Global, regional and national burden of alcohol cardiomyopathy from Global Burden of Disease Study 2019.

This study aimed to provide up-to-date and comprehensive estimates on the global alcohol cardiomyopathy (ACM) from 1990 to 2019. Detailed data on the prevalence, disability-adjusted life-years (DALYs), deaths,percentage change in the number of cases and estimated annual percentage change (EAPC) of ACM worldwide from 1990 to 2019 were obtained or calculated from the Global Burden of Disease Study (GBD) 2019. Globally, the estimated prevalent cases of ACM in 2019 were 707,652 [95% uncertainty interval (UI): 545,182-924,392], with a 35.4% (28.2-44.2) increase from 522,616 (95% UI: 394,118-683,206) in 1990, while the age-standardized prevalence rate (ASPR) was slightly decreased with an overall EAPC of - 1.30 (- 1.38 - - 1.22). Similar to ASPR, the global age-standardized DALYs rate and age-standardized death rate (ASDR) also declined, with an EAPC of - 1.12(- 2.09 - - 0.14) and - 1.53(- 2.36 - - 0.70) from 1990 to 2019, respectively. Conversely, the number of ACM-related DALYs cases in 2019 was 2,441,108 (95% UI: 2,046,734-2,782,542), with an increase of 38.8%(2.8-59.9) over the past 30 years, and the number of ACM-related deaths in 2019 was 71,723 (95% UI: 60,167-81,995), with an increase of 33.1% (0.5- 51.9) compared with 1990. A significant variation in the burden of ACM was observed between different regions and countries. Although the ASPR, age-standardized DALYs rate and ASDR slightly decreased from 1990 to 2019, the absolute number of prevalent cases, DALYs cases and deaths significantly increased. This showed that the burden of ACM remains an important global public health concern. Public health policy and decision-makers should develop and implement more effective strategies specific to geographical location to combat and reduce the burden of ACM in the future.

Global burden of atrial fibrillation/atrial flutter and its attributable risk factors from 1990 to 2019.

AIMS: The aim of this study was to estimate the global burden of atrial fibrillation (AF)/atrial flutter (AFL) and its attributable risk factors from 1990 to 2019. METHODS AND RESULTS: The data on AF/AFL were retrieved from the Global Burden of Disease Study (GBD) 2019. Incidence, disability-adjusted life years (DALYs), and deaths were metrics used to measure AF/AFL burden. The population attributable fractions (PAFs) were used to calculate the percentage contributions of major potential risk factors to age-standardized AF/AFL death. The analysis was performed between 1990 and 2019. Globally, in 2019, there were 4.7 million [95% uncertainty interval (UI): 3.6 to 6.0] incident cases, 8.4 million (95% UI: 6.7 to 10.5) DALYs cases, and 0.32 million (95% UI: 0.27 to 0.36) deaths of AF/AFL. The burden of AF/AFL in 2019 and their temporal trends from 1990 to 2019 varied widely due to gender, Socio-Demographic Index (SDI) quintile, and geographical location. Among all potential risk factors, age-standardized AF/AFL death worldwide in 2019 were primarily attributable to high systolic blood pressure [34.0% (95% UI: 27.3 to 41.0)], followed by high body mass index [20.2% (95% UI: 11.2 to 31.2)], alcohol use [7.4% (95% UI: 5.8 to 9.0)], smoking [4.3% (95% UI: 2.9 to 5.9)], diet high in sodium [4.2% (95% UI: 0.8 to 10.5)], and lead exposure [2.3% (95% UI: 1.3 to 3.4)]. CONCLUSION: Our study showed that AF/AFL is still a major public health concern. Despite the advancements in the prevention and treatment of AF/AFL, especially in regions in the relatively SDI quintile, the burden of AF/AFL in regions in lower SDI quintile is increasing. Since AF/AFL is largely preventable and treatable, there is an urgent need to implement more cost-effective strategies and interventions to address modifiable risk factors, especially in regions with high or increased AF/AFL burden.

[Probabilistic Risk Assessment of Arsenic Exposure Through Drinking Water Intake in Chinese Residents].

The total arsenic concentrations of the three main drinking water types in China were determined through a systematic literature review. The distribution models of drinking water exposure parameters for different age groups were obtained using the regression method. The carcinogenic and non-carcinogenic risks of different population groups caused by arsenic exposure through different drinking water types were evaluated by a probabilistic risk assessment. The results showed that the geometric mean of total arsenic content in all the drinking water samples in China was (13.0±38.1) µg·L-1. The highest arsenic content was found in the Inner Mongolia Autonomous Region, followed by Guangxi and Shanxi. Based on the relevant standards for drinking water quality, the probability exceeding the threshold value of groundwater and source water is 23.2% and 18.4%, respectively. According to the results of non-carcinogenic risk assessment, the probability of the residents drinking well water and surface water from the water source area exceeding the daily average exposure dose threshold was 24.0% and 19.5%, respectively. According to the carcinogenic risk assessment, the median of carcinogenic risk caused by arsenic in drinking water in China was 3.22×10-5, which is acceptable. The population group of 18-45 years old had the highest risk, and the median LCR was 1.37×10-5. There was still a certain probability that the LCR of drinking well water and surface water would exceed the acceptable risk level recommended by the US EPA. In conclusion, the potential health risks caused by arsenic exposure through drinking water intake exist among Chinese residents. Further control of the arsenic concentration in drinking water is required to reduce the health risk and improve the safety of drinking water. Meanwhile, it is suggested to strengthen the research on risk threshold to provide a scientific basis for the residents' health protection.

In vivo safety assessment, biodistribution and toxicology of polyvinyl alcohol microneedles with 160-day uninterruptedly applications in mice.

Dissolving microneedles (DMNs) are widely used in drug delivery systems since they are based on one-step application, which is simple and convenient for patients, especially for the patients such as diabetes who need daily or long-term self-administration. In general, the matrix materials of DMNs are water-soluble materials that can release the encapsulated drugs gradually by dissolving in the skin without generating sharp needle waste. However, the matrix materials of DMNs will also leave in the skin after application. Thus, it is vital to evaluate whether the matrix material of DMNs dissolved in the skin will cause health risks such as toxicity to the body or some skin-related complications to patients who frequent or long-term administration. In this work, PVA, as one of the typical matrix materials of DMNs, was selected to prepare the DMNs to research the safety of PVA-based MNs to the body after being dissolved in the skin. Briefly, in a 160 - days trial, the healthy mice were daily administrated by PVA MNs. The results showed that PVA materials mainly accumulated in the skin tissues of mice after dissolving and the concentration of PVA in the insertion sites gradually decreased and was almost undetectable at 6 days after administration. The observation of general conditions, blood hematological analysis and histological examinations of the mice demonstrated that the PVA-based MNs do not cause appreciable toxicity to the healthy mice after daily insertion in a 160 - days trial. Altogether, these results encourage further studies of PVA MNs for biomedical applications and support translation of PVA-based DMNs from pre-clinical development into clinical trials.

The Chinese version of Instrument of Professional Attitude for Student Nurses (IPASN): Assessment of reliability and validity.

BACKGROUND: Professional attitude is of great importance for nursing talents in the modern society. To develop an effective educational program for student nurses in China, an appropriate instrument is required for the assessment of their professional attitude. OBJECTIVE: To assess the validity and reliability of the Instrument of Professional Attitude for Student Nurses (IPASN) in Chinese version. METHODS: The original version of IPASN was translated through Brislin model (translation, back translation, culture adaption and pilot study) with the authorization from the developer. A total of 681 nursing students were chosen by stratified convenience sampling to assess construct validity using exploratory factor analysis (EFA). Besides, item analysis, Cronbach's alpha coefficients, test-retest reliability were conducted to test the psychometric properties in this part. A total of 204 nursing undergraduate trainees were selected by cluster convenience sampling to confirm the structure using confirmatory factor analysis (CFA) in another time. RESULTS: Corrected item-total correlations, alpha if item deleted were between 0.33 and 0.69, 0.906 and 0.913, respectively, indicating no item should be deleted. Cronbach alpha value was 0.91 for the total scale and Cronbach alpha coefficient for subscales ranged from 0.67 to 0.89. Test-retest reliability estimated from intraclass correlation coefficient (ICC) was 0.74 (P<0.05). Differences in item scores between the high-score group (the first 27%) and low-score group (the last 27%) were significant (P<0.001), indicating that the item discrimination ability was good. Seven subscales (contribution to increase of scientific information load, autonomy, community service, continuous education, to promote professional development, cooperation and theory guiding practice) were identified in EFA and confirmed in CFA, and explained 65.5% of the total variance. CONCLUSION: It indicated that the Chinese version of IPASN was valid and reliable for the evaluation of nursing students' professional attitude.

[Source and health risk assessment of heavy metals in ambient air PM10 from one coking plant].

To investigate the sources and health risk of heavy metals in ambient air PM10 from the coking plant, the PM10 in the air around one coking plant was collected in June 2012. Then the heavy metals concentrations in PM10 were tested by the microwave-ICP-MS method. Furthermore, the USEPA's human exposure assessment model was applied to preliminarily evaluate the human health risks of the heavy metals in air particulate matter. The results show that the concentrations of 10 kinds of heavy metals in PM10 from the coking plant vary significantly, ranging from 3.06 x 10(-5) mg x m(-3) to 1.77 x 10(-2) mg x m(-3), of which the concentration of Cr is the highest, while the concentration of Co is the lowest, and the concentration of the carcinogenic substances is higher than that of the non-carcinogenic substances. The coking plant is identified to be the major source of the heavy metals in ambient air PM10, and Ni is the main polluting heavy metal. Moreover, the heavy risk assessment results reveal that the carcinogenic risks for adults are higher than children, while the carcinogenic risks in industrial areas and school relatively large. The non-carcinogenic risks for children are the highest in all the population, and the non-carcinogenic risks in residential area can not be ignored. Among the carcinogenic substances, the potential carcinogenic risks of Cd, Cr and As are comparatively large, Ni and Co have certain potential risks. Whereas, among the non-carcinogenic substances, the non-carcinogenic risks of Mn is great. Consequently, relevant departments should pay close attention to this situation.

[Health risk assessment of heavy metals in drinking water based on field measurement of exposure factors of Chinese people].

This study was carried out in Biyang County, located in the junction of Yangtze river and Huaihe river. Drinking water samples of 20 sites in urban and rural areas in this county were collected to measure 14 heavy metals by ICP/MS. About 2 500 subjects with different age and sex were selected to measure exposure factors. Time-activity of drinking water by ingestion and dermal contact of each individual subject during the last three days were kept in dairy in detail by questionnaires. Intake of drinking water from direct and indirect consumption of water and time duration of dermal contact to water in each individual subject were kept in record based on real time measurements. Human health risks were assessed and sensitivity of exposure factors and uncertainty of risks were also analyzed. The results showed that the average drinking water intake rate of male and female are 2276 mL/d, 2265 mL/d in urban adults and 2464 mL/d, 2170 mL/d in rural adults respectively. Body surface area of male and female are 1.806 m2, 1.641 m2 in urban adults and 1.747 m2, 1.617 m2 in rural adults respectively. The contents of 14 heavy metals in this study area are all below the national drinking water standards. Cancer risks from exposure to As are ranged from 2.5 x 10(-6) to 5.2 x 10(-6) through ingestion and 1.1 x 10(-7) to 2.3 x 10(-7) through dermal exposure. Non-cancer risks are ranged from 2.1 x 10(-7) to 1.7 x 10(-6) through ingestion and 1.0 x 10(-8) to 6.0 x 10(-8) through dermal exposure. Non-cancer risks in rural population are 2.1 times to 5.6 times to the risks in urban populations. However all the risks are below the acceptable level. The sensitivity of various exposure factors including drinking water intake rate, dermal exposure time and body surface area are 71.5%. This indicates that exposure factors play a very important role in health risk assessment. Health risks in this research based on real measurement of exposure factors are about 0.94 time to 6.33 times higher than the risks based on the references of the data from the exposure factors handbooks in other countries. This study showed that the accuracy of health risk assessment could be improved a lot by the real measurements of exposure factors. Attentions should be attached to exposure factor investigation to decrease uncertainty of health risk assessment.

[Evaluation of resource exploitation value and ecosystem service loss in Mentougou District of Beijing City].

By using the evaluation approach of ecosystem services (including market value, opportunity cost, restoration cost, and shadow project approaches), and combining with situation investigation, the ecosystem service loss in Mentougou District of Beijing City caused by coal resource exploitation in 1949-2006 was systematically evaluated. In the study area, coal mining mainly induced the cost increase of solid waste disposal and sink reclamation, and the losses in food production, water self-preserving, residents moving, and water and soil resources. The ecosystem service loss caused by the coal mining in 1949-2006 was about 54.3 billion Yuan RMB, approximately 9 times high of its market economic benefit (5.9 billion Yuan RMB). It was very difficult or needed a long time to restore the damaged ecosystem.