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1.
J Glob Health ; 14: 04023, 2024 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-38175959

RESUMO

Background: Tuberculosis (TB) is expected to become the second leading single cause of death with several risk factors, but the related disease burden is currently unknown. We aimed to analyse the pre-coronavirus disease 2019 (COVID-19) changes in mortality of TB attributable to alcohol and tobacco worldwide from 1990 to 2019. Methods: We obtained data of TB deaths and age-standardised death rates attributed to alcohol and cigarette in 204 countries and territories from the Global Burden of Disease 2019 public database. We performed a spatial-temporal analysis of age-standardised death rate and the average annual per cent change (AAPC), after which we analysed the effects of gender and socio-demographic index on age-standardised death rate using an age-period-cohort model. Finally, we built machine learning models to predict the TB age-standardised death rate in 2035. Results: We found that the global age-standardised death rate of TB attributable to alcohol consumption declined from 5.35 (95% uncertainty interval (UI) = 3.51, 7.00) in 1990 to 2.54 (95% UI = 1.65, 3.33) in 2019, with significant declines in Andean Latin America (AAPC = -7.59; 95% confidence interval (CI) = -8, -7.16, P < 0.05), East Asia (AAPC = -7.32; 95% CI = -8.00, -6.62, P < 0.05), and Central Latin America (AAPC = -7.31; 95% CI = -7.63, -6.99, P < 0.05). However, there was an increase in a few regions, especially in parts of Central Asia. The age-standardised death rate for TB attributable to cigarette smoking declined more rapidly than that for TB attributable to alcohol, from 7.45 (95% UI = 6.17, 8.72) to 2.21 (95% UI = 1.78, 2.64), especially in East Asia (AAPC = -6.64; 95% CI = -7.07, -6.2, P < 0.05), North Africa and Middle East (AAPC = -6.47; 95% CI = -6.67, -6.28, P < 0.05), and Andean Latin America (AAPC = -6.31; 95% CI = -6.87, -5.75, P < 0.05). However, TB attributable to cigarette smoking increased in parts of Eastern Europe. In both TB attributable to alcohol consumption and to cigarette smoking, the age-standardised death rate was much higher in men than in women. The age-period-cohort model results showed that TB attributable to alcohol consumption was the highest in older adults aged 60-80 years, while TB attributable to cigarette smoking was the highest in adults aged 40-60 years. Machine learning models projected that by 2035, the age-standardised death rate for TB attributable to alcohol consumption would be 1.29 (per 100 000 population), while the age-standardised death rate for TB attributable to cigarette consumption would be 0.37 (per 100 000 population), which might not achieve the 2035 global target for eliminating TB. Conclusions: Globally, the age-standardised death rate for TB attributable to alcohol consumption declined slower than that attributable to cigarette smoking. Controlling these two factors would help achieve the global goal of TB elimination, especially for the elderly who are at high risk.


Assuntos
Carga Global da Doença , Tuberculose , Masculino , Idoso , Humanos , Feminino , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Consumo de Bebidas Alcoólicas/epidemiologia , Saúde Global
2.
Curr Med Sci ; 44(1): 71-80, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38289530

RESUMO

Cancer patients are at high risk of malnutrition, which can lead to adverse health outcomes such as prolonged hospitalization, increased complications, and increased mortality. Accurate and timely nutritional assessment plays a critical role in effectively managing malnutrition in these patients. However, while many tools exist to assess malnutrition, there is no universally accepted standard. Although different tools have their own strengths and limitations, there is a lack of narrative reviews on nutritional assessment tools for cancer patients. To address this knowledge gap, we conducted a non-systematic literature search using PubMed, Embase, Web of Science, and the Cochrane Library from their inception until May 2023. A total of 90 studies met our selection criteria and were included in our narrative review. We evaluated the applications, strengths, and limitations of 4 commonly used nutritional assessment tools for cancer patients: the Subjective Global Assessment (SGA), Patient-Generated Subjective Global Assessment (PG-SGA), Mini Nutritional Assessment (MNA), and Global Leadership Initiative on Malnutrition (GLIM). Our findings revealed that malnutrition was associated with adverse health outcomes. Each of these 4 tools has its applications, strengths, and limitations. Our findings provide medical staff with a foundation for choosing the optimal tool to rapidly and accurately assess malnutrition in cancer patients. It is essential for medical staff to be familiar with these common tools to ensure effective nutritional management of cancer patients.


Assuntos
Desnutrição , Neoplasias , Humanos , Avaliação Nutricional , Desnutrição/diagnóstico , Neoplasias/complicações
3.
Sci Rep ; 13(1): 19652, 2023 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-37950037

RESUMO

To investigate the value of T2* technique on 3.0 T magnetic resonance imaging (MRI) in evaluating the changes of cardiac and hepatic iron load before and after hematopoietic stem cell transplantation (HSCT) in patients with thalassemia (TM), the 141 TM patients were divided into 6 group for subgroup analysis: 6, 12, 18, 24 and > 24 months group, according to the postoperative interval. The T2* values of heart and liver (H-T2*, L-T2*) were quantified in TM patients before and after HSCT using 3.0 T MRI T2* technology, and the corresponding serum ferritin (SF) was collected at the same time, and the changes of the three before and after HSCT were compared. The overall H-T2* (P = 0.001) and L-T2* (P = 0.041) of patients after HSCT were higher than those before HSCT (mean relative changes = 19.63%, 7.19%). The H-T2* (P < 0.001) and L-T2* (P < 0.001) > 24 months after HSCT were significantly higher than those before HSCT (mean relative changes = 69.19%, 93.73%). The SF of 6 months (P < 0.001), 12 months (P = 0.008), 18 months (P = 0.002) and > 24 months (P = 0.001) were significantly higher than those before HSCT (mean relative changes = 57.93%, 73.84%, 128.51%, 85.47%). There was no significant improvement in cardiac and liver iron content in TM patients within 24 months after HSCT, while the reduction of cardiac and liver iron content in patients is obvious when > 24 months after HSCT.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Sobrecarga de Ferro , Talassemia , Talassemia beta , Humanos , Ferro/metabolismo , Ferritinas , Sobrecarga de Ferro/patologia , Talassemia beta/diagnóstico por imagem , Talassemia beta/terapia , Talassemia/diagnóstico por imagem , Talassemia/terapia , Talassemia/patologia , Imageamento por Ressonância Magnética/métodos , Fígado/metabolismo , Miocárdio/metabolismo
4.
BMC Psychol ; 11(1): 342, 2023 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-37853436

RESUMO

BACKGROUND: Employees' withdrawal behavior concerns organization leaders and policymakers in many countries. However, the specific mechanism which emotional labor affects withdrawal behavior has yet to be thoroughly discussed. There needs to be systematic research on how different emotional labor strategies affect work withdrawal, whether directly or through individual perception, and how to respond. METHODS: A total of 286 hotel and catering service employees participated in our study. A series of hierarchical moderated regression analyses were performed to test the hypothesis. RESULTS: The results indicated that surface acting positively affected withdrawal behavior, while deep acting had a negative effect. Emotional exhaustion mediated in this relationship of surface acting with withdrawal behavior and deep acting with withdrawal behavior. Mindfulness showed moderation effects between emotional exhaustion and withdrawal behavior. CONCLUSIONS: Emotional labor and emotional exhaustion are significant in predicting employees' intentions to withdraw, given that emotional exhaustion partially mediates the effects of emotional labor on withdrawal behavior. Significantly, the relationship between emotional exhaustion and withdrawal behavior is weakened by mindfulness.


Assuntos
Esgotamento Profissional , Atenção Plena , Humanos , Emoções , Esgotamento Profissional/psicologia
5.
Environ Int ; 179: 108152, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37598595

RESUMO

PM2.5 emissions from heavy-duty diesel trucks (HDDTs) have a significant impact on air quality, human health, and climate change, and seriously threaten the UN Sustainable Development Goals. Globally, a series of emission control measures have been implemented to reduce pollution emissions from HDDTs. Current studies assessing the impact of these measures on air quality and human health have mainly used coarse-grained emission data as input to dispersion model, resulting in the inability to capture the spatiotemporal variability of pollutant concentrations and tending to increase the uncertainty of health impact assessment results. In this study, we quantified the impact of pollution control policies for HDDTs in Beijing on PM2.5 concentrations, human health, and economic losses by integrating policy scenario analysis, pollution dispersion simulation, public health impact and economic benefit assessment models, supported by high spatiotemporal resolution emission data from HDDTs. The results show that PM2.5 concentrations from HDDTs exhibit significant spatial aggregation characteristics, with the intensity of aggregation at night being about twice as high as that during the day. The emission hotspots are mainly concentrated in the sixth, fifth and fourth rings and major highways. Compared to the "business as usual" scenario in 2018, the current policy of updating the fuel standard to China VI and the emission standard to China 6 can reduce PM2.5 concentrations by 96.72%, thereby avoiding 612 premature deaths, which is equivalent to obtaining economic benefits of 1.65 billion CNY. This study further emphasizes the importance of high spatiotemporal resolution emission data during traffic dispersion modeling. The results can help improve the understanding of the effectiveness of emission reduction measures for HDDTs from a health benefit perspective.


Assuntos
Veículos Automotores , Políticas , Humanos , Pequim , China , Material Particulado
6.
Proc Biol Sci ; 290(1995): 20230159, 2023 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-36946117

RESUMO

Humans exhibit a broad range of post-marital residence patterns and there is growing recognition that post-marital residence predicts women's reproductive success; however, the nature of the relationship is probably dependent on whether co-resident kin are cooperators or competitors. Here, we explore this relationship in a Tibetan population, where couples practice a mixture of post-marital residence patterns, co-residing in the same village with the wife's parents, the husband's parents or endogamously with both sets of parents. Using detailed demographic data from 17 villages we find that women who live with only their own parents have an earlier age at first birth (AFB) and age at last birth (ALB) than women who live with only their parents-in-law. Women who co-reside with both sets of parents have the earliest AFB and ALB. However, those with co-resident older siblings postponed reproduction, suggestive of competition-related delay. Shifts to earlier reproductive timing were also observed in relation to the imposition of family planning policies, in line with Fisherian expectations. Our study provides evidence of the costs and benefits to women's direct fitness of co-residing with different kin, against a backdrop of adaptive responses to cultural constraints on completed fertility.


Assuntos
Características da Família , Casamento , Feminino , Humanos , Fatores Socioeconômicos , Reprodução , Fertilidade
7.
Sensors (Basel) ; 23(4)2023 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-36850958

RESUMO

In this paper, a novel liquid level sensing system is proposed to enhance the capacity of the sensing system, as well as reduce the cost and increase the sensing accuracy. The proposed sensing system can monitor the liquid level of several points at the same time in the sensing unit. Additionally, for cost efficiency, the proposed system employs only one sensor at each spot and all the sensors are multiplexed. In multiplexed systems, when changing the liquid level inside the container, the float position is changed and leads to an overlap or cross-talk between two sensors. To solve this overlap problem and to accurately predict the liquid level of each container, we proposed a deep neural network (DNN) approach to properly identify the water level. The performance of the proposed DNN model is evaluated via two different scenarios and the result proves that the proposed DNN model can accurately predict the liquid level of each point. Furthermore, when comparing the DNN model with the conventional machine learning schemes, including random forest (RF) and support vector machines (SVM), the DNN model exhibits the best performance.

8.
Talanta ; 257: 124390, 2023 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-36848764

RESUMO

Thermal ionization mass spectrometry (TIMS) is the workhorse for lead isotopic ratio analysis due to its excellent precision. Silica gel as ionization activator on Re filament is proved to the best emitter that can provide excellent sensitivity even small Pb sample size. However, the price of Re filament is three times that of Ta filament that leads to high experimental cost for TIMS laboratory. Here, we first present a novel silicon nitride (ß-Si3N4) emitter on the Ta filament with good sensitivity for Pb isotopic ratio measurements. Hence, the cost of filament material is cut down ∼70%. The ß-Si3N4 emitter can yield stable and long-life Pb+ signal, about 2-3 V 208Pb and 0.65-0.90 V 208Pb for 20 ng and 5 ng NIST SRM981 sample size that is applicable to the most geological materials for bulk analysis. A suite of silicate reference materials were analyzed to verify the reliability and accuracy of our method. For 206Pb/204Pb, 207Pb/204Pb and 208Pb/204Pb isotope ratios of geological samples, excellent internal precisions (2 SE) of ±0.005%-0.013% are achieved. Replicate digestions and analyses of the basalt standard BCR-2 and coal fly ash standard GBW08401 demonstrate that good external precision is obtainable that is 0.10-0.18% (n = 6, 2 SD) for 206Pb/204Pb, 207Pb/204Pb and 208Pb/204Pb ratios.

9.
Front Public Health ; 10: 986728, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36276354

RESUMO

Background: Since 2011, through the Community-Based Colorectal Cancer Screening Program in Shanghai, China (SHcsp), residents aged >50 years were offered initial colorectal cancer screening using the fecal immunochemical test (FIT) and risk assessment questionnaire (RAQ) for free. Colonoscopy was then recommended for positive results. Objective: To evaluate the cost-effectiveness of the Community-Based Colorectal Cancer Screening Program in Shanghai, China from the payer perspective. Methods: This analysis estimated the long-term cost and effectiveness of the 2014-2016 SHcsp based on real-world follow-up data from the SHcsp database, Shanghai Cancer Registry System, vital statistics from Shanghai Municipal Center for Disease Control and Prevention and inpatient CRC expense data from hospitals. A decision-tree model and Markov model were constructed to simulate the 25-year health outcomes. The screening branch was the cohort with a definite diagnosis of adenoma, advanced adenoma, and CRC. The other branch was residents who were neither screened nor treated until CRC symptoms appeared. A payer prospective was adopted to measure direct costs and effectiveness by life years (LYs) and quality-adjusted life years (QALYs) gained, and were discounted by 3%. Stimulation robustness was tested by one-way sensitivity analysis. Results: Of 1,097,656 residents, 13,250 were diagnosed with adenoma, advanced adenoma, or CRC. Assuming those had not been found through screening, SHcsp resulted in 1,570.1 LYs and 13,984.3 QALYs gained at an extra cost of USD9.96 million. The incremental cost-effectiveness ratio (ICER) was USD6,342.02 per LY and USD712.08 per QALY obtained, far below the threshold of USD59,598 of three-time GDP per capita in Shanghai. Conclusion: The SHcsp was cost-effective than no screening strategy. The results were generalisable to the Chinese population for mass CRC screening.


Assuntos
Neoplasias Colorretais , Detecção Precoce de Câncer , Humanos , Detecção Precoce de Câncer/métodos , Análise Custo-Benefício , Estudos Prospectivos , China , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle
10.
Biomed Environ Sci ; 34(12): 937-951, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34981717

RESUMO

OBJECTIVE: We aimed to investigate and interpret the associations between socioeconomic factors and the prevalence, awareness, treatment, and control of hypertension at the provincial level in China. METHODS: A nationally and provincially representative sample of 179,059 adults from the China Chronic Disease and Nutrition Surveillance study in 2015-2016 was used to estimate hypertension burden. The spatial Durbin error model was fitted to investigate socioeconomic factors associated with hypertension indicators. RESULTS: Overall, it was estimated that 29.20% of the participants were hypertensive nationwide, among whom, 34.32% were aware of their condition, 27.69% had received antihypertensive treatment, and 7.81% had controlled their condition. Per capita gross domestic product (GDP) was associated with hypertension prevalence (coefficient: -2.95, 95% CI: -5.46, -0.45) and control (coefficient: 6.35, 95% CI: 1.36, 11.34) among adjacent provinces and was also associated with awareness (coefficient: 2.93, 95% CI: 1.12, 4.74) and treatment (coefficient: 2.67, 95% CI: 1.21, 4.14) in local province. Beds of internal medicine (coefficient: 2.66, 95% CI: 1.08, 4.23) was associated with control in local province. Old dependency ratio (coefficient: -3.58, 95% CI: -5.35, -1.81) was associated with treatment among adjacent provinces and with control (coefficient: -1.69, 95% CI: -2.42, -0.96) in local province. CONCLUSION: Hypertension indicators were not only directly influenced by socioeconomic factors of local area but also indirectly affected by characteristics of geographical neighbors. Population-level strategies should involve optimizing supportive socioeconomic environment by integrating clinical care and public health services to decrease hypertension burden.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/epidemiologia , Fatores Socioeconômicos , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/prevenção & controle , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Prevalência , Análise Espacial , Adulto Jovem
11.
Ying Yong Sheng Tai Xue Bao ; 31(8): 2680-2686, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34494791

RESUMO

Ecological vulnerability is a hot issue in the study of global change and sustainable development. Understanding the vulnerability of agro-ecological environment is conducive to rational utilization of regional agricultural resources, which could put forward effective measures for prote-cting agro-ecological environment. Given that the evaluation of agricultural eco-environment vulnerability generally does not consider the relationships among different indicators in different evaluation levels, we used the grey trigonometrically whitening weight set pair analysis (SPA) model to evaluate the vulnerability of agricultural eco-environment in Karst mountain by selecting 11 indicators such as population density, per capita arable land area and per capita afforestation area from the external vulnerability of ecological environment. The results showed that the vulnerability degree of agro-ecological environment in the study area was very high, mainly at the extreme, high and medium vulnerability grades. The proportion of extremely, highly, moderately, mildly and slightly vulnerable areas was 32.4%, 14.1%, 17.7%, 23.6% and 12.2% respectively. This result was consistent with the status of agricultural ecological environment vulnerability in the study area. It was feasible to evaluate the vulnerability of agro-ecosystem with the SPA Model of grey trigonometrically whitening weight, which provided a new method for evaluating agricultural ecological environment vulnerability.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Agricultura , China
12.
Psychol Bull ; 145(2): 189-236, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30652909

RESUMO

This study aimed to determine the relations between fluid intelligence (Gf) and reading/mathematics and possible moderators. A meta-analysis of 680 studies involving 793 independent samples and more than 370,000 participants found that Gf was moderately related to reading, r = .38, 95% CI [.36, .39], and mathematics, r = .41, 95% CI [.39, 44]. Synthesis on the longitudinal correlations showed that Gf and reading/mathematics predicted each other in the development even after controlling for initial performance. Moderation analyses revealed the following findings: (a) Gf showed stronger relations to mathematics than to reading, (b) within reading or mathematics, Gf showed stronger relations to complex skills than to foundational skills, (c) the relations between Gf and reading/mathematics increased with age, and (d) family social economic status (SES) mostly affected the relations between Gf and reading/mathematics in the early development stage. These findings, taken together, are partially in line with the investment theory but are more in line with the intrinsic cognitive load theory, mutualism theory, and the gene-SES interaction hypothesis of cognition and learning. More importantly, these findings imply an integration model of these theories from an educational and developmental perspective: Children may rely on Gf to learn reading and mathematics early on, when high family SES can boost the effects of Gf on reading/mathematics performance. As children receive more formal schooling and gain more learning experiences, their reading and mathematics improvement may promote their Gf development. During development, the negative effects of low family SES on the relations between Gf and reading/mathematics may be offset by education/learning experiences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Desenvolvimento Infantil/fisiologia , Inteligência/fisiologia , Aprendizagem/fisiologia , Matemática , Leitura , Classe Social , Criança , Humanos
13.
AIDS Behav ; 23(2): 523-533, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29971734

RESUMO

Risk of HIV infection is high in Chinese MSM, with an annual HIV incidence ranging from 3.41 to 13.7/100 person-years. Tenofovir-based PrEP is effective in preventing HIV transmission in MSM. This study evaluates the epidemiological impact and cost-effectiveness of implementing PrEP in Chinese MSM over the next two decades. A compartmental model for HIV was used to forecast the impact of PrEP on number of infections, deaths, and disability-adjusted life years (DALY) averted. We also provide an estimate of the incremental cost-effectiveness ratio (ICER) and the cost per DALY averted of the intervention. Without PrEP, there will be 1.1-3.0 million new infections and 0.7-2.3 million HIV-related deaths in the next two decades. Moderate PrEP coverage (50%) would prevent 0.17-0.32 million new HIV infections. At Truvada's current price in China, daily oral PrEP costs $46,813-52,008 per DALY averted and is not cost-effective; on-demand Truvada reduces ICER to $25,057-27,838 per DALY averted, marginally cost-effective; daily generic tenofovir-based regimens further reduce ICER to $3675-8963, wholly cost-effective. The cost of daily oral Truvada PrEP regimen would need to be reduced by half to achieve cost-effectiveness and realize the public health good of preventing hundreds of thousands of HIV infections among MSM in China.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Combinação Emtricitabina e Fumarato de Tenofovir Desoproxila/uso terapêutico , Infecções por HIV/prevenção & controle , Profilaxia Pré-Exposição/estatística & dados numéricos , Anos de Vida Ajustados por Qualidade de Vida , Minorias Sexuais e de Gênero , China/epidemiologia , Análise Custo-Benefício , Infecções por HIV/economia , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Incidência , Masculino , Modelos Econômicos , Modelos Estatísticos , Profilaxia Pré-Exposição/economia
15.
Ying Yong Sheng Tai Xue Bao ; 29(3): 839-849, 2018 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-29722226

RESUMO

To reveal the regulatory mechanism of agricultural management practices on soil quality, an experiment was carried out to study the different cropping system and straw management on soil organic carbon and fractions and soil enzyme activity in farmland of arid oasis region, which would provide a scientific basic for enhancing agricultural resources utilization and sustainable development. In crop planting planning area, we took the mainly crop (cotton, wheat, maize) as research objects and designed long-term continues cropping and crop rotation experiments. The results showed that the soil organic carbon (SOC), soil microbial biomass C, labile C, water-soluble organic C, and hot-water-soluble organic C content were increased by 3.6%-9.9%, 41.8%-98.9%, 3.3%-17.0%, 11.1%-32.4%, 4.6%-27.5% by crop rotation compared to continues cropping, and 12%-35.9%, 22.4%-49.7%, 30.7%-51.0%, 10.6%-31.9%, 41.0%-96.4% by straw incorporated compared to straw removed, respectively. The soil catalase, dehydrogenase, ß-glucosidase, invertase glucose, cellulase glucose activity were increased by 6.4%-10.9%, 6.6%-18.8%, 5.9%-15.3%, 10.0%-27.4%, 28.1%-37.5% by crop rotation compared to continues cropping, and 31.4%-47.5%, 19.9%-46.6%, 13.8%-20.7%, 19.8%-55.6%, 54.1%-70.9% by straw incorporated compared to straw removed, respectively. There were significant positive linear correlations among SOC, labile SOC fractions and soil enzyme. Therefore, we concluded that labile SOC fractions and soil enzyme were effective index for evaluating the change of SOC and soil quality. Based on factor analysis, in arid region, developing agricultural production using cropland management measures, such as straw-incorporated and combined short-term continues cotton and crop rotation, could enhance SOC and labile SOC fractions contents and soil enzyme activity, which could improve soil quality and be conducive to agricultural sustainable development.


Assuntos
Agricultura , Sequestro de Carbono , Solo/química , Carbono , Fazendas
16.
Sex Transm Dis ; 45(5): 343-349, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29465693

RESUMO

INTRODUCTION: The Joint United Nations Programme on human immunodeficiency virus (HIV)/acquired immune deficiency syndrome has proposed the 90-90-90 targets by 2020. Human immunodeficiency virus epidemic is spreading rapidly among men who have sex with men (MSM) in China. This study investigates how the scale-up of HIV testing and treatment in achieving the targets and its cost-effectiveness. METHODS: We constructed a compartmental model to forecast the HIV epidemic in Chinese MSM based on various "test-and-treat" scale-up scenarios. We assessed their cost effectiveness based on the cost for each HIV infection, death, and disability-adjusted life years (DALYs) prevented by the scale-up. RESULTS: If the current epidemic continued, HIV prevalence among Chinese MSM would increase from 9.2% in 2016 to 12.6% (9.2-15.6%) in 2020 and 16.2% (11.3-20.0%) in 2025. By 2020, 49.2% of infected MSM would be diagnosed and 40.1% of whom on treatment, falling short of the 90-90-90 targets, so would be even by 2025. To achieve these targets by 2020, additional 850,000 HIV screening tests and 112,500 person-years of antiretroviral treatment (ART) annually are necessary. This spending is US $478 million during 2016 to 2020, which almost tripled the status quo. However, by delaying to 2025, an investment of US $1210 million over 2016 to 2025 corresponding to 52% increase to the status quo, will enable extra 340,000 HIV screening tests and 60,000 person-year on ART annually. In both scenarios, the incremental cost-effectiveness ratio was US $733 to 960 for each DALY prevented, indicating highly cost-effective scenarios. CONCLUSIONS: Achieving the 90-90-90 targets by 2020 requires steep increase in investment, but delaying the targets to 2025 is practical and cost-effective.


Assuntos
Antirretrovirais/uso terapêutico , Epidemias/economia , Infecções por HIV/diagnóstico , Infecções por HIV/economia , Homossexualidade Masculina , Programas de Rastreamento/economia , China/epidemiologia , Análise Custo-Benefício , HIV/efeitos dos fármacos , HIV/isolamento & purificação , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Modelos Teóricos , Prevalência , Anos de Vida Ajustados por Qualidade de Vida , Minorias Sexuais e de Gênero
17.
Artigo em Inglês | MEDLINE | ID: mdl-27042034

RESUMO

BACKGROUND: COPD is the fourth leading cause of death worldwide, with particularly high rates in the People's Republic of China, even among never smokers. Large population-based cohort studies should allow for reliable assessment of the determinants of diseases, which is dependent on the quality of disease diagnoses. We assessed the validity of COPD diagnoses collected through electronic health records in the People's Republic of China. METHODS: The CKB study recruited 0.5 million adults aged 30-79 years from ten diverse regions in the People's Republic of China during the period 2004-2008. During 7 years of follow-up, 11,800 COPD cases were identified by linkage with mortality registries and the national health insurance system. We randomly selected ~10% of the reported COPD cases and then undertook an independent adjudication of retrieved hospital medical records in 1,069 cases. RESULTS: Overall, these 1,069 cases were accrued over a 9-year period (2004-2013) involving 153 hospitals across ten regions. A diagnosis of COPD was confirmed in 911 (85%) cases, corresponding to a positive predictive value of 85% (95% confidence interval [CI]: 83%-87%), even though spirometry testing was not widely used (14%) in routine hospital care. The positive predictive value for COPD did not vary significantly by hospital ranking or calendar period, but was higher in men than women (89% vs 79%), at age ≥70 years than in younger people (88%, 95% CI: 85%-91%), and when the cases were reported from both death registry and health insurance systems (97%, 95% CI: 94%-100%). Among the remaining cases, 87 (8.1%) had other respiratory diseases (chiefly pneumonia and asthma; n=85) and 71 (6.6%) cases showed no evidence of any respiratory disease on their clinical records. CONCLUSION: In the People's Republic of China, COPD diagnoses obtained from electronic health records are of good quality and suitable for large population-based studies and do not warrant systematic adjudication of all the reported cases.


Assuntos
Doença Pulmonar Obstrutiva Crônica/diagnóstico , Adulto , Idoso , China , Feminino , Humanos , Seguro Saúde , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
18.
Ying Yong Sheng Tai Xue Bao ; 26(6): 1751-8, 2015 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-26572028

RESUMO

The effects of plant density on population yield and economic output value in maize and soybean intercropping were studied with the design of the double saturated D-optimal regression. A mathematical model was developed, in which the densities of maize and soybean were independent variables, and population grain yield, dry matter accumulation and economic output value were dependent variables, respectively. The result showed that the plant density significantly affected the population grain yield, dry matter accumulation and economic output value, and the effects of density of maize on population indices were greater than those of density of soybean. Under the low level conditions of density, the population grain yield, dry matter accumulation and economic output value increased with the density of maize and soybean. The maximum population grain yield was 8101.31 kg · hm(-2) the optimized combination of 72023 plant maize · hm(-2) and 99924 plant soybean · hm(-2), while the maximum population dry matter accumulation was 15282.45 kg · hm(-2) with the optimized combination of 75000 plant maize · hm(-2) and 93372 plant soybean · hm(-2), and the maximum population economic output value was 23494.50 Yuan · hm(-2) with the optimized combination of 73758 plant maize · hm(-2) and 87597 plant soybean · hm(-2). The optimum combination of densities of maize and soybean calculated by computer were 58554-71547 plant · hm(-2) for maize and 82217-100303 plant · hm(-2) for soybean in order to obtain grain yield greater than 7500 kg · hm(-2), dry matter accumulation greater than 14250 kg · hm(-2) and economic output value greater 22500 yuan · hm(-2) under the condition of this experiment.


Assuntos
Agricultura/métodos , Glycine max/crescimento & desenvolvimento , Zea mays/crescimento & desenvolvimento , Biomassa , Modelos Teóricos
19.
Opt Lett ; 35(23): 4021-3, 2010 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-21124599

RESUMO

In this Letter, low-cost radio-over-fiber (ROF) transport systems are proposed and experimentally demonstrated. By utilizing a laser diode (LD) and a local oscillator (LO) to generate coherent multiband optical carriers, as well as a self-composed wavelength selector to separate every two carriers for different ROF transport systems, no any other dedicated LD or electrical frequency upconverting circuit/process is needed in the central station (CS). Compared with current ROF systems, the required numbers of LDs, LOs, and mixers in a CS are significantly reduced. Reducing the number of components not only can simplify the network structure but can also reduce the volume and complexity of the relative logistics. To demonstrate the practice of the proposed ROF transport systems, clear eye diagrams and error-free transmission performance are experimentally presented.


Assuntos
Lasers , Luz , Fibras Ópticas , Tecnologia sem Fio/economia , Fibras Ópticas/economia , Fenômenos Ópticos , Tecnologia sem Fio/instrumentação
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