cohort effects, and quantifies the influence of age, time, and birth cohort factors on disease rate. Estimable APC functions provide a useful parametric framework that complements standard non-parametric descriptive methods. 7 Although prior studies in China have applied the APC model to IHD analysis, 8 the data used in these studies was from 1987 to 2013, and the cohorts analyzed were born between 1904 and 1993. The cohort effects in younger generations have not yet been investigated.This study analyzed and quantified the age, period, and cohort effects on the secular trends of IHD incidence and mortality in China by using the data over an extended period obtained from the Global Burden of Disease Study (GBD) 2019. We aimed to determine the effects of IHD prevention in China, and to identify the high-risk population group, which should be taken into account in policy decisionmaking. The results may help to improve the long-term national IHD prevention policies and measures. Methods Data SourcesThis study obtained the IHD incidence and mortality rates I schemic heart disease (IHD) is a major public health issue and the main burden of cardiovascular diseases. 1 IHD has become the first leading global years-of-life lost (YLL) cause in 2019, whereas in 1990, it ranked only third. 2 The trends of IHD incidence and mortality vary from region to region. Regions such as North Africa and the Middle East, Central Asia, and Eastern Europe have higher prevalence rates of IHD. 2 For the high Sociodemographic Index (SDI) and high-middle SDI countries, the age-standardized incidence rates of IHD decreased by 27.4% from 1990 to 2017. 3 Regarding mortality, in Central Asia, the age-standardized death rate (ASDR) increased by 16.7% from 1990 to 2017. 4 However, in Korea, the ASDR decreased by 30% in males and by 37% in females from 2002 to 2012. 5 Also, the ASDR reduced from 65.3 to 51.3 per 100,000 and from 48.8 to 26.3 per 100,000 among Japanese males and females during 1995-2000, respectively. 6 Typical statistical analysis cannot decompose the risks when estimating incidence or mortality; therefore, an ageperiod-cohort (APC) model was developed and has been used for evaluating the long-term trend of IHD incidence and mortality. Specifically, the APC model is a generalized linear model that separates age effects, period effects, and

Introduction Geriatric assessment (GA) is widely used to detect vulnerability in older patients. As this process is time-consuming, prescreening tools have been developed to identify patients at risk for frailty. We aimed to assess whether the Geriatric 8 (G8) or the Korean Cancer Study Group Geriatric Score (KG-7) shows better performance in identifying patients who are in need of full GA. Materials and methods A consecutive series of patients aged ≥ 60 years with colorectal cancer were included. The sensitivity, specificity, predictive value, and 95% confidence intervals (95% CI) were calculated for the G8 and the KG-7 using the results of GA as the reference standard. ROC(Receiver Operating Characteristic) was used to evaluate the accuracy of the G8 and the KG-7. Results One hundred four patients were enrolled. A total of 40.4% of patients were frail according to GA, and 42.3% and 50.0% of patients were frail based on the G8 and the KG-7, respectively. The sensitivity and specificity of the G8 were 90.5% (95% CI: 77.4–97.3%) and 90.3% (95% CI: 80.1–96.4%), respectively. For the KG-7, the sensitivity and specificity were 83.3% (95% CI: 68.6–93.0%) and 72.6% (95% CI: 59.8–83.1%), respectively. Compared to the KG-7, the G8 had a higher predictive accuracy (AUC: (95% CI): 0.90 (0.83–0.95) vs. 0.78 (0.69–0.85); p < 0.01). By applying the G8 and the KG-7, 60 and 52 patients would not need a GA assessment, respectively. Conclusion Both the G8 and the KG-7 showed a great ability to detect frailty in older patients with colorectal cancer. In this population, compared to the KG-7, the G8 had a better performance in identifying those in need of a full Geriatric Assessment.

Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD) and induces increased mortality among COPD patients. However, there are no blood biomarkers to identify PH in COPD. Here, we investigated whether circulating angiogenic factors and cytokines could serve as (a) biomarker (s) for COPD-PH patients. Using Angiogenesis and Cytokine proteome profile array assay, we measured the level of 36 cytokines and 55 angiogenesis-associated proteins in plasma from four COPD patients with PH (COPD-PH) and four COPD patients without PH (COPD), respectively, tissue inhibitor of metalloproteinase 1 (TIMP-1) and thrombospondin 1(TSP-1) were significantly different between the two groups. Enzyme-linked immunosorbent assay (ELISA) was applied to measured TIMP-1 and TSP-1 in a validation cohort (COPD-PH, n = 28; COPD, n = 18), and TIMP-1 was the only factor that was significantly different between COPD-PH and COPD patients (P &lt; 0.01). Logistic regression analysis demonstrated that elevated TIMP-1 was an independent risk factor for COPD-PH [odds ratio (OR) = 1.258, 95% CI: 1.005–1.574, P &lt; 0.05). Next, we explored the expression level and function of TIMP-1 in human pulmonary arterial smooth muscle cells (hPASMCs) exposed to cigarette smoking extract (CSE, a major etiological factor of COPD). In cultured hPASMCs, CSE treatment increased both TIMP-1 protein level and cell proliferation, and exogenous TIMP-1 (25 ng/mL) treatment inhibited CSE-induced hPASMCs proliferation. Overall, our results indicated that TIMP-1 elevation could serve as a circulating biomarker to diagnose PH among COPD patients, and TIMP-1 elevation in COPD-PH could be adaptive.

Introduction The association of serum follicle-stimulating hormone (FSH) level with body fat mass remains inconclusive. Furthermore, little was known on the association of luteinizing hormone (LH) with body fat. This study aimed to investigate the associations of serum FSH and LH levels with fat and lean mass in women during menopausal transition. Methods The data analyzed in this study were derived from the National Health and Nutrition Examination Survey from 1999 to 2002. Women aged from 35 to 60 years were eligible. Serum FSH and LH levels were assayed using the Microparticle Enzyme Immunoassay technology. A dual energy X-ray absorptiometry was used to measure body fat mass and lean mass. Fat mass index (FMI) and fat-free mass index (FFMI) were respectively used to assess fat and lean mass. General linear regression was employed to examine the associations of serum FSH and LH levels with FMI and FFMI. Results This study included 1329 women. For the total participants, elevated serum FSH and LH levels were associated with increased FMI (β= 0.004 and 0.007; 95% CI: 0.002, 0.006 and 0.004, 0.010, respectively) and a decreased FFMI (β= -0.004 and -0.007; 95% CI: -0.006, -0.002 and -0.010, -0.004, respectively). Furthermore, the significant associations of serum FSH and LH levels with FMI and FFMI were fully observed in postmenopausal women, especially in a certain range of higher serum FSH and LH quartiles. Conclusion Elevated serum FSH and LH levels were associated with increased body fat mass but a decreased lean mass in postmenopausal women but not in premenopausal women. Furthermore, only higher serum FSH and LH percentiles were associated with fat and lean mass in postmenopausal women.