Global trends in the burden of chronic kidney disease attributable to type 2 diabetes: An age-period-cohort analysis.

AIM: To assess temporal trends of chronic kidney disease (CKD) attributable to type 2 diabetes (T2D) globally and in five sociodemographic index (SDI) regions. MATERIALS AND METHODS: We extracted the population data and CKD burden attributable to T2D from the Global Burden of Disease Study 2019. We evaluated the trends of disability-adjusted life years (DALYs), mortality, prevalence and incidence through age-period-cohort modelling, and calculated net drifts (overall annual percentage changes), local drifts (annual percentage changes in each age group), longitudinal age curves (fitted longitudinal age-specific rates), period relative risks (RRs) and cohort RRs. RESULTS: From 1990 to 2019, the global burden of CKD attributable to T2D showed increasing trends in general. The burden of CKD attributable to T2D was highest in the middle SDI region and lowest in the low SDI region. Age effects increased with age, and peaked at the ages of 75-79 and 80-84 years for incidence and prevalence, respectively. Period RRs in the burden of CKD attributable to T2D increased, with the high SDI being the most remarkable in DALYs and mortality, and the middle SDI being the most notable in incidence. Cohort RRs showed unfavourable trends in incidence and prevalence among recent cohorts. CONCLUSIONS: After a lengthy period of multi-initiative diabetes management, the high-middle SDI region exhibited improvement. However, unresolved issues and improvement gaps were still remarkable. Future efforts to reduce the burden of CKD attributable to T2D in the population should prioritize addressing the unfavourable patterns identified.

Temporal and spatial distributions, source identification, and health risk assessment of polycyclic aromatic hydrocarbons in PM2.5 from 2016 to 2021 in Shenzhen, China.

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous contaminants in the atmosphere that have drawn intense attention due to their carcinogenicity and mutagenicity. In this work, 1424 air samples were collected between January 2016 and December 2021 in three areas of Shenzhen, China to determine the concentrations of PM2.5 and PAHs and their spatiotemporal variation. Human health risks due to the daily intake and uptake of PAHs and the resulting incremental lifetime cancer risk (ILCR) were also evaluated. PAHs were detected frequently in the samples at concentrations between 0.28 and 32.7 ng/m3 (median: 1.04 ng/m3). PM2.5 and PAH concentrations decreased from 2016 to 2021, and the Yantian area had lower median concentrations of PM2.5 (23.0 µg/m3) and PAHs (0.02 ng/m3) than the Longgang and Nanshan areas. The concentrations of PM2.5 and PAHs were significantly higher in winter than in summer. Analysis of diagnostic ratios indicated that petroleum combustion was the dominant source of airborne PAHs in Shenzhen. The estimated daily intake (EDI) and uptake (EDU) of PAHs by local residents decreased gradually with increasing age, indicating that infants are at particular risk of PAH exposure. However, the incremental lifetime cancer risks (ILCRs) were below the threshold value of 10-6, indicating that inhalation exposure to PAHs posed a negligible carcinogenic risk to Shenzhen residents. While promising, these results may underestimate actual PAH exposure levels, so further analysis of health risks due to PAHs in Shenzhen is needed.

A holistic review on triclosan and triclocarban exposure: Epidemiological outcomes, antibiotic resistance, and health risk assessment.

Triclosan (TCS) and triclocarban (TCC) are antimicrobials that are widely applied in personal care products, textiles, and plastics. TCS and TCC exposure at low doses may disturb hormone levels and even facilitate bacterial resistance to antibiotics. In the post-coronavirus disease pandemic era, chronic health effects and the spread of antibiotic resistance genes associated with TCS and TCC exposure represent an increasing concern. This study sought to screen and review the exposure levels and sources and changes after the onset of the coronavirus disease (COVID-19) pandemic, potential health outcomes, bacterial resistance and cross-resistance, and health risk assessment tools associated with TCS and TCC exposure. Daily use of antimicrobial products accounts for most observed associations between internal exposure and diseases, while secondary exposure at trace levels mainly lead to the spread of antibiotic resistance genes. The roles of altered gut microbiota in multi-system toxicities warrant further attention. Sublethal dose of TCC selects ARGs without obviously increasing tolerance to TCC. But TCS induce persistent TCS resistance and reversibly select antibiotic resistance, which highlights the benefits of minimizing its use. To derive reference doses (RfDs) for humans, more sensitive endpoints observed in populational studies need to be confirmed using toxicological tests. Additionally, the human equivalent dose is recommended to be incorporated into the health risk assessment to reduce uncertainty of extrapolation.

Risk assessment of metal(loid)s in tea from seven producing provinces in China.

To evaluate metal(loid) contamination in tea leaves and assess health risks of tea drinking in China, metal(loid) concentrations in tea leaves from major tea-producing provinces were determined. Nine metal(loid)s (Al, Cr, Co, Ni, Cu, Zn, As, Cd and Pb) were measured in a total of 217 tea samples representing five tea varieties (black tea, dark tea, green tea, oolong tea and white tea) from seven major tea-producing provinces of China (Fujian, Guangdong, Henan, Hunan, Jiangsu, Yunnan and Zhejiang). The results indicated that tea samples from Hunan Province had the highest metal(loid) concentrations, likely due its high prevalence of heavy industrial activities and soil pollution. The concentrations of As and Pb in dark tea were markedly higher than those in other tea varieties. A strong Spearman correlation coefficient (0.78, P < 0.001) of As and Pb in all the tea varieties has also been found, indicating their similar sources. Human health risk assessment for the nine analyzed metal(loid)s indicated that co-exposure to these metal(loids) may not cause significant health risks (hazard index [HI] > 1 suggests considerable health risks). Among the five tea varieties, metal(loids)s in dark and green tea induced relatively higher health risks, with 90th percentile HI values approached 0.8. Co (53.6 %-84.5 %) and Al (3.33 %-15.8 %) made the highest contributions to the HI of the selected tea commodities. Thus, public and regulatory agencies should reduce excessive Co and Al accumulation in these tea varieties during cultivation and production processes.

Organophosphate ester exposure among Chinese waste incinerator workers: Urinary levels, risk assessment and associations with oxidative stress.

Organophosphate esters (OPEs), which are frequently used as flame retardants and plasticizers in versatile products, are readily released to the external environment. Although workers at municipal waste incineration plants may be extensively exposed to OPEs, only scarce health monitoring and risk assessments have been conducted in this population. In this study, we investigated the levels of eight metabolites of organophosphate esters (mOPEs) and the oxidative stress marker 8-hydroxy-2-deoxyguanosine (8-OHdG) in urine samples from 73 waste incinerator workers and 97 general residents from Shenzhen, China between September 2016 and June 2017. The overall detection rate of mOPEs was 82.2 %-100 %, and higher concentrations of di-p-cresyl phosphate and chlorinated mOPEs [bis(2-chloroethyl) phosphate (BCEP), bis(1-chloro-2propyl) phosphate (BCIPP), bis(1,3-dichloro-2-propyl) phosphate) (BDCIPP)] were found among incinerator workers than among general residents. The incinerator workers also showed significantly higher levels of 8-OHdG than general residents, but the measured levels of most mOPEs were not significantly correlated with the level of 8-OHdG; this may be because co-exposure to multiple toxic compounds can lead to oxidative stress. Risk assessment using Monte Carlo simulations revealed that 95 % of the incinerator workers were free from non-carcinogenic effects due to OPEs exposure (hazard index = 0.27, 95 % CI: 0.09, 0.77). However, the carcinogenic risk of tris(2-chloroethyl) phosphate (TCEP) for incinerator workers was between 10-6 and 10-4. These results indicate that incinerator workers are extensively exposed to OPEs, and better protective measures need to be implemented.

A nationwide investigation of perchlorate levels in staple foods from China: Implications for human exposure and risk assessment.

Perchlorate is an emerging pollutant and thyroid toxicant frequently occurred in air, water, soil and various foodstuffs. Rice and wheat flour are the most common staple foods, which could accumulate perchlorate from contaminated soils and irrigation water. However, human exposure to perchlorate via rice and wheat flour consumption has only been investigated to a limited extent. Therefore, we collected 207 rice samples and 189 wheat flour samples from 19 provinces in China to assess the level of perchlorate. The levels of perchlorate in rice and wheat flour ranged from not detected (N.D.) to 28.7 ng/g and less than limits of quantification (

Health risk assessment of perchlorate and chlorate in red swamp crayfish (Procambarus clarkii) in China.

Perchlorate and chlorate are both strong oxidants and thyroid toxicants that are widely distributed in soil, water and human foods. The red swamp crayfish (Procambarus clarkii) is a common aquatic organism that is popular in Chinese culinary dishes. Dietary intake is the main route of human exposure to perchlorate and chlorate, though the health risks of crayfish consumption are unknown. Thus, this study investigated the quantities of perchlorate and chlorate in red swap crayfish from sampling sites in five provinces located near the Yangtze River in China, along with the associated health risks of consuming this species. Perchlorate was detected in 55.6-100 % of crayfish samples in each sampling location, and chlorate was found in 100 % of samples cross all sites. Concentrations of perchlorate in crayfish from upstream provinces (Hubei, Hunan and Jiangxi) were higher than those from downstream provinces (Anhui and Jiangsu). Perchlorate and chlorate concentrations were positively correlated in crayfish, suggesting that chlorate may be a degradation byproduct of perchlorate. The quantities of both pollutants in hepatopancreas tissue were higher than in muscle tissues (p < 0.05), such that we do not recommend ingesting crayfish hepatopancreas. Hazard quotient (HQ) values for chlorate in crayfish were <1 across all provinces, suggesting no potential health risk of chlorate exposure through crayfish consumption. However, perchlorate concentrations in crayfish from the Jiangxi province had an associated HQ value >1, suggesting potential risks for human health. These results will be useful in informing mitigation measures aimed at reducing perchlorate exposure associated with crayfish consumption.

Design and Assessment of Convolutional Neural Network Based Methods for Vitiligo Diagnosis.

Background: Today's machine-learning based dermatologic research has largely focused on pigmented/non-pigmented lesions concerning skin cancers. However, studies on machine-learning-aided diagnosis of depigmented non-melanocytic lesions, which are more difficult to diagnose by unaided eye, are very few. Objective: We aim to assess the performance of deep learning methods for diagnosing vitiligo by deploying Convolutional Neural Networks (CNNs) and comparing their diagnosis accuracy with that of human raters with different levels of experience. Methods: A Chinese in-house dataset (2,876 images) and a world-wide public dataset (1,341 images) containing vitiligo and other depigmented/hypopigmented lesions were constructed. Three CNN models were trained on close-up images in both datasets. The results by the CNNs were compared with those by 14 human raters from four groups: expert raters (>10 years of experience), intermediate raters (5-10 years), dermatology residents, and general practitioners. F1 score, the area under the receiver operating characteristic curve (AUC), specificity, and sensitivity metrics were used to compare the performance of the CNNs with that of the raters. Results: For the in-house dataset, CNNs achieved a comparable F1 score (mean [standard deviation]) with expert raters (0.8864 [0.005] vs. 0.8933 [0.044]) and outperformed intermediate raters (0.7603 [0.029]), dermatology residents (0.6161 [0.068]) and general practitioners (0.4964 [0.139]). For the public dataset, CNNs achieved a higher F1 score (0.9684 [0.005]) compared to the diagnosis of expert raters (0.9221 [0.031]). Conclusion: Properly designed and trained CNNs are able to diagnose vitiligo without the aid of Wood's lamp images and outperform human raters in an experimental setting.

Discovery of a novel linc01125 isoform in serum exosomes as a promising biomarker for NSCLC diagnosis and survival assessment.

A non-invasive method to distinguish potential lung cancer patients would improve lung cancer prevention. We employed the RNA-sequencing analysis to profile serum exosomal long non-coding RNAs (lncRNAs) from non-small cell lung cancer (NSCLC) patients and pneumonia controls, and then determined the diagnostic and prognostic value of a promising lncRNA in four datasets. We identified 90 dysregulated lncRNAs for NSCLC and found the most significant lncRNA was a novel isoform of linc01125. Serum exosomal linc01125 could distinguish NSCLC cases from disease-free and tuberculosis controls, with the area under the curve values as 0.662 [95% confidence interval (CI) = 0.614-0.711] and 0.624 (95% CI = 0.522-0.725), respectively. High expression of exosomal linc01125 was also correlated with an unfavorable overall survival of NSCLC (hazard ratio = 1.48, 95% CI = 1.05-2.08). Clinic treatment decreased serum exosomal linc01125 in NSCLC patients (P = 0.036). Linc01125 functions to inhibit cancer growth and metastasis via acting as a competing endogenous RNA to up-regulate tumor necrosis factor alpha-induced protein 3 (TNFAIP3) expression by sponging miR-19b-3p. Notably, the oncogenic transformation of 16HBE led to decreased linc01125 in cells but increased linc01125 in cell-derived exosomes. The expression of linc01125 in total exosomes was highly correlated with that in tumor-associated exosomes in serum. Moreover, lung cancer cells were capable of releasing linc01125 into exosomes in vitro and in vivo. Our analyses suggest serum exosomal linc01125 as a promising biomarker for non-invasively diagnosing NSCLC and predicting the prognosis of NSCLC.

Assessment and treatment strategies for occult contralateral lymph node metastasis in hypopharyngeal squamous cell carcinoma patients with ipsilateral node-positive necks.

Hypopharyngeal squamous cell carcinoma (HSCC) is an aggressive disease with poor prognosis, yet studies have largely been more qualitatively focused. Our study aims to quantitatively predict the risk of occult contralateral lymph node metastasis (cLNM) for HSCC patients with ipsilateral lymph node metastasis (iLNM). This will be based on pre- and post-operative indexes to guide the selection of prophylactic contralateral lymph node dissection (cLND) and postoperative adjuvant treatments. Multivariate analyses of 462 primary HSCC patients with iLNM showed that the age of patients, subregions of tumor, pathological T (pT) stage, ipsiateral MLS and metastatic lymph node number (MLN), and lymph nodal necrosis were independent cLNM risk factors. These were used to construct two nomograms that can effectively predict the contralateral neck involvement in HSCC patients with ipsilateral positive lymph nodes. The first nomogram (pre-model) provides quantitative assessment on the necessity of cLND, while the second nomogram (post-model) informs regions of interest for therapeutic radiation. Overall, patients deemed high-risk of cLNM by pre-model should receive cLND. Post-operation, patients deemed high-risk of cLNM by post-model should receive therapeutic radiation targeting contralateral neck lymph nodes, moderate-risk group warrants comparatively lower dose contralaterally, while low-risk group requires only follow-up.

Low-Cost Nested-MIMO Array for Large-Scale Wireless Sensor Applications.

In modern communication and radar applications, large-scale sensor arrays have increasingly been used to improve the performance of a system. However, the hardware cost and circuit power consumption scale linearly with the number of sensors, which makes the whole system expensive and power-hungry. This paper presents a low-cost nested multiple-input multiple-output (MIMO) array, which is capable of providing O ( 2 N 2 ) degrees of freedom (DOF) with O ( N ) physical sensors. The sensor locations of the proposed array have closed-form expressions. Thus, the aperture size and number of DOF can be predicted as a function of the total number of sensors. Additionally, with the help of time-sequence-phase-weighting (TSPW) technology, only one receiver channel is required for sampling the signals received by all of the sensors, which is conducive to reducing the hardware cost and power consumption. Numerical simulation results demonstrate the effectiveness and superiority of the proposed array.