To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To address the problems of insufficient adaptability of photovoltaic (PV) cleaning robots in mountainous environments, where it is challenging to balance cleaning repeatability and cleaning integrity, this paper proposes a three-legged compound mobile mechanism and conducts optimization of its key parameters. First, the topological structure of the mechanism is designed based on the locomotion mode of inchworms. Combined with the requirements of PV panel cleaning tasks and the characteristics of cleaning methods, a compound motion mode integrating linear cleaning and rotational cleaning is adopted to determine the final structural configuration of the mechanism. Second, considering the relationship between the key parameters of the mechanism and the robot’s cleaning repeatability as well as cleaning integrity, a comprehensive performance index is constructed. The genetic algorithm is introduced for parameter optimization. Simulation results show that the optimal solution occurs at the larger step length and the maximum unilateral width of the cleaning mechanism within the valid interval. Finally, a prototype was fabricated for experiments. The results demonstrate that the robot can maintain stable adsorption on inclined and undulating PV panels, and the actual cleaning path is consistent with the theoretical trajectory, verifying the effectiveness of the design and the accuracy of the theoretical analysis in this paper.
Neuropsychiatric symptoms (NPSs) are prevalent in Alzheimer’s disease (AD), yet their neurobiological etiology remains elusive. We investigated relationships between NPS subsyndromes, plasma neurofilament light chain (NFL), AD-vulnerable brain atrophy, and cognition.
Methods
We included 146 participants from a Chinese cohort. NPSs were assessed using the Neuropsychiatric Inventory Questionnaire and clustered into four subsyndromes (hyperactivity, psychosis, affective, apathy), each graded by severity (none, mild, severe). Sequential mediation analyses examined whether NPSs influence cognition through NFL and atrophy. Additionally, 1534 ADNI participants were enrolled to (1) replicate mediation effects; (2) examine longitudinal relationships of NPSs with incident cognitive decline; and (3) evaluate cognitive discrimination of NPSs and NFL and onset hazards of NPS subsyndromes.
Results
In the discovery cohort, global NPSs burden and three subsyndromes (hyperactivity, affective, apathy) were associated with elevated plasma NFL, poorer global cognition and memory, and reduced brain volumes (all P < 0.05). Sequential mediation revealed that plasma NFL and atrophy mediated the cross-sectional NPSs–cognition relationship, replicated in ADNI. Adding NPSs and NFL improved cognitive discrimination (AUC: 0.6754 to 0.8210, P < 0.001). Additionally, apathy and psychosis showed lower onset hazards than affective and hyperactivity (both P < 0.001).
Conclusions
Baseline NPSs were cross-sectionally associated with elevated NFL, brain atrophy, and poorer cognition. Sequential mediation models supported a pathway linking NPSs to cognition via NFL and atrophy, though longitudinal evidence did not fully confirm temporal directionality. These hypothesis-generating findings require prospective validation.
The term ‘schizo-obsessive comorbidity (SOC)’ is used to describe the presence of obsessive-compulsive symptoms or obsessive-compulsive disorder (OCD) in patients with schizophrenia (SOC). Recent studies have found overlapped executive dysfunctions in SCZ and OCD implicating shared pathophysiology. However, specific deficits in the components of executive function (EF) in patients with SOC remains unclear.
Methods
We recruited 37 patients with SOC, 68 patients with SCZ, 70 patients with OCD, and 59 healthy controls (HCs). All participants completed a battery of measures for EF components, namely initiation, sustained attention, online updating, switching, disinhibition, and planning. Apart from traditional group-mean analysis, we applied machine learning approaches to identify the unique patterns of EF among different clinical groups.
Results
The results showed that the three clinical groups could be distinguished from HCs. The feature importance analysis showed that, to classify clinical groups from HC, online updating was the core feature of SCZ patients, whereas disinhibition and online updating jointly determine classification between OCD patients and HC. In differentiating SOC from HC, online updating, planning, and disinhibition collectively served as key features. Machine learning algorithms classified SOC and OCD with acceptable performance but classified SOC and SCZ with lower performance.
Conclusions
Deficits of EF are shared features among patients with SOC, SCZ, and OCD. However, the specific components of executive dysfunction in these clinical groups appeared distinct.
We present an experimental study on electron and X-ray generation from the interaction of a hundreds of TW femtosecond laser with microchannels. Leveraging the guiding effect of the channel structure on both the laser and electrons, a well-collimated electron beam is achieved, with a beam charge of 1.5 nC (>10 MeV), a slope temperature of 9.1 MeV and a nearly constant divergence angle (~14°) over a broad energy range (10–50 MeV). Meanwhile, we demonstrate a ring-shaped X-ray source generated through bremsstrahlung radiation mechanism from electrons collision with channel walls, exhibiting a characteristic energy of 90 keV and emittance of 0.8 mm mrad. Three-dimensional simulations elucidate the underlying acceleration dynamics. It is found that elongated channels facilitate the formation of well-collimated electron beams. These results establish the foundation for applications of channel guided electrons and secondary radiation sources and represent a key step toward the controlled manipulation of particle sources in laser-driven plasmas.
Multi-plane light conversion (MPLC) is a versatile technique that enables arbitrary manipulation of optical fields, and is numerically investigated as a novel avenue for coherent beam combining (CBC) applications. The optical parameters have been investigated to guide the MPLC design, indicating that the number of phase planes and plane spacing serve as pivotal factors. The channel scalability is simulated, revealing that the plane spacing should be increased in a larger array to maintain high performance under a few-plane limit. CBC of up to 1027 lasers has been numerically demonstrated with near-diffraction-limited beam quality (M2 of 1.16 and combining efficiency close to 100%) with only seven phase plates. Beam steering is investigated, revealing that steering capability is related to both the number of multiplexed modes in MPLC and their mode fidelities, and the main-lobe power ratio of 87.1% at one divergence angle is achieved in a 10-mode MPLC with five phase plates.
This paper is devoted to revealing the effects of swirling flows with radially dependent velocity profiles on thermoacoustic instability. By reformulating the three-dimensional linearized Euler equations in cylindrical coordinates under standing-wave assumptions according to inlet/outlet boundary reflections, and integrating flame response dynamics, we develop a dispersion relation framework for thermoacoustic instability analysis. In so doing, the model generalizes prior network-based approaches for thermoacoustic instabilities (with axial and circumferential flow) to incorporate radial velocity gradients. Validation against analytical and numerical solutions for benchmark cases spanning thermoacoustic instabilities and aeroacoustic phenomena demonstrates quantitative agreement across configurations. Subsequent parametric studies further indicate that both radially dependent azimuthal and axial velocity components exert a considerable influence on the prediction of azimuthal thermoacoustic instability in an annular duct. This finding suggests that the assumption of uniform velocities in existing models may lead to inaccurate estimations of instability. Additionally, acoustic energy analysis indicates that axial flow components (perpendicular to inlet/outlet cross-sections) exhibit higher acoustic energy efflux at the combustor outlet than the circumferential components of swirling flows. Meanwhile, in comparison with burner-induced acoustic energy variations at the combustor inlet, an increase in the circumferential flow component reduces acoustic energy transmission at the combustor outlet for counter-propagating waves while amplifying it for copropagating waves. These effects are further enhanced by a stronger axial component of swirling flows. Overall, the proposed framework provides a foundational tool for elucidating thermoacoustic mechanisms and advancing instability mitigation strategies in a swirling flow configuration within confined spaces.
Bioelectrical impedance analysis (BIA)-derived water composition ratios are non-invasive and cost-effective indices that reflect body fluid distribution. This study aimed to investigate the associations between these BIA-derived ratios and overall survival (OS) in patients with gastric cancer. A retrospective multicentre study included 385 gastric cancer patients. Optimal cut-offs were determined via receiver operating characteristic curves. Kaplan–Meier survival analysis, Cox regression analysis and restricted cubic spline (RCS) evaluated associations with OS. The optimal cut-off values were 0.389 for extracellular water (ECW)/total body water (TBW), 0·611 for intracellular water (ICW]/TBW and 0·638 for ECW/ICW. Kaplan–Meier survival analysis revealed that elevated ECW/TBW (72·6% vs. 58·7%; P < 0·001) and ECW/ICW (59·1% vs. 72·4%; P < 0·001) were associated with poorer OS, while a higher ICW/TBW (73·4% vs. 57·3%; P < 0·001) indicated better prognosis. In RCS models, ECW/TBW (hazard ratio (HR) = 1·552, 1·202–2·005, P = 0·001) and ECW/ICW (HR = 1·735, 1·320–2·280, P < 0·001) independently predicted worse OS, whereas ICW/TBW inversely correlated with mortality (HR = 0·620, 0·486–0·790, P < 0·001). Multivariable Cox regression analysis further confirmed that higher ECW/TBW (HR =1·552, 95% CI 1·272–2·688, P < 0·001) and ECW/ICW (HR = 1·735, 1·320–2·280, P < 0·001) ratios independently predicted worse OS. Conversely, a higher ICW/TBW ratio was inversely correlated with mortality (HR = 0·567, 95% CI 0·390–0·824, P = 0·003). The ECW/ICW ratio demonstrated the highest C-index (0·596), outperforming other ratios in predicting survival. These associations were consistent across subgroups, including advanced-stage patients. BIA-derived water composition ratios, particularly ECW/ICW, are robust and independent predictors of survival in gastric cancer patients, reflecting underlying metabolic and inflammatory disturbances. These non-invasive and cost-effective markers could enhance prognostic accuracy and guide personalised treatment strategies.
We developed a two-phase lattice Boltzmann model by coupling the entropic multiple-relaxation-time (EMRT or KBC) collision operator enabling low fluid viscosity, with a source term (Wang et al. 2022, Phys. Rev. E vol. 105, no 4) to independently adjust surface tension. The coupling is implemented via the exact difference method (EDM), which allows full consideration of external-force effects on the entropic stabiliser in KBC, in contrast to the recent work of Wang et al. (2022 Phys. Rev. E vol. 105) and Xu et al. (2024 Comput. Math. Appl. vol. 159, 92–101). More importantly, we address a major drawback of the EDM by explicitly demonstrating how its high-order error terms influence the pressure tensor and surface tension. Using the developed model, we investigated droplet impact and splashing on a thin liquid film at a remarkably high Weber number of ${\textit{We}} = 5000$ and Reynolds number of ${\textit{Re}} = 5000$. Droplet impact and splashing on flat surfaces and mesh structures at very high ${\textit{Re}}$ (15 200) and ${\textit{We}}$ (1020) are also studied after validating four representative cases against experiments. For droplet impact on flat surfaces, hydrophobicity promotes the growth of peripheral instabilities, leading to fingering splashing. Corona splashing transitions to fingering splashing as the liquid–gas viscosity ratio increases. For droplet impact on mesh structures, large openings promote liquid penetration, whereas small openings enhance spreading. As the solid ratio increases, the maximum spreading ratio increases monotonically but nonlinearly, whereas the maximum penetrated liquid pillar length first rises and then drops. These simulations demonstrate the proposed model offers significant advantages for accurately capturing and elucidating complex droplet impact and splashing dynamics at high ${\textit{Re}}$ and ${\textit{We}}$.
A total of 60 healthy lambs were randomly assigned to three treatment groups: control (CON), and groups receiving basal diet (dry matter base) supplemented with 400 mg/kg (CA400) and 800 mg/kg (CA800) of cinnamaldehyde (CA), the CA additive used silicon dioxide as adsorbent and the CA content was 25% (m/m). The study lasted 75 days, including a 15-day pre-trial and a 60-day trial period. Results showed average daily gain, feed-to-gain ratio, as well as digestibility rates of organic matter and crude protein were significantly improved compare with CON (P < 0.05). Serum total protein and immunoglobulin G levels were elevated in both CA groups (P < 0.05). The CA800 group had significantly higher total superoxide dismutase compared to CON, while glucose (Glu) levels were lower in CA groups (P < 0.05). Ruminal ammonia nitrogen level was significantly lower in the CA groups compared to CON (P < 0.05). The total volatile fatty acid concentration was highest in the CA400 group, followed by CON, with the lowest in the CA800 group; the acetate/propionate ratio tended to be lower in the CA groups (P > 0.05). The abundance of Bacteroidetes in CA800 group was significantly higher than that in CON (P < 0.05), and the abundance of Firmicutes in CA400 and CA800 groups were significantly decreased (P < 0.05). The abundance of Prevotella in CA400 and CA800 groups was significantly increased (P < 0.05), while abundance of Rikenellaceae_RC9_gut_group was significantly lower than that in CON group (P < 0.05). In conclusion, the addition of SiO2 adsorbing CA to the diet of lambs can improve the growth performance, nutrient apparent digestibility, antioxidant and immune ability, and changed composition of ruminal bacterial community, addition of 400 mg/kg (equivalent to 100 mg/kg pure) has the best effect.
Clinical pharmacists are increasingly recognized as essential members of multidisciplinary palliative care teams, yet their specific roles and impact have not been comprehensively summarized. This scoping review aimed to systematically map and synthesize published evidence on the clinical roles, interventions, and professional contributions of pharmacists within multidisciplinary palliative care services for patients with non-communicable diseases.
Methods
A scoping review was conducted by searching PubMed, Embase, Web of Science, and Scopus from January 2000 to May 2024. Eligible studies reported clinical pharmacist interventions in palliative care. Data were extracted on study characteristics, pharmacist activities, and clinical outcomes.
Results
Twelve studies were included, predominantly from the United States. Pharmacist-led interventions encompassed medication reconciliation (91.7%), symptom management (83.3%), adverse drug event prevention (75.0%), patient and caregiver education (58.3%), and policy-level contributions (33.3%). High physician acceptance rates (≥90%) were consistently reported. Outcomes included improved symptom control, reduced drug-related problems, and enhanced patient-reported quality of life.
Significance of results
This scoping review synthesizes current evidence on the roles of clinical pharmacists in palliative care teams. The findings highlight their essential contributions to medication safety, symptom management, deprescribing, and opioid stewardship, reinforcing the need for pharmacist integration into multidisciplinary palliative care models to improve patient-centered outcomes. Future research should focus on implementation models, cost-effectiveness analyses, and service expansion in community-based settings.
Research on the special engineering properties of laterite has highlighted the importance of interactions between colloidal oxides and clay minerals, yet their exact microscopic mechanisms remain elusive. To address this, this study employs molecular dynamics simulations to investigate the impact of isomorphic substitution on the interactions between illite and colloidal alumina. The stable configurations and the potential of mean force for these interactions were determined. The simulation results reveal that the heterogeneous charge distribution across the surfaces of illite and colloidal alumina underpins their interaction. Specifically, the negatively charged {001} surface of illite forms a stable adsorption structure with the positively charged Al atoms of colloidal alumina. Meanwhile, equilibrium cations (K+) and atoms from isomorphic substitution induce electrostatic attractions with O and Al atoms in colloidal alumina, leading to two localized stable states and an intermediate transition state on the {00-1} surface of illite. Furthermore, Mg substitution in the octahedral sheet and Al substitution in the tetrahedral sheet reduce the layer charge density, thereby weakening the affinity of the illite {00-1} surface for colloidal alumina. Conversely, Fe substitution in the octahedral sheet increases the local charge density, enhancing the attraction of the {001} surface. These simulation results provide molecular-level insights into the mechanisms governing the behaviour of laterite, offering a theoretical foundation for guiding future experimental studies and for the engineering application and performance control of laterite soils.
The current study aimed to investigate the effects of different iron sources on growth performance and small intestinal health in weaned piglets. Two hundred and forty piglets (Duroc × Large White × Landrace, 9.52 ± 1.60 kg, 40 ± 2 d) were assigned to four treatments including control group, a basal diet without iron supplemented in mineral premix; ferrous sulfate (FeSO4) group, 100 mg Fe/kg dry matter (DM); ferrous glycinate (Fe-Gly) group, 80 mg Fe/kg DM; amino acid-Fe(II)-chelator complexes group, 30 mg Fe/kg DM. There were four pens for each treatment, and each pen had fifteen piglets. The experiment lasted for 28 days. Compared to the control group, three iron sources increased average daily feed intake (P < 0.05). Fe-Gly and amino acid-Fe(II)-chelator complexes increased average daily gain (P < 0.05). Amino acid-Fe(II)-chelator complexes increased villus height in jejunum (P < 0.05). In addition, Fe-Gly increased Ki67 and leucine rich repeat containing G protein-coupled receptor 5 (Lgr5) mRNA expression in duodenum (P < 0.05). Amino acid-Fe(II)-chelator complexes increased claudin-1 mRNA expression, and both amino acid-Fe(II)-chelator complexes and Fe-Gly increased Lgr5 mRNA expression (P < 0.05) in jejunum. These results suggest that organic iron is more effective than FeSO4 in improving growth performance, and has a positive effect on intestinal health in weanling piglets.
Severe mental disorders (SMDs) impose profound suffering on patients and heavy burdens on family caregivers, often resulting in abusive behaviors. This study aimed to examine the association between psychiatric symptom severity and caregiver abuse, and to assess whether caregiver tobacco dependence moderates this relationship.
Methods
A cross-sectional study included 763 patient–caregiver dyads in rural Shandong, China. Psychiatric symptom severity was measured using the 18-item Brief Psychiatric Rating Scale. Caregiver tobacco dependence was assessed using the Fagerström Test for Nicotine Dependence. Patients reported caregivers’ verbal/physical abuse in the past year. Ordered logistic regression and interaction terms tested associations and moderation.
Results
Overall, 25.7% of caregivers engaged in verbal abuse and 14.9% in physical abuse. Psychiatric symptom severity was significantly associated with both verbal (OR = 1.018, 95% CI: 1.010–1.026) and physical abuse (OR = 1.015, 95% CI: 1.005–1.025). Caregivers with moderate to severe tobacco dependence were more likely to commit verbal (OR = 1.851, 95% CI: 1.136–3.016) and physical abuse (OR = 2.292, 95% CI: 1.287–4.079) than non-smokers. Moderate to severe tobacco dependence significantly amplified the association between psychiatric symptom severity and verbal abuse (interaction OR = 1.024, 95% CI: 1.002–1.046), but not physical abuse.
Conclusion
In rural China, greater psychiatric symptom severity among patients with SMDs is associated with increased frequency of both verbal and physical abuse by caregivers, particularly verbal abuse among those with moderate to severe tobacco dependence, underscoring the need for caregiver-targeted psychological support and tobacco cessation interventions.
In this paper, we investigate the ideal structure of uniform Roe algebras for general metric spaces beyond the scope of Yu’s Property A. Inspired by the ideal of ghost operators coming from expander graphs and in contrast to the notion of geometric ideal, we introduce a notion of ghostly ideal in a uniform Roe algebra, whose elements are locally invisible in certain directions at infinity. We show that the geometric ideal and the ghostly ideal are, respectively, the smallest and the largest element in the lattice of ideals with a common invariant open subset of the unit space of the coarse groupoid by Skandalis–Tu–Yu, and hence the study of ideal structure can be reduced to classifying ideals between the geometric and the ghostly ones. We also provide a criterion to ensure that the geometric and the ghostly ideals have the same $K$-theory, which helps to recover counterexamples to the coarse Baum–Connes conjectures. Moreover, we introduce a notion of partial Property A for a metric space to characterize the situation in which the geometric ideal coincides with the ghostly ideal. As an application, we provide a concrete description for the maximal ideals in a uniform Roe algebra in terms of the minimal points in the Stone–Čech boundary of the space.
The purpose of this study is to reveal the impact of pilot free trade zones (PFTZs) on local governance quality (LGQ) to provide a reference for driving governance reforms in China. Based on provincial panel data from 2004 to 2020 in China, the impact of the establishment of PFTZs on LGQ is analyzed by employing the multi-period difference-in-difference (DID) method. The results show that the establishment of PFTZs can significantly enhance the governance quality of local governments, but there is heterogeneity in location and establishment batches. PFTZs improve LGQ through the effects of institutional spillover, factor allocation, and talent agglomeration. FDI spillover can partially substitute for promoting the effect of PFTZs on LGQ, and economic growth pressures can distort the positive effect of PFTZs on LGQ. Therefore, policymakers should clarify the functional positioning of PFTZs and leverage their effects, which are institutional spillover, factor allocation, and high-end factor agglomeration, to enhance LGQ.
Late-onset depression (LOD) is featured by disrupted cognitive performance, which is refractory to conventional treatments and increases the risk of dementia. Aberrant functional connectivity among various brain regions has been reported in LOD, but their abnormal patterns of functional network connectivity remain unclear in LOD.
Methods
A total of 82 LOD and 101 healthy older adults (HOA) accepted functional magnetic resonance imaging scanning and a battery of neuropsychological tests. Static functional network connectivity (sFNC) and dynamic functional network connectivity (dFNC) were analyzed using independent component analysis, with dFNC assessed via a sliding window approach. Both sFNC and dFNC contributions were classified using a support vector machine.
Results
LOD exhibited decreased sFNC among the default mode network (DMN), salience network (SN), sensorimotor network (SMN), and language network (LAN), along with reduced dFNC of DMN-SN and SN-SMN. The sFNC of SMN-LAN and dFNC of DMN-SN contributed the most in differentiating LOD and HOA by support vector machine. Additionally, abnormal sFNC of DMN-SN and DMN-SMN both correlated with working memory, with DMN-SMN mediating the relationship between depression and working memory. The dFNC of SN-SMN was associated with depressive severity and multiple domains of cognition, and mediated the impact of depression on memory and semantic function.
Conclusions
This study displayed the abnormal connectivity among DMN, SN, and SMN that involved the relationship between depression and cognition in LOD, which might reveal mutual biomarkers between depression and cognitive decline in LOD.
Rice water weevils (RWWs) (Lissorhoptrus oryzophilus) and rice weevils (RW) (Echinocnemus squameus) (both Coleoptera: Curculionidae) are major rice pests that cause significant economic losses in China. Understanding their potential distribution areas is crucial for effective management. This study used the Biomod2 package in R to simulate and predict the current and future potential distributions, changes in suitable areas, shifts in distribution centres, and overlaps under climate change for both pests under three greenhouse gas emission scenarios. By 2023, the suitable areas for RWWs and RWs were 538.52 × 104 km2 and 376.05 × 104 km2, respectively. The suitable area for the former pest expanded southwestward and northeastward across China, whereas the latter spread mainly into Northeast China. The suitable area for RWWs is projected to remain stable, whereas that for RWs is expected to decline. The distribution centroid of RWWs is anticipated to shift toward southeastern or southwestern Shaanxi, whereas RWs are likely to migrate toward central-eastern or northeastern Shaanxi. The niche overlap between the two pests is high (Schoener’s D = 0.658, I = 0.816), with overlap concentrated in central, eastern, and southern China. The key factors influencing their distributions include precipitation of the wettest month (Bio13), mean temperature of the warmest quarter (Bio10), and precipitation of the driest month (Bio14). This study provides a theoretical basis for the prediction of the potential distribution of both pests, which offers valuable insights for the development of effective pest control strategies in China.
The current study aims to assess associations between trimethylamine N-oxide (TMAO) levels and mortality and to investigate modification effects of genetics. A total of 500 participants from a family-based cohort study were enrolled from 2005 to 2017 and followed up until 2020 in Fangshan District, Beijing, China. Serum TMAO levels were measured using the ELISA kit. The primary outcomes were all-cause mortality and deaths from CVD and stroke. During a median follow-up time of 7·38 years, thirty-eight deaths were recorded, including twenty deaths due to CVD and nineteen deaths due to stroke. Compared with the lowest TMAO quartile group, the HR for all-cause mortality was 1·35 (95 % CI: 0·44, 4·15), 1·65 (95 % CI: 0·58, 4·64) and 2·45 (95 % CI: 0·91, 6·57), respectively, in higher groups. No association was observed between TMAO and CVD mortality. However, compared with the lowest TMAO concentration group, the HR for stroke mortality was 1·93 (95 % CI: 0·40, 9·39), 1·91 (95 % CI: 0·41, 8·96) and 4·16 (95 % CI: 0·94, 18·52), respectively, in higher groups (Pfor trend = 0·046). Furthermore, polygenic risk score (PRS) for longevity modified the association of TMAO with all-cause mortality (Pfor interaction = 0·008). The risk of mortality (HR = 2·20, 95 % CI: 1·06, 4·57) was higher among participants with lower PRS compared with higher PRS (HR = 1·00, 95 % CI: 0·71, 1·40). The study indicates that elevated serum TMAO levels are potentially associated with long-term mortality risk in rural areas of northern China, especially for stroke deaths. Additionally, it provides novel evidence that genetic variations might modify the association.