Disparities in the prevalence of suicidal ideation according to oral contraceptive pill use among US women: A cross-sectional study.

Background and Aims: The relationship between oral contraceptive pill (OCP) and suicidal ideation remains unclear. This study aims to estimate the prevalence of suicidal ideation among US women and evaluate their associates overall and according to OCP use status. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2012 were used to calculate the prevalence and associates of suicidal ideation in women using OCP. Suicidal ideation was assessed using the Patient Health Questionnaire-9. Overall and OCP-specific weighted prevalence of suicidal ideation were estimated. Multivariable logistic regressions were used to investigate overall and OCP-specific associates. Results: The prevalence of suicidal ideation was 3.6% with no evident disparity between OCP groups, suggesting that OCP use is not associated with increased prevalence of suicidal ideation. Smoking was inversely associated with suicidal ideation in the former users of OCP. In the overall population, the prevalence of suicidal ideation was greater in those who were: Black or Hispanic, smoking, taking antidepressants, those with lower educational attainment, and women with low and middle income. Conclusion: Our findings suggest that OCP use was not associated with increased prevalence of suicidal ideation. Unique associates were identified among different OCP groups.

Hearing Loss Prevalence, Years Lived With Disability, and Hearing Aid Use in the United States From 1990 to 2019: Findings From the Global Burden of Disease Study.

OBJECTIVES: This article describes key data sources and methods used to estimate hearing loss in the United States, in the Global Burden of Disease study. Then, trends in hearing loss are described for 2019, including temporal trends from 1990 to 2019, changing prevalence over age, severity patterns, and utilization of hearing aids. DESIGN: We utilized population-representative surveys from the United States to estimate hearing loss prevalence for the Global Burden of Disease study. A key input data source in modeled estimates are the National Health and Nutrition Examination Surveys (NHANES), years 1988 to 2010. We ran hierarchical severity-specific models to estimate hearing loss prevalence. We then scaled severity-specific models to sum to total hearing impairment prevalence, adjusted estimates for hearing aid coverage, and split estimates by etiology and tinnitus status. We computed years lived with disability (YLDs), which quantifies the amount of health loss associated with a condition depending on severity and creates a common metric to compare the burden of disparate diseases. This was done by multiplying the prevalence of severity-specific hearing loss by corresponding disability weights, with additional weighting for tinnitus comorbidity. RESULTS: An estimated 72.88 million (95% uncertainty interval (UI) 68.53 to 77.30) people in the United States had hearing loss in 2019, accounting for 22.2% (20.9 to 23.6) of the total population. Hearing loss was responsible for 2.24 million (1.56 to 3.11) YLDs (3.6% (2.8 to 4.7) of total US YLDs). Age-standardized prevalence was higher in males (17.7% [16.7 to 18.8]) compared with females (11.9%, [11.2 to 12.5]). While most cases of hearing loss were mild (64.3%, 95% UI 61.0 to 67.6), disability was concentrated in cases that were moderate or more severe. The all-age prevalence of hearing loss in the United States was 28.1% (25.7 to 30.8) higher in 2019 than in 1990, despite stable age-standardized prevalence. An estimated 9.7% (8.6 to 11.0) of individuals with mild to profound hearing loss utilized a hearing aid, while 32.5% (31.9 to 33.2) of individuals with hearing loss experienced tinnitus. Occupational noise exposure was responsible for 11.2% (10.2 to 12.4) of hearing loss YLDs. CONCLUSIONS: Results indicate large burden of hearing loss in the United States, with an estimated 1 in 5 people experiencing this condition. While many cases of hearing loss in the United States were mild, growing prevalence, low usage of hearing aids, and aging populations indicate the rising impact of this condition in future years and the increasing importance of domestic access to hearing healthcare services. Large-scale audiometric surveys such as NHANES are needed to regularly assess hearing loss burden and access to healthcare, improving our understanding of who is impacted by hearing loss and what groups are most amenable to intervention.

Using mixed methods to design service quality evaluation indicator system of railway container multimodal transport.

Multimodal transport can bring the technical and economic advantages in different transportation modes into full play. While ensuring the level of service, it can reduce energy consumption and transport costs. Governments of most countries are actively promoting it. Therefore, it has become a research hot spot. Being a green, fast, and all-day transport mode, railways play an important role in multimodal transport. This article aims to analyze a multimodal transport service quality indicator system involving railways from the perspectives of customers, multimodal service providers, and governments. Qualitative and quantitative research methods were adopted to analyze the secondhand data of academic papers, government policy, and industry reports to clarify the quality characteristics of multimodal transport services. Using grounded theory and to analyze firsthand data from in-depth interviews with multimodal transport practitioners, 25 evaluation indicators of container multimodal transport service quality were chosen to be the evaluation index system. To test and improve the evaluation scale, 270 valid questionnaires were analyzed using SPSS 24.0 and AMOS 21.0 software, including reliability analysis, exploratory factor analysis, and confirmatory factor analysis. The results show that all the indicators meet the standard requirements and have good reliability and validity.

Trends in Sedentary Behavior Among the US Population, 2001-2016.

Importance: Prolonged sitting, particularly watching television or videos, has been associated with increased risk of multiple diseases and mortality. However, changes in sedentary behaviors over time have not been well described in the United States. Objective: To evaluate patterns and temporal trends in sedentary behaviors and sociodemographic and lifestyle correlates in the US population. Design, Setting, and Participants: A serial, cross-sectional analysis of the US nationally representative data from the National Health and Nutrition Examination Survey (NHANES) among children aged 5 through 11 years (2001-2016); adolescents, 12 through 19 years (2003-2016); and adults, 20 years or older (2003-2016). Exposures: Survey cycle. Main Outcomes and Measures: Prevalence of sitting watching television or videos for 2 h/d or more, computer use outside work or school for 1 h/d or more, and total sitting time (h/d in those aged ≥12 years). Results: Data on 51 896 individuals (mean, 37.2 years [SE, 0.19]; 25 968 [50%] female) were analyzed from 2001-2016 NHANES data, including 10 359 children, 9639 adolescents, and 31 898 adults. The estimated prevalence of sitting watching television or videos for 2 h/d or more was high among all ages (children, 62% [95% CI, 57% to 67%]; adolescents, 59% [95% CI, 54% to 65%]; adults, 65% [95% CI, 61% to 69%]; adults aged 20-64 years, 62% [95% CI, 58% to 66%]; and ≥65 years, 84% [95% CI, 81% to 88%] in the 2015-2016 cycle). From 2001 through 2016, the trends decreased among children over time (difference, -3.4% [95% CI, -11% to 4.5%]; P for trend =.004), driven by non-Hispanic white children; were stable among adolescents (-4.8% [95% CI, -12% to 2.3%]; P for trend =.60) and among adults aged 20 through 64 years (-0.7% [95% CI, -5.6% to 4.1%]; P for trend =.82); but increased among adults aged 65 years or older (difference, 3.5% [95% CI, -1.2% to 8.1%]; P for trend =.03). The estimated prevalence of computer use outside school or work for 1 h/d or more increased in all ages (children, 43% [95% CI, 40% to 46%] to 56% [95% CI, 49% to 63%] from 2001 to 2016; difference, 13% [95% CI, 5.6% to 21%]; P for trend <.001; adolescents, 53% [95% CI, 47% to 58%] to 57% [95% CI, 53% to 62%] from 2003 to 2016, difference, 4.8% [95% CI, -1.8% to 11%]; P for trend =.002; adults, 29% [27% to 32%] to 50% [48% to 53%] from 2003 to 2016, difference, 21% [95% CI, 18% to 25%]; P for trend <.001). From 2007 to 2016, total hours per day of sitting time increased among adolescents (7.0 [95% CI, 6.7 to 7.4] to 8.2 [95% CI, 7.9 to 8.4], difference, 1.1 [95% CI, 0.7 to 1.5]) and adults (5.5 [95% CI, 5.2 to 5.7] to 6.4 [95% CI, 6.2 to 6.6]; difference, 1.0 [95% CI, 0.7 to 1.3]; P for trend <.001 for both). Conclusions and Relevance: In this nationally representative survey of the US population from 2001 through 2016, the estimated prevalence of sitting watching television or videos for at least 2 hours per day generally remained high and stable. The estimated prevalence of computer use during leisure-time increased among all age groups, and the estimated total sitting time increased among adolescents and adults.

Ventilation system arrangement in large cross-section tunnels：a CFD simulation based on direct initial concentration assessment.

The dust removal efficiency is essential for safety protection in tunnels. For the cutting head working in a large cross-section tunnel, the extensive movement of the cutting head and large drift space decrease the accuracy of deduced initial dust concentrations. To ascertain the initial dust concentration, cutting models were employed. Then, computational fluid dynamics (CFD) models were established to study the dust movement regularity. Comparison of the best arrangement of the ventilation system, illustrates that some of the rules governing the layout of the ventilation system in small cross-section tunnels can be used in large cross-section tunnels. The results indicate the best range of a ventilation system for distance from forcing and exhausting outlet to working face and airflow ratio. Finally, the dust concentration in different height was analysed and optimized. The study is meaningful for further research and the rules could applied in other hard rock larger cross-section tunnels.

[Combination of narrow band imaging (NBI) and autofluorescence bronchoscopy (AFB) in the assessment of central lung cancer].

OBJECTIVE: To assess the diagnostic value of narrow-band imaging(NBI) in the diagnosis of central lung cancer. METHODS: Patients (n = 153) suspected of having lung cancer underwent white light bronchoscopy(WLB), NBI and autofluorescence bronchoscopy(AFB) in turn. At least 3 biopsies in each case were taken from sites visualized as lesions. The sensitivity and specificity of NBI, AFB and combination of NBI and AFB were compared. RESULTS: There were 106 male (69.3%) and 47 female patients (30.7%). By NBI, 91 and 62 cases were positive and negative respectively. The sensitivity and specificity of NBI were 63.5% (87/137) and 75.0% (12/16) respectively. By AFB, 140 and 13 cases were positive and negative respectively. The sensitivity and specificity of AFB were 94.2% (129/137) and 87.5% (5/16) respectively. By NBI combined with AFB, 133 and 20 cases were positive and negative respectively, the sensitivity and specificity being 95.6% (131/137) and 87.5% (14/16) respectively. The difference of specificity between NBI plus AFB and AFB alone was significant (P < 0.01), but the difference of sensitivity between NBI plus AFB and AFB alone(P > 0.05) was not. The difference of specificity between NBI plus AFB and NBI alone was significant (P < 0.01), but the P value of specificity between NBI plus AFB and NBI was 0.03. CONCLUSION: Combination of NBI and AFB could increase the specificity of lung cancer diagnosis compared to AFB alone.

[Combination of narrow-band imaging and autofluorescence imaging videobronchoscopy in the assessment of lung cancer].

BACKGROUND: Narrow-band imaging (NBI) and autofluorescence imaging (AFI) are new bronchoscopy technologies that are important in lung cancer diagnosis. The aim of this study is to determine whether or not the combination of these two technologies can improve sensitivity and specificity of lung cancer diagnosis. METHODS: A total of 137 patients who manifested symptoms of lung cancer were investigated in this project. All of the examinations were performed based on an Olympus Evis Lucera bronchoscopy system. The patients were examined by white light bronchoscopy (WLB), NBI and AFI. At least three biopsies from body parts visualized as lesions were obtained from each patient. RESULTS: WLB sensitivity and specificity were 56.6% and 62.5%, respectively. NBI sensitivity and specificity were 71.3% and 75.0%, respectively. AFI sensitivity and specificity were 82.2% and 25.0%, respectively. The sensitivity and the specificity of the combined NBI and AFI were 94.6% and 87.5%, respectively. The sensitivity and the specificity of the combined NBI and AFI were significantly higher than those of AFI alone (P<0.01). Likewise, the sensitivity and the specificity of the combined NBI and AFI were significantly higher than those of NBI alone (P<0.05). CONCLUSIONS: NBI or AFI exhibited higher sensitivity of lung cancer diagnosis than WLB. Combined NBI and AFI also showed significantly higher sensitivity and specificity than NBI or AFI.

Forest annual carbon cost: a global-scale analysis of autotrophic respiration.

Forest autotrophic respiration (R(a)) plays an important role in the carbon balance of forest ecosystems. However, its drivers at the global scale are not well known. Based on a global forest database, we explore the relationships of annual R(a) with mean annual temperature (MAT) and biotic factors including net primary productivity (NPP), total biomass, stand age, mean tree height, and maximum leaf area index (LAI). The results show that the spatial patterns of forest annual R(a) at the global scale are largely controlled by temperature. R(a) is composed of growth (R(g)) and maintenance respiration (R(m)). We used a modified Arrhenius equation to express the relationship between R(a) and MAT. This relationship was calibrated with our data and shows that a 10 degrees C increase in MAT will result in an increase of annual R(m) by a factor of 1.9-2.5 (Q10). We also found that the fraction of total assimilation (gross primary production, GPP) used in R(a) is lowest in the temperate regions characterized by a MAT of approximately 11 degrees C. Although we could not confirm a relationship between the ratio of R(a) to GPP and age across all forest sites, the R(a) to GPP ratio tends to significantly increase in response to increasing age for sites with MAT between 8 degrees and 12 degrees C. At the plant scale, direct up-scaled R(a) estimates were found to increase as a power function with forest total biomass; however, the coefficient of the power function (0.2) was much smaller than that expected from previous studies (0.75 or 1). At the ecosystem scale, R(a) estimates based on both GPP - NPP and TER - R(h) (total ecosystem respiration - heterotrophic respiration) were not significantly correlated with forest total biomass (P > 0.05) with either a linear or a power function, implying that the previous individual-based metabolic theory may be not suitable for the application at ecosystem scale.