PurposeThis study aimed to assess the relationship of serum uric acid with metabolic syndrome and its components in Tibetan adults on the Tibetan plateau.MethodsA total of 307 participants were enrolled in this study and biochemical parameters including serum uric acid, fasting plasma glucose, white blood cell, lymphocyte count, mononuclear cells, alanine aminotransferase, aspartate aminotransferase, creatinine, and lipid profile were analyzed using standard methods. The IDF criteria were applied to define metabolic syndrome. The association of serum uric acid with metabolic syndrome and its components was evaluated by multivariable logistic regression models.ResultsThe overall prevalence of metabolic syndrome was 17.3% (53/307) with 19.6% (31/158) in females and 14.8% (22/149) in male participants. The prevalence of hyperuricemia was 40.7% (125/307) with significant differences between the male (53.7%,80/149) and female (28.5%,45/158) groups. In regression analysis, we observed that the risk of MetS was higher in participants in the hyperuricemia group (adjusted OR, 4.01; 95% CI, 2.02~7.99) compared with those in the normouricemia group. After adjusting for all confounding factors, a 9% higher risk of MetS could be shown in participants with SUA increased per 10umol/L (adjusted OR, 1.09; 95% CI, 1.04~1.14). These relationships were not affected by sex or age (p >0.05). After adjusting for the confounding factors, hyperuricemia is positively associated with abdominal obesity (adjusted OR, 2.53; 95% CI, 1.41~4.53), elevated blood pressure (adjusted OR, 2.61; 95% CI, 1.37~4.97), and elevated triglycerides(adjusted OR, 2.47; 95% CI, 1.09~5.57).ConclusionsIn our study, hyperuricemia is significantly associated with the prevalence of metabolic syndrome and part of its components, and these relationships are not affected by sex or age. Given the high prevalence of MetS and hyperuricemia among Tibetan adults, more studies are required to explore the role of SUA in the pathogenesis of MetS.

Federated learning (FL), which provides a collaborative training scheme for distributed data sources with privacy concerns, has become a burgeoning and attractive research area. Most existing FL studies focus on taking unimodal data, such as image and text, as the model input and resolving the heterogeneity challenge, i.e., the challenge of non-identical distribution (non-IID) caused by a data distribution imbalance related to data labels and data amount. In real-world applications, data are usually described by multiple modalities. However, to the best of our knowledge, only a handful of studies have been conducted to improve system performance utilizing multimodal data. In this survey paper, we identify the significance of this emerging research topic of multimodal federated learning (MFL) and present a literature review on the state-of-art MFL methods. Furthermore, we categorize multimodal federated learning into congruent and incongruent multimodal federated learning based on whether all clients possess the same modal combinations. We investigate the feasible application tasks and related benchmarks for MFL. Lastly, we summarize the promising directions and fundamental challenges in this field for future research.

BackgroundThe relationship of mean heart rate (MHR) with 30-day mortality in ischemic stroke patients with atrial fibrillation in the intensive care unit (ICU) remains unknown. This study aimed to investigate the association between MHR within 24 h of admission to the ICU and 30-day mortality among patients with atrial fibrillation and ischemic stroke.MethodsThis retrospective cohort study used data on US adults from the Medical Information Mart for Intensive Care-IV (MIMIC-IV, version 1.0) database. Patients with ischemic stroke who had atrial fibrillation for and first time in ICU admission were identified from the MIMIC-IV database. We used multivariable Cox regression models, a restricted cubic spline model, and a two-piecewise Cox regression model to show the effect of the MHR within 24 h of ICU admission on 30-day mortality.ResultsA total of 1403 patients with ischemic stroke and atrial fibrillation (mean [SD] age, 75.9 [11.4] years; mean [SD] heart rate, 83.8[16.1] bpm; 743 [53.0%] females) were included. A total of 212 (15.1%) patients died within 30 days after ICU admission. When MHR was assessed in tertials according to the 25th and 50th percentiles, the risk of 30-day mortality was higher in participants in group 1 (< 72 bpm; adjusted hazard ratio, 1.23; 95% CI, 0.79–1.91) and group 3 (≥82 bpm; adjusted hazard ratio, 1.77; 95% CI, 1.23–2.57) compared with those in group 2 (72–82 bpm). Consistently in the threshold analysis, for every 1-bpm increase in MHR, there was a 2.4% increase in 30-day mortality (adjusted HR, 1.024; 95% CI, 1.01–1.039) in those with MHR above 80 bpm. Based on these results, there was a J-shaped association between MHR and 30-day mortality in ischemic stroke patients with atrial fibrillation admitted to the ICU, with an inflection point at 80 bpm of MHR.ConclusionIn this retrospective cohort study, MHR within 24 h of admission was associated with 30-day mortality (nonlinear, J-shaped association) in patients with ischemic stroke and atrial fibrillation in the ICU, with an inflection point at about 80 bpm and a minimal risk observed at 72 to 81 bpm of MHR. This association was worthy of further investigation. If further confirmed, this association may provide a theoretical basis for formulating the target strategy of heart rate therapy for these patients.

This study investigated the relationship between residence altitude and serum folate levels in healthy Tibetans living on the Tibetan Plateau. Participants were selected from those who underwent physical examinations at our health center between November 2019 and February 2020. Demographic characteristics and medical histories were collected, and fasting blood was tested for serum folate and other hematological indicators. The relationship between altitude and serum folate levels was analyzed using a multivariable linear regression model. Serum folate levels were associated with altitude (β = − 0.44; 95% confidence interval [CI] − 0.71; − 0.16), hemoglobin (β = − 0.01; 95% CI − 0.03; − 0.00), red blood cells (β = − 0.72; 95% CI − 1.18; − 0.27), hematocrit (β = − 0.07; 95% CI − 0.12; − 0.02), high-density lipoprotein cholesterol (β = 2.67; 95% CI 1.35; 3.98), and sex (β = 0.68; 95% CI 0.12; 1.23). Multivariate linear regression analysis revealed that altitude was negatively associated with serum folate levels. After adjusting for confounding factors, serum folate levels decreased by 0.33 ng/mL per each 500-m increase in altitude (β = − 0.33; 95% CI − 0.6; − 0.05; P = 0.022). Altitude was negatively associated with serum folate levels in Tibetan adults. The relationship between altitude and folate levels should be further explored in populations of different races and disease states. Further large-scale prospective studies should illustrate the causality of this relationship.