Disability weight measurement for the severity of different diseases in Wuhan, China.

BACKGROUND: Measurement of the Chinese burden of disease with disability-adjusted life-years (DALYs) requires disability weight (DW) that quantify health losses for all non-fatal consequences of disease and injury. The Global Burden of Disease (GBD) 2013 DW study indicates that it is limited by lack of geographic variation in DW data and by the current measurement methodology. We aim to estimate DW for a set of health states from major diseases in the Wuhan population. METHODS: We conducted the DW measurement study for 206 health states through a household survey with computer-assisted face-to-face interviews and a web-based survey. Based on GBD 2013 DW study, paired comparison (PC) and Population health equivalence (PHE) method was used and different PC/PHE questions were randomly assigned to each respondent. In statistical analysis, the PC data was analyzed by probit regression. The probit regression results will be anchored by results from the PHE data analyzed by interval regression on the DW scale units between 0 (no loss of health) and 1 (loss equivalent to death). RESULTS: A total of 2610 and 3140 individuals were included in the household and web-based survey, respectively. The results from the total pooled data showed health state "mild anemia" (DW = 0.005, 95% UI 0.000-0.027) or "allergic rhinitis (hay fever)" (0.005, 95% UI 0.000-0.029) had the lowest DW and "heroin and other opioid dependence, severe" had the highest DW (0.699, 95% UI 0.579-0.827). A high correlation coefficient (Pearson's r = 0.876; P < 0.001) for DWs of same health states was observed between Wuhan's survey and GBD 2013 DW survey. Health states referred to mental symptom, fatigue, and the residual category of other physical symptoms were statistically significantly associated with a lower Wuhan's DWs than the GBD's DWs. Health states with disfigurement and substance use symptom had a higher DW in Wuhan population than the GBD 2013 study. CONCLUSIONS: This set of DWs could be used to calculate local diseases burden for health policy-decision in Wuhan population. The DW differences between the GBD's survey and Wuhan's survey suggest that there might be some contextual or culture factors influencing assessment on the severity of diseases.

A nationwide survey of polycyclic aromatic hydrocarbons (PAHs) in household dust in China: spatial distribution, sources, and health risk assessment.

As a carrier of toxic substances, household dust has a great impact on human health. Here we collected 73 household dust samples from 27 provinces and 1 municipality in China to investigate the levels, spatial distribution, sources, and carcinogenic risk of 16 polycyclic aromatic hydrocarbons (PAHs). The total concentrations of 14 detected PAHs (∑14 PAHs) ranged from 3.72 to 60,885 ng g-1. High ∑14 PAHs were found in Northeast and Southwest China. High molecular weights (HMW) PAHs (4-6 rings) were predominant PAHs in most dust samples, accounting for 93.6% of ∑14 PAHs. Household fuel, cooking frequency, air conditioning, and smoking were the main factors influencing PAH concentrations in household dust. Principal component analysis model indicated that fossil combustion (81.5%) and biomass combustion and vehicle exhaust (8.1%) are the primary sources of PAHs. Positive matrix factorization model suggested that household cooking and heating contributed about 70% of ∑14 PAHs, and smoking contributed another 30%. The values of benzo[a]pyrene equivalent in rural dust were found to be higher than those in urban dust. The sum of toxic equivalents (TEQs) of 14 PAHs were in range of 0.372-7241 ng g-1, in which 7 HMW PAHs accounted for 98.0 ± 1.98% of the total TEQs. Monte Carlo Simulation showed a low to moderate potential carcinogenic risk of PAHs in household dusts. This study documents comprehensive information on human exposure to PAHs in household dust at a national-scale.

Low-cost laser cutting fabricated all-metallic metamaterial near-field focusing lens.

In this work, a low-cost all-metal metamaterial near-field lens based on laser cutting technology is proposed. A novel spiral-slot structure is proposed to achieve miniaturized unit cells with an adjustable 360-degree phase shift at a length smaller than 0.2 times the operating wavelength. Since the unit is entirely constructed of stainless steel, it is resistant to high temperatures and high pressures compared to existing results. Moreover, a four-layer structure is used to increase the transmission coefficient. The final L-band near-field lens is constructed of 20 × 20 units. Simulation and measured results show that the half-power beamwidth of the focus is less than 211 mm from 1.52 GHz to 1.68 GHz at the focal spot observation plane of 500 mm from the lens. Since numerically controlled machine tools and three-dimensional printing are prohibitively expensive for machining large metal components, a low-cost all-metallic lens was manufactured using laser cutting technology. The measured results are in agreement with the simulation results.

Polybrominated diphenyl ethers (PBDEs) in household dust: A systematic review on spatio-temporal distribution, sources, and health risk assessment.

Much attention has been paid on polybrominated diphenyl ethers (PBDEs) in household dust due to their ubiquitous occurrences in the environment. Based on the data from 59 articles sampled from 2005 to 2020, we investigated the spatio-temporal distribution, sources, and health risk of 8 PBDE homologues in household dusts worldwide. BDE-209 is the predominant PBDE in household dusts, followed by BDE-99 and BDE-47. The total concentrations of PBDEs (∑8PBDEs) are found to be high in household dusts sampled from 2005 to 2008 and show a significant decline trend from 2009 to 2016 (p < 0.05) and a little upward tendency from 2017 to 2020. The concentrations of PBDEs in household dusts vary greatly in different countries of the world. The use of penta-BDE is the main source of three to five bromo-biphenyl ether monomers contributing 17.4% of ∑8PBDEs, while BDE-209 and BDE-183 are derived from the use of household appliances contributing 82.6% of ∑8PBDEs. Ingestion is the main exposure route for adults and toddlers, followed by dermal contact. The values of hazard index (HI) exposed to PBDEs in household dusts are all less than 1 for both adults and toddlers, indicating a low non-cancer risk. The incremental lifetime cancer risks (ILCRs) of BDE-209 are less than 10-6 for both adults and toddlers, suggesting a negligible risk. However, the total carcinogenic risk of toddlers is higher than that of adults, indicating that much attention should be paid to toddlers exposed to BDE-209 in household dust.

Heavy metals in paired samples of hair and nails in China: occurrence, sources and health risk assessment.

The occurrence of heavy metals including chromium (Cr), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), cadmium (Cd) and lead (Pb) was investigated in paired samples of hair and nails collected from 121 volunteers in 16 cities, China. Results showed that the mean concentrations of Zn, Cu, As, Pb, Cr, Ni and Cd were 205, 18.0, 7.79, 6.18, 3.54, 2.02, 0.533 µg g-1 in hair and 103, 8.09, 0.760, 7.27, 6.07, 8.81, 0.485 µg g-1 in nails, respectively. The concentrations of Zn, Ni, Cr, Cd and Pb were positively correlated in paired samples of hair and nails, whereas a negative correlation was found for Cu and As between hair and nails. Higher concentrations of heavy metals were found in northern China than southern China. The multivariate analysis of variance revealed that dwelling environment was the dominant factor influencing the levels of Cd in hair (p < 0.05), while age was the dominant factor influencing the levels of Cr in nails (p < 0.05). Moreover, industrial pollution and smoking were also the important factors leading to the accumulation of heavy metals in human body. Principal component analysis (PCA) showed that industrial pollution and decoration material immersion were the main factors for the high concentrations of Cr and Ni in hair, accounting for 62.9% of the total variation; As in hair was dominantly related to groundwater pollution. The concentrations of heavy metals were within the recommended ranges in nails from this study. However, the mean levels of Cr, Ni and As in hair exceeded their recommended reference values, indicating potential health risks from heavy metals for residents in China.

Global morbidity and mortality of lower respiratory infections: A population -based study.

BACKGROUND: This study provides a comprehensive, comparative and updated estimates of temporal patterns of lower respiratory infections (LRIs) globally over the past three decades. METHODS: The data on morbidity and mortality of patients with LRIs at the global, regional and national levels were retrieved from the Global Burden of Disease (GBD) 2019 study. RESULTS: Globally, the incident cases of LRIs increased from 414,342,866 [95% uncertainty interval (UI):383,529,625 to 449, 086,938]in 1990 to 488,902,504(95% UI: 457,572,987 to 522,635,542)in 2019 with the age standardized incidence rate (ASIR) decreased from 8,276/100,000 persons (95% UI: 7,727 to 8,892) to 6,295/100,000 persons (95% UI: 5,887 to 6,737) between 1990 and 2019. Number of LRIs deaths were 2,493,200 (95% UI: 2,268,184 to 2,736,184) in 2019, a decrease of 24.9% (95% UI: -34.4 to -15.4) in the past 30 years. Meanwhile, the age-standardized death rate (ASDR) declined also from 67/100,000 persons (95% UI: 61 to 73) in 1990 to 34/100,000 persons (95% UI: 31 to 38) in 2019. Moreover, the numbers and age-standardized rates per 100,000 persons of morbidity and mortality varied widely by age, sex, Socio-Demographic Index (SDI) quintiles, and geographical locations in 2019. CONCLUSION: LRIs remain a major public health concern . Some differences in age, sex, SDI quintiles, and geographical locations contribute to LRIs-related global health policy development and health system resource optimization.

Pan-Cancer Analysis of BUB1B/hsa-miR-130a-3p Axis and Identification of Circulating hsa-miR-130a-3p as a Potential Biomarker for Cancer Risk Assessment.

Based on the fact that very little was found in the literature on the question of potential molecules and mechanism for high risk of cancer in patients with psoriasis, this study was designed and performed based on bioinformatics analysis including WGCNA. The most striking result to emerge from the data is that BUB1B/hsa-miR-130a-3p axis, closely related to the development of psoriasis, also plays a remarkable role in multiple cancer development. The expression patterns of hsa-miR-130a-3p were found significantly changed in multiple tumors, which was also associated with prognosis. Additionally, hsa-miR-130a-3p was downregulated in lesion skin of psoriasis, but there was no difference in blood between psoriasis patients and normal controls. Circulating has-miR-130a-3p was found to have a higher level of blood in multiple tumor patients, suggesting that hsa-miR-130a-3p has the potential to be a blood biomarker for cancer risk assessment in patients with psoriasis.

A gradient boosting tree model for multi-department venous thromboembolism risk assessment with imbalanced data.

Venous thromboembolism (VTE) is the world's third most common cause of vascular mortality and a serious complication from multiple departments. Risk assessment of VTE guides clinical intervention in time and is of great importance to in-hospital patients. Traditional VTE risk assessment methods based on scaling tools, which always require rules carefully designed by human experts, are difficult to apply to large-population scenarios since the manually designed rules are not guaranteed to be accurate to all populations. In contrast, with the development of the electronic health record (EHR) datasets, data-driven machine-learning-based risk assessment methods have proven superior predictability in many studies in recent years. This paper uses the gradient boosting tree model to study the VTE risk assessment problem with multi-department data. There exist two distinct characteristics of VTE data collected at the level of the entire hospital: its wide distribution and heterogeneity across multiple departments. To this end, we consider the prediction task over multiple departments as a multi-task learning process, and introduce the algorithm of a task-aware tree-based method TSGB to tackle the multi-task prediction problem. Although the introduction of multi-task learning improves overall across-department performance, we reveal the problem of task-wise performance decline while dealing with imbalanced VTE data volume. According to the analysis, we finally propose two variants of TSGB to alleviate the problems and further boost the prediction performance. Compared with state-of-the-art rule-based and multi-task tree-based methods, the experimental results show the proposed methods not only improve the overall across-department AUC performance effectively, but also ensure the improvement of performance over every single department prediction.

Heavy metals in marine food web from Laizhou Bay, China: Levels, trophic magnification, and health risk assessment.

Heavy metals in ocean may accumulate in seafood through food web and pose risks to human health. This study investigated the occurrence, trophic magnification, and health risks of 7 heavy metals in 20 marine organisms (n = 222) in Laizhou Bay (LZB), China. Results showed that Zn was the most abundant metal, followed by Cu, As, Cd, Cr, Ni and Pb. The total concentrations of 7 heavy metals in the organisms ranked in the order of crab ˃ shellfish ˃ algae ˃ fish ˃ starfish. Interspecific differences were found in the concentrations of Cr, Ni, Cu and Cd in marine organisms from LZB. Crab and shellfish showed much higher enrichment ability of heavy metals than that of algae, starfish and fish. Cd is the most biological accumulated element with the mean biota-sediment accumulation factor (BSAF) of 12.9. Stable isotope analysis showed a significant difference of δ15N among these five species (p < 0.01), and a food web was constructed accordingly. A biodilution pattern was found for Pb, As and Ni and no trophic interference in metal uptake was observed for Zn, Cu, Ni and Cr in the food web of LZB. The estimated daily intake (EDI) and target hazard quotients (THQs) of As and Cd indicated an adverse health effect on consumption of the seafood. The mean lifetime cancer risks (LCRs) for Cd and As suggested a potential carcinogenic effect on consumption of these seafood. This study provides a basis for health risk assessment of heavy metals in marine foods.

Heavy metals in road dust across China: occurrence, sources and health risk assessment.

We investigated the occurrence of Cd, Cr, Cu, Ni, Pb and Zn in 28 road dust samples collected across China from June to August, 2020. The mean concentrations of Cd, Cr, Cu, Ni, Pb and Zn were 3.16, 24.2, 27.4, 10.4, 49.8 and 608 mg·kg- 1, respectively. The mean levels of Cd and Zn exceeded the Chinese background values by 32.6- and 8.2- fold. Cd, Ni mainly distributed in southern China, whereas Cu, Pb and Zn mainly distributed in central China. Higher concentrations of Cd, Cr, Cu and Pb were found in road dusts from urban areas than those from rural areas. Cu and Ni mainly came from natural sources; Pb and Cd mainly originated from industrial emissions and vehicle exhaust. Hand-mouth ingestion was the most common exposure pathway for both adults and children, followed by dermal contact and inhalation. Pb was found to be the highest risk element via ingestion. No significant non-carcinogenic risks and carcinogenic risks were found for local residents.

Epidemiological and sociodemographic transitions of female breast cancer incidence, death, case fatality and DALYs in 21 world regions and globally, from 1990 to 2017: An Age-Period-Cohort Analysis.

Introduction: Breast cancer (BC) is the most widely studied disease due to its higher prevalence, heterogeneity and mortality. Objectives: This study aimed to compare female BC trends among 21 world regions and globally over 28 year of data and to assess the association between sociodemographic transitions and female BC risks. Methods: We used Global burden of disease study data and measure the female BC burden according to 21 world regions and sociodemographic indices (SDI). Age-period-cohort (APC) analysis was used to estimate time and cohort trend of BC in different SDI regions. Results: By world regions, age-standardised rate of female BC incidence were high in high-income-North America (ASR, 92.9; (95 %UI, 89.2, 96.6)), Western Europe (84.7; (73.4, 97.2)) and Australia (86; (81.7, 90.2)) in 2017. Whereas this rate was significantly increased by 89.5% between 1990 and 2017 in East Asia. We observed negative association between SDI and death, and DALYs in 25th and below percentiles of death and DALYs for the worldwide regions. Further, there was observed a strong negative correlation between SDI and case fatality percent (r2017 = -0.93; r1990 = -0.92) in both 2017 and 1990 worldwide and highest case fatality percentage was observed in Central Sub-Saharan Africa. Overall, the risk of case-fatality rate tends to decrease most noticeably in high middle SDI countries, and the reduction of the risk of case-fatality rate in the recent cohort was the lowest in the low SDI countries. Conclusions: Remarkable variations exist among various regions in BC burden. There is a need to reduce the health burden from BC in less developed and under developing countries, because under-developed countries are facing higher degree of health-related burden. Public health managers should execute more classified and cost-effective screening and treatment interferences to lessen the deaths caused by BC, predominantly among middle and low SDI countries having inadequate healthcare supplies.

Secular trends in global burden of diabetes attributable to particulate matter pollution from 1990 to 2019.

Increasing evidence suggests an association between fine particulate matter (PM2.5) exposure and type 2 diabetes mellitus. However, there is still a lack of comparative evaluation regarding diabetes burden due to ambient and indoor PM2.5 pollution at a global scale. This study attempts to provide a systematic and comprehensive profile for PM2.5-attributable burden of diabetes and its spatiotemporal trends, globally and regionally. Comparative estimates of diabetes attributable to ambient PM2.5 and household air pollution (HAP) from solid fuels for 204 countries and territories were derived from the Global Burden of Disease Study 2019. Globally, 292.5 (95% uncertainty interval: 207.1, 373.4) thousand deaths and 13.0 (9.1, 17.2) million disability-adjusted life years (DALYs) from diabetes were attributed to PM2.5 pollution in 2019, wherein more than two-thirds (67.3% deaths and 69.7% DALYs) were contributed by ambient PM2.5. Compared to 1990, age-standardized DALY rate (ASDR) in 2019 attributable to ambient PM2.5 increased by 85.9% (APC: 2.21% [2.15, 2.27]), while HAP-associated ASDR decreased by 37.9% (APC: - 1.66% [- 1.82, - 1.50]). We observed a negative correlation between SDI and APC in ASMR (rs = - 0.5, p < 0.001) and ASDR (rs = -0.4, p < 0.001) among 204 countries and territories. HAP-related diabetes experienced a sharp decline during 1990-2019, while global burden of diabetes attributable to ambient PM2.5 was rising rapidly. The elderly and people in low-SDI countries suffered from the greatest burden of diabetes due to PM2.5 pollution. More targeted interventions should be taken by governments to reduce PM2.5 exposure and related diabetes burden.

Nutritional assessment in esophageal fast-track surgery: comparisons of 4 objective malnutrition screening tools.

BACKGROUND: This cohort study aimed to compare the performance of the 2015 diagnostic criteria for malnutrition of the European Society of Clinical Nutrition and Metabolism (ESPEN), the Nutritional Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), and Short-Form of Mini-Nutritional Assessment (MNA-SF) in detecting malnutrition risk and predicting postoperative complications and the failure of early oral feeding (EOF) programs in esophageal cancer patients. METHODS: The 4 tools were used to conduct malnutrition assessments before surgery. The patients were divided into the groups of severe malnutrition and mild/moderate malnutrition and the incidences of the endpoints were observed. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were conducted. RESULTS: Two hundred and nineteen consecutive esophageal cancer patients were included in the study. The prevalence rates of severe malnutrition as determined by the ESPEN 2015 criteria, MUST, NRS 2002, and MNA-SF were 24.7%, 29.7%, 23.7%, and 16.0%, respectively. The moderate/severe malnutrition risk screened by the MUST had a high sensitivity (100.0%) with malnutrition identified by the ESPEN 2015 criteria. In total, 42 (19.2%) patients experienced major complications, and the incidence rate of EOF failure was 7.3%. The severe malnutrition identified by the ESPEN 2015 criteria, MUST, and NRS 2002 were comparable in predicting the incidence of postoperative pulmonary complications, anastomotic leakage, readmission to intensive care units (ICUs), and EOF failure, but the ESPEN 2015 criteria was better in predicting postoperative overall complications, major complications, and delayed hospital discharge. CONCLUSIONS: The ESPEN 2015 criteria specializes in identifying severe malnutrition and is better in predicting adverse surgical outcomes; however, the MUST and NRS 2002 are better superior in detecting early malnutrition and are also valuable in the perioperative management in esophageal surgery. It is recommended that the MUST be used as the malnutrition screening tool before the ESPEN 2015 criteria is applied.

Photon-upconverters for blue organic light-emitting diodes: a low-cost, sky-blue example.

In the research ecosystem's quest towards having deployable organic light-emitting diodes with higher-energy emission (e.g., blue light), we advocate focusing on fluorescent emitters, due to their relative stability and colour purity, and developing design strategies to significantly improve their efficiencies. We propose that all triplet-triplet annihilation upconversion (TTA-UC) emitters would make good candidates for triplet fusion-enhanced OLEDs ("FuLEDs"), due to the energetically uphill nature of the photophysical process, and their common requirements. We demonstrate this with the low-cost sky-blue 1,3-diphenylisobenzofuran (DPBF). Having satisfied the criteria for TTA-UC, we show DPBF as a photon upconverter (I th 92 mW cm-2), and henceforth demonstrate it as a bright emitter for FuLEDs. Notably, the devices achieved 6.5% external quantum efficiency (above the ∼5% threshold without triplet contribution), and triplet-exciton-fusion-generated fluorescence contributes up to 44% of the electroluminescence, as shown by transient measurements. Here, triplet fusion translates to a quantum yield (Φ TTA-UC) of 19%, at an electrical excitation of ∼0.01 mW cm-2. The enhancement is meaningful for commercial blue OLED displays. We also found DPBF to have decent hole mobilities of ∼0.08 cm2 V-1 s-1. This additional finding can lead to DPBF being used in other capacities in various printable electronics.

Construction of Spatiotemporal Difference Image of the Impact of Financial Structure on China's Total Factor Productivity.

My country's current research on the influencing factors of total factor productivity has problems such as single evaluation method, low efficiency, and poor overall level in terms of evaluation methods and evaluation efficiency. Based on this, this study divides the financial structure into three traditional sections, banking, securities, and insurance, and uses the DEA model to study the temporal and spatial differences of the financial structure's influence on the total factor productivity of the four major political and economic regions of China's eastern, western, central, and northeastern China. First, establish a DEA model based on data mining algorithms, combine financial data comparisons over the years, to achieve a quantitative analysis of the financial structure's impact on China's total factor productivity, calculate financial efficiency, and then combine the DEA analysis data model with the grey correlation method. Analyze its internal influence rules, and design experiments for model verification analysis. The results show that the DEA analysis model can realize 8 iterations of data on the impact of financial structure on China's total factor productivity, and its evaluation accuracy can reach more than 96.2%.

Free-breathing radial 3D fat-suppressed T1-weighted gradient echo (r-VIBE) sequence for assessment of pulmonary lesions: a prospective comparison of CT and MRI.

PURPOSE: To determine whether the pulmonary MR imaging with free-breathing radial 3D fat-suppressed T1-weighted gradient echo (r-VIBE) sequence can detect lung lesions and display lesion profiles with an accuracy comparable to that of computed tomography (CT), which is the reference standard in this study. POPULATION: Sixty-three consecutive patients were prospectively enrolled between October, 2016 and March, 2017. All the patients received both 3T MRI scanning with a free-breathing r-VIBE sequence and chest standard CT. Morphologic features of lesions were evaluated by two radiologists with a 5-point system. Chest standard CT were used as reference standard. Weighted kappa analysis and chi-squared test were used to determine both inter-observer agreement and inter-method agreement. RESULTS: A total of 210 solid pulmonary nodules or masses and 1 ground-glass nodule were detected by CT. Compared to CT, r-VIBE correctly detected 95.7% of pulmonary nodules, including 100% of detection rate with diameter greater than 6 mm, 92.3% of pulmonary nodules with diameter between 4 and 6 mm, and 83.3% of pulmonary nodules with diameter less than 4 mm The inter-method agreements between r-VIBE and standard-dose CT were either "substantial" or "excellent" in the evaluation of following features of pulmonary nodules with diameter more than 10mm: including lobulation, spiculation, convergence of vessels, bubble-like attenuation, cavitation and mediastinal lymph node enlargement (0.605≤K≤1.000; P<0.0001). However, K values for inter-method agreements were significant but "moderate" or "poor" for evaluating pleural tag, halo, and calcification (0.355≤ K≤0.451; P<0.0001). CONCLUSION: The use of pulmonary MR imaging with r-VIBE showed high detection rate of pulmonary nodules and inter-method agreement with CT. It is also useful for nodule morphologic assessment.

Modelled Economic Analysis for Dacomitinib-A Cost Effectiveness Analysis in Treating Patients With EGFR-Mutation-Positive Non-Small Cell Lung Cancer in China.

OBJECTIVES: To establish the cost-effectiveness of dacomitinib compared to gefitinib from the Chinese healthcare system perspective. PATIENTS: Advanced non-small cell lung cancer (NSCLC) harbouring epidermal growth factor receptor (EGFR) mutations. METHODS: Partitioned survival analysis was undertaken to examine the cost-effectiveness of dacomitinib utilising individual patient data (IPD) from the pivotal randomised controlled trial (RCT) (ARCHER 1050). The three health states modelled were progression-free, post-progression, and death. Parametric survival distributions were fitted to IPD against the Kaplan-Meier survival curves corresponding to progression-free survival (PFS) and overall survival (OS) outcomes by randomised groups. Costs included drug acquisition and administration, outpatient management (outpatient consultation and examinations), and best supportive care costs. Utility weights were sourced from the pivotal trial and other published literature. The incremental cost-effectiveness ratio (ICER) was calculated with costs and quality-adjusted life years (QALYs) discounted at an annual rate of 5%. Both deterministic and probabilistic sensitivity analyses were undertaken. RESULTS: In the base case, dacomitinib (CNY 265,512 and 1.95 QALY) was associated with higher costs and QALY gains compared to gefitinib (CNY 247,048 and 1.61 QALYs), resulting in an ICER of CNY 58,947/QALY. Using the empirical WTP/QALY threshold, dacomitinib is a cost-effective treatment strategy for patients with EGFR-mutation-positive advanced NSCLC. The probabilistic sensitivity analysis suggested that dacomitinib had a 97% probability of being cost-effective. CONCLUSIONS: Dacomitinib is a cost-effective treatment strategy in treating patients with EGFR-mutation-positive NSCLC from the Chinese healthcare system perspective. The uncertainty around the cost-effectiveness of dacomitinib could be reduced if long-term survival data become available. CLINICAL TRIAL REGISTRATION: NCT01024413.

Quality of life in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome in a HIV WeChat account and self-assessment of physical and mental health. / æŸå¾®ä¿¡å¹³å°äººç±»å ç–«ç¼ºé™·ç— æ¯’æ„ŸæŸ“è€ æˆ–è‰¾æ»‹ç— æ‚£è€ çš„ç”Ÿå‘½è´¨é‡ä¸Žè‡ªè¯„å¿ƒèº«å¥åº·çŠ¶å†µ.

OBJECTIVES: To investigate the quality of life, self-assessment of mental and physical health, and their related factors inpatients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). METHODS: A total of 1 500 patients were selected from people living with HIV/AIDS (PLWHA) users in the WeChat work account from a Center for Disease Control and Prevention (CDC). Self-made General Condition Questionnaires, Perceived Social Support Scale, Life Satisfaction Scale, Self-Stigma Scale,HIV/ AIDS Stress Scale, Patients Health Questionnaire for Depression (PHQ-2), Generalized Anxiety Disorder-2 Scale (GAD-2), Pittsburgh Sleep Quality Index, the 12-Item Short Form Health Survey (SF-12) were used to conduct a one-to-one questionnaire survey through WeChat video in the selected samples. Binary unconditional logistic regression was used to investigate the influential factors for PLWHA quality of life and mental and physical health. RESULTS: A total of 1 146 valid samples were obtained. The total mean score of Social Support Scale was 52±15, and 49.0% (562/1 146) of PLWHA users had low level social support (≤52 points); the total mean score of Life Satisfaction Scale was 13 ± 4, and 54.7% (627/1 146) of PLWHA users had high life satisfaction (>13 points); the total mean score of Self-Stigma Scale was 34 ± 8, and 52.2% (598/1 146) of PLWHA users had high self-stigma (>34 points); the total mean score of Stress Scale was 40±20, and 48.8% (559/1 146) of PLWHA users had high stress (>40 points); 53.4% (612/1 146) of PLWHA users had depressive symptoms in the past 2 weeks, 63.3% (725/1 146) had anxiety symptoms, and 24.3% (278/1 146) of PLWHA users had fair or very poor sleep quality in the past 1 month.There were significant differences in the mean standard scores of the 8 dimensions of the SF-12 scale in the PLWHA and the ordinary residents (all P<0.001). The results of binary unconditional logistic regression analysis showed that the poor sleep quality (OR=1.53, P<0.01), the HIV/AIDS-related stress (OR=1.42, P<0.05), the abnormal indicators in the last physical examination (OR=1.49, P<0.01), and the other chronic diseases in addition to HIV (OR=1.87, P<0.01) were risk factors for poor physical health domains of PLWHA quality of life; and the poor life satisfaction (OR=2.49, P<0.01), the suicidal ideation (OR=2.03, P<0.01), the depression (OR=3.26, P<0.01), the anxiety (OR=3.58, P<0.01), the poor sleep quality (OR=2.53, P<0.01), HIV/AIDS-related stress (OR=2.42, P<0.01), and the low levels of social support (OR=1.46, P<0.05) were the risk factors for poor mental health domains in PLWHA quality of life. CONCLUSIONS: Compared with the ordinary residents, the PLWHA have lower quality of life, and we should focus on interventions to improve their physical and mental health.

Polycyclic Aromatic Hydrocarbons (PAHs) in Indoor Dust Across China: Occurrence, Sources and Cancer Risk Assessment.

In this study, the occurrence of 16 polycyclic aromatic hydrocarbons (PAHs) was investigated in 31 household dusts that were sampled from 27 areas located in 10 provinces, China. The total concentrations of PAHs (∑ PAHs) were in the range of 613-10,111 ng·g-1 with a median of 2565 ng·g-1. The predominant PAHs were 2 to 3 ringed compounds, accounting for 85.3% of ∑ PAHs. The geographical location had little impact on the contents of PAHs. Higher concentrations of ∑ PAHs and individual homologues of PAHs except for naphthalene (NAP) were observed in rural areas, which is related to the higher usage of coal or biomass for cooking. Cooking method played a major role in contributing to the concentrations of PAHs. Both household cooking and petrogenic sources from outdoors were the primary sources of PAHs in household dust. Cancer risk assessment indicated that dermal contact and ingestion are the main exposure pathways to indoor residents. Furthermore, the average values of sum of incremental lifetime cancer risks (ILCRs) were 2.22 × 10-7 for adults and 2.51 × 10-7 for children, suggesting that there is a low health risk posed by PAHs in indoor dust. The contribution percentage of 4 to 6 rings PAHs to ILCRs was up to 96.3%, indicating that higher molecular weight PAHs in indoor dust, especially benzo[a]pyrene (BaP) and dibenzo[a,h]anthracene (DahA), are major factors contributing to cancer risk.

Heavy Metals in Indoor Dust Across China: Occurrence, Sources and Health Risk Assessment.

In this study, the occurrence of heavy metals including cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), and zinc (Zn) was investigated in indoor dust samples collected from 33 urban and rural areas in 11 provinces, China. The concentrations of the selected heavy metals were determined by an inductively coupled plasma mass spectrometry. The mean concentrations of Zn (166 mg kg-1), Pb (40.7 mg kg-1), Cr (19.8 mg kg-1), Cu (16.9 mg kg-1), and Cd (2.29 mg kg-1) in indoor dust are in low or moderate levels compared with other countries or regions. Cd was significantly enriched with the highest enrichment factor of 23.7, followed by Zn, Pb, Cu, and Cr, which were all lower than 3. The concentrations of Pb from Northern China (61.4 mg kg-1) were significantly higher than those from Southern China (8.88 mg kg-1). The concentrations of heavy metals in indoor dusts from rural areas were higher than those from urban areas except for Cu. The multivariate analysis of variance revealed that wall cover, fuel types, and air conditioning were dominant factors influencing the levels of heavy metals in indoor dust. Principal component analysis showed that outdoor dust and wall paint were main factors for the high concentrations of Cd, Pb, and Cr, accounting for 40.6% of the total contribution; traffic sources contributed to the high levels of Cu and Zn explained 20.6% of the total variance. The hazard indexes of selected heavy metals were less than 1 and carcinogenic risk value of Cr were between 1.01 × 10-6 and 1 × 10-4, indicating minor noncarcinogenic and carcinogenic risks from heavy metals in indoor dust for residents in China. Pb contributed 72.0% and 86.9% to the sum of noncarcinogenic risk values of selected heavy metals for adults and children, respectively. The carcinogenic risk value of Cr was approximately 13-fold higher than that of Cd for both adults and children. Children endured higher risks from heavy metals in indoor dust compared with adults.