Background: Hyperhomocysteinemia is a risk factor for cardiovascular disease. To date, limited prospective studies have examined the joint effects of the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, hyperhomocysteinemia and conventional vascular risk factors on risk of stroke and stroke death. Methods: A total of 39 165 subjects from nine communities within Anqing, Anhui Province, China were prospectively followed from March 1995 to April 2005, with an average follow-up period of 6.2 years. None of the subjects had any history of vascular events at baseline. At follow-up, 251 incident stroke cases were identified. Using a nested, case-control study design, this analysis includes 106 cases with complete MTHFR C677T genotyping data and plasma samples. We selected 106 controls without vascular events matched for age, sex, community and years of plasma storage. Plasma total homocysteine (tHcy) level was measured by high-performance liquid chromatography. Results: Hypertension was independently associated with incident stroke and stroke death after adjusting for important covariates including plasma log-transformed Hcy level. Relative to non-carriers of the MTHFR 677TT genotype with no hypertension, the adjusted odds ratio (95% confidence interval) of stroke and stroke death among hypertensive carriers of the MTHFR 677TT genotype was 10.6 (3.2 to 34.8), 5.8 (1.6 to 21.3), respectively. After excluding subjects with plasma Hcy above 20 μmol/L, the relative odds for stroke, but not for stroke death, was more significantly pronounced (OR = 24.1, 95% CI: 2.3 to 246.1) among subjects with moderate plasma Hcy levels. However, there was no significant interactive effect between hypertensive status and the MTHFR C677T variant on the odds of the two outcomes as estimated by interaction models. Conclusions: Our major findings suggest that joint effects of the MTHFR C677T polymorphism and hypertension are consistent in predicting a significantly high risk of stroke. In addition for moderate plasma levels of Hcy, the predicted effects on the risk for the primary end point of stroke were more pronounced. These results may help to modify current approaches to vascular disease prevention in Chinese hypertensive patients.

Existing research has noted a clear interaction between touristification and commercial gentrification; however, the differences between these two coexisting but distinct phenomena require further research. This study uses online big data and quantitative methods to explore the relationship between touristification and commercial gentrification. Taking Yuzhong District in Chongqing as an example, this study constructs an inter-attraction network based on 1306 itineraries extracted from online travel diaries, develops a method to evaluate community tourism centrality based on network analysis, and examines the correlation between community tourism centrality, touristification, and commercial gentrification. The results suggest that attractions with historical value, unique local landscapes, and mixed functions show greater tourism centrality in the tourist flow network. Attractions with similar themes are more likely to be included in one travel route, and the influence of distance is insignificant at the district level. Communities with higher tourism centrality are clustered in old city areas with a rich historic heritage and have experienced profound commercialisation. Although similar, touristification is primarily a bottom-up process, while commercial gentrification tends to be more involved with the top-down urban planning process. This study contributes to the methodological development of network analysis in tourism research and advances the understanding of the different mechanisms of touristification and commercial gentrification.

Background: The effect of serum L-carnitine (LC) concentrations on cancer risk remains unclear. This study aims to explore the association between serum LC and the risk of incident cancer. Methods: This is a case-control study, including 574 patients with incident cancer and 574 controls matched in a 1:1 ratio by age, sex, and residence, nested within the China H-Type Hypertension Registry Study (CHHRS). Conditional logistic regression analysis was used to assess the association of serum LC and incident cancer risk. Results: When LC was assessed as quartiles, compared with patients with low LC (Q1), patients in the highest quartile (Q4) had a 33% (OR = 0.67, 95% CI: 0.46 to 0.99), 52% (OR = 0.48, 95% CI: 0.23 to 0.99), and 39% (OR = 0.61, 95% CI: 0.38 to 0.99) decreased risk of overall, digestive system, and non-digestive system cancer in the adjusted models, respectively. In subgroup analyses, an inverse association of LC with cancer risk was observed in individuals who were overweight (obese), who never drink, who never smoke, and who were female. In the mediation analysis, serum trimethylamine-N-oxide (TMAO) concentrations did not mediate the reversed association of LC with cancer risk. Conclusions: This study showed that serum LC concentrations had a protective impact on overall, digestive system, and non-digestive system cancer risk.

Poverty is a challenge worldwide. Policy and regulations guiding anti-poverty measures for governments, NGOs, and multilateral institutions have not considered the spatial scale effect of regional poverty, resulting in low-efficiency poverty alleviation actions. This study addressed research gaps by analyzing the multi-scale (county, township, and village) features of regional poverty in Yanbian Korean Autonomous Prefecture in Jilin province, China. It examined the impact of geographic capital and associated spatial heterogeneity from four dimensions: natural environment, transport location, facilities accessibility, and socioeconomic development. The results identified that regional poverty varied at different scales: lower-scale poverty had higher levels of spatial differences, agglomeration, and spatial autocorrelation than higher-scale poverty, and the “island effect” was prominent. The factors potentially impacting regional poverty varied at different scales for geographical capital. At the township scale, only transport location and socioeconomic development dimensions could make significant differences. Factors in all four dimensions could affect village-scale poverty significantly, and the natural environment dimension was more effective than the other three dimensions. The impact of geographic capital and its spatial heterogeneity at the village scale varied, implying that local and diverse anti-poverty measures should increase. This study improves understanding of the multi-scale features of regional poverty and supports the formulation of effective anti-poverty measures.