[Analysis and prediction of disease burden of cirrhosis and other chronic liver diseases due to alcohol use in China from 1990 to 2030].

Objective: To comprehensively understand the disease burden of liver cirrhosis and other chronic liver diseases caused by alcohol use in China from 1990 to 2019, as well as to predict the trends in disease burden from 2020 to 2030. Methods: The analysis utilized data from the Global Burden of Disease study in 2019 (GBD2019). Key indicators such as incidence rate, mortality rate, disability-adjusted life years (DALY), years of life lost due to premature mortality, and years lived with disability were selected to describe the disease burden of alcohol-related liver cirrhosis and other chronic liver diseases in China from 1990 to 2019. The estimated annual percentage change (EAPC) was used to depict the temporal trends in disease burden. Furthermore, a Bayesian age-period-cohort (BAPC) model was constructed using R software to predict the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of alcohol-related liver cirrhosis and other chronic liver diseases in China from 2020 to 2030. Results: From 1990 to 2019, the incidence of alcohol-related liver cirrhosis and other chronic liver diseases in China showed an upward trend, with an EAPC of 0.31% (95%CI: 0.10%-0.52%). However, the DALY declined, with an EAPC of -2.81% (95%CI: -2.92% - -2.70%). The ASMR showed a downward trend, with an EAPC of -2.55% (95%CI: -2.66% - -2.45%). The highest incidence of cirrhosis of liver caused by alcohol and other chronic liver diseases was reported in the age group of 35-49 years, while the ASMR increased gradually with age, with a significant rise after the age of 30. The age-standardized DALY rate peaked between the ages of 55 and 64. The disease burden indicators for males were consistently higher than those for females during the same period. According to the predictions of the BAPC model, from 2020 to 2030, the ASIR for cirrhosis of liver caused by alcohol and other chronic liver diseases in the entire population of China was projected to increase from 3.45/100 000 in 2020 to 3.78/100 000 in 2030, a growth of 9.57%. Conversely, the ASMR was expected to decrease from 1.45/100 000 in 2020 to 1.24/100 000 in 2030, a reduction of 14.48%. Conclusions: The disease burden of cirrhosis of liver caused by alcohol and other chronic liver diseases remained serious in China, especially in men and the middle-aged to elderly population. There is a pressing need to prioritize attention and resources towards these groups. Despite the projected decrease in ASMR, the ASIR continued to rise and is expected to persist in its upward trend until 2030.

Vitamin D levels in the assessment of Crohn's disease activity and their relation to nutritional status and inflammation.

BACKGROUND: Crohn's disease (CD) is frequently associated with malnutrition, inflammation and a deficiency of vitamin D (VD) with the relationships between these symptoms being poorly defined. VD is a modulator of the immune system and is associated with the onset of CD and disease activity. The level of serum VD may have potential in the assessment of CD activity. This study aimed to evaluate the relationships between VD, nutritional status and inflammation, and to identify more accurate VD thresholds. METHODS: The study included 76 outpatients with CD diagnosed between October 2018 and October 2020 and 76 healthy volunteers. Levels of serum 25(OH)D and nutritional indicators, as well as biochemical and disease activity assessments, were conducted. RESULTS: Patients with CD and healthy participants were found to differ significantly in their 25(OH)D levels as well in levels of nutritional and inflammatory indicators. The optimal VD cut-off value was found to be 46.81 nmol/L for CD development and 35.32 nmol/L for disease activity. Levels of 25(OH)D were correlated with both nutritional status and inflammation. CONCLUSIONS: The VD level is likely to be a useful additional tool in the evaluation of CD patients and predicting the disease activity and clinical response. The VD level may relate both to the nutritional status and levels of inflammation in CD patients, and disease progression.

The social cost of gathering information for trust decisions.

Trust decisions are inherently uncertain, as people usually have incomplete information about the trustworthiness of the other person prior to their decision to trust or not trust. Therefore, it is typically beneficial to gather information about a trustee's past behaviour before deciding whether or not to trust them. However, elaborate inquiries about a trustee's behaviour may change the trustee's willingness to reciprocate, causing either a decrease due to the trustee's negative impressions of the investor or an increase because the investor appears to be highly betrayal-averse to the trustee. In turn, such a change could cause the investor to gather less or more information, respectively. Here, we examine how information acquisition is modulated by social context, monetary cost, and the trustee's trustworthiness. We gave participants the opportunity to sequentially sample information about a trustee's reciprocation history before they decided whether or not to invest. Participants sampled less when there was a monetary cost and when the gathered information was more conclusive. On some trials, we induced a social context by telling the participant that the trustee would learn how much the participant sampled ("overt sampling"). Crucially, when sampling was free, participants sampled less when sampling was overt than when it was covert, suggesting that they avoided leaving negative impressions. We find that the data were well accounted for by a Bayesian heuristic model, in which the agent continues sampling until uncertainty about trustworthiness-as measured by the width of the posterior belief-drops below a level that they find tolerable. This study opens the door to broader applications of the tools and models of information sampling to social decision-making.

[Risk assessment and early warning of imported COVID-19 in Guangdong province].

Objective: To assess the imported risk of COVID-19 in Guangdong province and its cities, and conduct early warning. Methods: Data of reported COVID-19 cases and Baidu Migration Index of 21 cities in Guangdong province and other provinces of China as of February 25, 2020 were collected. The imported risk index of each city in Guangdong province were calculated, and then correlation analysis was performed between reported cases and the imported risk index to identify lag time. Finally, we classified the early warming levels of epidemic by imported risk index. Results: A total of 1 347 confirmed cases were reported in Guangdong province, and 90.0% of the cases were clustered in the Pearl River Delta region. The average daily imported risk index of Guangdong was 44.03. Among the imported risk sources of each city, the highest risk of almost all cities came from Hubei province, except for Zhanjiang from Hainan province. In addition, the neighboring provinces of Guangdong province also had a greater impact. The correlation between the imported risk index with a lag of 4 days and the daily reported cases was the strongest (correlation coefficient: 0.73). The early warning base on cumulative 4-day risk of each city showed that Dongguan, Shenzhen, Zhongshan, Guangzhou, Foshan and Huizhou have high imported risks in the next 4 days, with imported risk indexes of 38.85, 21.59, 11.67, 11.25, 6.19 and 5.92, and the highest risk still comes from Hubei province. Conclusions: Cities with a large number of migrants in Guangdong province have a higher risk of import. Hubei province and neighboring provinces in Guangdong province are the main source of the imported risk. Each city must strengthen the health management of migrants in high-risk provinces and reduce the imported risk of Guangdong province.

[Risk assessment of exported risk of COVID-19 from Hubei Province].

Objective: To evaluate the exported risk of COVID-19 from Hubei Province and the imported risk in various provinces across China. Methods: Data of reported COVID-19 cases and Baidu Migration Indexin all provinces of the country as of February 14, 2020 were collected. The correlation analysis between cumulative number of reported cases and the migration index from Hubei was performed, and the imported risks from Hubei to different provinces across China were further evaluated. Results: A total of 49 970 confirmed cases were reported nationwide, of which 37 884 were in Hubei Province. The average daily migration index from Hubei to other provinces was 312.09, Wuhan and other cities in Hubei were 117.95 and 194.16, respectively. The cumulative COVID-19 cases of provinces was positively correlated with the migration index derived from Hubei Province, also in Wuhan and other cities in Hubei, with correlation coefficients of 0.84, 0.84, and 0.81. In linear model, population migration from Hubei Province, Wuhan and other cities in Hubei account for 71.2%, 70.1%, and 66.3% of the variation, respectively. The period of high exported risk from Hubei occurred before January 27, of which the risks before January 23 mainly came from Wuhan, and then mainly from other cities in Hubei. Hunan Province, Henan Province and Guangdong Province ranked the top three in terms of cumulative imported risk (the cumulative risk indices were 58.61, 54.75 and 49.62 respectively). Conclusion: The epidemic in each province was mainly caused by the importation of Hubei Province. Taking measures such as restricting the migration of population in Hubei Province and strengthening quarantine measures for immigrants from Hubei Province may greatly reduce the risk of continued spread of the epidemic.

[The definition of heat-wave based on mortality risk assessment in different regions of China].

Objective: To identify the definition of heat wave based on mortality risk assessment in different regions of China. Methods: Daily mortality (from China Information System for Disease Control and Prevention) and meteorological data (from National Meteorological Information Center in China) from 66 counties with a population of over 200 000 were collected from 2006-2011. With the consideration of climate type and administrative division, China was classified as seven regions. Firstly, distributed lag non-linear model (DLNM) was used to estimate community-specific effects of temperature on non-accidental mortality. Secondly, a multivariate meta-analysis was applied to pool the estimates of community-specific effects to explore the region-specific temperature threshold and the duration for definition of heat wave. Results: We defined regional heat wave of Northeast, North, Northwest, East, Central and Southwest China as being two or more consecutive days with daily mean temperature higher than or equal to the P(64), P(71), P(85), P(67), P(75) and P(77) of warm season (May to October) temperature, respectively, while the thresholds of temperature were 21.6, 23.7, 24.3, 25.7, 28.0 and 25.3 ℃. The heat wave in South China was defined as five or more consecutive days with daily mean temperature higher than or equal to the P(93) (30.4 ℃) of warm season (May to October) temperature. Conclusion: The region-specific definition of heat wave developed in our study may provide local government with the guidance of establishment and implementation of early heat-health response systems to address the negative health outcomes due to heat wave.

Overall obesity is leveling-off while abdominal obesity continues to rise in a Chinese population experiencing rapid economic development: analysis of serial cross-sectional health survey data 2002-2010.

BACKGROUND: Obesity epidemic is related to industrialization and urbanization that have lead to changes in nutrition, lifestyle and socio-economic status. However, information on the trajectory of the obesity epidemic in populations experiencing rapid economic development is limited. We therefore investigate trends in obesity from 2002 to 2010 in a southern Chinese population experiencing world's fastest economic development. METHODS: Between 2002 and 2010 four standardized surveys were conducted in a population of 85 million residents in Guangdong, China. Multistage cluster sampling was adopted to recruit representative samples. Weight, height and waist circumference of the participants were measured in a standardized way. The analysis included residents aged between 18 and 69 years. The number of participants included in the present analysis for Surveys conducted in 2002, 2004, 2007 and 2010 were 13058, 7646, 6441 and 8575, respectively. RESULTS: From year 2002 to 2010, the age-standardized Body mass index (BMI) insignificantly changed from 21.7 kg m(-2) to 22.3 kg m(-2), and the prevalence of overweight and overall obesity from 15.8 to 16.6% (both P>0.05). The age-standardized waist circumference increased from 73.7 to 78.4 cm, and prevalence of abdominal obesity increased from 12.9 to 23.7% (both P<0.001). In urban areas, BMI and overall obesity changed little during the 8-year period (BMI increased from 22.6 to 22.7 kg m(-2) and overall obesity changed from 23.7 to 21.4%), whereas there were slight increases of the same in rural areas (BMI increased from 20.8 to 22.1 kg m(-2)and overall obesity increased from 8.2 to 13.3%). Waist circumference and abdominal obesity increased significantly in both areas, but the increase was more pronounced in rural areas (in urban area, waist circumference increased from 75.1 to 78.5 cm and abdominal obesity from 16.8 to 26.5%; in rural area, waist circumference from 72.2 to 78.3 and abdominal obesity from 8.8 to 22.0%). CONCLUSIONS: BMI and overall obesity in this population, which has experienced the world's fastest economic development over the past three decades, has been leveling-off, while waist circumference and abdominal obesity, independent predictors of cardiovascular risk, have continued to rise. Our findings suggest that obesity epidemic transition in rapidly developing populations may be much faster than what has been observed in Western countries.