[Spatial and Temporal Distribution Characteristics of Ozone Concentration and Health Benefit Assessment in the Beijing-Tianjin-Hebei Region from 2015 to 2020].

To evaluate the spatial and temporal distribution characteristics of ambient ozone (O3) in the Beijing-Tianjin-Hebei (BTH) Region, the land use regression (LUR) model and random forest (RF) model were used to simulate the ambient O3 concentration from 2015 to 2020. Meanwhile, all-cause, cardiovascular, and respiratory mortalities as well as economic losses attributed to O3 were also estimated. The results showed that upward trends with fluctuation were observed for ambient O3 concentration, mortalities, and economic losses attributable to O3 exposure in the BTH Region from 2015 to 2020. The areas with high O3 concentration and great changes were concentrated in the central and southwestern regions, whereas the concentration in the northern region was low, and the change degree was small. The spatial distribution of the mortalities was also consistent with the spatial distribution of O3 concentration. From 2015 to 2020, the economic losses regarding all-cause mortality and cardiovascular mortality increased in 13 cities of the BTH Region, whereas the economic losses of respiratory mortality decreased in 4 cities in the BTH Region. The results indicated that the priority areas for O3 control were not uniform. Specifically, Beijing, Tianjin, Hengshui, and Xingtai were vital areas for O3 pollution control in the BTH Region. Differentiated control measures should be adopted based on the characteristics of these target areas to decline O3 concentration and reduce health impacts and economic losses associated with O3 exposure.

Secular trends and attributable risk factors of esophageal cancer deaths among non-elderly adults based on Global Burden of Disease Study.

OBJECTIVE: Esophageal cancer (EC) poses a persistent threat to the health of non-elderly adults. This study aims to elucidate the temporal trends of EC-related mortality and investigate the impact of various risk factors on such deaths in the age group of 20-59 years, spanning 3 decades. METHODS: Data on EC deaths were acquired from the Global Burden of Disease, Injuries, and Risk Factors (GBD) study. We employed estimated average percentage change (EAPC) and linear mixed-effects (LME) models to analyze mortality trends and pertinent risk factors for EC. RESULTS: Between 1990 and 2019, EC mortality showed a downward trend, and the global number of deaths from EC among non-elderly adults surged by 24.37%. During this period, mortality rates saw an increase in only two regions-the Caribbean and Western Sub-Saharan Africa (EAPCs > 0). For male deaths, smoking and alcohol use emerged as the primary risk factors, while high body mass index (BMI) stood out as the main risk factor for female deaths. Furthermore, the LME model identified male sex, advancing age, alcohol use, smoking, and chewing tobacco as factors associated with an additional rise in EC deaths. CONCLUSION: EC continues to exert a substantial toll on mortality among young and middle-aged adults globally. Implementing targeted interventions are significant in alleviating the burden of this disease within this population.

Correlation and Prognostic Assessment of Low T3 Syndrome and Norepinephrine Dosage for Patients with Sepsis: A Retrospective Single-Center (Cohort) Study.

Purpose: To investigate the correlation and prognostic significance of low triiodothyronine (T3) syndrome and norepinephrine dosage in patients with sepsis and septic shock. Methods: This single-center, retrospective, cohort study enrolled 169 patients with sepsis and septic shock that were admitted to the intensive care unit of First Hospital of Nanchang, Nanchang, China from June 2017 to July 2019. All included patients were followed up for 28 days or died, whichever was earlier. Patients with free T3 (FT3) of <3.1 pmol/L were considered with low T3 syndrome. The correlation and prognostic significance of the FT3 and maximum dosage of norepinephrine (MDN) within 72 h, as well as other clinical indicators, were analyzed by using correlation analysis, principal component analysis, receiver operating characteristic curve, Youden index, and logistic regression. Results: A total of 138 patients were allocated to the low T3 group. FT3 inversely correlated with the Sequential Organ Failure Assessment (SOFA) score within 24 h, fluid resuscitation volume within 24 h, and lactic acid levels, and positively correlated with the mean arterial pressure. The critical values of age, SOFA, and MDN for predicting the 28-day mortality were 79.5 years, 8.5 points, and 0.61 µg/kg/min, respectively. The mortality of the low T3 and normal T3 groups was similar. Considering the MDN of 0.61 µg/kg/min as the cutoff value, the mortality between the two groups was significantly different. Conclusion: Among patients with sepsis and septic shock, FT3 was inversely correlated with the disease severity. An MDN ≥ 0.61 µg/kg/min within 72 h may be an important prognostic indicator.

Risk factors assessment in patients with acute fatty liver of pregnancy treated without plasma exchange or renal replacement therapy.

OBJECTIVE: Acute fatty liver of pregnancy(AFLP) is a rare but very urgent obstetric disease in clinical. It is a common cause of liver failure in pregnancy and often needs to be admitted to the department of critical care medicine because of the rapid development of acute hepatic dysfunction and severe acute renal dysfunction. The etiology and pathogenesis of this disorder is not very clear although there have been many studies on it before. Meanwhile, the relatively high mortality requires a better recognition in order to better guide clinical decision making. Our previous multicentre retrospective study on AFLP demonstrated that total bilirubin and serum creatinine were independent risk factors for perinatal maternal mortality. And we aim to further assess maternal outcomes and risk factors in AFLP patients treated without plasma exchange or renal replacement therapy based on previous data we collected. METHODS: Retrospective cohort study of 133 hospitalized patients with AFLP was collected from four Chinese tertiary hospitals during the period between January 2009 and April 2014. One hundred thirty three patients were divided into two subgroups containing patients treated without plasma exchange (PE) or renal replacement therapy (CRT) and patients treated with PE or/and CRT. Logistic regression was used to analyze independent risk factors for maternal mortality of AFLP treated without PE or CRT. RESULTS: The maternal mortality rate was 12.0% in subgroup of patients treated without PE or CRT. And in subgroup of patients treated with PE or/and CRT, the maternal mortality rate was 26.8%. Independent risk factors for maternal mortality of AFLP treated without PE or CRT were direct bilirubin (OR = 1.012; 95% CI, 1.002-1.022) and serum creatinine (OR = 1.022; 95% CI, 1.007-1.036). CONCLUSION: Although less liver and kidney damage in AFLP treated without PE or CRT, direct bilirubin and serum creatinine remained to be independent risk factors for maternal mortality. Thus, the level of bilirubin and serum creatinine might not be necessary for AFLP to decide whether to give plasma exchange or dialysis treatment.

Diagnostic Performance of SGA, PG-SGA and MUST for Malnutrition Assessment in Adult Cancer Patients: A Systematic Literature Review and Hierarchical Bayesian Meta-Analysis.

Because cancer-associated malnutrition is a major health complication, timely nutritional screening is of utmost importance. The aim of this study was to conduct a systematic literature review and meta-analysis of three tools in order to identify the method with the best diagnostic performance. PubMed, EMBASE and Cochrane central register of controlled trials were searched for articles published from database inception to January 2021. Studies that assessed the diagnostic accuracy of the SGA, PG-SGA or MUST in adult cancer patients were included. In order to evaluate the quality of each included study, the QUADAS-2 tool was used after which a meta-analysis was conducted using the hierarchical bivariate model. This model accounts for both within and between study variability. 16 studies (18 datasets) were included to evaluate these tools. The overall sensitivity and specificity for SGA was 0.69 and 0.80, 0.95 and 0.81 for PG-SGA, along with 0.83 and 0.83 for MUST respectively. An assessment of the likelihood ratios showed that PG-SGA had the highest LR + and the lowest LR-, it therefore has the best diagnostic performance to confirm malnutrition in adult cancer patients.

The migration, transformation, and risk assessment of heavy metals in residue and bio-oil obtained by the liquefaction of pig manure.

The total contents and chemical speciation analysis of Zn, Cu, Pb, Cr, Mn, Ni, Cd, and As in pig manure (PM), liquefaction residues (LRs), and bio-oils (BOs) derived from PM by liquefaction with ethanol as a solvent at 180-300 °C were thoroughly investigated in this study. The environment risk assessment, leachability, and bioavailability of heavy metals in PM and LRs were studied. The results showed that more than 75% of heavy metals remained in LRs. The total contents of heavy metals in LRs were markedly elevated, but those in BOs gradually decreased with the increase in liquefaction temperature. Moreover, the acid soluble/exchangeable fraction and reducible fraction (F1 + F2) of heavy metals in LRs and BOs was significantly reduced, while oxidizable fraction and stable fraction (F3 + F4) desirably increased after liquefaction. Furthermore, the potential risk of heavy metals in LRs was decreased in comparison to that in PM, but the risk of Pb, Mn, and As had not been obviously reduced; therefore, the LRs from the liquefaction of PM should be pretreated before recycling. Temperatures from 220 to 260 °C were the optimum conditions for disposing of PM by liquefaction with ethanol.

Environmental risk assessment in livestock manure derived biochars.

Livestock-manure-derived biochar is one of major products obtained from the pyrolysis of livestock manure. This study quantitatively assesses the pollution level and ecological risks associated with heavy metals in livestock manure and the biochar produced by its pyrolysis. The geo-accumulation index (GAI) values of heavy metals in livestock manure were significantly decreased (P < 0.05) and indicated to be at the grade of uncontaminated expected for Zn in pig-manure-derived biochar (PMB, 0.94, 800 °C) via pyrolysis. Therefore, Zn should be paid more attention in PMB. The risk factors (E r i ) result shows that heavy metals in biochars were significantly decreased (P < 0.05) with increasing pyrolysis temperature. Potential ecological risk index values revealed that the integrated risks from the heavy metals were significantly decreased (P < 0.05) after pyrolysis. Similarly, the risk assessment code values indicated that the risks from the heavy metals in livestock-manure-derived biochars were significantly decreased (P < 0.05) after pyrolysis. In summary, pyrolysis represents an effective treatment method for livestock manure and can provide an effective method to reduce the risks of environmental pollution.

An assessment of platelet parameters in different ethnic groups with hypertension subtypes and associated risk factors in Xinjiang, China.

The goal of this study was to investigate platelet parameters in populations with hypertension subtypes among the Han, Uygur, and Kazakh ethnic groups and their associated risk factors in Xinjiang, northwestern China. In total, 9816 adult participants were recruited from a multiethnic, cross-sectional cardiovascular risk survey. Our results indicated that the platelet counts in Han, Uygur, and Kazakh participants with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic diastolic hypertension (SDH) varied significantly (P < 0.001). Additionally, the mean platelet volume (MPV) in Han, Uygur, and Kazakh participants with ISH was significantly different (P < 0.05). Furthermore, the individual platelet parameters had different associated risk factors. For example, the risk factors for platelet counts were Uygur ethnicity, Kazakh ethnicity, drinking, ISH, diabetes, and high triglycerides (TGs). The risk factors for MPV were Uygur ethnicity, smoking, overweight, obesity, ISH, IDH, diabetes, and high TGs. Gender was a risk factor for abnormal plateletcrit (PCT) values. Only a low high-density lipoprotein cholesterol level was found to be a risk factor for platelet distribution width (PDW). We suggest that more attention should be paid to platelet parameters and the associated risk factors to reinforce the effect of antiplatelet therapy and to provide a clinical basis for preventing the occurrence of thrombosis complications and cerebro- and cardiovascular diseases effectively.

External quality assessment for human papillomavirus 16/18 DNA detection and genotyping in Shanghai, China.

BACKGROUND: Human papillomavirus (HPV) DNA detection and genotyping is now being used for cervical screening by a growing number of laboratories in Shanghai, but they may have various levels of proficiency. The objective of this study was to evaluate the performance of clinical laboratories for HPV DNA detection and genotyping by an external quality assessment (EQA) program. METHODS: The EQA panels were clinically validated by the Cobas 4800 HPV test, and then distributed to the participating laboratories in May 2015 (round 1) and September 2015 (round 2). Each panel consisted of one negative sample and nine positive cell or clinical samples of HPV16 and HPV18 types at different concentrations. In total, 40 laboratories submitted 18 qualitative and 22 genotyping data sets in round 1 and 44 laboratories submitted 18 qualitative and 26 genotyping data sets in round 2. In both rounds, all laboratories used commercial assays. RESULTS: The negative samples were detected correctly in both rounds by all participating laboratories. There were no false-positive results in the qualitative data sets and only two false-positive results in the genotyping data sets in each of round 1 and round 2. The false-negative rates were 8.0% for round 1 and 2.7% for round 2. For the qualitative data sets, almost all of the laboratories (100% for round 1 and 97.8% for round 2) obtained a score of acceptable or better. For the genotyping results, acceptable or better scores were obtained in 81.8% (round 1) and 100% (round 2). CONCLUSIONS: Our results indicate that the majority of laboratories in Shanghai have reliable diagnostic ability for HPV detection and genotyping. Moreover, this study emphasizes the importance of EQA for monitoring the performance of clinical laboratories.

[Experience in transumbilical endoscopic surgery diagnosis for 3 cases of pseudomyxoma peritonei].

Three patients of pseudomyxoma peritonei who were diagnozed by transumbilical endoscopic surgery (TUES) were reviewed retrospectively from September 2014 to November 2014. Three cases of ascites patients underwent TUES were diagnozed as pseudomyxoma peritonei. All operations were successful. No open surgery or laparoscopic surgery was required. The mean operative time was (45±16) min; the mean intraoperative blood loss was 510 mL; the mean hospital stay time was 3 days. During the follow up of 911 months, no obvious scar was observed. Cosmetic results appear to be excellent. All patients were treated with intraperitoneal hyperthermia and chemotherapy. The survival rate was 100%. As a novel scarless endoscopic invasive abdominal surgery, TUES has high clinical value with the advantages such as small trauma, no scars, small risk and low cost in the diagnosis of unexplained ascites.

The impact of diminished housing wealth on health in the United States: evidence from the Great Recession.

The sharp decline in home values in many industrialized and developing countries was one of the most evident facets of the global economic recession of 2008. Using data from the Panel Study of Income Dynamics (PSID) for 2007-2011, this study examines how the decline in housing wealth affected the psychological and physical health and health-related behaviors of 4007 U.S. households who were homeowners in 2007. We focus on two mechanisms that could account for how the drop in housing wealth affects health: increase in stress and negative changes in health-related behaviors. Controlling for the changes in non-housing wealth and employment status during the recession, the decline in housing wealth is associated with a small but statistically significant increase in psychological distress. Psychological health deteriorates more as the housing wealth relative to total wealth decreases. Finally, homeowners who have difficulties with mortgage payments report substantial increases in psychological distress and have higher rates of depression. These findings, combined with limited evidence of the change in health-related behaviors, suggest that the increase in stress is the main cause of the adverse health outcomes.