Longitudinal assessment of early growth in children with IgE- and non-IgE-mediated food allergy in a healthy infant cohort.

BACKGROUND: There are conflicting associations reported between food allergies (FAs) and poor growth, with some indication that children with multiple FAs are at highest risk. OBJECTIVE: We analyzed longitudinal weight-for-length (WFL) trajectories from our healthy cohort to evaluate growth in children with IgE-mediated FAs and food protein-induced allergic proctocolitis (FPIAP), a non-IgE-mediated FA. METHODS: Our observational cohort of 903 healthy newborn infants was prospectively enrolled to evaluate the development of FAs. Longitudinal mixed effects modeling was used to compare differences in WFL among children with IgE-FA and FPIAP, compared with unaffected children, through age 2. RESULTS: Among the 804 participants who met inclusion criteria, FPIAP cases had significantly lower WFL than unaffected controls during active disease, which resolved by 1 year of age. In contrast, children with IgE-FA had significantly lower WFL than unaffected controls after 1 year. We also found that children with IgE-FA to cow's milk had significantly lower WFL over the first 2 years of age. Children with multiple IgE-FAs had markedly lower WFL over the first 2 years of age. CONCLUSION: Children with FPIAP have impaired growth during active disease in the first year of age which resolves, whereas children with IgE-FA, particularly those with multiple IgE-FA, have impaired growth more prominently after the first year of age. It may be appropriate to focus nutritional assessment and interventions accordingly during these higher risk periods in these patient populations.

Global burden of thyroid cancer and its attributable risk factors in 204 countries and territories from 1990 to 2019.

BACKGROUND: To investigate the burden of thyroid cancer and its attributable risk factors in 204 countries and territories during 30 years. METHODS: We extracted data from the Global Burden of Disease (GBD) 2019 database, including incidence, mortality, disability-adjusted life-years (DALYs), and the attributable risk factors of thyroid cancer from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to assess the changes in age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). We also examined the associations between cancer burden and the sociodemographic index (SDI). RESULTS: The global new cases, death, and DALYs of thyroid cancer in 2019 were 233 847 (95% UI: 211 637-252 807), 45 576 (95% UI: 41 290-48 775), and 1 231 841 (95% UI: 1 113 585-1 327 064), respectively. From 1990 to 2019, the ASIR of thyroid cancer showed an upward trend (EAPC = 1.25), but ASMR (EAPC = -0.15) and ASDR (EAPC = -0.14) decreased. The burden of thyroid cancer varied at regional and national levels, but the association between ASIR and SDI was positive. We found that the burden of thyroid cancer was mainly concentrated in females and that the age of onset tended to be younger. The proportion of DALYs from thyroid cancer attributable to high body-mass index was higher in high SDI regions, especially in males. CONCLUSIONS: The global incidence of thyroid cancer has continued to increase in the past three decades. The high body-mass index as an important risk factor for thyroid cancer deserves greater attention, especially in high SDI regions.

Eco-efficiency evaluation model: a case study of the Yangtze River Economic Belt.

After the concept of ecological efficiency (eco-efficiency) was put forward and constantly supplemented, it generally refers to the maximization of economic benefits with minimum energy consumption and environmental damage. In a new eco-efficiency model proposed by this paper, the input indexes take into account the consumption of capital, human, resources and energy, and the environmental load caused by them. The output indexes take into account GDP, income, and tax revenue. An optimal weighted cross-evaluation efficiency (OWCE) model based on data standardization is proposed, by improving the traditional data envelopment models of CCR and BCC. The OWCE model not only objectively weights but also unifies the comparison scale, and facilitates the establishment of the super-efficiency decomposition model, which is conducive to further exploring the reasons for the difference of eco-efficiency in various regions. Empirically, the eco-efficiencies of 11 provinces (municipalities) along the Yangtze River Economic Belt (YREB) were analyzed based on the data from 2008 to 2019. The results show that there has been a serious imbalance in the 11 provinces, showing a trend of high in the east and low in the west, although the eco-efficiency has been improving continuously in the past 10 years. Shanghai, Zhejiang, and Jiangsu, which are located in the traditional Yangtze River lower delta region, are the top in terms of eco-efficiency, among which Shanghai ranks the first place with absolute advantage, and also is far ahead in sub-efficiencies of basic input, energy consumption, capital and human input, and environmental cost. Geographical location, especially whether it is close to the ocean, and the length of river flow have a certain positive impact on eco-efficiency. Through in-depth analysis, high-energy consumption, high pollution, and low economic output are the main reasons for low eco-efficiency in the middle and upper reaches of the Yangtze River.

Economic transition and industrial sulfur dioxide emissions in the Chinese economy.

China transitioned into "new normal phase" during 2007 to 2017, shifting from pursuing rapid GDP growth to a win-win state of economic development and environmental improvement. Using the input-output (IO) table for 2007-2012 and the latest IO table for 2012-2017, an IO model of China's industrial SO2 emissions is established and structural decomposition analysis (SDA) is applied to examine the changes in industrial SO2 emissions resulting from this economic transition. Five influencing factors (emission intensity, production technology, final demand expenditure, final demand structure and economic scale) are taken into consideration. The analysis shows that emission intensity and economic scale are the most influential factors on SO2 emissions. Emission intensity reduced SO2 emissions by 16,560,886 t in 2012-2017 whilst economic scale increased SO2 emissions by 473,490 t. Compared with the period 2007-2012, the contribution rate of emission intensity increased from -82.3% to -189.2%, while that of economic scale decreased from 131.8% to 54.1%. The total contributions of 5 factors to SO2 reduction increased from -5,249,417 t to -12,783,248 t, and the contribution rate increased from -24.8% to -146%. China's energy conservation and emission reduction has achieved remarkable results between 2007 and 2017. In "new normal phase", the slowing of China economic growth, the transition of economic development, industrial structural adjustment and rational consumption habits have had significant effects in reducing environmental pollution.

Prospective Assessment of Pediatrician-Diagnosed Food Protein-Induced Allergic Proctocolitis by Gross or Occult Blood.

BACKGROUND: Food protein-induced allergic proctocolitis (FPIAP) is an early and common manifestation of food allergy, yet its epidemiology and relationship to other allergic diseases remain unclear. OBJECTIVE: To prospectively define the incidence of FPIAP as it is being diagnosed clinically in the community and to identify factors associated with its development. METHODS: A total of 1003 of 1162 eligible serial healthy newborn infants recruited from a single suburban pediatrics practice were followed prospectively for the diagnosis of FPIAP. Investigators reviewed each case to confirm prespecified inclusion criteria, including documented gross or occult blood in the stool. RESULTS: A total of 903 infants were analyzed (46% females, 89% term, 32% caesarian-section, 9% neonatal antibiotics); 153 cases met inclusion criteria, a cumulative incidence of 17%, while 63 (7%) had gross blood. Infants initially fed both breast milk and formula were 61% less likely to develop FPIAP compared with those exclusively formula-fed (hazard ratio, 0.39; P = .005). Breast milk and formula at any point during the first 4 months were also associated with lower risk compared with exclusive formula or exclusive breast milk (hazard ratio, 0.44; P = .005; hazard ratio, 0.62; P = .0497). Eczema (odds ratio, 1.5; 95% confidence interval, 1.1- 2.2; P = .02) or a first-degree relative with food allergies (odds ratio, 1.9; 95% confidence interval, 1.2-2.8; P = .005) were among risk factors for FPIAP development. CONCLUSIONS: The prospectively defined incidence of FPIAP when diagnosed clinically by community pediatricians without challenge is markedly higher than published estimates. Combination feeding of formula and breast milk is associated with the lowest rate of FPIAP in this population.