASUREMENTS

Vitamin D status was assessed with serum 25-hydroxyvitamin D (25(OH)D) concentrations from bloods drawn at visit 2. Prevalent, early AMD (n=511) was assessed at visit 3 (1993-95) with nonmydriatic retinal photographs of one randomly chosen eye. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for early AMD by categories of 25(OH)D in nmol/L (deficient <30, inadequate 30-<50, and two categories of adequate status: 50-<75 and ≥75). Linear trend was estimated using continuous 25(OH)D concentrations. ORs were adjusted for age, race, and smoking status. We further adjusted for hypertension status to examine if vitamin D status influenced early AMD via its effects on blood pressure. Exploratory analyses of effect modification by age, sex, race and high risk genotypes [Y402H complement factor H (CFH) rs1061170 and the A69S age-related maculopathy susceptibility 2 (ARMS2) rs10490924 polymorphisms] were conducted.

RESULTS

The prevalence of early AMD was 5%, and 5% of participants were vitamin D deficient. The adjusted OR (95% CIs) for early AMD among those with adequate (≥75 nmol/L) compared to deficient (<30 nmol/L) vitamin D status was 0.94 (0.59-1.50), p-trend=0.86. Further adjustment for hypertension status did not influence results (OR [95% CI]=0.95 [0.59-1.52], p-trend=0.84). Results did not vary significantly by age, race, sex, early AMD subtype (soft drusen or retinal pigment epithelium depigmentation), or ARMS2 genotype. Results did not vary significantly by CFH genotype in African Americans. The p for multiplicative interaction between 25(OH)D and CFH genotype was 0.06 in Caucasians, but OR [95% CIs] for AMD by vitamin D status were similar in each CFH genotype and not statistically significant.

CONCLUSIONS

Vitamin D status was not associated with early AMD in this cohort sample.

[The characteristics of a mouse model with nasal polyp established by lipopolysaccharide]

Objective:To explore the effect of lipopolysaccharide(LPS) on the formation of nasal polyps in mice and its mechanism.Method:Five or ten μg of LPS were dropped into the nasal cavities of six to eight-week C57BL/6J mice in order to establish animal models with nasal polyps.Buried food pellets experiment was used to assess olfactory function of mice.Hematoxylin-eosin staining,olfactory marker protein(OMP),and myeloperoxidase(MPO) for neutrophil immunohistochemistry were used to observe histopathological changes in the nasal mucosa.The expression levels of cytokines,such as interferon(IFN)-γ,tumor necrosis factor(TNF)-α,IL-6 in the nasal lavage fluid,were detected by ELISA.Result:Compared to the control group,mice in the LPS groups showed significant nasal polyp formation,olfactory dysfunction,more MPO⁺ cells while less OMP⁺ cells in the nasal mucosa,as well as increased significantly levels of IFN-γ,TNF-α,and IL-6 in the nasal lavage fluids(all P<0.05).Conclusion:LPS from Gram negative bacteria alone can induce the formation of nasal polyps in mice,characterized by more neutrophils,olfactory dysfunction,and increasing Th1 cytokine.Therefore,this model is commensurate with the characteristics of primary nasal polyps found in China and other major Asian.The current study suggests that LPS may be one of the important pathogenesis of gram negative bacteria in the nasal polyps.

[Micro-CT observations of the adaptation at gingival wall in Class II restorations with different dental restorative materials]

OBJECTIVE

To evaluate the adaptation of different materials for gingival layer in Class II restorations using Micro-CT.

METHODS

Eighteen extracted human premolars were selected, and Class II cavities were prepared. The teeth were randomly divided into six groups and restored using layering technique. Six materials were used for gingival layer, including four injectable materials: Beautifil Flow Plus F00 (F00), Beautifil Flow F10 (F10), Filtek Z350 Flowable (Z350F), FujiII LC CAPSULE (Fuji), and two packable materials: BeautifilII (BF), Filtek Z350 (Z350). The restored teeth were scanned with micro-CT and the images were 3D reconstructed to evaluate the volumes and the distribution of the voids on the restoration-tooth interface of the gingival layer. The volume of the voids were statistically analyzed using nonparametric Jonckheere-Terpstra tests.

RESULTS

The volumes (mm(3)) of the voids on the restoration-tooth interface were: Z350F (0.000 15), F10 (0.000 39), F00 (0.012), Fuji (0.070), Z350 (0.16) and BF (0.20). There were significant differences between Z350F/F10 and Fuji/Z350/BF (P < 0.05). Most of the voids were found on the point-line angles of the cavities.

CONCLUSION

The voids on the restoration-tooth interface were mainly on the point-line angles of the cavities. Injectable materials with high flowablility could reduce the restoration-tooth interface voids significantly when used for the gingival layer in Class II restorations.

Impact of exercise intensity on cardiac function in adolescent runners

BACKGROUND

Prolonged exercise may induce a transient reduction in the left ventricular (LV) function (exercise-induced cardiac fatigue) in adults. However, data related to the cardiovascular consequences of prolonged exercise in adolescents are extremely limited. This study examined the impact of exercise intensity adopted in routine long-distance run training on LV function in trained adolescent runners in a laboratory-based setting.

METHODS

Twelve male adolescent runners (14.5 ± 1.5 years) performed two 90-min treadmill runs with intensity set at the running speeds that corresponded to either 80% (T1) or 100% (T2) ventilatory threshold. LV function was examined echocardiographically pre- and post-exercise.

RESULTS

The two-factor repeated-measures ANOVA revealed no significant (P>0.05) main effects for the intensity and the interaction of intensityÍ pre- and postexercise in ejection fraction (EF), systolic blood pressure/end systolic volume ratio (SBP/ESV) and early to atrial diastolic flow velocity ratio (E:A). Nevertheless, the main effect for time course in EF was significant (P<0.05). Pre-exercise EF in T1 (74 ± 5 vs. 70 ± 5%, P<0.05), but not in T2 (75 ± 4 vs. 72 ± 7%, P>0.05), decreased significantly post-exercise, yet this did not reach clinical levels. Further, no difference (P>0.05) was found between pre- and post-exercise in SBP/ESV (T1: 3.9 ± 0.9 vs. 3.7 ± 1.1; T2: 4.0 ± 0.7 vs. 4.6 ± 1.9 mmHg·ml⁻¹) and E:A (T1: 1.87 ± 0.11 vs. 1.87 ± 0.11; T2: 1.83 ± 0.11 vs. 1.87 ± 0.09) in both trials.

CONCLUSION

These findings suggest that the training intensities adopted in routine long-distance run training in the adolescent runners do not seem to induce cardiac fatigue. Adolescent hearts appear to cope well with prolonged run performed on training.

Rapid reuptake of granzyme B leads to emperitosis: an apoptotic cell-in-cell death of immune killer cells inside tumor cells

A cell-in-cell process refers to the invasion of one living cell into another homotypic or heterotypic cell. Different from non-apoptotic death processes of internalized cells termed entosis or cannibalism, we previously reported an apoptotic cell-in-cell death occurring during heterotypic cell-in-cell formation. In this study, we further demonstrated that the apoptotic cell-in-cell death occurred only in internalized immune killer cells expressing granzyme B (GzmB). Vacuole wrapping around the internalized cells inside the target cells was the common hallmark during the early stage of all cell-in-cell processes, which resulted in the accumulation of reactive oxygen species and subsequent mitochondrial injury of encapsulated killer or non-cytotoxic immune cells. However, internalized killer cells mediated rapid bubbling of the vacuoles with the subsequent degranulation of GzmB inside the vacuole of the target cells and underwent the reuptake of GzmB by killer cells themselves. The confinement of GzmB inside the vacuole surpassed the lysosome-mediated cell death occurring in heterotypic or homotypic entosis processes, resulting in a GzmB-triggered caspase-dependent apoptotic cell-in-cell death of internalized killer cells. On the contrary, internalized killer cells from GzmB-deficient mice underwent a typical non-apoptotic entotic cell-in-cell death similar to that of non-cytotoxic immune cells or tumor cells. Our results thus demonstrated the critical involvement of immune cells with cytotoxic property in apoptotic cell-in-cell death, which we termed as emperitosis taken from emperipolesis and apoptosis. Whereas entosis or cannibalism may serve as a feed-on mechanism to exacerbate and nourish tumor cells, emperitosis of immune killer cells inside tumor cells may serve as an in-cell danger sensation model to prevent the killing of target cells from inside, implying a unique mechanism for tumor cells to escape from immune surveillance.

Phosphatidic acid regulates microtubule organization by interacting with MAP65-1 in response to salt stress in Arabidopsis

Membrane lipids play fundamental structural and regulatory roles in cell metabolism and signaling. Here, we report that phosphatidic acid (PA), a product of phospholipase D (PLD), regulates MAP65-1, a microtubule-associated protein, in response to salt stress. Knockout of the PLDα1 gene resulted in greater NaCl-induced disorganization of microtubules, which could not be recovered during or after removal of the stress. Salt affected the association of MAP65-1 with microtubules, leading to microtubule disorganization in pldα1cells, which was alleviated by exogenous PA. PA bound to MAP65-1, increasing its activity in enhancing microtubule polymerization and bundling. Overexpression of MAP65-1 improved salt tolerance of Arabidopsis thaliana cells. Mutations of eight amino acids in MAP65-1 led to the loss of its binding to PA, microtubule-bundling activity, and promotion of salt tolerance. The pldα1 map65-1 double mutant showed greater sensitivity to salt stress than did either single mutant. These results suggest that PLDα1-derived PA binds to MAP65-1, thus mediating microtubule stabilization and salt tolerance. The identification of MAP65-1 as a target of PA reveals a functional connection between membrane lipids and the cytoskeleton in environmental stress signaling.

Microenvironment-dependent homeostasis and differentiation of epidermal basal undifferentiated keratinocytes and their clinical applications in skin repair

Skin homeostasis is maintained by controlling the balance between proliferation and differentiation of epidermal stem cells. The microenvironment, including extrinsic stresses, growth factors, soluble molecules, cell-ECM and cell-cell communications, plays an important role in cell fate determination in vivo and in vitro. In response to external signals, keratinocytes cooperate with other cell types to modulate and facilitate the wound microenvironment during wound healing; however, the aberrant signals or conjunctions in the environment will lead to pathologic abnormalities. In addition, despite some drawbacks, the epidermal stem-cellbased bioengineered skin substitutes have greatly improved the quality of cutaneous repair. Thus, exploring the characteristics and regulation mechanisms of microenvironment-dependent homeostasis and differentiation of epidermal basal undifferentiated keratinocytes is necessary to understand skin development and wound repair and to design novel therapeutic strategies for skin wound healing.