Self-harm and interpersonal violence due to high temperature from the global burden of disease study 2019: A 30-year assessment.

BACKGROUND: The impact of global warming on health due to climate change is increasingly studied, but the global burden of self-harm and interpersonal violence attributable to high temperature is still limited. This study aimed to systematically assess the burden of self-harm and interpersonal violence attributable to high temperature globally or by region and climate zone from 1990 to 2019. METHODS: We obtained the global, regional, and national deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMR), and age-standardized disability-adjusted life year rates (ASDR) of self-harm and interpersonal violence due to high temperature from 1990 to 2019 through the Global Burden of Disease Study (GBD) 2019. The burden of self-harm and interpersonal violence due to high temperature was estimated by age, sex, climate zone, the socio-demographic index (SDI), and the healthcare access and quality index (HAQ). Average annual percentage changes (AAPCs) in ASMR and ASDR were calculated for 1990-2019 using the Joinpoint model. RESULTS: From 1990 to 2019, the global deaths and DALYs related to self-harm and interpersonal violence due to high temperature increased from 20,002 (95% UI, 9243 to 41,928) and 1,107,216 (95% UI, 512,062 to 2,319,477) to 26,459 (95% UI, 13,574 to 47,265) and 1,382,487 (95% UI, 722,060 to 2,474,441), respectively. However, the ASMR and ASDR showed varying degrees of decreasing trends, with decreases of 13.36% and 12.66%, respectively. The ASMR was high and declining in low and low-middle SDI regions, particularly in tropical and subtropical regions. In addition, SDI and HAQ index were negatively correlated with ASMR in 204 countries and regions. CONCLUSIONS: The global burden of self-harm and interpersonal violence attributed to high temperature has decreased over the past 30 years, but the number of deaths and DALYs continues to rise. Climate change continues to make heat stress a significant risk factor for self-harm and interpersonal violence worldwide.

Global, regional, and national burden of depressive disorders among young people aged 10-24 years, 2010-2019.

OBJECTIVE: To describe the latest disease burden, temporal trends, and risk factors of depressive disorders among young people. METHODS: Data from the Global Burden of Disease Study 2019 was utilized to analyze depressive disorders among individuals aged 10-24 years. The study focused on describing the incidence, prevalence, disability-adjusted life years (DALYs), and their attributable risk factors across 204 countries and territories from 2010 to 2019. The estimated annual percentage change (EAPC) was calculated to quantify the temporal trends. RESULTS: Globally, the incidence, prevalence, and DALYs rate of depressive disorders per 100 000 young people increased from 3003.01, 2445.69, and 448.61 in 2010 to 3035.26, 2470.67, and 452.58 in 2019, indicating a slight upward trend (EAPC = 0.11 for incidence and prevalence; EAPC = 0.09 for DALYs rate). Notably, the percentage of DALYs of depressive disorders among young people increased substantially from 3.24% in 2010 to 3.66% in 2019, an increase of 13.06% (EAPC = 1.26, 95%CI: 1.08-1.44), and the burden of depressive disorders among young people rose from fouth to second in females, and from tenth to fifth in males. Social demographic index (SDI) and other indicators were positively correlated with the percentage of DALYs of depressive disorder and negatively correlated with the EAPC of DALYs. CONCLUSION: The global burden of depressive disorders among young people is on the rise. The regional differences in depressive disorders among young people suggest the need for enhanced screening efforts in low-SDI areas, along with the adoption of more effective prevention and control measures.

Insight study of rare earth elements in PM2.5 during five years in a Chinese inland city: Composition variations, sources, and exposure assessment.

The booming development of rare earth industry and the extensive utilization of its products accompanied by urban development have led to the accelerated accumulation of rare earth elements (REEs) as emerging pollutants in atmospheric environment. In this study, the variation of REEs in PM2.5 with urban (a non-mining city) transformation was investigated through five consecutive years of sample collection. The compositional variability and provenance contribution of REEs in PM2.5 were characterized, and the REEs exposure risks of children and adults via inhalation, ingestion and dermal absorption were also evaluated. The results showed an increase in the total REEs concentration from 46.46 ± 35.16 mg/kg (2017) to 81.22 ± 38.98 mg/kg (2021) over the five-year period, with Ce and La making the largest contribution. The actual increment of industrial and traffic emission source among the three pollution sources was 1.34 ng/m3. Coal combustion source displayed a downward trend. Ingestion was the main exposure pathway for REEs in PM2.5 for both children and adults. Ce contributed the most to the total intake of REEs in PM2.5 among the population, followed by La and Nd. The exposure risks of REEs in PM2.5 in the region were relatively low, but the trend of change was of great concern. It was strongly recommended to strengthen the concern about traffic-related non-exhaust emissions of particulate matter.

Disease burden of chronic kidney disease attributable to lead exposure: A global analysis of 30 years since 1990.

BACKGROUND: Exposure to lead (Pb) is associated with an increased risk of chronic kidney disease (CKD). However, limited studies explored the global burden of CKD attributable to Pb exposure, especially in countries with different development levels. This study aimed to comprehensively evaluate the temporal and spatial trend in the disease burden of CKD attributable to Pb exposure in 204 countries and territories from 1990 to 2019. METHODS: We used the data from Global Burden of Disease Study (GBD) 2019 to estimate annual deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMR), and age-standardized DALYs rate (ASDR) of CKD attributable to Pb exposure. The annual average percentage change (AAPCs) was calculated using the Joinpoint model to evaluate the changing trend of CKD ASMR and ASDR attributable to Pb exposure from 1990 to 2019. Meanwhile, age-period-cohort (APC) model was used to assess changes in the mortality of CKD attributable to Pb exposure from 1990 to 2019. RESULTS: Global ASMR for CKD attributable to Pb exposure trended upward from 1990 to 2019. ASMR and ASDR were the highest in low and low-middle SDI regions. With the APC model, we found that global mortality rates for CKD attributable to Pb exposure increased with age. The global period rate ratio showed the highest value in 2000-2004 and the lowest in 2015-2019, while the global cohort rate ratio showed the highest value in 1941-1949 and the lowest during 1986-1994. CONCLUSIONS: From 1990 to 2019, the global burden of CKD attributable to Pb exposure increased globally, especially in low and low-middle SDI regions, as well as the elderly. Pb exposure is still a great threat to the global burden of CKD, and the implementation of effective prevention measures to reduce Pb exposure in the environment should be continually strengthened.

Global, regional, and national burden of ambient and household PM2.5-related neonatal disorders, 1990-2019.

Previous studies have shown a relationship between fine particulate matter (PM2.5) exposure and an increased risk of neonatal disorders. Considering the huge burden of neonatal disorders, we assessed spatiotemporal trends of neonatal disorders burden caused by ambient and household PM2.5 at the global, regional, and national levels from 1990 to 2019. The number, rate, and population attributable fraction (PAF) of ambient and household PM2.5-related neonatal disorders disability-adjusted life years (DALYs) in 204 countries and territories from 1990 to 2019 were obtained from the Global Burden of Disease Study 2019 to measure the related neonatal disorders burden by age, sex, subtype, and region. Estimated annual percentage change (EAPC) was estimated to quantify temporal trends. In 2019, approximately a fifth of the global neonatal disorders burden was attributable to PM2.5 exposure, with 7.54% for ambient PM2.5 and 13.23% for household PM2.5. Although the global neonatal disorders burden attributable to household PM2.5 has decreased substantially in the past 30 years, that attributable to ambient PM2.5 has increased, especially in lower sociodemographic index (SDI) regions. The highest rate and PAF of ambient PM2.5-related neonatal disorders DALYs in 2019 were in South Asia and East Asia, respectively, and the fastest increases were in Eastern Sub-Saharan Africa (for rate: EAPC = 2.55, 95% CI: 2.37-2.73) and South Asia (for PAF: EAPC = 3.88, 95% CI: 3.68-4.08). In addition, we found an inverted V-shaped between rates and PAFs of ambient PM2.5-related neonatal disorders DALYs in 2019, as well as corresponding EAPCs, and SDI, while rates and PAFs of household PM2.5-related neonatal disorders DALYs in 2019 were highly negatively correlated with SDI. In the past three decades, the global ambient PM2.5-related neonatal disorders burden largely increased, especially in lower SDI regions. Comparatively, the household PM2.5-related neonatal disorders burden decreased but still accounted for about two-thirds of the PM2.5-related neonatal disease burden.

An immediate postoperative response to therapy assessment can help avoid unnecessary RAI therapy.

Background: Radioiodine (RAI) therapy plays a vital role in the postoperative treatment of differentiated thyroid cancer (DTC) patients underwent total thyroidectomy (TT). However, even in the presence of capsular invasion and lymph node metastasis prognosis can be excellent and a postoperative RAI treatment might not be necessary for all patients. Therefore, this study explored the criteria for avoiding unnecessary RAI therapy in these patients. Method: We applied response to therapy assessment immediately after surgery and prospectively recruited 179 excellent or indeterminate response DTC patients with capsular invasion and/or LNM who underwent TT without RAI therapy. During the follow-up, thyroglobulin (Tg), thyroglobulin antibody (TgAb) levels, and cervical ultrasonography were collected and analyzed. Disease-free survival (DFS) was calculated using the Kaplan-Meier method. In addition, response to therapy assessments was performed on patients during each follow-up. Results: The mean follow-up period was 29.85 ± 17.44 months, and the 3- and 5-year DFS for all the patients was 99.3% in each. At the last follow-up, 165 (92.2%) patients had excellent responses, while 12 (6.7%) had an indeterminate response, and one (0.6%) each had biochemical and incomplete responses. No significant difference was observed in response to therapy between the subgroups of LNM and tumor invasion (P>0.05). For patients with capsular invasion and a number of metastatic lymph nodes ≤5 and >5, the proportions of recorded excellent responses were 95.9%, 91.0%, and 85.7%, respectively. Better responses were observed in females (excellent response: 95.5%, P=0.023), patients with stimulated Tg (s-Tg) ≤1ng/ml (excellent response: 100%, P<0.001), s-Tg ≤ 2ng/ml (excellent response: 98.4%, P<0.001), and excellent response for the immediate postoperative assessment (excellent response: 98.5%, P=0.004). Conclusions: The current study suggested that the response to therapy assessment immediately applied postoperatively could help avoid unnecessary RAI therapy among DTC patients with capsular invasion and/or LNM. Moreover, excellent response patients and patients with indeterminate response and s-Tg ≤ 2ng/ml could be managed without RAI therapy.

[Sources and Ecological Risk Assessment of Polycyclic Aromatic Hydrocarbons in the Jiaxing River Network].

In order to study the pollution source and ecological risk assessment of polycyclic aromatic hydrocarbons (PAHs) in the Jiaxing river network, PAHs were analyzed by GC-MS. The results show that with the influence of rainfall and surface runoff in the wet season, the types and mass concentrations of PAHs in the river network of Jiaxing differ from the dry season. Ten and 16 priority PAHs were detected in the dry season and wet season, respectively. The average mass concentration of PAHs in the dry season was 143.83ng·L-1 and 73.47ng·L-1 in the wet season. The range of mass concentration of PAHs in the dry and wet season was 77.32-283.76ng·L-1 and 13.05-133.02ng·L-1, respectively, and 2-ring and 3-ring PAHs accounted for 79.18% in the dry season and 73.60% in the wet season. PAHs pollution in the river network of Jiaxing was at a low level compared with the domestic and foreign areas. The isomer ratio and principal component analysis found that the PAHs in the Jiaxing river network mainly come from urban non-point source pollution, combustion source, and traffic pollution in the dry season and wet season. The results of the Kalf risk entropy method show that in the dry season, naphthalene(Nap), acenaphthylene(Acy), acenaphthene(Ace), fluorene(Flu), phenanthrene(Phe), anthracene(Ant), fluoranthene(Fla), pyrene(Pyr), and benzo(a)anthracene(BaA) are at moderate ecological risk. In the wet season, Nap, Acy, Flu, Phe, Fla, Pyr, BaA, benzo(b)fluoranthene(BbF), benzo(k)fluoranthene(BkF), benzo(a)pyrene(BaP), indeno(1,2,3-cd)pyrene(InP), and benzo(g,h,i)perylene(BghiP) are at moderate ecological risk. In the dry season, ∑PAHs are at moderate ecological risk, and low in the wet season. On the whole, PAHs pollution in the Jiaxing river network presents moderate ecological risk levels, and measures to reduce the ecological risk of PAHs in the river network should be taken by the Departments concerned.

An evidence-based assessment for the association between long-term exposure to outdoor air pollution and the risk of lung cancer.

Although outdoor air pollution has been identified as carcinogenic to humans, the magnitude of the relative risk (RR) and the 95% confidence interval (CI) for lung cancer in relation to outdoor air pollution remain uncertain. On a global scale, we quantified the risk of lung cancer associated with long-term exposure to outdoor air pollution using a meta-analytic approach. Relevant cohort studies from two databases (PubMed and Web of Science) through 31 May 2014 were searched, and a total of 21 cohort studies were identified in the analysis. The risk of lung cancer mortality or morbidity increased 7.23 (95% CI: 1.48-13.31)%/10 µg/m increase in fine particles (PM2.5), 13.17 (95% CI: 5.57-21.30)%/10 parts per billion (ppb) increase in nitrogen dioxide (NO2), 0.81 (95% CI: 0.14-1.49)%/10 ppb increase in nitrogen oxides (NOx), and 14.76 (95% CI: 1.04-30.34)%/10 ppb increase in sulfur dioxide (SO2). These positive associations remained when analysis was restricted to never-smokers or studies with high methodological quality, and showed no difference by sex. In addition, the association of fine particles with lung cancer was suggestively stronger among never-smokers (RR per each 10 µg/m=1.18, 95% CI: 1.06-1.32). There was a null association for carbon monoxide and ozone. Our study indicated that long-term exposure to PM2.5, NO2, NOx, and SO2 may be associated with an increased risk of lung cancer. Although the magnitude of the RR is relatively small, our finding, if validated, may be of public health importance because a large proportion of the population is exposed to air pollution globally.

Simulation of the pharmacokinetics of bisoprolol in healthy adults and patients with impaired renal function using whole-body physiologically based pharmacokinetic modeling.

AIM: To develop and evaluate a whole-body physiologically based pharmacokinetic (WB-PBPK) model of bisoprolol and to simulate its exposure and disposition in healthy adults and patients with renal function impairment. METHODS: Bisoprolol dispositions in 14 tissue compartments were described by perfusion-limited compartments. Based the tissue composition equations and drug-specific properties such as log P, permeability, and plasma protein binding published in literatures, the absorption and whole-body distribution of bisoprolol was predicted using the 'Advanced Compartmental Absorption Transit' (ACAT) model and the whole-body disposition model, respectively. Renal and hepatic clearances were simulated using empirical scaling methods followed by incorporation into the WB-PBPK model. Model refinements were conducted after a comparison of the simulated concentration-time profiles and pharmacokinetic parameters with the observed data in healthy adults following intravenous and oral administration. Finally, the WB-PBPK model coupled with a Monte Carlo simulation was employed to predict the mean and variability of bisoprolol pharmacokinetics in virtual healthy subjects and patients. RESULTS: The simulated and observed data after both intravenous and oral dosing showed good agreement for all of the dose levels in the reported normal adult population groups. The predicted pharmacokinetic parameters (AUC, C(max), and T(max)) were reasonably consistent (<1.3-fold error) with the observed values after single oral administration of doses ranging from of 5 to 20 mg using the refined WB-PBPK model. The simulated plasma profiles after multiple oral administration of bisoprolol in healthy adults and patient with renal impairment matched well with the observed profiles. CONCLUSION: The WB-PBPK model successfully predicts the intravenous and oral pharmacokinetics of bisoprolol across multiple dose levels in diverse normal adult human populations and patients with renal insufficiency.

[A caregiver survey in Beijing, Xi'an, Shanghai and Chengdu: health services status for the elderly with dementia].

OBJECTIVE: In order to rationally allocate resources and to improve the quality of life of people with dementia, it is necessary to assess their current health services status. METHODS: A population-based door-to-door caregiver survey was conducted in Beijing, Xi'an, Shanghai and Chengdu in 1998. Totally 1 141 individuals with dementia were found among 34 807 residents aged 55 years and over on the basis of national prevalence study of dementia. Then 428 families with demented patients were randomly selected for questionare interview. Interviews were completed in 405 but refused by 23 families. Measurements included demographic characteristics of patients and their caregivers, perspective of the victim of the disease, current awareness of the disease and medical and welfare services provided. RESULTS: Among 405 cases of dementia (including 298 cases of AD and 81 cases of VaD), mean MMSE scores were 16.3 +/- 5.3 for 157 mild cases, 12.7 +/- 5.4 for 135 moderate cases, and 6.2 +/- 5.8 for 110 severe cases. Most patients (96%) were cared for at home by family members. Among caregivers, 189 (48.8%) considered the impairment of cognition, behavior and daily living activity in demented persons as a result of normal aging. Half of the caregivers spend over 8 hours each day looking after the patient. Whether the caregivers brought their relatives with dementia to a doctor was determined by disease severity, i.e. 8.3% for mild, 13.5% for moderate, and 19.4% for severe in 1996 to approximately 1997 and 14.4%, 25.6% and 33.6%, respectively in 1998-1999. Of those, only 26.9% reported receiving a dementia diagnosis, and only 21.3% received a recommedation to take medication. However, there was no established standard treatment and only 2% patient's used Ache-I. CONCLUSIONS: General education is needed to increase the public awareness of dementia. For patients with dementia, early diagnosis, early treatment and optimal care are important to improve their quality of life.