Classification of brain tumor types through MRIs using parallel CNNs and firefly optimization.

Image segmentation is a critical and challenging endeavor in the field of medicine. A magnetic resonance imaging (MRI) scan is a helpful method for locating any abnormal brain tissue these days. It is a difficult undertaking for radiologists to diagnose and classify the tumor from several pictures. This work develops an intelligent method for accurately identifying brain tumors. This research investigates the identification of brain tumor types from MRI data using convolutional neural networks and optimization strategies. Two novel approaches are presented: the first is a novel segmentation technique based on firefly optimization (FFO) that assesses segmentation quality based on many parameters, and the other is a combination of two types of convolutional neural networks to categorize tumor traits and identify the kind of tumor. These upgrades are intended to raise the general efficacy of the MRI scan technique and increase identification accuracy. Using MRI scans from BBRATS2018, the testing is carried out, and the suggested approach has shown improved performance with an average accuracy of 98.6%.

Association between long-term exposure to fine particulate matter and its chemical constituents and premature death in individuals living with HIV/AIDS.

Long-term exposure to fine particulate matter (PM2.5) is associated with an increased total mortality. However, the association of PM2.5 with mortality in people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS, PLWHA) and the relationship between its constituents and adverse outcomes remain unknown. In this cohort study, 28,140 PLWHA were recruited from the HIV/AIDS Comprehensive Response Information Management System of the Hubei Provincial Centre for Disease Control and Prevention in China between 2001 and 2020. The annual PM2.5 chemical composition data, including sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), black carbon (BC), and organic matter (OM), was extracted from the Tracking Air Pollution (TAP) dataset in China. A Cox proportional hazard model with time-varying exposure and time-to-event quantile-based generalized (g) computation was used to assess the associations between PM2.5 chemical constituents, and mortality in PLWHA. A multivariate Cox proportional hazard model estimated an excess hazard ratio (eHR) of 0.32% [95% confidence interval (CI): (0.01%, 0.64%)] for AIDS-related death (ARD), associated with 1 µg/m3 rise in PM2.5 exposure. An increase of 1 µg/m3 in NH4+ was associated with 5.13% [95% CI: (2.89%, 7.43%)] and 2.97% [95% CI: (1.52%, 4.44%)] increase in the risk of ARD and all-cause deaths (ACD), respectively. When estimated using survival-based quantile g-computation, the eHR for ARD with a joint change in a decile increase in all five components was 6.10% [95% CI: 3.77%, 8.48%)]. Long-term exposure to PM2.5 chemical composition, particularly NH4+ increased the risk of death in PLWHA. This study provides epidemiological evidence that SO42- and NH4+ increased the risk of ARD and that NH4+ increased the risk of ACD in PLWHA. Multi-constituent analyses further suggested that NH4+ may be a key component in increasing the risk of premature death in patients with HIV/AIDS. Individuals aged ≥65 with HIV/AIDS are more vulnerable to SO42-, and consequent ACD.

Utilizing daily excessive concentration hours to estimate small for gestational age infants attributable to fine particulate matter in Wuhan, China.

Limited studies in China have explored the association between gravidae exposure to PM2.5 and small for gestational age infants (SGA), yielding inconsistent results. This study in Wuhan utilized daily excessive concentration hours (DECH) as a novel measure to assess PM2.5's impact on SGA. Data on air pollutants and pregnant women were collected from the Wuhan Municipal Ecology and Environmental Bureau and Wuhan Children's Hospital, respectively. Logistic regression models were employed to evaluate the contribution of PM2.5-DECH and PM2.5-mean to SGA. Significant correlations were observed between PM2.5-mean and SGA during the second trimester [OR = 1.23 (95% CI: 1.14-1.32)] and the entire pregnancy [OR = 1.15 (95% CI: 1.07-1.24)]. Similar correlations were found between PM2.5-DECH and SGA. These findings suggest that increased PM2.5 exposure is associated with a higher risk of SGA, and DECH may be used as a prospective substitute indicator for daily average concentration in similar studies.

Is short-term exposure to primary gaseous air pollutants associated with AIDS-related deaths? Evidence from a time-stratified case-crossover study.

Primary gaseous air pollutants have been associated with death from multiple causes, however, it remains unknown if they play a role in premature mortality among individuals living with HIV/AIDS. Data on HIV/AIDS patients were collected from the Hubei Provincial Center for Disease Control and Prevention, with a total of 1,467 AIDS-related deaths (ARD) between 2013 and 2020. Daily mean sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were generated by artificial intelligence algorithms combined with big data. We employed a time-stratified case-crossover approach and conditional logistical regression models to investigate the acute effects of primary gaseous air pollutants on ARD. Per interquartile range increase in the concentrations of SO2 was significantly linked with ARD, with a corresponding odds ratio (OR) of 1.17 [95% confidence intervals (CIs): 1.01, 1.35] at lag 4 day. Furthermore, our findings indicated that males exhibited a heightened vulnerability to the adverse effects of SO2 and NO2, for example, the ORs were 1.24 (95% CIs: 1.05, 1.47) and 1.16 (95% CIs: 1.01, 1.34), respectively. Moreover, individuals aged over 65 years were more susceptible to SO2 and CO. Additionally, we identified the warm season as a sensitive period for mortality associated with SO2 and NO2. Our study furnished fresh evidence regarding the detrimental effects of primary gaseous air pollutants on ARD.

Long-term trends in incidence, mortality and burden of liver cancer due to specific etiologies in Hubei Province.

Liver cancer, a chronic non-communicable disease, represents a serious public health problem. Long-term trends in the burden of liver cancer disease are heterogeneous across regions. Incidence and mortality of liver cancer, based on the Global Burden of Disease, were collected from the Chinese Centre for Disease Control and Prevention. Age-period-cohort model was utilized to reveal the secular trends and estimate the age, period and cohort effects on primary liver cancer due to specific etiologies. Both the age-standardized incidence and mortality rate of liver cancer in Hubei province were on the rise, although there were discrepancies between gender groups. From age-period-cohort analysis, both incidence and mortality of liver cancer due to Hepatitis B virus were the highest in all age groups. The incidence of all liver cancer groups increased with time period in males, while this upward trend was observed in females only in liver cancer due to alcohol use group. Cohort effects indicated the disease burden of liver cancer decreased with birth cohorts. Local drifts showed that the incidence of liver cancer due to specific etiologies was increasing in the age group of males between 40 and 75 years old. The impact of an aging population will continue in Hubei Province. the disease burden of liver cancer will continue to increase, and personalized prevention policies must be adopted to address these changes.

Global burden of non-optimal temperature attributable stroke: The long-term trends, population growth and aging effects.

Since the 20th century, the world has undergone climate change, population growth and population aging, which may result in alterations in the epidemiology of non-optimal temperature-associated strokes. We employed multiple methodologies and data from the global burden of disease 2019 to unveil the long-term curvilinear trends in strokes attributed to non-optimal temperature and the impact of aging and population growth on its changing epidemiology. From 1990 to 2019, the age-standardized DALYs rate (ASDR) of strokes attributable to low temperature had been decreasing, but from 2016, the continued downward trend in ASDR disappeared and began to remain stable. On the contrary, the ASDR of strokes attributable to high temperature continued to increase. The high socio-demographic index (SDI) region experienced the fastest decreased trend. The disease burden of stroke attributable to low temperature is increased by aging in 178 countries (87.25%), compared with 130 (63.73%) for high temperature. After excluding aging and population growth, the DALY rate for strokes attributed to high temperature was increasing in 87 countries and territories (42.64%). The disease burden of strokes attributed to low temperature is far greater than that of high temperature in absolute figures. However, globally, there is a significant trend toward an increase in strokes attributed to high temperature. Social development has largely offset the burden of strokes attributed to low temperature, but most regions of the world are equally affected by strokes attributed to high temperature. Simultaneously, in the framework of climate change, aging is also largely hindering stroke prevention efforts.

Ambient temperature variations and AIDS-related mortality: A time-stratified case-crossover study in 103 counties, China.

BACKGROUND: Climate change, characterized by the steady ascent of global temperatures and the escalating unpredictability of climate patterns, poses multifaceted challenges to public health worldwide. However, vulnerable groups, particularly the population affected by HIV/AIDS, have received little attention. OBJECTIVES: We aimed to examine the impacts of temperature variations on AIDS-related mortality. METHODS: Data on individuals with HIV/AIDS were collected from the HIV/AIDS Comprehensive Response Information Management System between 2013 and 2019. Temperature variation metrics were constructed by diurnal temperature range (DTR), temperature changes between neighboring days (TCN), and temperature variability (TV0-t). Time-stratified case-crossover design with conditional logistic regression models was used to investigate the associations between ambient temperature variations and AIDS-related mortality. RESULTS: Each 1 °C elevated in DTR was linked with a 5.28 % [95 % confidence intervals (CIs): 1.61, 9.08] increment in AIDS-related mortality at a lag of 0-6 days. Stronger associations between DTR and AIDS-related mortality were observed in the married than in single, with corresponding excess ORs (%) of 5.33 (95 % CIs: 0.29, 10.62) versus 4.79 (95 % CIs: -0.50, 10.36) for 1 °C increased in DTR at lag 0-6 days. Additionally, we noticed the impact of DTR was more pronounced in the warm season, leading to a 7.32 % (95 % CIs: 0.57, 14.51) elevation in the risks of AIDS-related mortality for 1 °C increase in DTR at lag 0-6 days, while the effect value decreased to 5.16 % (95 % CIs: 0.71, 9.81) in the cold season. CONCLUSIONS: Our findings indicated that DTR might be a significant risk factor for AIDS-related deaths among ambient temperature variation indicators, and underscored the importance of considering temperature variability in public health interventions aimed at mitigating this risk of AIDS-related mortality.

Long-term ozone exposure and all-cause mortality: Cohort evidence in China and global heterogeneity by region.

BACKGROUND: Cohort evidence linking long-term ozone (O3) exposure to mortality remained largely mixed worldwide and was extensively deficient in densely-populated Asia. This study aimed to assess the long-term effects of O3 exposure on all-cause mortality among Chinese adults, as well as to examine potential regional heterogeneity across the globe. METHODS: A national dynamic cohort of 42153 adults aged 16+ years were recruited from 25 provinces across Chinese mainland and followed up during 2010-2018. Annual warm-season (April-September) O3 and year-round co-pollutants (i.e., nitrogen dioxide [NO2] and fine particulate matter [PM2.5]) were simulated through validated spatial-temporal prediction models and were assigned to each enrollee in each calendar year. Cox proportional hazards models with time-varying exposures were employed to assess the O3-mortality association. Concentration-response (C-R) curves were fitted by natural cubic spline function to investigate the potential nonlinear association. Both single-pollutant model and co-pollutant models additionally adjusting for PM2.5 and/or NO2 were employed to examine the robustness of the estimated association. The random-effect meta-analysis was adopted to pool effect estimates from the current and prior population-based cohorts (n = 29), and pooled C-R curves were fitted through the meta-smoothing approach by regions. RESULTS: The study population comprised of 42153 participants who contributed 258921.5 person-years at risk (median 6.4 years), of whom 2382 death events occurred during study period. Participants were exposed to an annual average of 51.4 ppb (range: 22.7-74.4 ppb) of warm-season O3 concentration. In the single-pollutant model, a significantly increased hazard ratio (HR) of 1.098 (95% confidence interval [CI]: 1.023-1.179) was associated with a 10-ppb rise in O3 exposure. Associations remained robust to additional adjustments of co-pollutants, with HRs of 1.099 (95% CI: 1.023-1.180) in bi-pollutant model (+PM2.5) and 1.093 (95% CI: 1.018-1.174) in tri-pollutant model (+PM2.5+NO2), respectively. A J-shaped C-R relationship was identified among Chinese general population, suggesting significant excess mortality risk at high ozone exposure only. The combined C-R curves from Asia (n = 4) and North America (n = 17) demonstrated an overall increased risk of all-cause mortality with O3 exposure, with pooled HRs of 1.124 (95% CI: 0.966-1.307) and 1.023 (95% CI: 1.007-1.039) per 10-ppb rise, respectively. Conversely, an opposite association was observed in Europe (n = 8, HR: 0.914 [95% CI: 0.860-0.972]), suggesting significant heterogeneity across regions (P < 0.01). CONCLUSIONS: This study provided national evidence that high O3 exposure may curtail long-term survival of Chinese general population. Great between-region heterogeneity of pooled O3-mortality was identified across North America, Europe, and Asia.

Submicronic particulate matter (PM1), a "neglected killer" for HIV/AIDS patients in Hubei, China: Results from a cohort study from 2001 to 2020.

BACKGROUND: Although with the progress of antiretroviral therapy, the life expectancy of HIV/AIDS patients was still not equal to that of normal people. Submicronic particulate matter (PM1) might play a role in mortality among people living with HIV/AIDS, However, cohort evidence is extensively scarce. METHODS: This twenty-year open cohort study involved all individuals officially diagnosed with HIV/AIDS in Hubei Province from 2001 to 2020. Time-varying Cox proportional hazard models were applied to investigate the associations between long-term exposure to PM1 and mortality in HIV/AIDS patients. The concentration-response curves between PM1 and AIDS-related deaths/all-cause deaths were characterized by fitting restricted cubic spline models. These curves were then utilized to estimate the number of deaths attributed to PM1. RESULTS: Long-term exposure to PM1 was significantly associated with AIDS-related deaths and all-cause death among HIV/AIDS patients, with excess risks of 2.33 % [95 % confidence interval (CIs): 1.62, 3.15] and 0.69 % (0.22, 1.17) for each 1 µg/m3 increase in annual PM1. HIV-positive people with lower initial CD4+ cell count levels or aged over 65 years old were more susceptible to PM1 exposure. We estimated about 844 AIDS-related deaths and 1175 all-cause deaths can be attributable to ambient PM1 exposure, accounting for 41.7 % and 23.8 % of the total deaths from corresponding causes, respectively. CONCLUSIONS: Long-term exposure PM1 was a novel factor hindering the life spans of people living with HIV/AIDS. Early establishment of PM1 concentration standards and efforts to achieve them will bring substantial health benefits to people living with HIV/AIDS, especially in low- and middle-income countries facing the dual challenges of high air pollution and high AIDS prevalence.

Short-term exposure to ozone and mortality from AIDS-related diseases: A case-crossover study in the middle Yangtze River region, China.

BACKGROUND: Previous investigations have predominantly concentrated on the influence of ozone (O3) on general population mortality. However, a noticeable gap exists regarding the attention directed towards susceptible demographics, specifically individuals afflicted by human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). METHODS: A dataset comprising 1467 AIDS-related fatalities from 2013 to 2020 was amassed from the Hubei Provincial Center for Disease Control and Prevention. Daily maximum 8-h average O3 levels and meteorological parameters were extracted from the ChinaHighAirPollutants dataset and the National Meteorological Science Data Center, respectively. A time-stratified case-crossover methodology was employed to scrutinize the connection between short-term exposure to O3 and AIDS-related deaths. RESULTS: A rise of one interquartile (IQR) in O3 concentration, lagged by 4 days, was associated with a 15% [95% confidence intervals (CIs): 2, 31] increase in AIDS-related deaths. Notably, males demonstrated heightened susceptibility to the adverse consequences of O3, marked by an odds ratio of 1.20 (95% CIs: 1.05, 1.37) at lag 4 day. Additionally, patients aged over 65 years exhibited escalated vulnerability to brief O3 exposure. Marriage status and educational attainment emerged as influential factors modifying the interplay between O3 and AIDS-related mortality. CONCLUSIONS: Our study presents novel evidence spotlighting the deleterious repercussions of O3 on mortality in the HIV/AIDS population.

Independent and interactive effects of ozone and thermal inversion exposure on the risk of gestational diabetes mellitus in Wuhan, China.

The adverse effects of exposure to thermal inversion (TI) and ozone (O3) on human health have been reported; however, there are few studies have explored the independent and potential interactive effects of them on gestational diabetes mellitus (GDM). A total of 31,262 pregnant women from the Wuhan Children's Hospital covering the period from 2017 to 2021 were included in this study. The logistic regression adjusted for the covariates was applied to explore the independent effect of exposure to O3 and TI on GDM. The relative excess risk due to the interaction (RERI) analysis was applied to assess the possible interactive effect. Per 10 µg/m3 increased in O3 (OR = 1.069, 95% CI: 1.049, 1.089) during the first trimester and per 10 days increased in TI (OR = 1.041, 95% CI: 1.005, 1.080) in the second trimester were significantly associated with the risk of GDM. The synergistic effect of exposure to TI and O3 was larger than their sum effect (RERI = 0.330, 95% CI: 0.170, 0.476). This study added further support for public health-related policy to improve maternal health by curbing TI and O3.

Association between traffic-related air pollution and osteoporotic fracture hospitalizations in inland and coastal areas: evidences from the central areas of two cities in Shandong Province, China.

Our result showed that short-term exposure to traffic-related air pollutants (TRAPs) might increase the risk of hospitalizations for osteoporotic fractures. It was suggested that government should formulate emission reduction policies to protect the health of citizens. INTRODUCTION: As the main source of urban air pollution in China, exhaust emissions of motor vehicles have been linked to adverse health outcomes, but evidence of the relationship between short-term exposure to TRAPs and osteoporotic fractures is still relatively rare. METHODS: In this study, a total of 5044 inpatients from an inland city (Jinan) and a coastal city (Qingdao), two cities with developed transportation in Shandong Province, were included. A generalized additive model (GAM) was used to investigate the association between TRAPs and hospitalizations for osteoporotic fractures. The stratified analyses were performed by gender and age. RESULTS: Positive associations between TRAPs and osteoporotic fracture hospitalizations were observed. We found that short-term exposure to TRAPs was associated with increased numbers of hospitalizations for osteoporotic fractures. PM2.5 and PM10 were statistically significant associated with hospitalizations for osteoporotic fractures at both single-day and multiday lag structures only in Qingdao, with the strongest associations at lag06 and lag07 [RR=1.0446(95%CI: 1.0018,1.0891) for PM2.5, RR=1.0328(95%CI: 1.0084,1.0578) for PM10]. For NO2 and CO, we found significant associations at lag4 in the single lag structure in Jinan [RR=1.0354 (95%CI: 1.0071, 1.0646) for NO2, RR=1.0014 (95%CI: 1.0002, 1.0025) for CO], while only CO at lag4 was significantly associated with hospitalizations for osteoporotic fractures in Qingdao [1.0038 (1.0012, 1.0063)]. Stratified analyses indicated that the associations were stronger in females and older individuals (65 + years). CONCLUSION: This study implied that short-term exposure to TRAPs pollution was associated with an increased risk of hospitalizations for osteoporotic fractures. Female patients and patients aged 65 + years appeared to be more vulnerable to TRAPs, suggesting that poor air quality is a modifiable risk factor for osteoporotic fractures.

The effects of fine particulate matter, solid fuel use and greenness on the risks of diabetes in middle-aged and older Chinese.

BACKGROUND: Previous studies provided clues that environmental factors were closely related to diabetes incidence. However, the evidence from high-quality and large cohort studies about the effects of PM2.5, solid fuel use and greenness on the development of diabetes among middle-aged and older adults in China was scarce. OBJECTIVE: To separately investigate the independent effects of PM2.5, solid fuel use and greenness on the development of diabetes among middle-aged and older adults. METHODS: A total of 9242 participants were involved in this study extracted from the China Health and Retirement Longitudinal Study. Time-varying Cox regression was applied to detect the association of diabetes with PM2.5, solid fuel use and greenness, separately. The potential interactive effect of air pollution and greenness were explored using the relative excess risk due to interaction (RERI). RESULTS: Per 10 µg/m3 increases in PM2.5 were associated with 6.0% (95% CI: 1.9, 10.2) increasing risks of diabetes incidence. Females seemed to be more susceptible to PM2.5. However, the effects of solid fuel use only existed in older and lower BMI populations, with hazard ratios (HRs) of 1.404 (1.116, 1.766) and 1.346 (1.057, 1.715), respectively. In addition, exposure to high-level greenness might reduce the risks of developing diabetes [HR = 0.801 (0.687, 0.934)]. Weak evidence of the interaction effect of PM2.5/solid fuel use and greenness on diabetes was found. SIGNIFICANCE: Both PM2.5 and solid fuel use were associated with the increasing incidence of diabetes. In addition, high-level greenness might be a beneficial environmental factor for reducing the risks of developing diabetes. All in all, our findings might provide valuable references for public health apartments to formulate very fruitful policies to reduce the burden of diabetes. IMPACT STATEMENT: Both PM2.5 and solid fuel use were associated with the increasing incidence of diabetes while high-level greenness was not, which might provide valuable references for public health apartments to make policies.

Synergic effects of PM1 and thermal inversion on the incidence of small for gestational age infants: a weekly-based assessment.

BACKGROUND: The synergic effects of thermal inversion (TI) and particulate matter with an aerodynamic diameter ≤1 µm (PM1) exposure and incidence of small for gestational age (SGA) was not clear. OBJECTIVE: We aimed to explore the independent effects of prenatal TI and PM1 exposure on incidence of SGA and their potential interactive effects. METHODS: A total of 27,990 pregnant women who delivered in Wuhan Children's Hospital from 2017 to 2020 were included. The daily mean concentration of PM1 was obtained from ChinaHighAirPollutants (CHAP) and matched with the residential address of each woman. Data on TI was derived from National Aeronautics and Space Administration (NASA). The independent effects of PM1 and TI exposures on SGA in each gestational week were estimated by the distributed lag model (DLM) nested in Cox regression model, and the potential interactive effects of PM1 and TI on SGA were investigated by adapting the relative excess risk due to interaction (RERI) index. RESULTS: Per 10 µg/m3 increase in PM1 was associated with an increase in the risk of SGA at 1-3 and 17-23 gestational weeks, with the strongest effect at the first gestational week (HR = 1.043, 95%CI: 1.008, 1.078). Significant links between one day increase of TI and SGA were found at the 1-4 and 13-23 gestational weeks and the largest effects were observed at the 17th gestational week (HR = 1.018, 95%CI: 1.009, 1.027). Synergistic effects of PM1 and TI on SGA were detected in the 20th gestational week, with RERI of 0.208 (95%CI: 0.033,0.383). IMPACT STATEMENT: Both prebirth PM1 and TI exposure were significantly associated with SGA. Simultaneous exposure to PM1 and TI might have synergistic effect on SGA. The second trimester seems to be a sensitive window of environmental and air pollution exposure.

Air pollution weaken your muscle? Evidence from a cross-sectional study on sarcopenia in central China.

BACKGROUND: As the world experiences a demographic shift towards aging populations, there will be a significant surge in the number of sarcopenia patients, along with an unprecedented expansion in the associated economic burden. The multitudinous risk factors for sarcopenia have been reported, but evidence for air pollution remains rare. METHODS: This cross-sectional study employed multi-stage random sampling to select 1592 participants over 40 years of age from Hubei Province. Daily mean concentrations of air pollutants were collected ChinaHighAirPollutants dataset. Unconditional logistic regression models were utilized to investigate the associations between air pollution and sarcopenia. RESULTS: For each 1 µg/m3 increase in PM2.5, PM10, SO2 and O3, there were corresponding elevations of 11.1% [95% confidence interval (CI): 4.9, 17.7], 4.3% (95% CI: 1.4, 7.2), 22.6% (95% CI: 7.2, 40.1) and 9.3% (95% CI: 0.7, 18.7) in the risk of sarcopenia, respectively. The associations of PM2.5/PM10/O3-sarcopenia were more pronounced in females, with corresponding odds ratios (ORs) and 95% CIs of 1.179 (1.062, 1.310), 1.079 (1.027, 1.135) and 1.180 (1.026, 1.358), separately. Additionally, individuals residing in rural areas were more susceptible to the effects of PM2.5 and PM10. Current/ever smokers or drinkers were also at higher risk of developing sarcopenia caused by PM2.5, PM10 and O3 exposure. Mixture analyses show a surge of 48.4% (95% CI: 3.6%, 112.5%) in the likelihood of suffering from sarcopenia, and the joint impacts of the air pollution were mainly driven by PM2.5. CONCLUSIONS: Our results produced evidence for a relationship between air pollution exposure and the increased prevalence of sarcopenia in China. Public health and relevant departments should make efforts to prevent sarcopenia, particularly in China experiencing rapid demographic aging.

Prevalence and risk factors of osteoporosis and osteopenia among residents in Hubei province, China.

It is the first time to estimate the prevalence and characterize of osteoporosis in Hubei province, China. The prevalence of osteoporosis was 12.19%, 3.69% for males, and 18.94% for females; 56.6% were diagnosed with osteopenia, 44.96% for males, and 65.84% for females. INTRODUCTION: The disease burden of osteoporosis is increasing, but there are few studies on the prevalence and risk factors in Hubei, China. This study aims to analyze the prevalence of osteoporosis using dual-energy X-ray absorptiometry (DXA) measurement and the risk factors of osteoporosis using epidemiological survey methods. OBJECTIVE: To explore the prevalence of osteoporosis and osteopenia in Hubei province, and provide the epidemiological basis for policymakers, to reduce the prevalence of osteoporosis METHODS: Based on data derived from the epidemiological survey of osteoporosis in Hubei province in 2018, 1592 residents aged 40 and above from 32 neighborhood committees/villages in 4 districts/counties of Hubei province were selected by multistage stratified random sampling. The lumbar spine AP (L1-L4 and L2-L4), femoral neck, and total hip BMD were measured using DXA of the internationally recognized gold standard and assessed according to WHO diagnostic criteria, utilizing unconditional logistic regression to explore the risk factors of osteoporosis and osteopenia. RESULTS: The overall crude prevalence of osteoporosis was 12.19%, 3.69% for males, and 18.94% for females. Osteopenia was diagnosed in 56.6% of all participants, 44.96% in males, and 65.84% in females. Increasing age, females, and underweight were related to the high prevalence of osteoporosis and osteopenia, while people with higher levels of education, overweight, and obese had a low prevalence of osteoporosis and osteopenia. In women, the absence of chronic disease and moderate intake of dairy products probably be associated with the low prevalence of osteopenia. CONCLUSIONS: The prevalence of osteoporosis and osteopenia is high in Hubei, China. The risk of prevalence of osteoporosis and osteopenia was higher in females and people with higher age and low BMI. While high BMI, high education, the absence of chronic disease, and intaking dairy moderately were negatively correlated with the prevalence of osteopenia or osteoporosis. The government should support the prevention and treatment of osteoporosis.

Ambient particulate matter, a novel factor hindering life spans of HIV/AIDS patients: Evidence from a ten-year cohort study in Hubei, China.

BACKGROUND: The life spans of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients have been extended in the era of antiretroviral therapy. However, few studies have considered the influence of the environment on the life expectancy of people living with HIV/AIDS. Several studies have investigated mortality and air pollution associations, but the evidence for associations between long-term exposure to particulate matter (PM) and mortality among HIV/AIDS patients remains extremely sparse. METHODS: We conceived a dynamic cohort study by enrolling people with HIV/AIDS from 103 counties in Hubei province, China from 2010 to 2019, with 23,809 persons and 78,457.2 person-years of follow-up. The county-level annual concentrations of PM2.5 and PM10 were extracted from the ChinaHighAirPollutants dataset. Cox proportional hazards models with time-varying exposures were conducted to assess the associations between PM and mortality. RESULTS: Per 1 µg/m3 increased in PM2.5 and PM10 would elevate 0.69 % (95 % CIs: 0.39, 1.00) and 0.39 % (95 % CIs: 0.18, 0.59) risk of all-cause deaths (ACD) and 1.65 % (95 % CIs: 1.14, 2.17) and 0.90 % (95 % CIs: 0.56, 1.24) of AIDS-related deaths (ARD), respectively. Significantly stronger associations of PM-ARD were found in patients aged over 60 years old, with corresponding excess risk of 2.66 % (95 % CIs: 1.76, 3.58) for PM2.5 and 1.62 (95 % CIs: 1.01, 2.23) for PM10. CONCLUSIONS: This study added to the existing evidence that long-term exposure to ambient PM adversely affects the life spans of HIV/AIDS patients. Hence, public health departments should take proactive measures to prevent further life loss and promote survival among those living with HIV/AIDS.

Global Burden of osteoarthritis associated with high body mass index in 204 countries and territories, 1990-2019: findings from the Global Burden of Disease Study 2019.

OBJECTIVE: To quantify the burden of osteoarthritis (OA) associated with high body mass index (BMI) across 204 countries and territories from 1990 to 2019. METHODS: This study extracted global, regional, and national data on years lived with disability (YLD) of OA associated with high BMI from GBD 2019. The YLD burden of OA associated with high BMI was systematically analyzed by age, SDI, sex, and EAPC. RESULTS: At the global level, ~2.67 million (95% UI: 1.04, 5.75) YLD were attributable to OA associated with high BMI, with an age-standardized rate of 31.9 (95% UI: 12.4, 68.75) YLD per 100,000 population in 2019. There was a 0.5 increase (95% UI: 0.35, 0.79) over the 30 years with an EAPC of 1.45. In 2019, Australasia {57.49 (95% UI: 23.62, 125.38)}, high-income North America {56.2 (95% UI: 23.32, 121.97)}, and Andean Latin America {49.77 (95% UI: 19.73, 111.73)} had the highest age-standardized YLD rates. The population aged at 60-74 group had a higher YLD rate for both males and females. Females tended to be more sensitive to the OA associated with high BMI than male in any region. CONCLUSIONS: In summary, the YLD rate of OA associated with high BMI presented a continuous upward trend in most countries. Women and older people are more sensitive to OA due to physiological and psychological factors. Controlling modifiable risk factors such as maintaining an appropriate BMI is needed for disease prevention.

Short-term exposure to ambient particulate matter and mortality among HIV/AIDS patients: Case-crossover evidence from all counties of Hubei province, China.

BACKGROUND: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has been a worrisome public health problem in the world. However, evidence for associations between short-term exposure to particulate matter (PM) and mortality among HIV/AIDS patients is scarce. METHODS: We collected daily death records in people with HIV/AIDS from all counties (N = 103) of Hubei province, China from 2018 to 2019. The county-level daily concentrations of PM1, PM2.5 and PM10 in the same period were extracted from ChinaHighAirPollutants dataset. A time-stratified case-crossover design with conditional logistic regression analysis was performed to assess the associations between PM and mortality. RESULTS: Each 1 µg/m3 increased in PM1 corresponded with 0.89 % elevated in all-cause deaths (ACD) at lag 0-4 days. The largest effects of PM1, PM2.5 and PM10 on AIDS-related deaths (ARD) were detected at lag 0-4 days, and PM1 [percent changes in odds ratio: 2.51 % (95 % CIs: 0.82, 4.22)] appeared greater health hazards than PM2.5 [1.24 % (95 % CIs: 0.33, 2.15)] as well as PM10 [0.65 % (95 % CIs: 0.01, 1.30)]. In subgroup analyses, the significant associations of PM1/PM2.5 and ACD were only found in male and the cold season. We also observed the effects of PM1 and PM10 on ARD were significantly stronger (P for interaction <0.05) in males than females. In addition, we caught sight of HIV/AIDS patients aged over 60 years old were more susceptible to ARD caused by PM than younger population. CONCLUSIONS: Our study suggested PM1 was positively linked with the risk of ACD and ARD. Male patients with HIV/AIDS were more significantly susceptible to PM1, PM2.5 and PM10. PM1/PM2.5 appeared stronger associations with ARD in HIV/AIDS patients aged over 60 years old and in the cold season.