OBJECTIVE—To examine whether the long-term resting heart rate (RHR) pattern can predict the risk of having arterial stiffness in a large ongoing cohort study.
APPROACH AND RESULTS—This ...community-based cohort included 12 554 participants in the Kailun study, who were free of myocardial infarction, stroke, arrhythmia, and cancer. We used latent mixture modeling to identify RHR trajectories in 2006, 2008, and 2010. We used multivariate linear regression model to examine the association between RHR trajectory patterns and the risk of having arterial stiffness, which was assessed by brachial–ankle pulse wave velocity in 2010 to 2016. We adjusted for possible confounding factors, including socioeconomic status, lifestyle factors, use of medications, comorbidities, and serum concentrations of lipids, glucose, and high-sensitivity C-reactive proteins. We identified 5 distinct RHR trajectory patterns based on their 2006 status and on the pattern of change during 2006 to 2010 (low–stable, moderate–stable, moderate–increasing, elevated–decreasing, and elevated–stable). We found that individuals with elevated–stable RHR trajectory pattern had the highest brachial–ankle pulse wave velocity value and individuals with the low–stable RHR trajectory pattern had the lowest value (adjusted mean difference=157 cm/s; P<0.001). Adjusted odds ratio for risk of having arterial stiffness (brachial–ankle pulse wave velocity ≥1400 cm/s) was 4.14 (95% confidence interval, 2.61–6.57) relative to these 2 extreme categories. Consistently, a higher average RHR, a higher annual RHR increase rate, and a higher RHR variability were all associated with a higher risk of having arterial stiffness.
CONCLUSIONS—Long-term RHR pattern is a strong predictor of having arterial stiffness.
In this paper, a novel infrared target co-detection model combining the self-correlation features of backgrounds and the commonality features of targets in the spatio-temporal domain is proposed to ...detect small targets in a sequence of infrared images with complex backgrounds. Firstly, a dense target extraction model based on nonlinear weights is proposed, which can better suppress background of images and enhance small targets than weights of singular values. Secondly, a sparse target extraction model based on entry-wise weighted robust principal component analysis is proposed. The entry-wise weight adaptively incorporates structural prior in terms of local weighted entropy, thus, it can extract real targets accurately and suppress background clutters efficiently. Finally, the commonality of targets in the spatio-temporal domain are used to construct target refinement model for false alarms suppression and target confirmation. Since real targets could appear in both of the dense and sparse reconstruction maps of a single frame, and form trajectories after tracklet association of consecutive frames, the location correlation of the dense and sparse reconstruction maps for a single frame and tracklet association of the location correlation maps for successive frames have strong ability to discriminate between small targets and background clutters. Experimental results demonstrate that the proposed small target co-detection method can not only suppress background clutters effectively, but also detect targets accurately even if with target-like interference.
Background
One measurement of hs‐CRP (high‐sensitivity C‐reactive protein) is associated with increased risk of cardiovascular disease (CVD). The objective of this study was to characterize the ...association of cumulative exposure to increased hs‐CRP with incident cardiovascular events.
Methods and Results
We included 53 065 participants with hs‐CRP measured at 3 examinations in 2006, 2008, and 2010. Cumulative exposure to hs‐CRP was calculated as the weighted sum of the average hs‐CRP level for each time interval (level×time). Participants were classified into nonexposed group (hs‐CRP<3.0 mg/L in all 3 examinations), 1‐exposed group (hs‐CRP≥3.0 mg/L in 1 of the 3 examinations), 2‐exposed group (hs‐CRP≥3.0 mg/L in 2 of the 3 examinations), and 3‐exposed group (hs‐CRP≥3.0 mg/L in 3 examinations). Cox proportional hazards models were used to assess the association of cumulative hs‐CRP with incident CVD. The study showed a dose‐response pattern with risk of CVD and myocardial infarction as the number of years of exposure to hs‐CRP increases. Participants in the 3‐exposed group had significantly increased CVD risk with hazard ratio (95% confidence interval) of 1.38 (1.11–1.72), in comparison with 1.28 (1.07–1.52) for participants in the 2‐exposed group and 1.13 (0.97–1.31) for those in the 1‐exposed group (P<0.05); meanwhile, the similar and significant associations were also observed for myocardial infarction with respective hazard ratio (95% confidence interval) of 2.13 (1.42–3.18), 1.60 (1.12–2.27), and 1.57 (1.17–2.10). The associations between stroke and cumulative hs‐CRP were not statistically significant (P=0.360).
Conclusions
Cumulative exposure to hs‐CRP was dose dependently associated with a subsequent increased risk of CVD and myocardial infarction.
Clinical Trial Registration
URL: https://www.clinicaltrials.gov/. Unique identifier: ChiCTR‐TNC‐11001489.
Abstract Background Stroke is a common complication of hypertension, but the predictive value of metabolic syndrome parameters' variability on stroke risk in individuals with hypertension remains ...unclear. Therefore, our objective was to investigate the relationship between metabolic syndrome parameters' variability and the risk of total stroke and its subtypes in hypertensive patients. Methods This prospective cohort study included 17,789 individuals with hypertension from the Kailuan study since 2006. Metabolic syndrome parameters, including waist circumference (WC), fasting blood glucose (FBG), systolic blood pressure (SBP), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG), were collected at three follow-up visits in the 2006, 2008, and 2010 surveys. We assess the variability utilizing the coefficient of variation (CV), standard deviation (SD), average real variation (ARV), and variability independent of the mean (VIM), with CV initially assessed. Participants were categorized based on the number of high-variability metabolic syndrome parameters (0, 1, 2, ≥ 3). Stroke cases were identified by reviewing medical records. The associations between variability in metabolic syndrome parameters and the risk of total stroke and its subtypes were analyzed using Cox proportional hazard regression models. Results During a median follow-up of 9.32 years, 1223 cases of stroke were recorded. Participants with ≥ 3 high-variability metabolic syndrome parameters had an increased risk of total stroke (HR: 1.29, 95%CI 1.09–1.52), as well as an increased risk of ischemic stroke (HR: 1.31, 95%CI 1.05–1.63) compared to those without high-variability parameters. The study also examined variability in each metabolic syndrome parameter, and significant associations with an increased risk of total stroke were observed for variability in SBP (HR: 1.24, 95%CI 1.05–1.46) and HDL-C (HR: 1.34, 95%CI 1.09–1.64). Conclusions Long-term fluctuations in metabolic syndrome parameters significantly increase the risk of total stroke, especially ischemic stroke. Maintaining low variability in metabolic syndrome parameters could benefit health, and hypertensive individuals must be regularly monitored.
Traditional Chinese landscape painting is prone to low-resolution image issues during the digital protection process. To reconstruct high-quality images from low-resolution landscape paintings, we ...propose a novel Chinese landscape painting generation diffusion probabilistic model (CLDiff), which is similar to the Langevin dynamic process, and realizes the transformation of the Gaussian distribution into the empirical data distribution through multiple iterative refinement steps. The proposed CLDiff can provide ink texture clear super-resolution predictions by gradually transforming the pure Gaussian noise into a super-resolution landscape painting condition on a low-resolution input through a parameterized Markov Chain. Moreover, by introducing an attention module with an energy function into the U-Net architecture, we turn the denoising diffusion probabilistic model into a powerful generator. Experimental results show that CLDiff achieves better visual results and highly competitive performance in traditional Chinese Landscape painting super-resolution tasks.
The impact of long-term serum uric acid (SUA) exposure and time course of SUA accumulation on diabetes mellitus (DM) is unknown. This study aimed to evaluate the association of cumulative SUA ...(cumSUA) exposure and its accumulation time course with risk of DM.
This prospective study included 46,434 participants without DM and underwent three examinations at 2006, 2008, and 2010. CumSUA from 2006 to 2010 was calculated, multiplying mean values between consecutive examinations by time intervals between visits. Time course of SUA accumulation was categorized as the slope of SUA versus time from 2006 to 2010, or by splitting the overall accumulation into an early (cumSUA
) and late accumulation (cumSUA
).
During 6.99 years of follow-up, we identified 2971 incident DM cases. In the fully adjusted model, a higher risk of DM was observed in participants with the highest quartile of cumSUA (hazard ratio HR, 1.31; 95% confidence interval CI, 1.17-1.46), cumulative burden >0 (HR, 1.23; 95% CI, 1.08-1.40), and with 6 year of hyperuricemia exposure duration (HR, 1.25; 95% CI, 1.01-1.55). When considering the time course of SUA accumulation, participants with a negative slope (HR, 1.05; 95% CI, 1.01-1.12), or combined with cumSUA ≥ median and a negative slope had elevated risk of DM (HR, 1.58; 95% CI, 1.18-2.11).
Incident DM risk depends on cumulative exposure of SUA and time course of SUA accumulation. Early SUA accumulation resulted in a greater risk increase compared with later accumulation, emphasizing the importance of optimal SUA control early in life.
Atrial fibrillation (AF) is associated with adverse outcomes in the general population, but its impact on patients with chronic kidney disease (CKD) remains unclear. In this study, we assessed the ...association between AF and risks of all-cause mortality and stroke in Chinese adults with CKD.
We enrolled adults aged 45 years or older with CKD (defined as an estimated glomerular filtration rate <60 mL/min per 1.73 m2 and/or proteinuria identified using the urine dipstick method) from the Kailuan study between 2008 and 2014. AF was identified by 12-lead electrocardiography or hospital discharge diagnostic codes. Mortality data were collected from the provincial vital statistics, and physician-diagnosed ischemic or hemorrhagic stroke was confirmed in the biennial interview.
Among the 21587 CKD adults, 216 patients were identified with AF, the median follow-up duration was 5.21 years (5.69 ± 1.96 years); During follow-up, there were 70 cases of death, and 16 cases of ischemic stroke and 6 cases of hemorrhagic stroke in the participants with AF in comparison with 2572 cases of death and 656 cases of ischemic stroke and 184 cases of hemorrhagic stroke among the participants without AF. After adjustment for potential confounders, AF was associated with an 86% increase in the rate of death (hazard ratio HR, 1.86; 95% confidence interval CI, 1.33-2.59, P<0.001), a 104% (HR, 2.04; 95% CI, 1.09-3.83, P = 0.026) and 325% (HR, 4.25; 95% CI, 1.74-10.36, P = 0.001) increase in the rate of ischemic stroke and hemorrhagic stroke, respectively. These associations were still consistent and strong after propensity score-matched analysis.
Our study shows that AF is independently associated with increased risk of all-cause mortality, ischemic and hemorrhagic stroke in Chinese CKD adults. Future studies are required to elucidate the physiological mechanisms underlying this association.
The association of the severity of hepatic steatosis in metabolic dysfunction-associated fatty liver disease (MAFLD)/metabolic dysfunction-associated steatotic liver disease (MASLD) and the remission ...of MAFLD/MASLD with CKD occurrence is unclear.
The study enrolled 79 540 participants from the Kailuan cohort. Hepatic steatosis was diagnosed by ultrasound. MAFLD/MASLD was defined as hepatic steatosis combined with metabolic dysfunction and MASLD further excluded alcohol or other causes of liver disease. Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate<60 mL/min per 1.73 m
or positive proteinuria (≥1+). Hazard ratio (HR) was calculated by Cox regression models. After a median follow-up of 12.9 years, CKD occurred in 20 465 participants. After adjusting for potential confounders, MAFLD was associated with a higher risk of CKD compared with non-MAFLD (HR, 1.12 95% CI, 1.09-1.16), and this risk increased with increasing severity of hepatic steatosis (
-trend<0.001). Consistent findings were observed when MASLD was used as the exposure. Compared with persistent non-MAFLD, no statistical difference was found in the risk of CKD in MAFLD remission (HR, 1.04 95% CI, 0.95-1.15); however, MASLD remission still had a higher risk of CKD compared with persistent non-MASLD (HR, 1.15 95% CI, 1.03-1.27). When grouped according to the prior severity of hepatic steatosis, there was no statistically significant difference in risk of CKD in mild-MAFLD/MASLD remission compared with persistent non-MAFLD/MASLD, but moderated/severe-MAFLD/MASLD remission still had a higher risk.
The risk of CKD in patients with MAFLD/MASLD increased with the severity of hepatic steatosis. Even after remission of the disease, patients with MAFLD/MASLD with prior moderate to severe hepatic steatosis still had a higher risk of CKD.
Using a time-dependent density functional theory method, we perform a systematic numerical study of the transition of high-order harmonic generation in neon (Ne) systems from an isolated Ne atom to ...an extended Ne system of solid density. We show that ionized electrons wander in such extended systems until they meet a nearby ion and collide with it. The maximum energy edge for the main feature of the high-order harmonic spectrum in this “wandering electron” picture is determined as Eedge = Ip + 8Up, where Ip is the ionization energy of Ne and Up is the ponderomotive energy delivered by the driving laser. The factor of 8 comes from the maximum kinetic energy of an ionized electron in the driving laser field. Beyond the atomic limit of high-order harmonic spectra, a multiplatform feature is observed, corresponding to re-collisions of ionized electrons with their nearby ions. It is also shown that a Ne simple cubic lattice of appropriate size provides a selection condition for the direction of polarization of high-order harmonics beyond the atomic limit, which may be further used to manipulate the emitted radiation.
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