Historical trends of breast cancer burden attributable to metabolic factors among Chinese women, 1990-2019: A population-based epidemiological study.

BACKGROUND:  This study aims to analyze breast cancer burden attributable to high body mass index (BMI) and high fasting plasma glucose (FPG) in China from 1990 to 2019. METHODS: Data were obtained from the Global Burden of Disease (GBD) study 2019. Deaths and disability-adjusted life years (DALYs) were used for attributable burden, and age-period-cohort (APC) model was used to evaluate the independent effects of age, period and birth cohort. RESULTS: In 2019, the age-standardized mortality and DALY rates of breast cancer attributable to high BMI were 1.107 (95% UI: 0.311, 2.327) and 29.990 (8.384, 60.713) per 100 000, and mortality and DALY rates attributable to high FPG were 0.519 (0.095, 1.226) and 13.662 (2.482, 32.425) per 100 000. From 1990 to 2019, the age-standardized mortality and DALY rates of breast cancer attributable to high BMI increased by 1.192% and 1.180%, and the trends of high FPG were not statistically significant. The APC results showed that the age effects of high BMI and high FPG-mortality and DALY rates increased, with the highest rates in the age group over 80 years. The birth cohort effects of high BMI showed "inverted V" shapes, while high FPG showed downward trends. CONCLUSIONS: Age was the main reason for the increase of attributable burden, and postmenopausal women were the high-risk groups. Therefore, targeted prevention measures should be developed to improve postmenopausal women's awareness and effectively reduce the prevalence of obesity and diabetes, thereby reducing the breast cancer burden caused by metabolic factors in China.

Viscoelasticity in trapezius myofascial pain syndrome: quantitative assessment using Real-Time Shear-Wave Elastography.

OBJECTIVE: To investigate the differences in the viscoelastic properties between normal trapezius muscles and those in patients with trapezius myofascial pain syndrome (MPS) using real-time shear-wave elastography (SWE). MATERIALS AND METHODS: This study included 31 patients with trapezius MPS and 31 volunteers. Sixty-one trapezius muscles (41 and 20 on the affected and non-affected side, respectively) of patients with MPS and 62 normal trapezius muscles in volunteers were assessed. Conventional ultrasonic parameters, including skeletal muscle thickness, resistance index (RI), and mean shear wave velocity (SWVmean) of trapezius muscles, were obtained in the seated position with the shoulders and neck relaxed. The daily neck leaning time (unit:hours) of all participants was obtained using a questionnaire. RESULTS: Ultrasound showed no statistically significant differences in thickness or RI of the trapezius muscles of the affected and non-affected sides in MPS patients versus normal trapezius muscles (p = 0.976 and 0.106, respectively). In contrast, the SWVmean of trapezius muscles in patients with MPS was significantly higher than that of normal trapezius muscles in both the affected and non-affected sides (4.41 ± 1.02 m/s vs. 3.35 ± 0.79 m/s, p < 0.001; 4.05 ± 0.63 m/s vs. 3.35 ± 0.79 m/s, p = 0.002). There was no significant difference between the SWVmean of the trapezius muscles on the affected and non-affected sides in patients with MPS (4.41 ± 1.02 m/s vs. 4.05 ± 0.63 m/s, p = 0.225). Correlation analysis showed that daily neck forward time was positively correlated with the SWVmean of the trapezius muscles on the affected and non-affected sides in patients with MPS (r = 0.635, p < 0.001; r = 0.576, p = 0.008). CONCLUSION: SWE can quantitatively evaluate stiffness of trapezius muscles in patients with trapezius MPS. The stiffness of both affected and non-affected trapezius muscles increased in patients with trapezius MPS, and the degree of increase positively correlated with the time of cervical forward leaning.

Acquired risk factors and incident atrial fibrillation according to age and genetic predisposition.

BACKGROUND AND AIMS: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. Investigations of risk factor profiles for AF according to age and genetic risk groups are essential to promote individualized strategies for the prevention and control of AF. METHODS: A total of 409 661 participants (mean age, 56 years; 46% men) free of AF at baseline and with complete information about risk factors were included from the UK Biobank cohort. The hazard ratios and population-attributable risk (PAR) percentages of incident AF associated with 23 risk factors were examined, including 3 social factors, 7 health behaviours, 6 cardiometabolic factors, 6 clinical comorbidities, and the genetic risk score (GRS), across 3 age groups (40-49, 50-59, and 60-69 years) and 3 genetic risk groups (low, moderate, and high GRS). RESULTS: After a follow-up of 5 027 587 person-years, 23 847 participants developed AF. Most cardiometabolic factors and clinical comorbidities showed a significant interaction with age, whereby the associations were generally strengthened in younger groups (Pinteraction < .002). However, only low LDL cholesterol, renal dysfunction, and cardiovascular disease showed a significant interaction with genetic risk, and the associations with these factors were stronger in lower genetic risk groups (Pinteraction < .002). Cardiometabolic factors consistently accounted for the largest number of incident AF cases across all age groups (PAR: 36.2%-38.9%) and genetic risk groups (34.0%-41.9%), with hypertension and overweight/obesity being the two leading modifiable factors. Health behaviours (PAR: 11.5% vs. 8.7%) and genetic risk factors (19.1% vs. 14.3%) contributed to more AF cases in the 40-49 years group than in the 60-69 years group, while the contribution of clinical comorbidities remained relatively stable across different age groups. The AF risk attributable to overall cardiometabolic factors (PAR: 41.9% in the low genetic risk group and 34.0% in the high genetic risk group) and clinical comorbidities (24.7% and 15.9%) decreased with increasing genetic risk. The impact of social factors on AF was relatively low across the groups by age and genetic risk. CONCLUSIONS: This study provided comprehensive information about age- and genetic predisposition-related risk factor profiles for AF in a cohort of UK adults. Prioritizing risk factors according to age and genetic risk stratifications may help to achieve precise and efficient prevention of AF.

Association between internal migration experience and depressive symptoms: analysis of PSID data.

BACKGROUND: Depression is on the rise globally. Additionally, the United States has a high level of population mobility. The main aim of this study was to provide a reference for improving the mental health of internal migrants by investigating the relationship between internal migration experience and depressive symptoms. METHODS: We analysed data from the Panel Study of Income Dynamics (PSID). We included PSID data from the 2005 to 2019 waves in which all respondents were asked about their internal migration experience and depressive symptoms. This study included 15,023 participants. T tests, chi-square tests, multiple logistic regression methods were performed and fixed effects model. RESULTS: In the sample, the prevalence of depressive symptoms was 4.42%. The risk of depression in internal migrants was 1.259 times (OR = 1.259, 95% CI = (1.025-1.547, p < 0.05) that of nonmigrants. Internal migration experience was significantly positively associated with female depressive episodes (OR = 1.312, 95% CI = 1.010-1.704, p < 0.05) and increased risk of becoming depressed at a young age (OR = 1.304, 95% CI = 1.010-1.684, p < 0.05). The association between internal migration experience and depressive symptoms was more significant for participants who might move (OR = 1.459, 95% CI = 1.094-1.947, p < 0.05). In addition, different internal migratory causes are associated with depressive symptoms to varying degrees. CONCLUSIONS: Our findings highlight the need for greater policy attention to mental health inequalities between Internal migrants and those who never move away from their hometown in the United States. Our study provides a foundation for further research.

The association between outpatient continuation/maintenance electroconvulsive therapy, readmission risk and total direct cost in patients with depressive, bipolar and psychotic disorders: A naturalistic retrospective cohort study.

BACKGROUND: The transdiagnostic effect of continuation/maintenance ECT (CM-ECT) across mood and psychotic disorders on hospital psychiatric readmission risk and total direct cost remains unclear. METHODS: A naturalistic retrospective analysis of 540 patients who received inpatient acute ECT treatment from May 2017 to Mar 2021 in a tertiary psychiatric institution. Patients were assessed with validated clinical rating scales pre-ECT and after the first 6 treatments of a course of inpatient acute ECT. After discharge, patients who continued with CM-ECT were compared with those not receiving CM-ECT using survival analysis of hospital readmission. Total direct cost (hospitalisation and ECT treatment cost) was also analysed. All patients were subjected to a standard post-discharge monitoring program with case managers checking in on the patients regularly after discharge and ensuring they were given an outpatient appointment within a month of discharge. RESULTS: Both cohorts had significant improvement in their rating scales scores after their first six 6 sessions of inpatient acute ECT. Patients who continued with CM-ECT after completing their inpatient acute ECT (mean number of acute ECT: N = 9.9, SD 5.3), had a significantly lower risk of readmission [adjusted hazard ratio of 0.68 (95 % CI: 0.49-0.94, p = 0.020)]. Patients who received CM-ECT also had a significantly lower average total direct cost compared to those who did not (SGD$35,259 vs SGD$61,337). For patients with mood disorders, the CM-ECT group had a significantly lower inpatient ECT cost, hospitalisation cost and total direct costs compared to those without CM-ECT. LIMITATIONS: The naturalistic study cannot prove a causal relationship between CM-ECT and reduced readmission and lower healthcare costs. CONCLUSION: CM-ECT is associated with lower readmission risks and lower total direct healthcare costs for the treatment of mood and psychotic disorders, especially for mood disorders.

Spatiotemporal Dynamic Evolution and Its Driving Mechanism of Carbon Emissions in Hunan Province in the Last 20 Years.

Global warming caused by carbon emissions is an environmental issue of great concern to all sectors. Dynamic monitoring of the spatiotemporal evolution of urban carbon emissions is an important link to achieve the regional "double carbon" goal. Using 14 cities (prefectures) in Hunan Province as an example, based on the data of carbon emissions generated by land use and human production and life, and on the basis of estimating the carbon emissions in Hunan Province from 2000 to 2020 using the carbon emission coefficient method, this paper uses the Exploratory Spatial-Temporal Data Analysis (ESTDA) framework to analyze the dynamic characteristics of the spatiotemporal pattern of carbon emissions in Hunan Province from 2000 to 2020 through the Local Indicators of Spatial Association (LISA) time path, spatiotemporal transition, and the standard deviation ellipse model. The driving mechanism and spatiotemporal heterogeneity of urban carbon emissions were studied by using the geographically and temporally weighted regression model (GTWR). The results showed that: (1) In the last 20 years, the urban carbon emissions of Hunan Province have had a significant positive spatial correlation, and the spatial convergence shows a trend of first increasing and then decreasing. Therefore, priority should be given to this relevance when formulating carbon emission reduction policies in the future. (2) The center of carbon emission has been distributed between 112°15'57″~112°25'43″ E and 27°43'13″~27°49'21″ N, and the center of gravity has shifted to the southwest. The spatial distribution has changed from the "northwest-southeast" pattern to the "north-south" pattern. Cities in western and southern Hunan are the key areas of carbon emission reduction in the future. (3) Based on LISA analysis results, urban carbon emissions of Hunan from 2000 to 2020 have a strong path dependence in spatial distribution, the local spatial structure has strong stability and integration, and the carbon emissions of each city are affected by the neighborhood space. It is necessary to give full play to the synergistic emission reduction effect among regions and avoid the closure of inter-city emission reduction policies. (4) Economic development level and ecological environment have negative impacts on carbon emissions, and the population, industrial structure, technological progress, per capita energy consumption, and land use have a positive impact on carbon emissions. The regression coefficients are heterogeneous in time and space. The actual situation of each region should be fully considered to formulate differentiated emission reduction policies. The research results can provide reference for the green and low-carbon sustainable development of Hunan Province and the formulation of differentiated emission reduction policies, and provide reference for other similar cities in central China.

Assessment of sleep disturbances with the athlete sleep screening questionnaire in Chinese athletes.

This study investigated the factors that are associated with sleep disturbances among Chinese athletes. Sleep quality and associated factors were assessed by the Athlete Sleep Screening Questionnaire (ASSQ, n â€‹= â€‹394, aged 18-32 years, 47.6% female). Sleep difficulty score (SDS) and level of sleep problem (none, mild, moderate, or severe) were used to classify participants' sleep quality. Categorical variables were analyzed by Chi-square or fisher's exact tests. An ordinal logistic regression analysis was used to explore factors with poor sleep (SDS ≥8). Approximately 14.2% of participants had moderate to severe sleep problem (SDS ≥8). Fifty-nine percent of the athletes reported sleep disturbance during travel, while 43.3% experienced daytime dysfunction when travelling for competition. No significant difference was found in the SDS category between gender, sports level and events. Athletes with evening chronotype were more likely to report worse sleep than athletes with morning and intermediate chronotype (OR, 2.25; 95%CI, 1.44-3.52; p â€‹< â€‹0.001). For each additional year of age, there was an increase of odds ratio for poor sleep quality (OR, 1.15; 95%CI, 1.04-1.26; p â€‹= â€‹0.004), while each additional year of training reduced the odds ratio (OR, 0.95; 95%CI, 0.91-0.99; p â€‹= â€‹0.044). To improve sleep health in athletes, chronotype, travel-related issues, age and years of training should be taken into consideration.

What fragile factors hinder the pace of China's alleviation efforts of the poverty-stricken population? A study from the perspective of impoverishment caused by medical expenses.

OBJECTIVE: China has made remarkable achievements in poverty alleviation. However, with the change in economic development and age structure, the population stricken by poverty due to medical expenses and disability accounted for 42.3 and 14.4% of the total poverty-stricken population, respectively. Accordingly, it is crucial to accurately pinpoint the characteristics of people who are about to become poor due to illness. In this study, we analyzed the incidence of impoverishment by medical expense at the provincial, family, and different medical insurance scheme levels to identify the precise groups that are vulnerable to medical-related poverty. METHOD: Data were extracted from the Fifth National Health Service Survey in China in 2013 through a multi-stage, stratified, and random sampling method, leaving 93,570 households (273,626 people) for the final sample. The method recommended by World Health Organization (WHO) was adopted to calculate impoverishment by medical expense, and logistic regression was adopted to evaluate its determinants. RESULTS: The poverty and impoverishment rate in China were 16.2 and 6.3% respectively. The poverty rate in western region was much higher than that of central and eastern regions. The rate of impoverishment by medical expense (IME) was higher in the western region (7.2%) than that in the central (6.5%) and eastern (5.1%) regions. The New Cooperative Medical Scheme (NCMS) was associated with the highest rate (9.1%) of IME cases. The top three diseases associated with IME were malignant tumor, congenital heart disease, and mental disease. Households with non-communicable disease members or hospitalized members had a higher risk on IME. NCMS-enrolled, poorer households were more likely to suffer from IME. CONCLUSION: The joint roles of economic development, health service utilization, and welfare policies result in medical impoverishment for different regions. Poverty and health service utilization are indicative of households with high incidence of medical impoverishment. Chronic diseases lead to medical impoverishment. The inequity existing in different medical insurance schemes leads to different degrees of risk of IME. A combined strategy to precise target multiple vulnerabilities of poor population would be more effective.

Comparison of organic matter (OM) pools in water, suspended particulate matter, and sediments in eutrophic Lake Taihu, China: Implication for dissolved OM tracking, assessment, and management.

Suspended particulate matter (SPM) and sediments are important sources of dissolved organic matter (DOM) in lake water. However, studies on what extent and how both sources affect DOM composition are lacking, which hampers DOM management. Herein, DOM, SPM-extracted particulate organic matter (POM), and sediment-extracted organic matter (SOM) were characterized and compared in terms of absorption spectral properties and chemical composition in Lake Taihu, a large cyanobacterial bloom-affected shallow lake. A statistical method was proposed to quantify the similarity of organic matter (OM) in the different states and to evaluate the potential effects of SPM and sediments on DOM. Results showed that POM and DOM were mainly composed of small-molecular-size and low-humified organic components (i.e., 27 %-38 % tryptophan-like and ~30 % protein-like substances), and most of them were derived from autochthonous sources. While tyrosine-like (57 %) and humic-like (27 %) substances were dominant in SOM. The OM similarity between POM and DOM was approximately 1.5 times higher than that between SOM and DOM, indicating the greater effect of SPM than sediments on DOM composition. High pH and low nitrogen (e.g., nitrate and ammonia) were positively correlated to the OM similarity between POM and DOM. Further, the findings indicated that nitrogen limitation enhanced the OM exchange between POM and DOM by promoting the production of extracellular polymeric substances (EPS) in cyanobacterial aggregates. The obtained findings highlighted the importance of SPM in shaping the DOM composition relative to sediments and facilitating the DOM management in bloom-affected lakes.

Chemo-Immunotherapy Regimes for Recurrent or Metastatic Nasopharyngeal Carcinoma: A Network Meta-Analysis and Cost-Effectiveness Analysis.

Introduction: In 2021, two phase III clinical trials confirmed that toripalimab or camrelizumab combined with gemcitabine and cisplatin (TGP or CGP) provide more benefits in the first-line treatment of R/M NPC than GP. Fortunately, TGP and CGP were recently approved as first-line treatments for cases experiencing R/M NPC by the China National Medical Products Administration in 2021. However, due to the high cost and variety of treatment options, the promotion of chemo-immunotherapeutics in the treatment of R/M NPC remains controversial. Therefore, we performed a cost-effectiveness assessment of the two newly approved treatment strategies to assess which treatments provide the greatest clinical benefits at a reasonable cost. Methods: A cost-effectiveness analysis and network meta-analysis network meta-analysis was conducted based on the JUPITER-02 and CAPTAIN-first Phase 3 randomized clinical trials. A Markov model was expanded for the evaluation of the effectiveness and cost of TGP, CGP, and GP chemotherapy with a 10-years horizon and measured the health achievements in quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and life-years (LYs). We constructed a treatment strategy and other parameters based on two clinical trials and performed one-way and probabilistic sensitivity experiments for the evaluation of the uncertainty in the model. Results: For the model of patients with treatment-R/M NPC, TGP was associated with a total cost of $48,525 and 2.778 QALYs (4.991 LYs), leading to an ICER of $15,103 per QALY ($10,321 per LY) compared to CGP. On comparing the GP chemotherapy, we found TGP and CGP incurred substantial health costs, resulting in ICERs of $19,726 per QALY and $20,438 per QALY, respectively. The risk of adverse events (AEs) and the price of the drugs had significant impacts on the ICER. At the assumed willingness-to-pay (WTP) threshold of $35,673 per QALY, there were approximately 75.8 and 68.5% simulations in which cost-effectiveness was achieved for TGP and CGP, respectively. Conclusion: From the Chinese payer's perspective, TGP is more possible to be a cost-effective regimen compared with CGP and GP for first-line treatment of patients with R/M NPC at a WTP threshold of $35,673 per QALY.

Anatomy of intergovernmental finance for essential public health services in China.

BACKGROUND: The Chinese government launched health care reforms in 2009 and introduced a national list of essential public health services (EPHS) as an integral part of the plan to deliver health care for all. EPHS was also built into the national plan to promote the equalisation of public services across the country. A national standard was set for financial input to EPHS. As the services are co-funded by the central and local governments, a robust intergovernmental fiscal system is essential to guarantee that the hundreds of thousands of service providers have adequate financing to meet the service commitment. METHODS: We examined the flow of funds through China's complex intergovernmental fiscal system to see whether the promise of equal funding for EPHS was implemented, and how the costs were distributed across levels of government. Information was collated from funding documents issued by all levels of governments involved, for a sample that includes the central government, 12 provincial governments, eight prefectural governments and 11 county-level governments. For each level of government, we examined: (i) when and how much funding they disbursed or received from higher levels; (ii) when and how much matching funds were made; and (iii) the allocation rules adopted. RESULTS: Overall, we found the central government met its commitments for the program on time and in full, and good compliance from local governments in passing through funding from higher levels and as well as meeting their own financial responsibilities. However, we also found the following problems: (i) the involvement of so many levels of government resulted in delays in the disbursement of funds; (ii) the use of outdated population data in calculating required funding resulted in some under-allocation; and (iii) localities that needed funding the most were not well targeted by the distribution of funds. CONCLUSION: This study traces how the 2018 subsidy for EPHS was disbursed from the central government to service providers, focusing on the roles played by intermediate levels of subnational governments-provinces, prefectures and counties. In this way, it identifies gaps in the current intergovernmental financing of EPHS and points to areas for further improvement.

Health risk assessment of heavy metal(loid)s in the farmland of megalopolis in China by using APCS-MLR and PMF receptor models: Taking Huairou District of Beijing as an example.

The quality of agricultural soils is important for agricultural production and food safety. The contamination of agricultural soils by heavy metal(loid)s (HMs) has aroused global attention. Fifty-two topsoil samples with 8 HMs were gathered to assess the health risks of farmland soil in Huairou District, Beijing. As a significantly enriched pollutant, the results revealed that Hg had greater ecological risks relative to other HMs. We found that the positive matrix factorization (PMF) model appears to be more physically plausible in identifying complex pollution sources compared to the absolute principal components score-multiple linear regression (APCS-MLR) model, which had a higher fit coefficient (r2 = 0.69-0.99). Five HMs from pollution sources, including agricultural activities, traffic source, natural source, fuel burning, and industrial production, were identified by integrating the PMF model with Pearson's correlation analysis, revealing corresponding contribution rates of 29.40%, 22.54%, 20.16%, 15.20%, and 12.70%, respectively. The probabilistic health risk evaluation results showed an absence of non-carcinogenic risks in all populations, but the carcinogenic risk could not be ignored, especially in children. In addition, the source-oriented health risks showed that agricultural activities made the largest contribution to the health risks of all populations. This research provides scientific evidence for preventing HMs contamination and control of farmland.

Safety assessment of drinking water sources along Yangtze River using vulnerability and risk analysis.

Recently, the safety of drinking water sources along Yangtze River Basin is received much attention. But few works have carried out large-scale and all-round safety assessment of drinking water sources on the main stream of the whole Yangtze River Basin. In this work, 97 drinking water sources in 8 provinces of the main stream of the Yangtze River were selected as the objects to clarify the spatial distribution of the safety risk levels of drinking water sources in the whole basin and analyze the causes of drinking water source risks. The results showed that 13.4%, 55.7%, 25.8%, 5.1%, and 0% of the 97 drinking water sources were classified as low, moderate, considerate, high, and very high respectively, according to the safety risk level. This indicated that the safety risk of drinking water sources in the mainstream of Yangtze River is generally low, but there are also a number of high safety risk drinking water sources. And the safety risk degree of the lower and upper reaches in the mainstream of Yangtze River is generally higher than that of the middle reaches. The current situation of drinking water sources along the mainstream of Yangtze River could be attributed to the superposition of human activities and natural background factors. This study could contribute to the government's targeted management and control of safety risk sources for drinking water sources along the Yangtze River Basin.

Recognize and assessment of key host humic-reducing microorganisms of antibiotic resistance genes in different biowastes composts.

Humic-reducing microorganisms (HRMs) can utilize humic substance as terminal electron mediator promoting the bioremediation of contaminate, which is ubiquitous in composts. However, the impacts of HRMs on antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) in composts and different HRMs community composition following the types of biowastes effected the spread of ARGs have not been investigated. Herein, the dynamics and mobility of ARGs and HRMs during protein-, lignocellulose- and lignin-rich composting were investigated. Result show that ARGs change significantly at the thermophilic phase, and the relative abundance of most ARGs increase during composting. Seven groups of HRMs communities are classified as primary host HRMs of ARGs, and most host HRMs groups from protein-rich composts. Conclusively, regulating methods for inhibiting ARGs spread for different composts are proposed. HRMs show a higher ARGs dissemination capacity in protein-rich composts than lignocellulose- and lignin-rich composts, but the spread of ARGs can be inhibited by regulate physicochemical parameters in protein-rich composts. In contrary, most HRMs have inhibitory effects on ARGs spread in lignocellulose- and lignin-rich composts, and those HRMs can be used as a new agent that inhibits the spread of ARGs. Our results can help in understanding the potential risk spread of ARGs by inoculating functional bacteria derived from different biowastes composts for environmental remediation, given their expected importance to developing a classification-oriented approach for composting different biowastes.

Physiological and transcriptomic analyses reveal the toxicological mechanism and risk assessment of environmentally-relevant waterborne tetracycline exposure on the gills of tilapia (Oreochromis niloticus).

With the increasing application of tetracycline (TC) in medical treatment, animal husbandry and aquaculture in recent decades, high quantities of TC have been frequently detected in the aquatic environment, and accordingly TC-related toxicity and environmental pollution have become a global concern. The present study was performed to explore the toxicological influences of TC exposure at its environmentally relevant concentrations on the gills of tilapia Oreochromis niloticus, based on the alteration in histopathology, oxidative stress, inflammatory response, cell cycle, mitochondrial function, apoptosis, and transcriptomic analysis. Our findings revealed that TC exposure damaged the structure and function, induced oxidative stress, affected inflammatory responses, and reduced Na+/K+-ATPase (NKA) activity in the gills. TC also caused the inhibition in cell cycle, resulted in mitochondrial dysfunction and activated apoptosis. Further transcriptomic analysis indicated the extensive influences of TC exposure on the gill function, and immune system was the main target to waterborne TC exposure. These results elucidated that environmental TC had more complex toxicological effects on gills of fish than previously assessed, and provided novel insight into molecular toxicology of TC on fish and good basis for assessing the environmental risk of TC.

Profiling racial prejudice during COVID-19: Who exhibits anti-Asian sentiment in Australia and the United States?

Following the COVID-19 outbreak, anti-Asian racism increased around the world, as exhibited through greater instances of abuse and hate crimes. To better understand the scale of anti-Asian racism and the characteristics of people who may be expressing racial prejudice, we sampled respondents in Australia and the United States over 31 August-9 September 2020 (1375 Australians and 1060 Americans aged 18 or above; source YouGov). To address potential social desirability bias, we use both direct and indirect (list experiment) questions to measure anti-Asian sentiment and link these variables to key socioeconomic factors. We find that, instead of being universal among general populations, anti-Asian sentiment is patterned differently across both country contexts and socioeconomic groups. In the United States, the most significant predictor of anti-Asian bias is political affiliation. By contrast, in Australia, anti-Asian bias is closely linked to a wide range of socioeconomic factors including political affiliation, age, gender, employment status and income.

Emotional and financial health during COVID-19: The role of housework, employment and childcare in Australia and the United States.

During the first few months of the COVID-19 pandemic, the world witnessed major economic, school, and daycare closures. We sampled respondents in Australia and the US during the height of the first restrictions to understand how the first quarantine structured their emotional strain and financial worry (825 Australians and 835 Americans aged between 18 and 65; May 2-3, 2020; source YouGov). We apply structural equation modeling to demonstrate that the emotional well-being impacts of COVID-19 are not only gendered but also vary between childless people and parents. Specifically, we show that compared to Australians, Americans were more impacted by changes in their financial circumstances. Further, while the financial worry and emotional strain impacts were similar between childless people and parents in Australia, significant differences existed between the two groups in the United States. In particular, we identify American mothers as the most disadvantaged group-feeling the most anxious and financially worried about both employment and domestic changes under COVID-19. Policy wise, we argue that COVID-19 is exacerbating gender inequality in emotional health. To slow down this trend, more adequate mental health supports are needed, particularly for mothers.

Minimizing the Risk of Catastrophic Health Expenditure in China: A Multi-Dimensional Analysis of Vulnerable Groups.

Background: In moving toward universal health coverage in China, it is crucial to identify which populations should be prioritized for which interventions rather than blindly increasing welfare packages or capital investments. We identify the characteristics of vulnerable groups from multiple perspectives through estimating catastrophic health expenditure (CHE) and recommend intervention priorities. Methods: Data were from National Health Service Survey conducted in 2003, 2008, and 2013. According to the recommendation of WHO, this study adopted 40% as the CHE threshold. A binary regression was used to identify the determinants of CHE occurrence; a probit model was used to obtain CHE standardized incidence under the characteristics of single and two dimensions in 2013. Results: The total incidence of CHE in 2013 was 13.9%, which shows a general trend of growth from 2003 to 2013. Families in western and central regions and rural areas were more at risk. Factors related to social demography show that households with a female or an unmarried head of household or with a low socioeconomic status were more likely to experience CHE. Households with older adults aged 60 and above had 1,524 times higher likelihood of experiencing CHE. Among the health insurance schemes, the participants covered by the New Rural Cooperative Medical Scheme had the highest risk compared with the participants of all basic health insurance schemes. Households with several members seeking outpatient, inpatient care or with non-communicable diseases were more likely to experience CHE. Households with members not seeing a doctor or hospitalized despite the need for it were more likely to experience CHE. Characteristics such as a household head with characteristics related to low socioeconomic status, having more than two hospitalized family members, ranked high. Meanwhile, the combination of having illiterate household heads and with being covered by other health insurance plans or by none ranked the first place. Cancer notably caused a relatively high medical expenditure among households with CHE. Conclusion: In China, considering the vulnerability of the population across different dimensions is conducive to the alleviation of high CHE. Furthermore, people with multiple vulnerabilities should be prioritized for intervention. Identifying and targeting them to offer help and support will be an effective approach.

Diagnostic accuracy of pelvic magnetic resonance imaging for the assessment of bone marrow involvement in diffuse large B-cell lymphoma.

PURPOSE: We investigated the efficacy of pelvic magnetic resonance imaging (MRI) in the diagnosis of bone marrow involvement (BMinv) in diffuse large B-cell lymphoma (DLBCL) patients. PATIENTS AND METHODS: This was a retrospective study of data from a previous study (NCT02733887). We included 171 patients who underwent bone marrow biopsy (BMB) and bone marrow smear (BMS), pelvic MRI, and whole-body positron emission tomography-computed tomography (PET/CT) from January 2016 to December 2019 at a single center. BMB/BMS and whole-body PET/CT results were used as reference standards against which we calculated the diagnostic value of pelvic MRI for BMinv in DLBCL patients. A chi-square test was used to compare detection rates, and a receiver operating characteristic curve was used to evaluate diagnostic value of pelvic MRI. Propensity-score matching was performed according to clinical information, and Kaplan-Meier curves were constructed to compare progression-free survival (PFS) and overall survival (OS) of patients. RESULTS: The BMinv detection rate of pelvic MRI (42/171) was higher (P = 0.029) than that of BMB/BMS (25/171), and similar to that of PET/CT (44/171; P = 0.901). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of pelvic MRI were 83.33%, 98.37%, 94.15%, 95.24%, and 93.80%, respectively. Median PFS values were as follows: BMB/BMS-positive, 17.8 months vs. BMB/BMS-negative, 26.9 months (P = 0.092); PET/CT-positive, 24.8 months vs. PET/CT-negative, 33.0 months (P = 0.086); pelvic MRI-positive, 24.9 months vs. pelvic MRI-negative, 33.1 months (P<0.001). Median OS values were as follows: BMB/BMS-positive, 22.3 months vs. BMB/BMS-negative, 29.8 months (P = 0.240); PET/CT-positive, 27.9 months vs. PET/CT-negative, 33.9 months (P = 0.365); pelvic MRI-positive, 27.3 months vs. pelvic MRI-negative, 35.8 months (P = 0.062). CONCLUSION: Pelvic MRI is effective for detecting BMinv in DLBCL patients, providing a more accurate indication of PFS than BMB/BMS and PET/CT do. It may ultimately be used to improve the accuracy of clinical staging, guide patient treatment, and evaluate prognosis.