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e., creating mental distress, rather than facilitating connectedness). Contributors' responses offered various opportunities for connectedness both on- and off-line. Safe online spaces, such as r/COVID19_support, can serve as a protective factor amid suicidality, facilitating connectedness, and thereby helping to curtail suicidal thoughts from advancing to suicidal actions. This subreddit and similar online spaces can benefit specific populations who may otherwise find it challenging to access services or who wish to remain anonymous.The global crises of climate change and of the COVID-19 pandemic are straining young peoples' mental health and their mitigation behaviours. We surveyed German-speaking university students aged 18 to 30 years on their negative emotions regarding both crises repeatedly before and during the COVID-19 crisis. Different emotional patterns emerged for climate change and for COVID-19 with negative emotions regarding COVID-19 increasing during the pandemic. We were further able to differentiate between emotional responses associated with impaired wellbeing and those associated with mitigation efforts. Our findings emphasise the need to focus on a mixture of highly inactivating and activating emotions regarding COVID-19 as they are associated with both reduced wellbeing and mitigation behaviours. The findings broaden the understanding of how young adults react to the burden of two global crises and what role negative emotions play.Visualizing low-dimensional representations with scatterplots is a crucial step in analyzing single-cell genomic data. However, this visualization has significant biases. The first bias arises when visualizing the gene expression levels or the cell identities. The scatterplot only shows a subset of cells plotted last, and the cells plotted earlier are masked and unseen. The second bias arises when comparing the cell-type compositions across samples. The scatterplot is biased by the unbalanced total number of cells across samples. We developed SCUBI, an unbiased method that visualizes the aggregated information of cells within non-overlapping squares to address the first bias and visualizes the differences of cell proportions across samples to address the second bias. We show that SCUBI presents a more faithful visual representation of the information in a real single-cell RNA sequencing (RNA-seq) dataset and has the potential to change how low-dimensional representations are visualized in single-cell genomic data.

Limited information exists about the incidence of first-ever stroke at the population level, particularly in low- and middle-income countries (LMIC). Longitudinal data from the CRONICAS Cohort Study includes both altitude and urbanization and allows a detailed assessment of stroke incidence in resource constrained settings. The aim of this study was to estimate the incidence and explore risk factors of first-ever stroke at the population level in Peru.

Stroke was defined using a standardised approach based on information from cohort participants or family members. This information was adjudicated centrally by trained physicians using common definitions. Time of follow-up was calculated as the difference between date of enrolment and the reported date of the stroke event. Unstandardised and age-standardised, first-ever stroke incidence rate and 95% confidence intervals (95% CI) were calculated. Generalized linear models, assuming Poisson distribution and link log, were utilized to determine potential factoto lower incidence of stroke in a longitudinal study. However, this information needs to be considered with cautions because of the study limitations.

Our results indicate a high incidence of first-ever strokes in Peruvian general population. These results are consistent with the estimates found in previous LMIC reports. Our study also found a contributing role of hypertension, increasing the risk of having a first-ever stroke. This work further advances the field of stroke epidemiology by identifying high altitude as a factor related to lower incidence of stroke in a longitudinal study. However, this information needs to be considered with cautions because of the study limitations.

During the coronavirus 2019 (COVID-19) pandemic, increased anxiety and depression were reported, with mixed findings among individuals of different races/ethnicities. This study examines whether anxiety and depression increased during the COVID-19 pandemic compared to the pre-COVD-19 period among different racial/ethnic groups in the US.

The Health Information National Trend Surveys 5 (HINTS 5) Cycle 4 data was analyzed. We used the time when the survey was administered as the pre-COVID-19 period (before March 11, 2020, weighted

=77,501,549) and during the COVID-19 period (on and after March 11, 2020, weighted

=37,222,019). The Patient Health Questionnaire (PHQ) was used to measure anxiety/depression and further compared before and during COVID-19. Separate multivariable logistic regression analyses were used to determine the association of the COVID-19 pandemic with anxiety/depression after adjusting for age, sex, insurance, income, and education.

A higher percentage of Non-Hispanic whites (NHW) with chronic conditions reported anxiety (24.3% vs. 11.5%,

=0.0021) and depression (20.7% vs. 9.3%,

=0.0034) during COVID-19 than pre-COVID-19. The adjusted odds ratio (AOR) of anxiety and depression for NHWs with chronic conditions during the COVID-19 pandemic was 2.02 (95% confidence interval of 1.10-3.73,

=0.025) and 2.33 (1.17-4.65,

=0.018) compared to NHWs who participated in the survey before the COVID-19.

Limited to the NHW US population. PHQ can only be used as the initial screening tool.

The COVID-19 pandemic was associated with an increased prevalence of anxiety and depression among NHW adults with chronic conditions, but not among people of color.

The COVID-19 pandemic was associated with an increased prevalence of anxiety and depression among NHW adults with chronic conditions, but not among people of color.

To determine the association between diabetic retinopathy (DR) severity and quantitative retinal vascular features.

Retrospective image analysis study.

Eyes with DR and eyes with no posterior segment disease (normal eyes) that had undergone ultra-widefield fluorescein angiography (UWFA) with associated color fundus photography. Exclusion criteria were any previous laser photocoagulation, low image quality, intravitreal or periocular pharmacotherapy within 6 months of imaging, and any other significant retinal disease including posterior uveitis, retinal vein occlusion, and choroidal neovascularization.

The centered early mid-phase UWFA frame that captured the maximum vessel area was selected using automated custom software for each eye. Panretinal and zonal vascular features were extracted using a machine learning algorithm. Eyes with DR were graded for DR severity as mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR, and proliferative DR (PDR). Parameters of normal eyes were compared with aeral geodesic distance were among the most important features for distinguishing mild NPDR from advanced forms of DR and PDR versus eyes without PDR.

Automated analysis of retinal vasculature demonstrated associations with DR severity and visual and subvisual vascular biomarkers. Further studies are needed to evaluate the clinical significance of these parameters for DR prognosis and therapeutic response.

Automated analysis of retinal vasculature demonstrated associations with DR severity and visual and subvisual vascular biomarkers. Further studies are needed to evaluate the clinical significance of these parameters for DR prognosis and therapeutic response.

Air pollution might accelerate cognitive ageing; it is unclear whether large-scale interventions, such as China's Clean Air Act (CCAA), can mitigate cognitive deterioration. We aimed to evaluate the effect of CCAA on changes in cognitive function in older adults.

In this population-based, quasi-experimental study, we did a difference-in-differences analysis of the data collected during the 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The study design used a counterfactual analysis feature by dividing CLHLS participants into two groups. The intervention group included participants who lived in areas where the provincial government set a target of reducing particulate matter (PM) by at least 5% annually from 2014 onward, whereas the control group consisted of individuals who lived in areas without a PM reduction target. Global cognitive function was measured using the Mini-Mental State Examination (MMSE). We used fixed-effects models to examine the between-group differen score decline of 0·80 points (0·32-1·29).

Implementing stringent clean air policies might mitigate the risk of air pollutant-associated cognitive ageing in older people.

National Natural Sciences Foundation of China, National Key R&D Program of China, China Postdoctoral Science Foundation funded project, the Duke/Duke-National University of Singapore Collaboration Pilot Project, the National Institute on Aging and Peking University-Baidu Fund, Energy Foundation, and the Fundamental Research Funds for the Central Universities.

National Natural Sciences Foundation of China, National Key R&D Program of China, China Postdoctoral Science Foundation funded project, the Duke/Duke-National University of Singapore Collaboration Pilot Project, the National Institute on Aging and Peking University-Baidu Fund, Energy Foundation, and the Fundamental Research Funds for the Central Universities.

Understanding the nature of transitions from a healthy state to chronic diseases and death is important for planning health-care system requirements and interventions. MitoPQ We aimed to quantify the trajectories of disease and disability in a population of healthy older people.

We conducted a secondary analysis of data from the ASPREE trial, which was done in 50 sites in Australia and the USA and recruited community-dwelling, healthy individuals who were aged 70 years or older (≥65 years for Black and Hispanic people in the USA) between March 10, 2010, and Dec 24, 2014. Participants were followed up with annual face-to-face visits, biennial assessments of cognitive function, and biannual visits for physical function until death or June 12, 2017, whichever occurred first. We used multistate models to examine transitions from a healthy state to first intermediate disease events (ie, cancer events, stroke events, cardiac events, and physical disability or dementia) and, ultimately, to death. We also examined the eke, 88 events per 1000 person-years (68-111) from cardiac disease, 69 events per 1000 person-years (58-82) from disability or dementia, and four events per 1000 person-years (4-5) from a healthy state. Age was significantly associated with an accelerated rate for most transitions. Male sex (

female sex) was significantly associated with an accelerate rate for five of 12 transitions.

We describe a multistate model in a healthy older population in whom the most common transition was from a healthy state to cancer. Our findings provide unique insights into the frequency of events, their transition rates, and the impact of age and sex. These results have implications for preventive health interventions and planning for appropriate levels of residential care in healthy ageing populations.

The National Institutes of Health.

The National Institutes of Health.

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