Sex Specific Global Burden of Osteoporosis in 204 Countries and Territories, from 1990 to 2030: An Age-Period-Cohort Modeling Study

BACKGROUND

Osteoporosis is a highly prevalent disease with distinct sex pattern. We aimed to estimate the sex specific incidence, prevalence, and disability-adjusted life (DALYs) years of osteoporosis between 1990 and 2019, with additional predictions from 2020 to 2034.

METHODS

We collected osteoporosis disease burden data from the Global Burden of Disease study covering the years 1990 through 2019 in 204 countries and territories. The data included information on the number of incident cases of osteoporosis, DALYs, age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR) and age-standardized DALYs rates. Additionally, we performed an age-period-cohort analysis to forecast the burden of osteoporosis.

RESULTS

The global number of incidence cases of osteoporosis, in 2019, reached 41.5 million cases. From 1990 to 2019, the low-middle socio-demographic index (SDI) region had the highest estimated annual percentage change in the world. Compared to males, female's ASIR and ASPR were all about 1.5 times higher than males for the same years in the same SDI regions. The projected global total number of incidence cases for osteoporosis between 2030 and 2034 is estimated to reach 263.2 million (154.4 million for females and 108.8 for males). Additionally, the burden in terms of DALYs is predicted to be 128.7 million (with 78.4 million for females and 50.3 million for males).

CONCLUSION

The global burden of osteoporosis is still increasing, mainly observed in high SDI countries. Females bear a burden 1.5 times higher than males in terms of incidence and DALYs. Steps should be taken to reduce the osteoporosis burden, especially in high SDI countries.

Uniform thin ice on ultraflat graphene for high-resolution cryo-EM

Cryo-electron microscopy (cryo-EM) visualizes the atomic structure of macromolecules that are embedded in vitrified thin ice at their close-to-native state. However, the homogeneity of ice thickness, a key factor to ensure high image quality, is poorly controlled during specimen preparation and has become one of the main challenges for high-resolution cryo-EM. Here we found that the uniformity of thin ice relies on the surface flatness of the supporting film, and developed a method to use ultraflat graphene (UFG) as the support for cryo-EM specimen preparation to achieve better control of vitreous ice thickness. We show that the uniform thin ice on UFG improves the image quality of vitrified specimens. Using such a method we successfully determined the three-dimensional structures of hemoglobin (64 kDa), α-fetoprotein (67 kDa) with no symmetry, and streptavidin (52 kDa) at a resolution of 3.5 Å, 2.6 Å and 2.2 Å, respectively. Furthermore, our results demonstrate the potential of UFG for the fields of cryo-electron tomography and structure-based drug discovery.

Investigation of a haze-to-dust and dust swing process at a coastal city in northern China part I: Chemical composition and contributions of anthropogenic and natural sources

The long retention of dust air masses in polluted areas, especially in winter, may efficiently change the physicochemical properties of aerosols, causing additional health and ecological effects. A large-scale haze-to-dust weather event occurred in the North China Plain (NCP) region during the autumn-to-winter transition period in 2018, affecting the coastal city Qingdao several times between Nov. 27th and Dec. 1st. To study the evolution of the pollution process, we analyzed the chemical characteristics of PM_2.5 and PM_10-2.5 and source apportionments of PM_2.5 and PM_10, The dust stagnated around NCP and moved out and back to the site, noted as dust swing process, promoting SO₄^2- formation in PM_2.5 and NO₃^- formation in PM_10-2.5. Source apportionments were analyzed using the Positive Matrix Factorization (PMF) receptor model and weighted potential source contribution function (WPSCF). Before the dust invasion, Qingdao was influenced by severe haze; waste incineration and coal burning were the major contributors (~80 %) to PM_2.5, and the source region was in the southwest of Shandong Province. During the initial dust event, mineral dust and the mixed factor of dust and sea salt were the major contributors (46.0 % of PM_2.5 and 86.5 % of PM₁₀). During the polluted dust period, the contributions of regional transported biomass burning (22.3 %), vehicle emissions (20.8 %), and secondary aerosols (33.8 %) to PM_2.5 from the Beijing-Tianjin-Hebei region significantly increased. The secondary aerosols source was more regional than that of vehicle emissions and biomass burning and contributed considerably to PM₁₀ (30.8 %) during the dust swing process. Our findings demonstrate that environmental managers should consider the possible adverse effects of winter dust on regional and local pollution.

Cryoballoon ablation for atrial fibrillation in patients with heart failure with mildly reduced and preserved ejection fraction

AIMS

Limited data are available on the outcomes of cryoballoon ablation (CBA)-based pulmonary vein isolation (PVI) for atrial fibrillation (AF) in patients with heart failure (HF) with preserved ejection fraction (HFpEF) and mildly reduced ejection fraction (HFmrEF). The present study aimed to evaluate the safety and effectiveness of CBA in such patients.

METHODS AND RESULTS

Consecutive patients with AF referred for CBA-based PVI from two highly experienced electrophysiology centres were included in this retrospective study. Of 651 patients undergoing CBA, 471 cases were divided into four groups: No HF (n = 255), HFpEF (n = 101), HFmrEF (n = 78), and HF with reduced ejection fraction (n = 37). Similar early recurrence of atrial arrhythmia was found among groups (16.2% vs. 15.4% vs. 14.9% vs. 12.2%, P = 0.798), and no significant difference of long-term sinus rhythm (SR) maintenance was identified among the HFmrEF, HFpEF, and No HF groups (71.8% vs. 75.2% vs. 79.6%, P = 0.334). CBA is safe for patients with HFmrEF and HFpEF with similar complications compared with the No HF group (3.8% vs. 4.0% vs. 3.1%, P = 0.814). The reassessment of cardiac function after CBA showed that patients with HF indicated beneficial outcomes. Left atrial diameter (LAD) and left ventricular ejection fraction were significantly improved in the HFmrEF group. There were 41.6% of patients in the HFpEF group who were completely relieved from HF. LAD and New York Heart Association (NYHA) were associated with recurrence in the HFpEF and HFmrEF groups, and the maintenance of SR was an independent predictor of NYHA improvement for all HF groups.

CONCLUSIONS

Patients with HFmrEF and HFpEF could benefit from CBA with high SR maintenance and significant HF improvement.

Effect of the interaction between alcohol and meat consumption on the hyperlipidaemia risk among elderly individuals: Evidence from Shanghai, China

Background

Diet and other lifestyle habits may have an increased effect on blood lipids in older people. This study aimed to examine the associations between diet (meat, fish, and egg), alcohol consumption and blood lipids.

Methods

Surveillance data on chronic diseases and their risk factors were collected from Shanghai during 2017–2018. A Kish table was used for sampling 438 older adults, of whom 71 consumed alcohol. Logistic regression was used to test the relationships between diet, alcohol consumption and blood lipid levels in elderly individuals, and the marginal effects (MEs) were estimated.

Results

Dyslipidaemia was more common among drinkers than among nondrinkers (P < 0.01). Alcohol consumption was associated with dyslipidaemia (OR = 2.667, P < 0.01 for TC; OR = 1.919, P < 0.05 for LDL; OR = 3.412, P < 0.01 for TG), and consumption of more than 50 g of meat per day showed similar associations (OR = 3.227, P < 0.01 for TC; OR = 3.263, P < 0.01, for LDL; OR = 2.329, P < 0.01 for TG). The MEs of alcohol drinking and excessive meat consumption on the rate of dyslipidaemia were 0.324 for TC (P < 0.01), 0.255 for LDL (P < 0.05), and 0.174 for TG (P < 0.01).

Discussion

The risk of hyperlipidaemia was increased among elderly individuals with excessive meat and alcohol consumption, which also had an interactive effect.

Bismuth nanoparticles embedded in a carbon skeleton as an anode for high power density potassium-ion batteries

Bismuth is a promising anode for potassium-ion batteries (PIBs) due to its suitable redox potential, large theoretical capacity, and superior electronic conductivity. Herein, we report a Bi@C (Bi nanoparticles uniformly embedded in a carbon skeleton) composite anode which delivers a superior rate performance of 244.3 mA h g-1 at 10.0 A g-1 and a reversible capacity of 255.6 mA h g-1 after 200 cycles in an optimized ether-based electrolyte. The outstanding electrochemical performance results from its robust structural design with fast reaction kinetics, which are confirmed by both experimental characterization studies and first-principles calculations. The reversible potassium storage mechanism of the Bi@C composite was also investigated by in situ X-ray diffraction. In addition, the full PIB cell assembled with a Bi@C composite anode and nickel-based Prussian blue analogue cathode exhibits high discharge voltage (3.18 V), remarkable power density (>10 kW kg-1), and an excellent capacity retention of 87.8% after 100 cycles. The results demonstrate that the PIBs with Bi anodes are promising candidates for power-type energy storage devices.

Activation of lesion projection zone in primary visual cortex is dependent on bilateral central vision loss in patients with end-stage glaucoma

PURPOSE

To investigate activation of the lesion projection zone (LPZ) in the primary visual cortex during end-stage glaucoma using functional magnetic resonance imaging (fMRI), as well as the relationship between fMRI responses and clinical data.

METHODS

Twelve subjects with bilateral end-stage glaucoma (group A), 12 with unilateral end-stage glaucoma (group B) and 12 healthy controls (group C) were enrolled. fMRI was performed under two testing stimuli conditions: passive viewing of a full-field flickering checkerboard and active viewing of a one-back task with scene images. In fMRI analysis, the primary visual cortex was divided into six regions of interest (ROIs). The beta values of the six ROIs were compared across the three groups using one-way analysis of variance under two viewing conditions. Associations between the fMRI beta value and clinical data including multifocal electroretinogram (mfERG), microperimeter-1 and optical coherence tomography were analysed by Spearman correlation.

RESULTS

The beta values for ROIs 1-3 representing the LPZ were significantly different between the three groups under active viewing conditions, whereas no significant changes were detected under passive viewing. In group A, there were significant differences between all six ROIs for the two viewing conditions, while no significant differences were found in groups B and C. In group A, the P-wave amplitudes of the mfERG was significantly correlated with the beta values of ROIs 1 and 2 under active viewing. In addition, the P-wave latencies of the mfERG were significantly correlated with the beta values for ROIs 2-5. No associations were found between fMRI beta values and clinical data in groups B and C.

CONCLUSIONS

Activation of the LPZ in the primary visual cortex was observed in patients with bilateral end-stage glaucoma under active viewing conditions. These changes were correlated with residual retinal function.

Efficacy of ablation index-guided pulmonary vein isolation in patients with paroxysmal atrial fibrillation

BACKGROUND

Ablation index (AI) is a novel technology of ablation lesion quality to help improve homogeneity of lesion size and continuity. In this study, we aim to evaluate whether AI-guided PVI improves clinical outcomes compared to CF-guided PVI in patients with paroxysmal AF (PAF).

METHODS

Patients undergoing first-time radiofrequency ablation for PAF were randomized in a 2:1 ratio to two groups: AI-guided PVI and CF-guided PVI. In the AI group, AI ≥500 was recommended at the anterior/superior/inferior walls, 350-400 at the posterior wall, and inter-lesion distance ≤4 mm. The primary endpoint is the freedom from atrial arrhythmia recurrence during 12 months follow-up, without antiarrhythmic drug therapy (ADT). The key secondary endpoints include intra-procedural efficiency and peri-procedural complications.

RESULTS

225 patients were randomized (AI group (n = 149) and CF group(n = 76)). First-pass isolation rate in AI group was significantly higher than that in CF group (58.3% vs. 43.4%, p = 0.035). After a median follow-up of 12.2 months, 154/225(68.4%) of patients were free from atrial arrhythmia recurrence without ADT, which was higher in AI group compared with CF group, but without significant difference (71.1% vs. 63.2%, p = 0.253). The incidence of peri-procedural complications is low and without difference between two groups.

CONCLUSIONS

AI-guided ablation provided higher acute efficacy than CF-guided ablation in PV isolation for patients with paroxysmal AF. The long-term success rate in AI group was higher than CF group, but did not reach statistical significance. This article is protected by copyright. All rights reserved.

Effect of Modified Vertical Rectus Belly Transposition vs Augmented Superior Rectus Transposition Plus Medial Rectus Recession for Chronic Sixth Nerve Palsy: A Randomized Clinical Trial

Importance

Both vertical rectus belly transposition (VRBT) and superior rectus transposition (SRT) can be performed simultaneously with ipsilateral medial rectus recession (MRc) and have been shown to be effective for chronic sixth nerve palsy. However, it is unclear whether VRBT is superior to SRT in correcting esotropia.

Objective

To compare the effectiveness of modified VRBT plus MRc (mVRBT-MRc) vs augmented SRT plus MRc (aSRT-MRc) in Chinese patients with chronic sixth nerve palsy.

Design, Setting, and Participants

This parallel-design, double-masked, single-center, randomized clinical trial was conducted from January 15, 2018, to May 24, 2021. The follow-up visits were scheduled at 1 month and 6 months. Eligible Chinese participants with unilateral chronic sixth nerve palsy were randomly assigned to receive either mVRBT-MRc (VRBT group) or aSRT-MRc (SRT group).

Interventions

mVRBT-MRc or aSRT-MRc.

Main Outcomes and Measures

Change of horizontal deviation in primary position from baseline to 6 months.

Results

Of the total 25 eligible participants, the mean (SD) age was 45.4 (12.6) years, with 10 male participants (40%) and 15 female participants (60%). Thirteen participants (52%) were randomly assigned to the VRBT group, and 12 (48%) were randomly assigned to the SRT group. At baseline, the mean (SD) horizontal deviation was 65.7 (10.8) prism diopters (Δ) in the VRBT group and 60.5Δ(14.1Δ) in the SRT group. Similar amounts of MRc were performed in both groups. At 6 months, the horizontal deviation changed from baseline by 66.3Δ in the VRBT group and by 51.5Δ in the SRT group. The adjusted group difference was 10.9Δ (95% CI, 5.3Δ-16.6Δ), favoring the VRBT group (P = .001). Four times as many participants corrected more than 60Δ with mVRBT-MRc compared with aSRT-MRc. The group difference of the improvement of abduction limitation was -0.2 (95% CI, -0.8 to 0.5; P = .64). Although there was a higher proportion of undercorrection in the SRT group (difference, 45%; 95% CI, 16%-75%; P = .01), no differences were identified for other suboptimal outcomes between groups.

Conclusions and Relevance

Compared with aSRT-MRc, mVRBT-MRc showed better effect in correcting esotropia with no differences detected for other suboptimal outcomes. mVRBT-MRc may be a promising alternative surgical procedure for chronic sixth nerve palsy, particularly for large esotropia of more than 60Δ, if these results are confirmed in larger, diverse cohorts with longer follow-up.

Trial Registration

ChiCTR Identifier: ChiCTR-INR-17013705.

Impact of diabetic retinopathy on prognosis of patients with heart failure with preserved ejection fraction

BACKGROUND AND AIMS

Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes mellitus (DM), and could increase the risks of adverse cardiovascular events among DM patients. Since heart failure with preserved ejection fraction (HFpEF) and DM often coexist, our present study aimed to explore the associations of DR with adverse outcomes in HFpEF patients.

METHODS AND RESULTS

We conducted this study in a large, international population suffering from HFpEF (n = 3442) based on the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. The associations of baseline DR with clinical outcomes were expressed as adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using the Cox proportional hazard regression models. The crude incidence rates of all the outcomes studied were significantly increased when DM patients with or without DR compared to those without DM (all P < 0.05), whereas there were no differences between DM patients without DR versus those with DR (all P > 0.05). In the multivariate cox regression analysis, DR was not significantly associated with increased risks of the primary composite outcome (HR, 1.178 [95% CI, 0.870-1.596]) and secondary outcomes including all-cause death, cardiovascular death, all-cause hospitalization, hospitalization for HF, myocardial infarction, and stroke (all P > 0.05).

CONCLUSIONS

Our results of current study suggested that DM but not DR could be regarded as an independent risk factor for the prognosis of HFpEF.

CLINICAL TRIAL REGISTRATION

URL: https://clinicaltrials.gov. Unique identifier: NCT00094302.

Capillaries segmentation of NIR-II images and its application in ischemic stroke

Fluorescence imaging in the second near-infrared window (NIR-II) offers μm resolution blood vessel information noninvasively, which is crucial for the diagnosis and surgery treatment of some blood vessel-related diseases. However, only a few blood vessel segmentation algorithms have been done for the NIR-II images so far. Here, we proposed a vessel segmentation algorithm that used multi-scale enhancement and fractional differential to enhance capillaries, and then segmented vessels based on the blood vessels' tubular characteristics. Experimental results showed that this method could effectively suppress the point and lump tissue noise influence during vascular segmentation. The accuracy of vessel identification by other algorithms dropped below 30%, while our algorithm still achieved an accuracy of around 50% in deep vessel segmentation experiments with the 6.5 mm Intralipid. So it had the advantage of accurately detecting deep and dim blood capillaries. Meanwhile, the vascular density quantization algorithm had been successfully applied to the mice's ischemic stroke evaluations for the first time. In addition, this algorithm can provide the quantified vessel features under physiological or pathological conditions, which could be used to accurately evaluate the stroke drugs' therapeutic effect in the future.

Moricizine prevents atrial fibrillation by late sodium current inhibition in atrial myocytes

Background

Enhanced late sodium current (INaL) is reportedly related to an increased risk of atrial fibrillation (AF). Moricizine, as a widely used anti-arrhythmia drug for suppressing ventricular tachycardia, has also been shown to prevent paroxysmal AF. However, the mechanism of its therapeutic effect remains poorly understood.

Methods

Angiotensin II (Ang II) was induced in C57Bl/6 mice (male wild-type) for 4 weeks to increase the susceptibility of AF, and acetylcholine-calcium chloride was used to induce AF. The whole-cell patch-clamp technique was used to detect INaL from isolated atrial myocytes. The expression of proteins in atrial of mice and HL-1 cells were examined by Western-blot.

Results

The results showed that moricizine significantly inhibited Ang II-mediated atrial enlargement and reduced AF vulnerability. We found that the densities of INaL were enhanced in Ang II-treated left and right atrial cardiomyocytes. Simultaneously, the Ang II-induced increase in INaL currents density was alleviated by the administration of moricizine, and no alteration in Nav1.5 expression was observed. In normal isolated atrial myocytes, moricizine significantly reduced Sea anemone toxin II (ATX II)-enhanced INaL density with a reduction of peak sodium currents. In addition, moricizine reduced the Ang II-induced upregulation of phosphorylated calcium/calmodulin-dependent protein kinase-II (p-CaMKII) in both the left and right atria. In HL-1 cells, moricizine also reduced the upregulation of p-CaMKII with Ang II and ATX II intervention, respectively.

Conclusions

Our results indicate that Ang II enhances the INaL via activation of CaMKII. Moricizine inhibits INaL and reduces CaMKII activation, which may be one of the mechanisms of moricizine suppression of AF.

POS1002 DIAGNOSTIC DELAY AND ITS ASSOCIATED FACTORS IN CHINESE AXIAL SPONDYLOARTHRITIS: A RETROSPECTIVE STUDY

Background

Few data on the prolonged diagnosis and its associated factors in Chinese axial spondyloarthritis (axSpA) is available.

Objectives

To delineate the landscape of diagnostic delay in Chinese axSpA, investigate its associated factors and explore its potential impact on medication modalities.

Methods

A total of 1,295 patients fulfilling the ASAS classification criteria were obtained. Demographic and clinical data were collected through predesigned questionnaires and available medical records. Logistic regression analyses in univariate and multivariable model were performed, using the median of diagnostic delay as cut-off point for group classification. Differences between early and late diagnosed group were subsequently compared by the Pearson chi-square test or Mann-Whitney U test.

Results

The median (IQR) diagnostic delay in Chinese axSpA was 3.0 (1.0~7.0) years and 24.8% of them reported a history of misdiagnosis. Older age at onset (OR=0.97, P<0.001) and higher education attainment (P=0.001) were correlated with early diagnosis of axSpA, whereas coming from less developed areas (P=0.002), a history of peripheral arthritis at the time of diagnosis (OR=1.58, P=0.002) and history of misdiagnosis (OR=1.98, P<0.001) increased the risk of diagnostic delay. Medication modalities were similar between two groups, but the proportion with no medication ever and percentage without regular medication in recent 3 months were higher in the late diagnosed group than early group (26.5% vs. 20.7%, P=0.02; 34.7% vs. 28.6%, P=0.02).

Conclusion

Our findings depicted a detailed spectrum of diagnostic delay in Chinese axSpA, verified five associated factors and pinpointed a remarkable treatment delay even after diagnosis, especially in late diagnosis group.

References

[1]Masson Behar V, Dougados M, Etcheto A, Kreis S, Fabre S, Hudry C, et al. Diagnostic delay in axial spondyloarthritis: A cross-sectional study of 432 patients. Joint bone spine. 2017;84(4):467-71.

Figure 1.

Cumulative distribution of age at onset and age at diagnosis in Chinese axSpA

(A) the entire group. (B) stratified by early and late diagnosed group. (C) stratified by education level (college, middle school, secondary school). (D) stratified by history of peripheral arthritis when diagnosed. (E) stratified by history of misdiagnoses when diagnosed. (F) stratified by native place, as statistical significance was found between eastern coastal and western China, only these two groups were presented.

Disclosure of Interests

None declared

A Multifunctional Ionic Liquid Additive Enabling Stable and Efficient Perovskite Light-Emitting Diodes

The electroluminescence performance and long-term stability of perovskite light-emitting diodes (PeLEDs) are greatly affected by the film quality of perovskite emitting layer. Herein, the authors employ an ionic liquid, 1-butyl-3-methylimidazolium trifluoromethanesulfonate ([BMIm]OTf), to manipulate the growth of quasi-2D perovskite films by providing heterogeneous nucleation sites. The [BMIm]OTf molecules simultaneously realize uniform perovskite films by reducing the contact angles of precursor solution on the hole transport layer (HTL), and eliminate defect states through bonding [BMIm]⁺ cations to negatively-charged uncoordinated Br and OTf^- anions to uncoordinated Pb²⁺ defects that effectively suppresses the defect states assisted nonradiative recombination in perovskite films. As a result, the efficiency and the operational lifetime of the resultant PeLED are enhanced by more than twofold and threefold, respectively, achieving a maximum external quantum efficiency of 17.6% and an operational lifetime of over 500 min at an initial brightness of 100 cd m^-2 .

Photoacoustic Effect of Near-Infrared Absorbing Organic Molecules via Click Chemistry

Near-infrared dyes were developed to be contrast agents due to their ability to improve the productivity of photoacoustic (PA) imaging and photothermal therapy (PTT) treatments. During the article, we described in detail the PA and PT effects of a category of organic molecules. F₄-TCNQ could potentially cause a red-shift in the peak PA intensity. The results show that the PTT intensity of the near-infrared dyes with phenyl groups were higher than near-infrared dyes with thiophene groups. We also investigated the photodynamic treatment effect of C1b to demonstrate that these dyes are highly desirable in biochemistry. The high photoacoustic intensity of the organic molecules and the good yield of reactive oxygen species could indicate that these dyes have good potential for a wide range of imaging applications. Finally, we embedded the dye (C1b) in a liposomal hydrophobic phospholipid bilayer (C1b⊂L) to facilitate the application of hydrophobic dyes in biomedical applications, which can be absorbed by cells with good compatible and high stability for the imaging of cellular PA.

Relationship Between Old-Aged Preferences Regarding Various Types of Physical Activity and Chronic Disease Status: A Cross-Sectional Study in Shanghai, China

Background

A lack of physical activity (PA) is a threat to public health. However, for the elderly, most PA abilities are limited. By focusing on the types and intensity of PA that the elderly can bear, this study aimed to reveal whether preferences regarding types of PA (including housework, transportation, and recreational activities) and their intensity were associated with health status. The main forms of PA include shopping, cooking, cleaning, walking, cycling, various fitness activities and other activities with a certain intensity.

Methods

Surveillance data on chronic diseases and their risk factors were collected from one district of Shanghai in 2017-2018. A Kish table was used for sampling 500 older adults, including the diagnosed group (chronic diseases diagnosed by physicians, n = 119), the abnormal group (not diagnosed but abnormal indicators detected in this investigation, n = 287) and the healthy group (n = 94). Multiple regressions were used to test the relationship between the various types, durations and intensities of PA the elderly individuals participated in and their health status.

Results

All three groups included a large proportion of older adults who participated in housework- and transport-related PA. The diagnosed group had the largest proportion (63.06% for housework-related PA; 87.39% for transport-related PA) and median minutes (17.14 min of housework-related PA per day; 30.00 min of transport-related PA per day). The diagnosed group had more metabolic equivalents (METs) of moderate-intensity PA than the two other groups (H = 33.01, P < 0.01), and more people met the WHO recommendation (χ² = 34.71, P < 0.01). Diagnosis was associated with performing housework- and transport-related PA and moderate-intensity PA and with meeting the WHO's recommendation. Higher education levels were a positive factor for elderly individuals to participate in PA.

Conclusions

Transportation and housework activities are good targets for increasing PA in older adults. Diagnosis is associated with older adults' more PA.

Confinement of all-inorganic perovskite quantum dots assembled in metal-organic frameworks for ultrafast scintillator application

Nucleation and growth of quantum dots (QDs) are thermodynamic processes driven by the total Gibbs free energy change (ΔG). We discuss the nucleation and growth theory of perovskite quantum dots (PeQDs) inside a metal-organic framework (MOF) as a strong constraint framework, which can effectively confine the size of QDs below 3 nm and achieve a scintillator with an ultra-fast transient lifetime of fluorescence. Therefore, based on the requirements for the optical properties of ultra-fast scintillation materials, two kinds of suitable MOFs (UiO-67-bpy and MIL-101(Cr)) were selected for synthesis. The method of 'ship-in-bottle' was adopted to embed perovskite quantum dots CsPbBrCl₂ into MOF cages to form PeQDs@MOF composite materials, which is different from the one-pot method. In order to further improve the stability of PeQDs@MOF, polystyrene was used to cure the composite scintillator, which can resist exposure to UV light and withstand the ISO level 4 test, with the fastest transient lifetime of 2.13 ns and a fluorescence emission wavelength of 445 nm.

Enhancing strength and ductility via crystalline-amorphous nanoarchitectures in TiZr-based alloys

Crystalline-amorphous composite have the potential to achieve high strength and high ductility through manipulation of their microstructures. Here, we fabricate a TiZr-based alloy with micrometer-size equiaxed grains that are made up of three-dimensional bicontinuous crystalline-amorphous nanoarchitectures (3D-BCANs). In situ tension and compression tests reveal that the BCANs exhibit enhanced ductility and strain hardening capability compared to both amorphous and crystalline phases, which impart ultra-high yield strength (~1.80 GPa), ultimate tensile strength (~2.3 GPa), and large uniform ductility (~7.0%) into the TiZr-based alloy. Experiments combined with finite element simulations reveal the synergetic deformation mechanisms; i.e., the amorphous phase imposes extra strain hardening to crystalline domains while crystalline domains prevent the premature shear localization in the amorphous phases. These mechanisms endow our material with an effective strength-ductility-strain hardening combination.