Rate Of Decline Research Articles

Influence of design parameters on heat production of a multilateral butted closed loop geothermal system

To efficiently develop hot dry rock and other geothermal energy, a multilateral butted closed loop geothermal system (MBCLGS) is presented in this paper to replace the U-shaped closed-loop geothermal system (UCLGS). Besides, a casing-cement-formation transient heat transfer model is established to investigate the influences of key factors on the heat production of MBCLGS. After thermal-fluid-structural coupling analysis, we can find that higher injected rate and lower fluid temperature can improve heat power but reduce output temperature. In addition, the output temperature and heat power do not increase continuously with the increasing of branch well number. There is an optimal value of branch well number. Longer well pair distance can improve both output temperature and heat power. Considering the drilling technology level and design purpose, the recommended injected flow rate of MBCLGS is 90 m3/h, the injected fluid temperature is 42.5 °C, the number of branch wells is 10 and the well pair distance is 200m. Finally, by comparing MBCLGS and UCLGS, it is found that MBCLGS has a lower temperature decline rate and higher output temperature than UCLGS under the same conditions. It works more stable and has better economy. Overall, the proposal of MBCLGS is expected to promote the efficient development of deep geothermal resources.

Trends in US Pediatric Asthma Hospitalizations, by Race and Ethnicity, 2012-2020.

Some racial and ethnic minority communities have long faced a higher asthma burden than non-Hispanic White communities. Prior research on racial and ethnic pediatric asthma disparities found stable or increasing disparities, but more recent data allow for updated analysis of these trends. Using 2012-2020 National Inpatient Sample data, we estimated the number of pediatric asthma hospitalizations by sex, age, and race and ethnicity. We converted these estimates into rates using data from the US Census Bureau and then conducted meta-regression to assess changes over time. Because the analysis spanned a 2015 change in diagnostic coding, we performed separate analyses for periods before and after the change. We also excluded 2020 data from the regression analysis. The number of pediatric asthma hospitalizations decreased over the analysis period. Non-Hispanic Black children had the highest prevalence (range, 9.8-36.7 hospitalizations per 10,000 children), whereas prevalence was lowest among non-Hispanic White children (range, 2.2-9.4 hospitalizations per 10,000 children). Although some evidence suggests that race-specific trends varied modestly across groups, results overall were consistent with a similar rate of decrease across all groups (2012-2015, slope = -0.83 [95% CI, -1.14 to -0.52]; 2016-2019, slope = -0.35 [95% CI, -0.58 to -0.12]). Non-Hispanic Black children remain disproportionately burdened by asthma-related hospitalizations. Although the prevalence of asthma hospitalization is decreasing among all racial and ethnic groups, the rates of decline are similar across groups. Therefore, previously identified disparities persist. Interventions that consider the specific needs of members of disproportionately affected groups may reduce these disparities.

Effect of a cash transfer intervention on memory decline and dementia probability in older adults in rural South Africa

Evidence on cash transfers as a population-level intervention to support healthy cognitive aging in low-income settings is sparse. We assessed the effect of a cash transfer intervention on cognitive aging outcomes in older South African adults. We leveraged the overlap in the sampling frames of a Phase 3 randomized cash transfer trial [HIV Prevention Trial Network (HPTN) 068, 2011-2015] and an aging cohort [Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community (HAALSI), 2014-2022] in rural Mpumalanga Province, South Africa. In 2011/12, young women and their primary caregivers were randomly assigned 1:1 to receive a monthly cash transfer or control. In 2014/2015, 862 adults aged 40+ y living in trial households were enrolled in the HAALSI cohort, with cognitive data collected in three waves over 7 y. We estimated the impact of the intervention on rate of memory decline and dementia probability scores. Memory decline in the cash transfer arm was 0.03 SD units (95% CI: 0.002, 0.05) slower per year than in the control arm. Dementia probability scores were three percentage points lower in the cash transfer arm than the control arm (β = -0.03; 95% CI: -0.05, -0.001). Effects were consistent across subgroups. A modestly sized household cash transfer delivered over a short period in mid- to later-life led to a meaningful slowing of memory decline and reduction in dementia probability 7 y later. Cash transfer programs could help stem the tide of new dementia cases in economically vulnerable populations in the coming decades.

Age-specific all-cause mortality trends in the UK: Pre-pandemic increases and the complex impact of COVID-19

ObjectivesThis study aims to analyse age-specific all-cause mortality trends in the UK before and after COVID-19 emergence to determine if pre-pandemic trends contributed to increased mortality levels in the post-pandemic era. Study designStatistical analysis of UK mortality data. MethodsWe utilised age-structured population and mortality data for all UK countries from 2005 to 2023. Mortality rates were calculated for each age group, and excess mortality was estimated using the Office for National Statistics (ONS) method. ResultsOur most concerning finding is an increase in all-cause mortality rates for middle-aged adults (30–54 years) starting around 2012. The COVID-19 pandemic may have further impacted these rates, but the pre-existing upward trend suggests that current elevated mortality rates might have been reached regardless of the pandemic. This finding is more alarming than the slowdown in the decline of cardiovascular disease death rates for individuals under 75 noted by the British Heart Foundation. ConclusionOur results highlight the importance of considering both immediate pandemic impacts and long-term mortality trends in public health strategies. This underscores the need for targeted interventions and improved healthcare planning to address both ongoing and future challenges.

The Association Between Hypothyroidism and Cognitive Function Change in Women across the Menopause Transition: The Study of Women's Health Across the Nation.

Background: Patients treated for hypothyroidism with levothyroxine (LT4) monotherapy may present with persistent hypothyroidism symptoms, including cognitive symptoms, despite having a normal thyroid stimulating hormone (TSH) level. It remains unclear whether LT4 monotherapy is sufficient to normalize cognitive function outcomes over time. Methods: This is a multisite longitudinal study of a diverse group of women during midlife representing 5 ethnic/racial groups from 7 enrollment sites across the United States in the Study of Women's Health Across the Nation. Women were screened for a history of thyroid disease and the use of LT4. The study consisted of two primary groups: women with LT4-treated hypothyroidism and control women without thyroid disease. Each participant completed up to 9 cognitive assessments over the study period testing processing speed, working memory, and episodic memory (immediate and delayed recall). Multivariable generalized linear mixed models of scores for each cognitive assessment were developed to determine the association between LT4-treated hypothyroidism and cognitive function trajectories. Covariates included sociodemographic, clinical characteristics, and menopausal status (pre/early peri, late peri, and surgical/post). Sensitivity analyses were conducted to assess the impact of abnormal TSH levels and practice effects (i.e., improvements in scoring after repeated testing). Results: Of the 2033 women who were included in the study, 227 (11.2%) met criteria for LT4-treated hypothyroidism. At baseline, both processing speed and working memory scores were higher in LT4-treated women (mean processing speed scores: 56.5 vs 54.4; p value = 0.006; mean working memory scores: 6.8 vs 6.4; p value = 0.018). However, when considering the effect of LT4-treated hypothyroidism over time, there were no significant differences in the rate of cognitive decline (in any measure) between the hypothyroidism and control groups with or without covariate adjustment. The results were similar when considering LT4-treated women with abnormal TSH levels or after minimizing practice effects. Conclusions: We observed no difference in cognitive decline between women with LT4-treated hypothyroidism and women without thyroid disease. For similar aged patients with cognitive complaints, if thyroid function testing is normal, clinicians should consider causes other than inadequate thyroid hormone treatment to explain these symptoms.

Warming decreased plant litter decomposition by modulating soil fauna interactions in a Tibetan alpine meadow

Litter decomposition is a vital process for maintaining ecosystem carbon cycling. It is affected by soil fauna which are predators and decomposers of litter. However, how the interactions of soil fauna communities affect litter decomposition remains unclear under warming. Here, we conducted a five-year in-situ manipulative warming experiment by Open-Top Chamber (OTC) in an alpine meadow on the Tibetan Plateau to reveal how warming affects litter decomposition. The results demonstrated that warming decreased the litter decomposition rate by 29 %, the soil collembola abundance by 25 %, and the nematode abundance by 27 %. Nematode ecological indices remain stable but a shift in the decomposition of litter to the fungivores pathway under warming. The piecewise structural equation modelling result revealed that the combined reduction in soil collembola and nematodes synergistically leads to a massive decline in litter decomposition rate under warming. Our results highlight that the interactions of soil fauna can regulate litter decomposition under warming, and collembola abundance as the “speed-limiter” of litter decomposition. Therefore, the response of changes in soil fauna relationships to warming should be completely considered in future climate change modelling of the grassland carbon cycle.

Analyzing the Fertility Rate Trends in Kuwait with GIS Between 2014 and 2024

A highly evident trend globally has emerged since the middle of last century, namely the decline in fertility rates. Whilst the underlying reasons are complicated and multifaceted, it is sufficient to say that there is no easy solution or permanent reversal plan that works. This study investigates the fertility rate in the state of Kuwait and uses GIS tools, such as Hotspot analysis to compare fertility rates between 2014 and 2024 along with their spatial distribution. The aim is to evaluate a government attempt to slow down or stop the decline by offering significant financial support to families with children. Furthermore, the method attempts to identify differences in fertility behavior between ethnic groups in Kuwait (Hadar and Badu) by spatially comparing the fertility rates in suburbs dominated by each group. The output results suggest that the government policies have only been partially successful in stopping the fertility rates; the fertility rates decreased, although only slightly, on average between 2014 and 2024. Additionally, it was clear that the Badu group of Kuwaitis, residing in the new peripheral regions, form significantly larger families than Hadar who live close to the older central suburbs. Combined, these findings suggest that further modifications to the policy umbrella for fertility are necessary that should match the motivations and address the concerns of each ethnic group and district in a more tailored way, rather than simply offering a lump sum to every family.

Nutritional assessment and medical dietary therapy for management of obesity in patients with non-dialysis chronic kidney disease: a practical guide for endocrinologist, nutritionists and nephrologists. A consensus statement from the Italian society of endocrinology (SIE), working group of the club nutrition-hormones and metabolism; the Italian society of nutraceuticals (SINut), club ketodiets and nutraceuticals "KetoNut-SINut"; and the Italian society of nephrology

Chronic kidney disease (CKD) is a serious health concern with an estimated prevalence of about 13.4% worldwide. It is cause and consequence of various comorbidities, including cardiovascular diseases. In parallel, common pathological conditions closely related to ageing and unhealthy dietary habits increase the risk of CKD development and progression, including type 2 diabetes and obesity. Among these, obesity is either independent risk factor for new onset kidney disease or accelerates the rate of decline of kidney function by multiple mechanisms. Therefore, the role of diets aimed at attaining weight loss in patients with obesity is clearly essential to prevent CKD as to slow disease progression. Various dietary approaches have been licensed for the medical dietary therapy in CKD, including low-protein diet and Mediterranean diet. Interestingly, emerging evidence also support the use of low-carbohydrate/ketogenic diet (LCD/KD) in these patients. More specifically, LCD/KDs may efficiently promote weight loss, improve metabolic parameters, and reduce inflammation and oxidative stress, resulting in a dietary strategy that act globally in managing collateral conditions that are directly and indirectly related to the kidney function. This consensus statement from the Italian Society of Endocrinology (SIE), working group of the Club Nutrition - Hormones and Metabolism; the Italian Society of Nutraceuticals (SINut), Club Ketodiets and Nutraceuticals "KetoNut-SINut"; and the Italian Society of Nephrology (SIN) is intended to be a guide for Endocrinologist, Nutritionists and Nephrologist who deal with the management of patients with obesity with non-dialysis CKD providing a practical guidance on assessing nutritional status and prescribing the optimal diet in order to best manage obesity to prevent CKD and its progression to dialysis.

Decarceration in Southern Europe: Notes on Climate Change in the Penal Field

AbstractAgainst the backdrop of the economic and political crises affecting Europe in the late 2000s and early 2010s, incarceration rates began to shrink in many European countries, ushering in a decarceration period that continues to this day—albeit with cross-border divergences. In fact, Europe was the world region with the greatest decline in incarceration rates in the 2010s. Evidently, this unexpected shift stands in stark contrast to the penal populism policies characterising penality in global north regions in the 1990s and 2000s, as well as to the mass incarceration path still followed by many global south jurisdictions in the 2020s. Spain is a suitable national case to examine this recent turn, since Spanish incarceration rates increased almost eightfold in just three decades, before an intriguing and steady decline began that is almost unparalleled in western Europe. This paper focuses on the Spanish case, exploring the background and proximate causes that have enabled the current decarceration scenario. In addition, it scrutinises if and to what extent the changes witnessed in the Spanish case reverberate across wider European regions. In so doing, the paper attempts to grasp the climate change impacting the penal field in many global north jurisdictions.

Variation in bacterial pathotype is consistent with the sit-and-wait hypothesis.

The sit-and-wait hypothesis predicts that bacteria can become more virulent when they survive and transmit outside of their hosts due to circumventing the costs of host mortality. While this hypothesis is largely supported theoretically and through comparative analysis, experimental validation is limited. Here we test this hypothesis in Streptococcus suis, an opportunistic zoonotic pig pathogen, where a pathogenic ecotype proliferated during the change to intensive pig farming that amplifies opportunities for fomite transmission. We show in an in vitro environmental survival experiment that pathogenic ecotypes survive for longer than commensal ecotypes, despite similar rates of decline. The presence of a polysaccharide capsule has no consistent effect on survival. Our findings suggest that extended survival in the food chain may augment the zoonotic capability of S. suis. Moreover, eliminating the long-term environmental survival of bacteria could be a strategy that will both enhance infection control and curtail the evolution of virulence.

Fabrication and characterization of poly(methyl vinyl ether maleic anhydride) blended poly(lactic acid) ultrafiltration membrane with upgraded antifouling and separation performance

In this present study, a novel environment-friendly bio-polymeric hybrid ultrafiltration membrane was fabricated by incorporating poly(methyl vinyl ether maleic anhydride) (PMVEAMA) into the poly(lactic acid) (PLA) polymer matrix. The integration of PMVEAMA into PLA significantly altered the membrane's structural morphology, functional characteristics, and filtration performance. As a result, key functional parameters like membrane porosity and water content were increased, which exhibiting the improved hydrophilicity. Furthermore, the molecular weight cut-off of the PLA/PMVEAMA membrane reached up to a maximum of 66.5 KDa with an average pore size of 9.14 nm, subsequently improving the flux of the membrane up to 2.8 times than PLA membrane. The functional capacity of the synthesized membrane was further assessed by testing its ability to filter toxic chlorophenolic compounds. Rejection studies reveal that the PLA/PMVEAMA membrane achieved a rejection efficiency of 44.64 % pentachlorophenol (PCP) and 51.85 % 2,4-dichlorophenol (DCP). Moreover, fouling studies revealed enhanced PCP and DCP flux recovery ratios of 50.94 % and 51.40 %, respectively, with a significant reduction in the flux decline rate. Additionally, the synthesized PLA/PMVEAMA membranes improved stability and regenerative properties up to 12 filtration cycles and antifouling properties highlight its potential to filter chlorophenolic compounds from wastewater.

The absence of formal work experience may affect the rate of cognitive decline in older adult women: findings from the health and retirement study.

This study investigated the relationship between years of employment and cognitive health among older non-Latinx Black, Latinx, and non-Latinx White women. We hypothesized that women who had never been formally employed (i.e., zero years of formal work experience) would exhibit a pronounced cognitive decline. Our study included 5,664 older adult women from the Health and Retirement Study (2010-2016) aged 65-101 (M = 75.41). Out of 5,664 participants, 850 identified as non-Latinx Black, 475 identified as Latinx, and 4,339 identified as non-Latinx White. Furthermore, 5,292 women indicated having a professional employment history of at least one year, whereas 372 women reported no formal work experience. The Telephone Interview for Cognitive Status-27 (TICS-27) was used to assess cognitive performance. Linear mixed effects models were conducted to assess whether employment history was associated with the rate of cognitive decline. In all three racial and ethnic groups, lower age, higher education, greater number of years worked, fewer chronic conditions, and greater household income were associated with better cognitive performance at baseline (p < .05). Additionally, women who had not worked in any formal capacity had a lower baseline cognitive performance (p < .001) and a more extreme decline in cognitive performance over time (p = .04). In conclusion, we found that women without any formal work experience performed lower at baseline and experienced a steeper cognitive decline over time. These findings underscore the need to further explore the complex interrelationships between employment duration and cognitive trajectories, especially among older women and those from different racial and ethnic backgrounds.

Associations of socioeconomic status and healthy lifestyle with incident dementia and cognitive decline: two prospective cohort studies

Little is known about the complex associations of socioeconomic status (SES) and healthy lifestyle with cognitive dysfunction. Using data from the Health and Retirement Study (HRS) [2008-2020] and the English Longitudinal Study of Ageing (ELSA) [2004-2018], SES was constructed by latent class analysis using education level, total household income and wealth. Overall healthy lifestyle was derived using information on never smoking, low to moderate alcohol consumption (drinks/day: (0, 1] for women and (0, 2] for men), top tertile of physical activity, and active social contact. A total of 12,437 and 6565 participants from the HRS and ELSA were included (40.8% and 46.0% men and mean age 69.3 years and 65.1 years, respectively). Compared with participants of high SES, those of low SES had higher risk of incident dementia (hazard ratio 3.17, 95% confidence interval 2.72-3.69 in the HRS; 1.43, 1.09-1.86 in the ELSA), and the proportions mediated by overall lifestyle were 10.4% (7.3%-14.6%) and 2.7% (0.5%-14.0%), respectively. Compared with participants of high SES and favorable lifestyle, those with low SES and unfavorable lifestyle had a higher risk of incident dementia (4.27, 3.40-5.38 in the HRS; 2.02, 1.25-3.27 in the ELSA) and accelerated rate of global cognitive decline (β=-0.058 SD/year; 95% CI:-0.073,-0.043 in the HRS; β=-0.049 SD/year; 95% CI:-0.063,-0.035 in the ELSA). Unhealthy lifestyle only mediated a small proportion of the socioeconomic inequality in dementia risk in both US and UK older adults. This work was supported by grants from the National Natural Science Foundation of China (82088102 and 82370819), the National Key R&D Program of China (2023YFC2506700), the Shanghai Municipal Government (22Y31900300), the Shanghai Clinical Research Center for Metabolic Diseases (19MC1910100), the Innovative Research Team of High-Level Local Universities in Shanghai, the Special Project for Clinical Research in Health Industry of Shanghai Municipal Health Commission (202340084), and Ruijin Hospital Youth Incubation Project (KY20240805). Y.X. is supported by the National Top Young Talents program.

Global legal trends in fertility interventions: A criminal justice perspective

The global decline in birth rates has heightened the urgency of addressing infertility, a condition that affects approximately one in six individuals worldwide. This paper explores the complex causes of infertility, including genetic predispositions, lifestyle choices, and environmental exposures, which collectively contribute to reproductive challenges in both men and women. The advent of Assisted Reproductive Technologies (ART), particularly In Vitro Fertilization (IVF), has revolutionized infertility treatment since 1978, providing hope to millions. Despite the remarkable advancements in ART, these technologies raise significant legal and ethical concerns, necessitating robust regulatory frameworks. This paper examines the historical development of ART, with a focus on global trends and data from ART registries, highlighting the steady increase in ART cycles worldwide. Furthermore, it delves into the legal and ethical challenges associated with ART, including issues related to donor rights, parental responsibilities, and the potential health risks for children born through these technologies. The paper advocates for continued refinement of ART practices and regulations to ensure safety, efficacy, and ethical integrity. It also underscores the importance of ongoing research into the long-term health implications for children conceived via ART and the broader societal impacts. By addressing these concerns, ART can continue to offer a viable solution to infertility while upholding human dignity and societal well-being.

Progressive cervical cord atrophy parallels cognitive decline in Alzheimer’s disease

Alzheimer’s disease (AD) is characterized by progressive episodic memory dysfunction. A prominent hallmark of AD is gradual brain atrophy. Despite extensive research on brain pathology, the understanding of spinal cord pathology in AD and its association with cognitive decline remains understudied. We analyzed serial magnetic resonance imaging (MRI) scans from the ADNI data repository to assess whether progressive cord atrophy is associated with clinical worsening. Cervical cord morphometry was measured in 45 patients and 49 cognitively normal controls (CN) at two time points over 1.5 years. Regression analysis examined associations between cord atrophy rate and cognitive worsening. Cognitive and functional activity performance declined in patients during follow-up. Compared with controls, patients showed a greater rate of decline of the anterior–posterior width of the cross-sectional cord area per month (− 0.12%, p = 0.036). Worsening in the mini-mental state examination (MMSE), clinical dementia rating (CDR), and functional assessment questionnaire (FAQ) was associated with faster rates of cord atrophy (MMSE: r = 0.320, p = 0.037; CDR: r = − 0.361, p = 0.017; FAQ: r = − 0.398, p = 0.029). Progressive cord atrophy occurs in AD patients; its rate over time being associated with cognitive and functional activity decline.

Effects of fasting on golden pompano Trachinotus ovatus: Physiological and biochemical responses

In practice, golden pompano (Trachinotus ovatus) reared in offshore cages may experience short-term fasting during extreme weather conditions, yet their physiological and biochemical responses remain poorly understood. To investigate the responses of this species to fasting, golden pompano weighing 138.0 ± 2.1 g were deprived of food for 0, 7, 14, 21 and 28 days, followed by assessments of body mass, somatic parameters, proximate composition, muscle glycogen, intestinal digestive enzymes, muscle amino acid and fatty acid profiles, nutritional value, and muscle texture and water holding capacity. Lower condition factor, hepatosomatic index, viscerosomatic index, hepatic glycogen, and intestinal activities of amylase, lipase and trypsin were found in the fasted fish than in the non-fasted fish, while a sharp decline in these parameters occurred on the first week of fasting. Fresh mass, dry mass, whole body and muscle contents of crude protein and lipid tended to decrease with prolonged fasting, while no statistical differences were found in these parameters between fish fasted for 7 days and the non-fasted fish. Furthermore, the decline rate of whole body crude lipid was consistently higher than that of whole body crude protein throughout the different stages of the 28-day fasting period, with the exception of the second week of fasting. No statistical differences were found in the total essential amino acids (∑EAA), non-essential amino acids (∑NEAA), ratio of ∑EAA to∑NEAA, chemical score, amino acid score, and essential amino acid index in the fasted fish compared to the non-fasted fish of group 0d. Fasting altered the muscle profile of SFA, MUFA and PUFA, sometimes reducing muscle springiness (groups 7d and 14d) and hardness (group 21d). Compared to non-fasted fish, fish fasted for 7 and 14 days exhibited statistically lower or equal drip loss, water loss rate, storage losses, and frozen exudate rate, whereas higher cooked meat rate. The above results indicate that during the 28-day fasting period, the visceral fat and hepatic glycogen are initially metabolized, followed by body proteins and lipids, to maintain the normal metabolism in fasted fish. Fasting has beneficial effects on the nutritional value of amino acids and fatty acids in muscle, although it modifies the muscle SFA, MUFA and PUFA composition and sometimes has negative effects on muscle texture. Considering the balance between body weight loss and flesh quality improvement, the duration of fasting for cultured golden pompano prior to harvesting should not exceed 14 days.

Beyond complete remission: A comparative analysis of long-term laryngeal function in patients with hypopharyngeal and laryngeal cancer following radiotherapy and concurrent chemoradiation.

This study evaluates functional larynx preservation in patients with hypopharyngeal cancer (HPC) and laryngeal cancer (LC) who achieved complete remission following radiotherapy (RT) or concurrent chemoradiation (CCRT). HPC and LC patients treated with RT/CCRT from 1999 to 2017 were retrospectively analyzed. Severe late dysphagia and tracheostomy cases were assessed to determine laryngeal function. Long-term preservation rate of functional larynx and associated factors were evaluated. Of 152 patients (55 HPC, 97 LC), nine developed severe dysphagia, occurring on average 58.2 months post-treatment. HPC and cervical node metastasis significantly increased the risk of laryngeal function impairment (p < 0.001 and p = 0.014, respectively), presenting a continued decline in functional larynx preservation rate beyond 10 years. Patients with HPC and cervical node metastasis demonstrate an increased risk for long-term laryngeal function impairment despite successful oncologic outcomes. This risk extends beyond 10 years, underscoring the need for prolonged monitoring and comprehensive support.

A Comparative Study on the Dietary Iodine Intake and the Contribution Rates of Various Foods to the Dietary Iodine Intake among Residents in Zhejiang in 2010 and 2022.

We aim to analyze the changes in dietary iodine intake and the contribution rates of various foods to it after the reduction in salt iodine concentration in Zhejiang. We used data from two cross-sectional nutrition surveillance surveys conducted by the Zhejiang Provincial Center for Disease Control and Prevention in 2010 (9798 residents) and 2022 (5980 residents). In both surveys, multi-stage stratified and systematic sampling were adopted, and uniformly trained investigators conducted the dietary surveys using a 24 h dietary review and weighing record methods for 3 consecutive days. From 2010 to 2022, the median salt iodine concentration and the consumption rate of qualified iodized salt in Zhejiang households dropped from 28.80 to 22.08 mg/kg and from 76.65% to 64.20%, respectively. Moreover, the residents' median dietary iodine intake decreased from 277.48 to 142.05 μg/d. Significant interregional differences in dietary iodine intake were found in 2010 and 2022 (H = 639.175, p < 0.001; H = 588.592, p < 0.001, respectively); however, no significant differences existed between urban and rural areas (p > 0.05). From 2010 to 2022, the proportion of residents with dietary iodine intake below the estimated average requirement increased from 15.10% to 34.80%, while that of residents with intake above the tolerable upper limit decreased from 15.00% to 2.90%. The contribution rate of salt to dietary iodine intake among residents in Zhejiang decreased from 74.92% to 48.54%, showing an apparent overall downward trend despite the dietary intake being generally adequate (markedly inadequate in coastal regions). The salt iodine concentration and the consumption rate of qualified iodized salt in households in Zhejiang showed downward trends. Salt remained the main source of dietary iodine; however, its contribution decreased significantly. Zhejiang may need to reverse the trend of the continuous decline in the consumption rate of qualified iodized salt to protect the health of its residents.

New Evidence of Healthier Aging: Positive Cohort Effects on Verbal Fluency.

Cross-sectional studies have shown improvements in cognition in later-born cohorts. However, it remains unclear whether these cohort effects extend beyond cognitive levels and are also detectable in the rate of age-related cognitive decline. Additionally, evidence is scarce on the presence and consistency of cohort effects throughout different segments of the distribution of cognitive trajectories. This study evaluates the existence and variability of cohort effects across the entire distribution of aging-related trajectories of verbal fluency. With this purpose, we develop sex and education-adjusted longitudinal norms of verbal fluency using data from 9 waves of the English Longitudinal Study of Aging (ELSA) by fitting quantile mixed models. The effect of age was modeled using splines to assess birth cohort effects, after grouping individuals in 5-year groups from 1920 to 1950 according to their age at study entry. To test for possible cohort effects across the 10th, 50th, and 90th quantiles, the coefficients associated with the splines were allowed to vary among cohorts. Our results suggest that, consistently across longitudinal quantiles, decline in verbal fluency across age is less pronounced for later-born individuals (p < .001), supporting the hypothesis of cohort effects. Additionally, we also found that quantiles of verbal fluency at any age are shifted upwards in later-born cohorts compared to those in earlier-born cohorts. These results enhance our understanding of cognitive decline in older adults by demonstrating that cohort effects on cognition are observable both cross-sectionally and longitudinally, affecting the entire range of verbal fluency trajectories.

Association between changes of frailty status/frailty components status and rapid loss of kidney function in middle- aged and older populations

BackgroundFrailty and its components are proposed to associate with kidney function, but little attention is paid to the significance of changes in their status on rapid loss of kidney function. This study aimed to investigate the association between changes in frailty and its components status with rapid loss of renal function.MethodsThis study used data from China Health and Retirement Longitudinal Study (CHARLS). Frailty status was measured using the Fried frailty phenotype (FP) scale, including five components: slowness, weakness, exhaustion, inactivity, and shrinking. Frailty status was further classified into three levels: robust (0 component), prefrail (1–2 components) and frail (3–5 components). Changes in frailty status were assessed by frailty status at baseline and 4- year follow-up. Rapid loss of kidney function was defined as a rate of estimate glomerular filtration rate(eGFR) decline ≥ 4 ml/min per 1.73 m2per year. Logistic regression models were performed to assess the association between changes in frailty status and its components status with rapid eGFR decline.ResultsA total of 2705 participants were included with 316 (11.68%) participants categorized as rapid eGFR decline during the 4-year follow-up. Compared with baseline prefrail participants who progressed to frail, prefrail participants who maintained prefrail or recovered to robust status had decreased risks of rapid eGFR decline (stable prefrail status, OR = 0.608, 95% CI: 0.396–0.953; recover to robust, OR = 0.476, 95% CI: 0.266–0.846). In contrast, among baseline robust or frail participants, we did not find changes in frailty status significantly affect the risks of rapid loss of kidney function. Moreover, participants who experienced incident weakness showed the significant relationship with an increased risk of rapid eGFR decline (OR = 1.531, 95% CI: 1.051–2.198) compared to stable non-weakness participants. Other changes of frailty components status did not significantly affect the risks of rapid eGFR decline.ConclusionsThe progression of frailty status increases the risks of rapid eGFR decline among prefrail populations. Preventing weakness, may benefit kidney function.