Clinical and Hemodynamic Associations and Prognostic Implications of Ventilatory Efficiency in Patients With Preserved Left Ventricular Systolic Function

BACKGROUND

Ventilatory efficiency (minute ventilation required to eliminate carbon dioxide, VE/VCO2) during exercise potently predicts outcomes in advanced heart failure with reduced ejection fraction, but its prognostic significance for at-risk individuals with preserved left ventricular systolic function is unclear. We aimed to characterize mechanistic determinants and prognostic implications of VE/VCO2 in a single-center dyspneic referral cohort (MGH-ExS [Massachusetts General Hospital Exercise Study]) and in a large sample of community-dwelling participants in the FHS (Framingham Heart Study).

METHODS

Maximum incremental cardiopulmonary exercise tests were performed. VE/VCO2 was assessed as the slope pre- and post-ventilatory anaerobic threshold (VE/VCO2_pre-VATslope, VE/VCO2_{post-VATslope}), the slope throughout exercise (VE/VCO2_{overall-slope}), and as the lowest 30-second value (VE/VCO2_nadir).

RESULTS

In the MGH-ExS (N=493, age 56±15 years, 61% women, left ventricular ejection fraction 64±8%), higher VE/VCO2_nadir was associated with lower peak exercise cardiac output and steeper increases in exercise pulmonary capillary wedge pressure (both P<0.0001). VE/VCO2_nadir (hazard ratio, 1.34 per 1-SD unit [95% CI, 1.10-1.62] P=0.003) was associated with future cardiovascular hospitalization/death and outperformed classical VE/VCO2 measures used in heart failure with reduced ejection fraction (VE/VCO2_{overall-slope}). In FHS (N=1936, age 54±9 years, 53% women), VE/VCO2 measures taken in low-to-moderate intensity exercise (including VE/VCO2_pre-VATslope, VE/VCO2_nadir) were directly associated with cardiovascular risk factor burden (smoking, Framingham cardiovascular disease risk score, and lower fitness; all P<0.001).

CONCLUSIONS

Impaired ventilatory efficiency is associated with cardiovascular risk in the community and with adverse hemodynamic profiles and future hospitalizations/death in a referral population, highlighting the prognostic importance of easily acquired submaximum exercise ventilatory gas exchange measurements in broad populations with preserved left ventricular systolic function.

Ebola, Zika, Corona…What Is Next for Our World?

In the past century, there have been several pandemics. Within the context of global health, these pandemics have often been viewed from the lens of determinants such as population, poverty, and pollution. With an ever-changing world and the COVID-19 pandemic, the current global determinants of public health need to be expanded. In this editorial, we explore and redefine the major determinants of global public health to prevent future pandemics. Policymakers and global leaders should keep at heart the determinants suggested hereby in any planning, implementation, and evaluation of efforts to improve global public health and prevent pandemics.

Comparison of Cardiovascular Risk Factors in European Population Cohorts for Predicting Atrial Fibrillation and Heart Failure, Their Subsequent Onset, and Death

Background

Differences in risk factors for atrial fibrillation (AF) and heart failure (HF) are incompletely understood. Aim of this study was to understand whether risk factors and biomarkers show different associations with incident AF and HF and to investigate predictors of subsequent onset and mortality.

Methods and Results

In N=58 693 individuals free of AF/HF from 5 population‐based European cohorts, Cox regressions were used to find predictors for AF, HF, subsequent onset, and mortality. Differences between associations were estimated using bootstrapping. Median follow‐up time was 13.8 years, with a mortality of 15.7%. AF and HF occurred in 5.0% and 5.4% of the participants, respectively, with 1.8% showing subsequent onset. Age, male sex, myocardial infarction, body mass index, and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) showed similar associations with both diseases. Antihypertensive medication and smoking were stronger predictors of HF than AF. Cholesterol, diabetes mellitus, and hsCRP (high‐sensitivity C‐reactive protein) were associated with HF, but not with AF. No variable was exclusively associated with AF. Population‐attributable risks were higher for HF (75.6%) than for AF (30.9%). Age, male sex, body mass index, diabetes mellitus, and NT‐proBNP were associated with subsequent onset, which was associated with the highest all‐cause mortality risk.

Conclusions

Common risk factors and biomarkers showed different associations with AF and HF, and explained a higher proportion of HF than AF risk. As the subsequent onset of both diseases was strongly associated with mortality, prevention needs to be rigorously addressed and remains challenging, as conventional risk factors explained only 31% of AF risk.

Specific Dietary (Poly)phenols Are Associated with Sleep Quality in a Cohort of Italian Adults

Background: Diet has been the major focus of attention as a leading risk factor for non-communicable diseases, including mental health disorders. A large body of literature supports the hypothesis that there is a bidirectional association between sleep and diet quality, possibly via the modulation of neuro-inflammation, adult neurogenesis and synaptic and neuronal plasticity. In the present study, the association between dietary total, subclasses of and individual (poly)phenols and sleep quality was explored in a cohort of Italian adults. Methods: The demographic and dietary characteristics of 1936 adults living in southern Italy were analyzed. Food frequency questionnaires (FFQs) were used to assess dietary intake. Data on the (poly)phenol content in foods were retrieved from the Phenol-Explorer database. The Pittsburg Sleep Quality Index was used to measure sleep quality. Multivariate logistic regression analyses were used to test the associations. Results: A significant inverse association between a higher dietary intake of lignans and inadequate sleep quality was found. Additionally, individuals with the highest quartile of hydroxycinnamic acid intake were less likely to have inadequate sleep quality. When individual compounds were taken into consideration, an association with sleep quality was observed for naringenin and apigenin among flavonoids, and for matairesinol among lignans. A secondary analysis was conducted, stratifying the population into normal weight and overweight/obese individuals. The findings in normal weight individuals showed a stronger association between certain classes of, subclasses of and individual compounds and sleep quality. Notably, nearly all individual compounds belonging to the lignan class were inversely associated with inadequate sleep quality. In the overweight/obese individuals, there were no associations between any dietary (poly)phenol class and sleep quality. Conclusions: The results of this study suggest that a higher dietary intake of certain (poly)phenols may be associated with better sleep quality among adult individuals.

Are tiny subterranean ants top predators affecting aboveground ant communities?

Ants are a widespread group of ecologically important insects. Therefore, ants that are important predators of other ants are likely to play key roles by changing the abundance and impacts of their prey. Familiar arthropod predators, like army ants, are known for their overwhelming raids on invertebrate prey but are limited to mostly tropical systems. Thief ants (Genus: Solenopsis Westwood) are a cosmopolitan group of mostly subterranean ants found in a wide variety of ecosystem types. They are known for their extremely small sizes and their specialized predation where they stealthily tunnel into the nests of other larger ant species to capture and consume only immature ants (larvae and pupae). Predation of ant colonies by other ants, and specialized predatory behaviors of presumed top ant predators (e.g., army ants) are well known. However long-term predation effects, such as across several seasons, are still poorly understood because of a lack of experimental studies. Here we report results of a ~1.5-year press field experiment where thief ants were reduced in natural ant communities. Potential impacts, such as predator-release, were quantified by sampling the co-occurring ant community. Compared to control plots, overall worker abundance and biomass increased where thief ants were reduced, and effects varied among ant species. Results suggest predator release as select aboveground foraging ant species increased in abundance and that thief ants may act as significant predators. Because thief ants are abundant and widespread, similar predatory effects may occur in many ant communities, and our understanding of important predators may need to adjust to include thieving species as well as army ants. Thief ants are very abundant, tiny, specialized to consume immature life stages, equipped with powerful venom, eusocial, and subterranean. This suite of adaptive traits seems unique to eusocial predators compared to animals, where "thieving" predators are usually larger in size compared to their adult-sized prey. Future work quantifying top-down regulation of prey and cascading consumptive and non-consumptive effects will help to understand thief ant predation and potential effects on ecosystem processes.

The prognostic effect of smoking status on intensively treated acute myeloid leukaemia - A Danish nationwide cohort study

With rising life expectancy, the importance of patient-related prognostic factors and how to integrate such data into clinical decision-making becomes increasingly important. The aim of this study was to evaluate the prognostic impact of smoking status in patients with acute myeloid leukaemia (AML) treated with intensive chemotherapy. We conducted a nationwide cohort study based on data obtained from the Danish National Leukaemia Registry (DNLR). The study comprised Danish patients aged 18-75 years, diagnosed with AML between 1 January 2000 and 31 December 2012. Medical records were reviewed and data on smoking status were collected. A total of 1040 patients (median age 59 years) were included, and 602 patients (58·9%) were categorised as ever-smokers and the remaining as never-smokers. Kaplan-Meier survival estimates revealed that ever-smokers had a significant shorter median overall survival (OS) at 17·2 months [95% CI (14·9;19·1)] compared to never-smokers at 24·5 months (95% CI [19·2;30·7]). Multivariate analysis revealed smoking status as a significant prognostic factor for inferior OS with a hazard ratio (HR) of 1·22 [95% CI (1·04;1·44)]. In conclusion, smoking status was found to be associated with inferior OS in intensively treated AML patients.

Association Between Atrial Fibrillation and Cognitive Impairment in Individuals With Prior Stroke: A Meta-Analysis and Meta-Regression Analysis

Background and Purpose- Atrial fibrillation (AF) is the most common chronic arrhythmia. Dementia and cognitive impairment (CI) are major burdens to public health. The prevalence of all 3 entities is projected to increase due to population aging. Previous reports have linked AF with a higher risk of CI and dementia in patients without prior stroke. Stroke is known to increase the risk for dementia and CI. It is unclear if AF in patients with history of stroke can further increase the risk for dementia or CI. Our purpose was to evaluate the impact of AF on risk for dementia or CI among patients with history of stroke. Methods- Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed. Pubmed, Scopus, and Cochrane central were searched. The outcomes of interest were dementia, CI, and the composite end point of dementia or CI. A random-effect model meta-analysis was performed. Meta-regression analysis was also performed. Publication bias was assessed with the Egger test and with funnel plots. Results- Fourteen studies and 14 360 patients (1363 with AF) were included in the meta-analysis. In the meta-analysis of adjusted odds ratio, AF was associated with increased risk of CI (odds ratio, 1.60 [95% CI, 1.20-2.14]), dementia (odds ratio, 3.11 [95% CI, 2.05-4.73]), and the composite end point of CI or dementia (odds ratio, 2.26 [95% CI, 1.61-3.19]). The heterogeneity for the composite end point of dementia or CI was moderate (adjusted analysis). The heterogeneity for the analysis of the end point of CI only was substantial in the unadjusted analysis and moderate in the adjusted analysis. The heterogeneity for the end point of dementia only was moderate in the unadjusted analysis and zero in the adjusted analysis. Conclusions- Our results indicate that an association between AF and CI or dementia is patients with prior strokes is possible given the persistent positive associations we noticed in the unadjusted and adjusted analyses. The heterogeneity levels limit the certainty of our findings.

[The sociological research methods in practice of medical social work]

The specificity of medical and social work as professional activity targeted to restoring, preserving and promoting population health determines related focus of research practice and interdisciplinary nature of research. In accordance with purpose of medical and social work, specificity of emerging research practice is related to the fact that comprehensive assistance in maintaining and promoting population health implies the presence in activities of social worker medical and social profile of psychological, pedagogical, legal, technological and research competence. The article also applies the concept of "professional social worker involved in the provision of medical and social assistance to the population." This concept has following meaning: these are citizens who work in the positions of "social worker" and "specialist in social work" in medical organizations and social service organizations of population, who have job function related to restoring, maintaining and improving population health in general, social and in particular social and medical services. Therefore, content of the problem field, choice of areas of scientific support is concerned to each of these aspects of activity and associated social reflection. The article presents the results of theoretical study of the role of sociological methods in implementation of medical and social work.

Epidemiological considerations in transgender health: A systematic review with focus on higher quality data

Background: High quality data pertaining to the size of the transgender and gender diverse (TGD) population are scant, however, several recently published studies may provide more reliable contemporary estimates. Aims: To summarize the estimated number and proportion of TGD individuals overall and across age groups, based on most accurate data. Methods: This systematic review focused on recent studies (published from 2009 through 2019) that utilized sound methodology in assessing the proportion of TGD people in the general population. Publications were included if they used clear definitions of TGD status, and calculated proportions based on a well-defined sampling frame. Nineteen eligible publications represented two broad categories of studies: those that used data from large health care systems; and those that identified TGD individuals from population surveys. Results: Among health system-based studies, TGD persons were identified using relevant diagnostic codes or clinical notes. The proportions of individuals with a TGD-relevant diagnosis or other recorded evidence ranged between 17 and 33 per 100,000 enrollees. In population surveys TGD status was ascertained based on self-report with either narrow or broad definitions. The survey-based estimates were orders of magnitude higher and consistent across studies using similar definitions. When the surveys specifically inquired about 'transgender' identity, the estimates ranged from 0.3% to 0.5% among adults, and from 1.2% to 2.7% among children and adolescents. When the definition was expanded to include broader manifestations of 'gender diversity', the corresponding proportions increased to 0.5-4.5% among adults and 2.5-8.4% among children and adolescents. Upward temporal trends in the proportion of TGD people were consistently observed. Conclusions: Current data indicate that people who self-identify as TGD represent a sizable and increasing proportion of the general population. This proportion may differ, depending on inclusion criteria, age, and geographic location, but well-conducted studies of similar type and design tend to produce comparable results.

Documentation of clinically relevant genomic biomarker allele frequencies in the next-generation FINDbase worldwide database

FINDbase (http://www.findbase.org) is a comprehensive data resource recording the prevalence of clinically relevant genomic variants in various populations worldwide, such as pathogenic variants underlying genetic disorders as well as pharmacogenomic biomarkers that can guide drug treatment. Here, we report significant new developments and technological advancements in the database architecture, leading to a completely revamped database structure, querying interface, accompanied with substantial extensions of data content and curation. In particular, the FINDbase upgrade further improves the user experience by introducing responsive features that support a wide variety of mobile and stationary devices, while enhancing computational runtime due to the use of a modern Javascript framework such as ReactJS. Data collection is significantly enriched, with the data records being divided in a Public and Private version, the latter being accessed on the basis of data contribution, according to the microattribution approach, while the front end was redesigned to support the new functionalities and querying tools. The abovementioned updates further enhance the impact of FINDbase, improve the overall user experience, facilitate further data sharing by microattribution, and strengthen the role of FINDbase as a key resource for personalized medicine applications and personalized public health.

Quantification of Outcrossing Events in Haploid Fungi Using Microsatellite Markers

Species in genera of the fungal family Ceratocystidaceae are known to have different mating strategies, including heterothallism and homothallism. Of these, species of Ceratocystis, typified by the pathogen Ceratocystis fimbriata all undergo unidirectional mating-type switching. This implies that the pathogens possess the ability to self, but also to undergo sexual outcrossing between isolates of different mating types. In this study, we extended the recently developed microsatellite-based technique to determine the extent to which outcrossing occurs in ascospore masses of haploid fungi to two field collections of Ceratocystis albifundus. In this way, the role of reproductive strategies in shaping population structure and diversity could be better understood. Results showed that a high frequency of outcrossing occurs in isolates of the pathogen from both non-native and native areas. This explains the high level of genetic diversity previously observed in this population despite the fact that this pathogen has the ability to self.

Genetic position of Hungarian Grey among European cattle and identification of breed-specific markers

Hungarian Grey is an indigenous cattle breed that is one of the national symbols of Hungary. However, genetic description of the Hungarian Grey cattle has not yet been conducted based on whole-genome screening. Using the GeneSeek high-density Bovine SNP (single nucleotide polymorphism) 150 K BeadChip, we sampled the genome of 36 Hungarian Grey, 12 Maremmana, 13 Hungarian Fleckvieh and 5 Holstein-Friesian cattle for population studies and used data of 139 other cattle from an additional dataset created on European cattle breeds (Upadhyay et al.2017. Heredity 118, 169-176). The performance of a multidimensional scaling plot showed that Hungarian Grey clustered independently from other European cattle. The number and total length of runs of homozygosity (ROH) is similar or slightly below the value of other European cattle; FROH coefficients (proportion of the autosomal genome covered by ROH) are similar to Maremmana and Maronesa. The frequency of ROH does not show increased values as it can be noticed in Heck and Maltese. These results indicate that the Hungarian Grey cattle have been successfully maintained avoiding negative genetic effects, and reflect the uniqueness among European cattle. The identification of breed-specific loci has been aimed at differentiating Hungarian Grey (n = 136 in this case) from other cattle breeds (n = 169). Ten loci (-log10P > 5) were identified as markers capable for differentiation of Hungarian Grey. These markers are located on chromosomes 6, 14, 15, 16, 20 and 24.

A Retrospective Analysis of Mortality From 2015 Gorkha Earthquakes of Nepal: Evidence and Future Recommendations

OBJECTIVE

The aim of this study was to explore the mortality pattern due to Gorkha earthquakes in 2015 and review the response and recovery efforts immediately following the earthquakes.

METHODS

Data from published reports of the Nepal Police showed over 8000 deaths. These death counts were categorized by gender, ethnicity, and age groups (interval of 5 years). The mortality rate was calculated (per 100 000 population), using the projected population as the denominator as of April 2015.

RESULTS

Children < 10 years and older adults > 55 years showed a higher rate of deaths, with similar trends for the most affected districts. Almost 8 more females' deaths were reported per 100 000 population compared with their male counterparts. There was a higher death rate from Province 3 with a notable gender difference: Nearly 20 more females' deaths were reported per 100 000 population compared with their male counterparts. There was a higher death rate in mountains (542.4 per 100 000) compared with hills (55.0 per 100 000) and the southern Terai region (0.96 per 100 000) of Nepal.

CONCLUSIONS

Young and older adults, female, and residents of remote, mountainous regions of Nepal were vulnerable to the earthquakes. Future earthquake preparedness should focus on the vulnerable population by age and gender and the geographical accessibility.

Assistive technology use and unmet need in Canada

BACKGROUND

Around the world, variations and inequities in access to assistive technology (AT) are evident. Development of legislation, policies, and programmes has not kept pace with the increasing demand for AT. Therefore, context-specific needs assessment is required, which can assist in anticipating the accessibility and human support needs of individuals with impairments, and in turn, inform resource allocation and prioritisation of services. The purpose of this cross-sectional study was to describe the current use and unmet needs of AT use in community-dwelling Canadians experiencing activity limitation or participation restriction (disability).

DATA AND METHODS

Bootstrapping was used to estimate the prevalence of AT use and unmet needs using data from the 2012 Canadian Survey on Disability (CSD). The total sample size for the CSD was 45,443 individuals.

RESULTS

Among the estimated 3,775,920 Canadians with a disability (13.7% of the Canadian population), 3,579,580 used some form of AT. Among these individuals, 3,050,750 use glasses or contact lenses and 1,109,060 use bathroom aids. The results of the study showed that the most common unmet need was for hearing aids (0.86% of the total population), followed by bathroom aids (0.36%).

INTERPRETATIONS

This study comes at a time when global attention is focussed on research on access to AT. This study using data from the CSD will serve disability and social policy analysts at all levels of government, as well as associations for persons with disabilities and researchers working in the field of disability policy and programmes.Implication for RehabilitationThe current initiatives on assistive technology, including the World Health Organization's Global Cooperation on Assistive Technology (GATE) project, recognize the substantial gap between the need for and provision of assistive devices. In Canada, for example, as well as in other countries, despite rapid growth in innovation, unmet needs for assistive devices persist and multiple barriers have been reported by individuals in accessing needed assistive devices. A better understanding of the met and unmet needs of assistive technology users can assist in anticipating accessibility and human support needs of individuals with disabilities, and in turn, inform resource allocation and prioritization of services. • The study estimates the prevalence of assistive device use in community dwelling Canadians and describes the unmet needs for assistive devices of Canadians with activity limitation (disability).• This study provides evidence on the use and unmet assistive technology needs for disability and social policy analysts at all levels of government, as well as associations for persons with disabilities and researchers working in the field of disability policy and programmes.• The results of this study can be used for planning and evaluating services, programmes and policies for Canadian adults with disabilities to help enable their full participation in society.

Recombination Pattern Characterization via Simulation Using Different Maize Populations

Efficient recombination is critical to both plant breeding and gene cloning. However, almost all traditional recombination studies and genetic improvements require the slow and labor-intensive population construction process, and little is known about the recombination characteristics of populations of different types, generations, and origins. Here, we provide a simple and efficient simulation method for population construction based on doubled haploid (DH) and intermated B73 × Mo17 maize (IBM) populations to predict the recombination pattern. We found that the chromosomes had 0, 1, 2, and 3 recombination events that occurred at rates of 0.16, 0.30, 0.23, and 0.15, respectively, in the DH and the recombination rate of each chromosome in the IBM population ranged from 0 to 12.1 cM per 125 kb. Based on the observed recombination parameters, we estimated the number of recombination events and constructed the linkage maps of the simulated DH and recombination inbred line (RIL) populations. These simulated populations exhibited similar recombination patterns compared with the real populations, suggesting the feasibility of this simulation approach. We then compared the recombination rates of the simulated populations of different types (DH induced or self-crossed), generations, and origins (using the 8, 16, and 32 multiparent advanced generation intercross (MAGIC) populations), and suggested a rapid and cost-effective population construction procedure for breeders and geneticists, while maintaining an optimal recombination rate. This study offers a convenient method for optimizing the population construction process and has broader implications for other crop species, thereby facilitating future population studies and genetic improvement strategies.

The North Karelia Project: Prevention of Cardiovascular Disease in Finland Through Population-Based Lifestyle Interventions

The North Karelia Project was started in 1972 as a response to the high cardiovascular mortality among men in North Karelia, Finland's easternmost province. Prevalent cardiovascular disease risk factors in the province included elevated serum cholesterol, hypertension, and smoking. Through a sociobehavioral framework utilizing community-based interventions and national-level policy changes and legislation, the project targeted lifestyle changes as a means to alleviate cardiovascular disease risk factors. Diet recommendations included minimizing the use of saturated fats and decreasing salt intake. Another target of the project was to reduce the prevalence of smoking. As a result of the lifestyle interventions that continued beyond the initial 5 years of the project and then expanded to all of Finland, there were significant reductions in serum cholesterol levels, hypertension, smoking prevalence, and cardiovascular disease mortality. The North Karelia Project demonstrates that successful population-based lifestyle interventions serve as a sustainable public health solution to the growing chronic disease burden.

Effects of the Community Cats Program on Population Control, Migration and Welfare Status of Free-Roaming Cats in Tokyo, Japan

The community cats program (CCP), which includes trap-neuter-return activities, has been promoted in Japan to reduce the population of free-roaming cats without harmful effects on their welfare. To ascertain the effects of the CCP, a two-year route census of free-roaming cats was conducted in an area with CCP and the other area without CCP in urban Tokyo, Japan. The estimated number of cats was lower in the CCP area than the non-CCP area, but there was no difference in the rate of decline in cat populations between areas. More cats emigrated or disappeared rather than immigrated in both areas in the second year and more males tended to immigrate into the CCP area. There was no difference in the behavior of cats between areas and among seasons. The proportion of cats with poor health was lower in the CCP area than the non-CCP area. These results suggest that the CCP may improve the welfare of free-roaming cats. As the effect of CCP was restrictive in reducing the population of free-roaming cats, the further promotion of neutering of cats may be necessary to reduce the population density of cats.

[Analysis of Activity and Its Emissions Trend for Construction Equipment in China]

Emissions from non-road equipment are attracting more attention due to their increasing contribution to air pollution. Thus, an accurate estimate of emission inventory for non-road equipment is imperative for air quality management and improvement. Activity data from a large range of construction equipment were collected from multiple sources, including on-site/phone interviews and literature review, and used for further analysis to characterize its operations. Activity analysis of construction equipment included:①activity of construction equipment by type (functionality); ②activity differences by geographical area; and ③activity differences by age. A back-propagation neural network model was developed to estimate the construction equipment population in China from 2018 to 2025. Furthermore, real-world measurements of emissions were made on 47 selected examples of construction equipment using a portable emission measurement system. Population, activity, and emission factors were then combined to develop emission inventories for construction equipment in China from 2015 to 2025. The results showed that activity of construction equipment differs by type or functionality, ranging from 1439 to 4332 hours per year. Furthermore, there are differences in activity by as much as three times due to geographical area differences for the same construction equipment type. In general, activity of construction equipment decreases as it ages by a rate of approximately 140 to 150 hours per year. It is estimated that CO, HC, NO, and PM_2.5 emissions of construction equipment in China in 2015 were approximately 2.099, 0.462, 3.452, and 0.574 million tons, respectively. Compared to 2015, due to the slow growth of the construction equipment population, CO, HC, and PM_2.5 emissions will decrease by 2.4%-33.1% and 7.1%-64.7% by 2020 and 2025, respectively, depending on pollutant. It should be noted that NO emissions appear to increase slightly for the first several years in the future, but then decrease after 2020. As increasingly stringent regulations have been enforced for on-road vehicles, but less has been done regarding non-road equipment, although total emissions from non-road equipment continue to decrease, their contribution to air pollution will continue to increase; they should therefore be one of the focuses for future work.

Systematic Coronary Risk Evaluation estimated risk and prevalent subclinical atherosclerosis in coronary and carotid arteries: A population-based cohort analysis from the Swedish Cardiopulmonary Bioimage Study

BACKGROUND

It is not clear if the European Systematic Coronary Risk Evaluation algorithm is useful for identifying prevalent subclinical atherosclerosis in a population of apparently healthy individuals. Our aim was to explore the association between the risk estimates from Systematic Coronary Risk Evaluation and prevalent subclinical atherosclerosis.

DESIGN

The design of this study was as a cross-sectional analysis from a population-based study cohort.

METHODS

From the general population, the Swedish Cardiopulmonary Bioimage Study randomly invited individuals aged 50-64 years and enrolled 13,411 participants mean age 57 (standard deviation 4.3) years; 46% males between November 2013-December 2016. Associations between Systematic Coronary Risk Evaluation risk estimates and coronary artery calcification and plaques in the carotid arteries by using imaging data from a computed tomography of the heart and ultrasonography of the carotid arteries were examined.

RESULTS

Coronary calcification was present in 39.5% and carotid plaque in 56.0%. In men, coronary artery calcium score >0 ranged from 40.7-65.9% and presence of carotid plaques from 54.5% to 72.8% in the age group 50-54 and 60-65 years, respectively. In women, the corresponding difference was from 17.1-38.9% and from 41.0-58.4%. A doubling of Systematic Coronary Risk Evaluation was associated with an increased probability to have coronary artery calcium score >0 (odds ratio: 2.18 (95% confidence interval 2.07-2.30)) and to have >1 carotid plaques (1.67 (1.61-1.74)).

CONCLUSION

Systematic Coronary Risk Evaluation estimated risk is associated with prevalent subclinical atherosclerosis in two major vascular beds in a general population sample without established cardiovascular disease or diabetes mellitus. Thus, the Systematic Coronary Risk Evaluation risk chart may be of use for estimating the risk of subclinical atherosclerosis.

Variation in morphological traits affects dispersal and seedling emergence in dispersive diaspores of Geropogon hybridus

PREMISE

Intraspecific variation in diaspore characteristics could affect various aspects of plant performance at the population, individual plant, and seed levels. We quantified variation in dispersal traits in a wind-dispersed annual, Geropogon hybridus (Asteraceae), focusing on continuous morphological traits of dispersive diaspores and their relationships to dispersal ability and seedling emergence.

METHODS

We measured the morphological traits, terminal velocity, and seedling emergence of 1140 seeds from 10 populations in two successive years. We assessed the variation in traits among three hierarchical levels of organization and between years, and quantified their effects on diaspore terminal velocity and seedling emergence.

RESULTS

Diaspore morphological traits varied substantially at the population, plant, and diaspore levels. Variables of pappus geometry, especially pappus width and pappus opening angle, were consistent between years and were found to be the best predictors of diaspore terminal velocity and seedling emergence. There was a significant negative relationship between diaspore terminal velocity and seedling emergence.

CONCLUSIONS

The intraspecific variation in diaspore traits is sufficiently large to substantially allow a dispersal-dormancy trade-off of individual diaspores. Our results support the hypothesis that traits of dispersive diaspores evolve in concert to select for increased dispersal potential, and provide an avenue to predict plant offspring performance through simply measured traits.

Renal Denervation in Asia: Consensus Statement of the Asia Renal Denervation Consortium

The Asia Renal Denervation Consortium consensus conference of Asian physicians actively performing renal denervation (RDN) was recently convened to share up-to-date information and regional perspectives, with the goal of consensus on RDN in Asia. First- and second-generation trials of RDN have demonstrated the efficacy and safety of this treatment modality for lowering blood pressure in patients with resistant hypertension. Considering the ethnic differences of the hypertension profile and demographics of cardiovascular disease demonstrated in the SYMPLICITY HTN (Renal Denervation in Patients With Uncontrolled Hypertension)-Japan study and Global SYMPLICITY registry data from Korea and Taiwan, RDN might be an effective hypertension management strategy in Asia. Patient preference for device-based therapy should be considered as part of a shared patient-physician decision process. A practical population for RDN treatment could consist of Asian patients with uncontrolled essential hypertension, including resistant hypertension. Opportunities to refine the procedure, expand the therapy to other sympathetically mediated diseases, and explore the specific effects on nocturnal and morning hypertension offer a promising future for RDN. Based on available evidence, RDN should not be considered a therapy of last resort but as an initial therapy option that may be applied alone or as a complementary therapy to antihypertensive medication.

The Positive Impacts of Exhibition-Driven Tourism on Sustainable Tourism, Economics, and Population: The Case of the Echigo-Tsumari Art Triennale in Japan

After the recession in Japan in the 1990s, Japanese art exhibitions began to appear. The purpose of these exhibitions was to revitalize these areas through the presentation of art (attracting visitors and tourists). Correspondingly, this study explores the significance of exhibition-driven tourism in Japan. The Echigo–Tsumari Art Triennial (ETAT) was used as a case to study how exhibition-driven tourism has impacted sustainable tourism, economics, and the population. The current paper collected panel data from 1900 to 2018. These panel data were analyzed by descriptive statistics and a correlation analysis (a one-way ANOVA and a Pearson correlation analysis in SPSS26). The empirical analysis showed that the Echigo–Tsumari Art Triennial (exhibition-driven tourism) had positive impacts on sustainable tourism, economics, and the population; its correlations with Niigata were also clear. This study generated results that are valuable from both academic and industry perspectives (exhibition-driven tourism), as this field has not been extensively researched. The current paper also presents the theoretical and practical implications of the statistical results.

Estimated cardiorespiratory fitness in childhood and cardiometabolic health in adulthood: 1970 British Cohort Study

Background

Associations of cardiorespiratory fitness in childhood and adulthood with adult cardiometabolic risk factors are poorly understood, not least because of the paucity of studies.

Objectives

We investigated associations between nonexercise testing cardiorespiratory fitness (NETCRF) in childhood/adulthood and cardiometabolic risk factors in adulthood.

Methods

Based on an established algorithm comprising gender, age, body mass index, resting heart rate, and self‐reported physical activity at age 10, we computed NETCRF. Risk factors were assessed at age 46 in 5009 participants when NETCRF was again calculated. Linear regression was used to summarize associations between NETCRF in childhood and risk factors in adulthood and, additionally, the relationship between NETCRF in adulthood and risk factors in adulthood after adjusting for childhood NETCRF.

Results

Inconsistent associations were observed between childhood NETCRF and adult risk factors. NETCRF in adulthood was associated with blood pressure [−5.8 (−6.7, −4.9)], glycated hemoglobin [−3.41 (−4.06, −2.76)], total cholesterol [−0.16 (−0.24, −0.08)], HDL cholesterol [0.19 (0.16, 0.22)], triglycerides [−0.68 (−0.85, −0.50)], and C‐reactive protein [−0.29 (−0.35, −0.22)] in adult males. Similar associations were observed in adult females. Compared to those with low estimated fitness in both childhood and adulthood, participants with low fitness in childhood and high fitness in adulthood had a lower risk of two or more cardiometabolic risk factors (odds ratio: 0.25; 95% confidence interval: 0.19, 0.31).

Conclusion

Associations between estimated fitness and risk factors are stronger in adulthood than from childhood to adulthood. Adults with previously sedentary childhoods may still gain benefits from improving their fitness.

Lineage Divergence of Dendrolimus punctatus in Southern China Based on Mitochondrial Genome

In southern China, the masson pine caterpillar, Dendrolimus punctatus, has caused serious damage to the Pinus massoniana (Lamb.) pine forests. Here, the whole mitochondrial DNA (mtDNA) was employed to analyze the population evolution of D. punctatus and to understand the process underlying its current phylogenetic pattern. D. punctatus populations within its distribution range in China were categorized into five subgroups: central and eastern China (CEC), southwestern China (SWC), Yibin in Sichuan (SC), Baise in Guangxi (GX), and Luoding in Guangdong (GD), with a high level of haplotype diversity and nucleotide diversity among them. The genetic distances between subgroups are relatively large; however, the genetic distances between populations within the CEC subgroup were relatively small, suggesting that many populations were closely related in this subgroup. The mantel test showed that geographic distance had an important impact on the genetic distance of different geographic populations (r = 0.3633, P < 0.001). The neutrality tests, Bayesian skyline plot, and haplotype network showed that D. punctatus experienced a population expansion around 100,000 years ago. The divergence times of GX/SC, SWC, GD, and CEC were 0.347, 0.236, 0.200, and 0.110 million years ago, respectively. The SWC, CEC, and GD subgroups might have evolved from GX or SC subgroups. The population genetic structure of D. punctatus was closely related to its host tree species, geographic distance among populations, the weak flight capacity, and many eco-environment conditions.