Cost-Effective Whole Transcriptome Sequencing Landscape and Diagnostic Potential Biomarkers in Active Tuberculosis.

Tuberculosis (TB) is a prevalent and severe infectious disease that poses a significant threat to human health. However, it is frequently disregarded as there are not enough quick and accurate ways to diagnose tuberculosis. Here, we develop a strategy for tuberculosis detection to address the challenges, including an experimental strategy, namely, Double Adapter Directional Capture sequencing (DADCSeq), an easily operated and low-cost whole transcriptome sequencing method, and a computational method to identify hub differentially expressed genes as well as the diagnosis of TB based on whole transcriptome data using DADCSeq on peripheral blood mononuclear cells (PBMCs) from active TB and latent TB or healthy control. Applying our approach to create a robust and stable TB multi-mRNA risk probability model (TBMMRP) that can accurately distinguish active and latent TB patients, including active TB and healthy controls in clinical cohorts, this diagnostic biomarker was successfully validated by several independent cross-platform cohorts with favorable performance in differentiating active TB from latent TB or active TB from healthy controls and further demonstrated superior or similar diagnostic accuracy compared to previous diagnostic markers. Overall, we develop a low-cost and effective strategy for tuberculosis diagnosis; as the clinical cohort increases, we can expand to different disease kinds and learn new features through our disease diagnosis strategy.

Assessing Patterns of Continuous Glucose Monitoring Use and Metrics of Glycemic Control in Type 1 Diabetes and Type 2 Diabetes Patients in the Veterans Health Care System: Integrating Continuous Glucose Monitoring Device Data with Electronic Health Records Data.

Objective: To integrate long-term daily continuous glucose monitoring (CGM) device data with electronic health records (EHR) for patients with type 1 and type 2 diabetes (T1D and T2D) in the national Veterans Affairs Healthcare System to assess real-world patterns of CGM use and the reliability of EHR-based CGM information. Research Design and Methods: This observational study used Dexcom CGM device data linked with EHR (from 2015 to 2020) for a large national cohort of patients with diabetes. We tracked the initiation and consistency of CGM use, assessed concordance of CGM use and measures of glucose control between CGM device data and EHR records, and examined results by age, ethnicity, and diabetes type. Results: The time from pharmacy release of CGM to patients to initiation of uploading CGM data to Dexcom servers averaged 3 weeks but demonstrated wide variation among individuals; importantly, this delay decreased markedly over the later years. The average daily wear time of CGM exceeded 22 h over nearly 3 years of follow-up. Patterns of CGM use were generally consistent across age, race/ethnicity groups, and diabetes type. There was strong concordance between EHR-based estimates of CGM use and Dexcom CGM wear time and between estimates of glucose control from both sources. Conclusions: The study demonstrates our ability to reliably integrate CGM devices and EHR data to provide valuable insights into CGM use patterns. The results indicate in the real-world environment that CGM is worn consistently over many years for both patients with T1D and T2D within the Veterans Affairs Healthcare System and is similar across major race/ethnic groups and age-groups.

[Groundwater Pollution Risk Assessment in Plain Area of Barkol-Yiwu Basin].

Groundwater pollution risk assessment is an important part of groundwater pollution prevention and control. Taking groundwater in the plain area of Barkol-Yiwu Basin as the research object, the DRSTIW model was constructed to evaluate groundwater vulnerability. According to the survey data of contaminated sites and land use types, point source and non-point source pollutions were classified, and the groundwater pollution load was evaluated. The primary value, economic value, and ecological value of groundwater were considered to evaluate the functional value of groundwater. The groundwater pollution risk assessment map was generated by using the map algebra function of ArcGIS software. The ROC curve was used to verify the risk assessment results of groundwater pollution. The spatial distribution of cold and hot spots of groundwater pollution risk was obtained by calculating the G index, and the change in hot spots was quantitatively analyzed by combining the center of gravity and standard deviation ellipse. The results showed that the groundwater vulnerability was generally low. The gentle terrain slope, shallow groundwater depth, and strong aquifer permeability made it easy for pollutants to enter the aquifer, resulting in high groundwater vulnerability in the northwest of Santanghu Town, the southeast of Dahongliuxia Township, and Kuisu Town in Barkol County. The groundwater pollution load and groundwater functional value were generally low, whereas the point source and non-point source pollution caused by industrial and agricultural production and life would increase the groundwater pollution load in local areas, and the human economic activities and habitat quality levels would affect the distribution of high groundwater function value areas. Groundwater pollution risk was generally low; very high and high pollution risk areas only accounted for 6.8% of the study area, mainly distributed in Naomaohu Town and Yanchi Town of Yiwu County, Kuisu Town, Shirenzi Township, Huayuan Township of Barkol County, and Hongshan Farm of Corps. The shallow groundwater depth, strong permeability of soil surface and vadose zone media, poor adsorption capacity, and concentrated distribution of pollution sources made it easy for pollutants to migrate and enrich in these areas. Under the dual influence of high vulnerability and high pollution load of groundwater, the risk of groundwater pollution in local areas increased. Affected by human activities, there was a certain spatial agglomeration of groundwater pollution risk, and the overall trend was from northwest to southeast. The results of groundwater pollution risk assessment provided a scientific reference for the division of groundwater pollution prevention and control areas.

[Assessment of Groundwater Contamination Risk in the Plain Area of Southern Turpan Basin].

Groundwater contamination risk assessment is an effective tool for groundwater pollution prevention and control. The evaluation system mainly includes three parts:groundwater contamination source load assessment, groundwater vulnerability assessment, and groundwater function value evaluation. Taking the plain area of southern Turpan Basin as an example, based on the survey data and land use data, point source pollution and non-point source pollution were divided to evaluate the load of groundwater pollution sources, the classical DRASTIC model was selected to evaluate the vulnerability of groundwater, and the functional value of groundwater was evaluated from the point of view of water quality and quantity. The three factors were weighted and superimposed via GIS platform to generate the risk zoning map of groundwater contamination. The results showed that the overall risk of groundwater contamination in the study area was low. The area of high-risk and relatively high-risk areas accounted for 15.5% of the total study area, which were mainly distributed in L1, L2, and L3 of the study area. L1 was mainly affected by high pollution source load and high groundwater vulnerability. L2 was mainly the result of the joint action of high groundwater function value and domestic non-point source pollution. Non-point source pollution dominated by agricultural activities and high functional value of groundwater were the main reasons for the high risk of groundwater pollution in the L3 area. The results of the groundwater contamination risk assessment serve as an important reference for decision-makers to delineate the prevention and control area of groundwater pollution.

Effect of China's long-term care insurance on health outcomes of older disabled people: role of institutional care.

Since the public long-term care insurance (LTCI) system was piloted in Chengdu, China, in October 2017, there has been considerable growth of LTC institutions in China. This study aimed to evaluate the health value effect of LTCI in older patients with severe disabilities in an LTC institution. This prospective study was based on data from 985 severe disability patients with or without LTCI from October 2017 to May 2021 in the Eighth People's Hospital, Chengdu, China. The Cox proportional hazard model estimated LTCI's health value, including survival probability and risk of pneumonia/pressure ulcers. Subgroup analysis was performed for sex, age, Charlson Comorbidity Index (CCI), and the number of drugs. In the analysis, 519 and 466 patients in LTCI and non-LTCI groups were included, respectively. In adjusted Cox analyses, the LTCI group had a significantly elevated survival rate compared with the non-LTCI groups at 12 months (P < .001, hazard ratio (HR) = 1.758, 95% confidence interval (CI) 1.300-2.376). At 40 months, the adjusted survival rate was 62.6% in the LTCI group, which was significantly higher (53.7%; P = .003, HR = 1.438, 95% CI 1.131-1.831). The subgroups of patients aged 60 to 79 years (interaction P = .007) and with CCI ≥ 3 (interaction P = .026) were more significantly associated with survival improvement than those aged >80 years and with CCI< 3. The LTCI group was also at lower risk for hospital-acquired pneumonia (P = .016, HR 0.622, 95% CI 0.422-0.917) and pressure ulcers (P = .008, HR 0.695, 95% CI 0.376-0.862). The improved survival of LTCI remained stable in sensitivity analyses. For older patients with severe disabilities, in a LTC institution, LTCI significantly improved their health profile and longevity after a year, suggesting the large role and development potentiality of institution care in the LTCI system of China.

[Groundwater Pollution Risk Assessment in Plain Area of the Yarkant River Basin].

Groundwater pollution risk assessment is an effective method to manage groundwater resources and prevent groundwater pollution. The DRSTIW model was used to evaluate the groundwater vulnerability in a plain area of the Yarkant River Basin, and factor analysis was used to identify pollution sources for pollution loading evaluation. The functional value of groundwater was estimated by considering both the mining value and the in-situ value. The entropy weight method and the analytic hierarchy process (AHP) were used to determine the comprehensive weight, and a groundwater pollution risk map was generated based on the overlay function of ArcGIS software. The results showed that the natural geological factors such as large groundwater recharge modulus, wide recharge sources, strong permeability of soil surface and unsaturated zone, and shallow groundwater depth facilitated pollutant migration and enrichment, resulting in a higher overall groundwater vulnerability. Very high vulnerability and high vulnerability areas were mainly distributed in Zepu County, Shache County, Maigaiti County, Tumushuke City, and the eastern part of Bachu County. The pollution loading of groundwater was generally low, the main pollution sources were point source pollution caused by water-rock interaction, non-point source pollution caused by pesticides and fertilizers, and point source pollution caused by industry and life. The overall functional value of groundwater was low because of human economic activities, fine water quality, and good habitat quality. Groundwater pollution risk was generally low, and very high and high pollution risk areas accounted for 20.7% of the study area, mainly distributed in Shache County, Zepu County, Maigaiti County, Tumushuke City, and the western part of Bachu County. Natural conditions such as strong aquifer permeability, weak groundwater runoff conditions, large groundwater recharge modulus, low vegetation coverage, and strong water-rock interaction, coupled with frequent human activities such as application of agricultural fertilizers and discharge of industrial and domestic sewage, made the groundwater pollution risk higher in these areas. Groundwater pollution risk assessment provided strong data support for the optimization of the groundwater monitoring network and the prevention of groundwater pollution.

Patient-reported outcome (PRO)-based symptom assessment in patients with advanced lung cancer receiving first-line combination immunotherapy: a protocol for a multicenter, prospective, observational study.

BACKGROUND: Immunotherapy is currently applied in the first-line treatment regimens for numerous advanced cancers, especially advanced lung cancer. Immune-related adverse events (irAEs) resulting from immunotherapy can vary in severity and cause a substantial symptom burden to patients. However, there are limited data on symptom burden in patients with advanced lung cancer following immunotherapy. To address this deficit, this study aims to provide insight into the symptom burden and severity through patient-reported outcome measurements and conduct an analysis of temporal trends and clinical consequences of symptom burden in patients with advanced lung cancer receiving combination immunotherapy. METHODS: We will prospectively recruit 168 eligible patients from 14 hospitals in China. Eligible patients will be aged ≥ 18 years, pathologically diagnosed with locally advanced or stage IV primary lung cancer without surgical indications, and agreed to receive immunotherapy in combination with other therapies. The primary outcome of this study is the symptom burden of patients during the immunotherapy course. Longitudinal symptom data will be collected using the MD Anderson Symptom Inventory-Lung Cancer module (MDASI-LC) and the symptomatic irAEs scale at baseline (once before treatment) and weekly after treatment, until 1 month after the last treatment cycle has been completed. The trajectory of symptom burden following combination immunotherapy will be depicted, and by linking it to clinical outcomes (the secondary outcome and exploratory outcome of this study), the consequence of symptom burden in patients with advanced lung cancer receiving combination immunotherapy will be examined further. DISCUSSION: This study intends to establish longitudinal symptom trajectories in patients with lung cancer receiving immunotherapy, and explore its association with clinical outcomes. These findings may serve as an important reference for clinicians in the symptomatic management of patients with lung cancer receiving immunotherapy. TRIAL REGISTRATION NUMBER: ChiCTR2200061540. Registered on June 28, 2022.

Initiation of Continuous Glucose Monitoring Is Linked to Improved Glycemic Control and Fewer Clinical Events in Type 1 and Type 2 Diabetes in the Veterans Health Administration.

OBJECTIVE: To determine the benefit of starting continuous glucose monitoring (CGM) in adult-onset type 1 diabetes (T1D) and type 2 diabetes (T2D) with regard to longer-term glucose control and serious clinical events. RESEARCH DESIGN AND METHODS: A retrospective observational cohort study within the Veterans Affairs Health Care System was used to compare glucose control and hypoglycemia- or hyperglycemia-related admission to an emergency room or hospital and all-cause hospitalization between propensity score overlap weighted initiators of CGM and nonusers over 12 months. RESULTS: CGM users receiving insulin (n = 5,015 with T1D and n = 15,706 with T2D) and similar numbers of nonusers were identified from 1 January 2015 to 31 December 2020. Declines in HbA1c were significantly greater in CGM users with T1D (-0.26%; 95% CI -0.33, -0.19%) and T2D (-0.35%; 95% CI -0.40, -0.31%) than in nonusers at 12 months. Percentages of patients achieving HbA1c <8 and <9% after 12 months were greater in CGM users. In T1D, CGM initiation was associated with significantly reduced risk of hypoglycemia (hazard ratio [HR] 0.69; 95% CI 0.48, 0.98) and all-cause hospitalization (HR 0.75; 95% CI 0.63, 0.90). In patients with T2D, there was a reduction in risk of hyperglycemia in CGM users (HR 0.87; 95% CI 0.77, 0.99) and all-cause hospitalization (HR 0.89; 95% CI 0.83, 0.97). Several subgroups (based on baseline age, HbA1c, hypoglycemic risk, or follow-up CGM use) had even greater responses. CONCLUSIONS: In a large national cohort, initiation of CGM was associated with sustained improvement in HbA1c in patients with later-onset T1D and patients with T2D using insulin. This was accompanied by a clear pattern of reduced risk of admission to an emergency room or hospital for hypoglycemia or hyperglycemia and of all-cause hospitalization.

Assessment of hepatic fat content and prediction of myocardial fibrosis in athletes by using proton density fat fraction sequence.

PURPOSE: To explore the characteristics of the hepatic fat content in athletes, and predict late gadolinium enhancement (LGE) based on magnetic resonance imaging-proton density fat fraction (MRI-PDFF). MATERIAL AND METHODS: From March 2020 to March 2021, 233 amateur athletes and 42 healthy sedentary controls were prospectively recruited. The liver fat content of four regions of interest (ROIs 1-4), the mean liver fat fraction (FF), cardiac function, and myocardium LGE were recorded, respectively. The values of ROIs 1-4 and FF were compared between athletes and controls. According to the liver fat content threshold for distinguishing athletes and controls, the cutoff total exercise time that induced a change in liver fat was obtained. The correlations among the liver fat content, cardiac function, and other parameters were analyzed. Moreover, the liver fat content was used to predict myocardium LGE by logistic regression. RESULTS: There were significant differences for the values of ROI 1, ROI 3, ROI 4, and FF between athletes and controls (allp< 0.05). The cutoff total exercise time for inducing a change in the liver fat content was 1680 h (area under the curve [AUC] = 0.593, specificity = 83.3,p< 0.05). Blood indexes, cardiac function, and basic clinical parameters were related to liver fat content (allp< 0.05). The prediction model for LGE had an AUC value of 0.829 for the receiver operator characteristic curve. CONCLUSION: MRI-PDFF could assess liver fat content and predict cardiac fibrosis in athletes for risk stratification and follow-up.

Dynamic assessment of coronary artery during different cardiac cycle in patients with coronary artery disease using coronary CT angiography.

INTRODUCTION: To evaluate the effect of the cardiac cycle for the coronary artery opening and coronary stenosis at the plaque to determine the phase of measuring maximum diameters required for coronary artery disease (CAD). METHODS: This retrospective study assessed data for 208 consecutive patients who underwent coronary computed tomography angiography (CTA). The cross-sectional area and diameters of the opening of the left main coronary artery (LM), left anterior descending branch (LAD), left circumflex branch (LCX) and right coronary artery (RCA), the stenosis rate of involved vessels were measured in 10 cardiac cycles. And all their dynamic changes were estimated by the linear mixed model. The relationship between stenosis rate and opening orifice were analyzed by monofactorial variance. RESULTS: The opening parameters and stenosis rate of the four main coronary arteries varied within the cardiac cycle (p < .05). The maximum opening area occurred at the 45%-55% phase; The range of stenosis rate varied approximately 11%-14% and the maximum stenosis rate was at the 65% phase. The degree of vascular stenosis for LM, LAD and LCX were not associated with their corresponding opening diameters, but were positively intercorrelation with each other. CONCLUSION: For patients with CAD, the maximum coronary artery stenosis rate were at 65% phase and the maximum value of coronary artery opening were at 45%-55% phase, which were chosen for the appropriate measurement and evaluation by CTA.

The use of immersive virtual reality for cancer-related cognitive impairment assessment and rehabilitation: A clinical feasibility study.

Objective: This brief study aimed to examine the potential effects of virtual reality (VR)-assisted cognitive rehabilitation intervention on the health outcomes of patients with cancer. Methods: A single group of pre-test and post-test study designs were used. An innovative VR system was developed to assess cancer-related cognitive impairment and provide cognitive rehabilitation. The potential effects of the system were determined by measuring changes in cognitive function (learning and memory, information processing speed, executive function, and verbal fluency) and the severity of depression, anxiety, and insomnia. Results: Nine subjects completed the entire VR intervention and were included in the analysis. The participants' mean age was 43.3 years (standard deviation, 8.9 years). The VR-based cognitive intervention significantly improved the subjective cognitive measures of perceived cognitive impairment and perceived cognitive ability (P â€‹= â€‹0.01 and P â€‹< â€‹0.01, respectively). The intervention also improved the objective cognitive measures of verbal learning memory as measured using the Auditory Verbal Learning Test (eg., P â€‹< â€‹0.01 for 5-min delay recall), information processing speed as measured using the trail-making test-A (P â€‹= â€‹0.02) and executive function as measured using the trail-making test-B (P â€‹= â€‹0.03). Only the subtest of delayed recall showed no statistically significant difference after the intervention (P â€‹= â€‹0.69). The VR-based psychological intervention significantly reduced the severity of sleep disorders (P â€‹< â€‹0.01). Conclusions: The use of immersive VR was shown to have potential effects on improving cognitive function for patients with cancer. Future studies will require a larger sample size to examine the effects of immersive VR-assisted cognitive rehabilitation on the health outcomes of patients with cancer.

Risk controlled decision trees and random forests for precision Medicine.

Statistical methods generating individualized treatment rules (ITRs) often focus on maximizing expected benefit, but these rules may expose patients to excess risk. For instance, aggressive treatment of type 2 diabetes (T2D) with insulin therapies may result in an ITR which controls blood glucose levels but increases rates of hypoglycemia, diminishing the appeal of the ITR. This work proposes two methods to identify risk-controlled ITRs (rcITR), a class of ITR which maximizes a benefit while controlling risk at a prespecified threshold. A novel penalized recursive partitioning algorithm is developed which optimizes an unconstrained, penalized value function. The final rule is a risk-controlled decision tree (rcDT) that is easily interpretable. A natural extension of the rcDT model, risk controlled random forests (rcRF), is also proposed. Simulation studies demonstrate the robustness of rcRF modeling. Three variable importance measures are proposed to further guide clinical decision-making. Both rcDT and rcRF procedures can be applied to data from randomized controlled trials or observational studies. An extensive simulation study interrogates the performance of the proposed methods. A data analysis of the DURABLE diabetes trial in which two therapeutics were compared is additionally presented. An R package implements the proposed methods ( https://github.com/kdoub5ha/rcITR).

Performance evaluation of low-cost air quality sensors: A review.

The monitoring of air quality compliance requires the use of Federal Reference Methods (FRM)/Federal Equivalent Methods (FEM); nevertheless, the validity and reliability of low-cost sensors deserve attention due to their affordability and accessibility. This review examines the methodologies of previous studies to characterise the performance of low-cost air quality sensors and to identify the influential factors in sensor evaluation experiments. The data on four statistical measures (Correlation of Determination, r2; Root Mean Square Error, RMSE; Mean Normalised Bias, MNB; and Coefficient of Variation, CV) and details about five methodological factors in experimental design (environmental setting, reference instrument, regression model, pollutant attribute, and sensor original equipment manufacturer (OEM) specification) were extracted from a total of 112 primary articles for a detailed analysis. The results of the analysis suggested that low-cost air quality sensors exhibited improved r2 and RMSE in the experiments with stable environmental settings, in the comparison against non-designated reference instruments, or in the analysis where advanced regression models were used to adjust the sensor readings. However, the pollutant attribute and sensor OEM specification had inconclusive effects on r2 and RMSE due to contradictory results and lack of sufficient data. MNB and CV, two measures that US EPA recommends to determine the suitable application tier of air quality sensors, varied significantly among published experiments due to the discrepancy in experimental design. The outcomes of this work could provide direction to researchers regarding sensor evaluation experiments and guide practitioners to effectively select and deploy low-cost sensors for air quality monitoring.

Comparison of Primary and Secondary Prophylaxis Using PEGylated Recombinant Human Granulocyte-Stimulating Factor as a Cost-Effective Measure in Malignant Neoplasms: A Multicenter Retrospective Study.

Purpose: The aim of the study was to evaluate the cost-effectiveness of PEGylated recombinant human granulocyte-stimulating factor (PEG-rhG-CSF) as a means of achieving primary and secondary prophylaxis against chemotherapy-induced neutropenia cancer cases. Methods: Individuals who underwent PEG-rhG-CSF therapeutics were monitored for 12 months, together with thorough examination of individual medical records for extracting medical care costs. Both prophylaxis-based therapeutic options (primary/secondary) were scrutinized for cost-effectiveness, using a decision-making analysis model which derived the perspective of Chinese payers. One-way and probabilistic sensitivity analyses were used to assess the robustness of the model. Results: In summary, 130 clinical cases treated using PEG-rhG-CSF prophylaxis were included in this study: 51 within the primary prophylaxis (PP) group and 79 within the secondary prophylaxis (SP) group. Compared with SP, PP-based PEG-rhG-CSF successfully contributed to a 14.3% reduction in febrile neutropenia. In general, PP was estimated to reduce costs by $4,701.81 in comparison to SP, with a gain of 0.02 quality-adjusted life years (QALYs). Equivalent results were found in differing febrile neutropenia (FN) risk subgroups. Sensitivity analyses found the model outputs to be most affected for the average time of hospitalization and for the cost of FN. Conclusion: From the perspective of Chinese payers, PP with PEG-rhG-CSF should be considered cost-effective compared to SP strategies in patients who received chemotherapy regimens with a middle- to high-risk of FN.

Medical expenditure for lung cancer in China: a multicenter, hospital-based retrospective survey.

BACKGROUND: Lung cancer is the most prevalent cancer, and the leading cause of cancer-related deaths in China. The aim of this study was to estimate the direct medical expenditure incurred for lung cancer care and analyze the trend therein for the period 2002-2011 using nationally representative data in China METHODS: This study was based on 10-year, multicenter retrospective expenditure data collected from hospital records, covering 15,437 lung cancer patients from 13 provinces diagnosed during the period 2002-2011. All expenditure data were adjusted to 2011 to eliminate the effects of inflation using China's annual consumer price index. RESULTS: The direct medical expenditure for lung cancer care (in 2011) was 39,015 CNY (US$6,041) per case, with an annual growth rate of 7.55% from 2002 to 2011. Drug costs were the highest proportionally in the total medical expenditure (54.27%), followed by treatment expenditure (14.32%) and surgical expenditure (8.10%). Medical expenditures for the disease varied based on region, hospital level, type, and stage. CONCLUSION: The medical expenditure for lung cancer care is substantial in China. Drug costs and laboratory test are the main factors increasing medical costs.

Assessment of thoracic aorta in different cardiac phases in patients with non-aorta diseases using cardiac CT.

The aim was to evaluate the thoracic aorta in different cardiac phases to obtain the correct cardiac phase for measuring the maximum diameter required to predict aortic disease. Cardiac CT was performed on 97 patients for suspected coronary artery disease. The average diameter of ascending (AAD) and descending aorta (DAD) in the plane of pulmonary bifurcation, in the plane of the sinus junction (AAD [STJ] and DAD [STJ]), descending aorta in the plane of the diaphragm (DAD [Dia]), the diameter of the main pulmonary artery (MPAD), distance from the sternum to the spine (S-SD), and distance from the sternum to the ascending aorta (S-AAD) were assessed at 20 different time points in the cardiac cycle. Differences in aortic diameter in different cardiac phases and the correlation between aortic diameter and traditional risk factors were analyzed by the general linear mixed model. The diameter of the thoracic aorta reached the minimum at the phase of 95-0%, and reached the maximum at 30-35%. The maximum values of AAD, AAD (STJ), DAD, DAD (STJ), and DAD (Dia) were 32.51 ± 3.35 mm, 28.86 ± 3.01 mm, 23.46 ± 2.88 mm, 21.85 ± 2.58 mm, and 21.09 ± 2.66 mm, respectively. The maximum values of MPAD/AAD and DAD/AAD (STJ) were 0.8140 ± 0.1029, 0.7623 ± 0.0799, respectively. The diameter of the thoracic aorta varies with the cardiac phase. Analyzing the changes in aortic diameter, which can be done using cardiac CT, could provide a more accurate clinical measurement for predicting aortic disease.

The epidemiological trends in the burden of lung cancer attributable to PM2.5 exposure in China.

OBJECTIVE: PM2.5, which is a major contributor to air pollution, has large effects on lung cancer mortality. We want to analyse the long-term trends in lung cancer burden attributable to PM2.5 exposure and provide evidence that can be used for preventive measures and health resource planning. METHODS: Mortality data related to lung cancer were obtained from the Global Burden of Disease (GBD) 2019 project. A joinpoint regression analysis was used to assess the magnitude and direction of the trends in mortality from 1990 to 2019, and the age-period-cohort method was used to analyse the temporal trends in the mortality rate of lung cancer attributable to PM2.5 exposure by age, period, and cohort. RESULTS: From 1990 to 2019, the age-standardized mortality rate (ASMR) attributable to PM2.5 exposure trended slowly upwards, and the ASMR due to ambient PM2.5 exposure (APE) increased significantly, that due to household PM2.5 exposure (HPE) decreased. The longitudinal age curves show that the mortality rates due to PM2.5 exposure among younger individuals were low, and they significantly increased from their levels among those in the 45-49 age group to their levels among those in the over-85 age group. From 1990 to 2019, the period RRs due to APE increased, but those due to HPE decreased. Similar trends were observed in the cohort RRs. The overall net drift per year attributable to PM2.5 exposure was below 0. The local drift values increased with age and were above 0 for the over-80 age groups. The overall net drifts per year were above zero for APE and below zero for HPE. The corresponding results among males were higher than those among females. CONCLUSIONS: In China, the type of air pollution responsible for lung cancer has changed from household air pollution to ambient air pollution. PM2.5 exposure is more harmful among males and older people. Ambient air pollution should be emphasized, and China should strengthen its implementation of effective public policies and other interventions.

Dynamic assessment of the central vein throughout the cardiac cycle in adults with no right heart disease by cardiac CT.

PURPOSE: The aim of this study was to investigate the effect of the cardiac cycle on the vena cava and determine the phase of measuring maximum diameters. METHODS: A total of 152 patients who underwent cardiac computed tomography (CT) were included. Patients' basic information was collected. The major axis, minor axis, and cross-sectional area (CSA) of the vena cava in 10 phases reconstructed at 10% step from 5% to 95% R-R interval were measured in four planes (SVC1 layer: the bifurcation of the pulmonary artery; SVC2 layer: the superior vena cava (SVC) into the right atrium; IVC1 layer: the intersection of the inferior vena cava (IVC) and the right atrium; IVC2 layer: the IVC into the anterior hepatic plane). The difference in vena cava diameters between cardiac cycles was determined using the linear mixed model. RESULTS: The variations in diameter and CSA of the SVC in cardiac cycles were statistically significant (p < 0.05), while those of the suprahepatic IVC were not. In the SVC1 layer, the maximum value of the SVC major and minor axes was observed in 85% and 45% phases, respectively, while that in the SVC2 layer was observed in 45% phases. The maximum SVC diameters in the SVC1 and SVC2 layers were 19.48 ± 2.57 mm and 17.43 ± 3.09 mm, respectively. The SVC and IVC diameters and CSA were positively correlated with the body surface area in the linear mixed model. CONCLUSION: The maximum SVC diameter and CSA were mostly observed in 45% phase, which provides a reference for selecting the best phase to measure the abnormality of vena cava diameter in the future.

Has air pollution emission level in the Beijing-Tianjin-Hebei region peaked? A panel data analysis.

The Beijing-Tianjin-Hebei (BTH) region is one of the important economic centers of China, but it suffers from severe air pollution. Based on the panel pollution-related data of 2013-2017, this research adopted a Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) equation to fit the relationship between pollution emission level and its related socio-economic indicators. The pollution emission level of the BTH region was fitted and projected by using the entropy evaluation method to measure the emission levels, the partial least squares algorithm to estimate the STIRPAT equation parameters, and the hybrid trend extrapolation model to forecast the future development of the above socioeconomic indicators. Empirical analysis showed that the fitting curve to air pollution emission level reached the peak in 2015 and then decreased with a fluctuating and slow process. The air pollution emissions in 2025 will decrease to the level of 2007. With regard to the impacts on the change of the air emission pollution level, industrial waste gas emissions play a decisive role. The influence of soot (dust) emissions is considerably smaller but still larger than that of SO2 emissions. Besides, the slowing down of the economic development in the future will contribute to air quality improvement. However, the rapid growth of population in Hebei and Tianjin would hinder such improvement. Empirical analysis also implied that governments in this region should specially monitor the operation of building material industries to ensure the steady improvement of air quality.

[Water Quality Analysis and Health Risk Assessment for Groundwater at Xiangshui, Chongzuo].

To investigate the environmental quality and human health risks of different types of groundwater at Xiangshui, Chongzuo, several regular water quality indexes and concentrations of metals in 60 groundwater samples were measured and analyzed. The environmental quality of groundwater was analyzed by means of the Nemerow index. The health risks were assessed by using a human health risk assessment model. The regular water quality indexes and concentrations of metals of the well water, spring water, and underground river water exceeded the standards to different degrees. The environmental quality of groundwater was at a poor grade. The comprehensive evaluation score of underground river water (F=4.26) was the lowest. The well water had the same score as spring water (F=7.10). The high hardness and salinity were conducive to enrichment of Cr, and the reducing environment was of great advantage for the enrichment of As. The environmental geochemistry of Zn, Pb, Cd, and Cu was similar. The sources of Fe, Al, and Mn were similar. The results of the health risk assessment indicated that the health risks of well water, spring water, and underground river water were relatively high. The health risks decreased in the order of well water > underground river water > spring water. The health risks mainly came from the carcinogenic metallic element Cr. Carcinogenic risks were 4-6 orders of magnitude higher than non-carcinogenic risks. Carcinogenic risks were higher than the maximum allowance levels (5.0×10-5 a-1). Non-carcinogenic risks were lower than the allowance levels (10-6 a-1). Children had greater health risks than adults. The health risks of metals through the drinking pathway were 2-3 orders of magnitude higher than the values caused by the dermal contact pathway. For the sake of drinking water safety, the well water, underground river water, and spring water should be properly treated and the concentration of Cr in groundwater should be controlled before drinking.