Incidence, Morbidity and years Lived With Disability due to Type 2 Diabetes Mellitus in 204 Countries and Territories: Trends From 1990 to 2019.

Background: We aimed to examine the descriptive epidemiology and trends in the burden of type 2 diabetes mellitus (T2DM). Methods: Data were extracted from the Global Burden of Disease 2019 dataset. Estimated annual percentage changes (EAPCs) were calculated to assess the trends in incidence rate, mortality and disability-adjusted life-years (DALYs) associated with T2DM. Measures were stratified by sex, region, country, age and social development index (SDI) value. Results: The global age-standardized incidence rate of T2DM increased from 1990 to 2019, with an EAPC of 1.25 (95% CI, 1.19 to 1.31). In 2019, the highest age-standardized incidence rate of T2DM was observed in high-SDI regions, and the largest increase in this rate from 1990 to 2019 was also in high-SDI regions (EAPC, 1.74;95% CI, 1.57 to 1.90). At the regional level, Central Asia (EAPC, 2.53;95% CI, 2.45 to 2.61) had the largest increase in the age-standardized incidence rate of T2DM from 1990 to 2019. At the national level, Luxembourg (EAPC, 4.51;95% CI, 4.37 to 4.65) and Uzbekistan (EAPC, 3.63; 95% CI, 3.44 to 3.82) had the largest increases in the age-standardized incidence rate of T2DM from 1990 to 2019. The global age-standardized death and DALY rates increased from 1990 to 2019, with EAPCs of 0.26 (95% CI, 0.16 to 0.37) and 0.81 (95% CI, 0.77 to 0.85), respectively. The age-standardized death and DALY rates showed the largest increases in Central Asia, South Asia and Southern Sub-Saharan Africa. Conclusions: Globally, the age-standardized incidence, death and DALY rates increased from 1990 to 2019. Central Asia, South Asia and Southern Sub-Saharan Africa were found to have the greatest burden of T2DM. Future strategies should focus on these high-risk regions and other high-risk populations.

Short term outcomes of extremely low birth weight infants from a multicenter cohort study in Guangdong of China.

With the increase in extremely low birth weight (ELBW) infants, their outcome attracted worldwide attention. However, in China, the related studies are rare. The hospitalized records of ELBW infants discharged from twenty-six neonatal intensive care units in Guangdong Province of China during 2008-2017 were analyzed. A total of 2575 ELBW infants were enrolled and the overall survival rate was 55.11%. From 2008 to 2017, the number of ELBW infants increased rapidly from 91 to 466, and the survival rate improved steadily from 41.76% to 62.02%. Increased survival is closely related to birth weight (BW), regional economic development, and specialized hospital. The incidence of complications was neonatal respiratory distress syndrome (85.2%), oxygen dependency at 28 days (63.7%), retinopathy of prematurity (39.3%), intraventricular hemorrhage (29.4%), necrotizing enterocolitis (12.0%), and periventricular leukomalacia (8.0%). Among the 1156 nonsurvivors, 90.0% of infants died during the neonatal period (≤ 28 days). A total of 768 ELBW infants died after treatment withdrawal, for reasons of economic and/or poor outcome. The number of ELBW infants is increasing in Guangdong Province of China, and the overall survival rate is improving steadily.

Disparities in air quality downscaler model uncertainty across socioeconomic and demographic indicators in North Carolina.

Studies increasingly use output from the Environmental Protection Agency's Fused Air Quality Surface Downscaler ("downscaler") model, which provides spatial predictions of daily concentrations of fine particulate matter (PM2.5) and ozone (O3) at the census tract level, to study the health and societal impacts of exposure to air pollution. Downscaler outputs have been used to show that lower income and higher minority neighborhoods are exposed to higher levels of PM2.5 and lower levels of O3. However, the uncertainty of the downscaler estimates remains poorly characterized, and it is not known if all subpopulations are benefiting equally from reliable predictions. We examined how the percent errors (PEs) of daily concentrations of PM2.5 and O3 between 2002 and 2016 at the 2010 census tract centroids across North Carolina were associated with measures of racial and educational isolation, neighborhood disadvantage, and urbanicity. Results suggest that there were socioeconomic and demographic disparities in surface concentrations of PM2.5 and O3, as well as their prediction uncertainties. Neighborhoods characterized by less reliable downscaler predictions (i.e., higher PEPM2.5 and PEO3) exhibited greater levels of aerial deprivation as well as educational isolation, and were often non-urban areas (i.e., suburban, or rural). Between 2002 and 2016, predicted PM2.5 and O3 levels decreased and O3 predictions became more reliable. However, the predictive uncertainty for PM2.5 has increased since 2010. Substantial spatial variability was observed in the temporal changes in the predictive uncertainties; educational isolation and neighborhood deprivation levels were associated with smaller increases in predictive uncertainty of PM2.5. In contrast, racial isolation was associated with a greater decline in the reliability of PM2.5 predictions between 2002 and 2016; it was associated with a greater improvement in the predictive reliability of O3 within the same time frame.

Global, regional, and national burden of cervical cancer for 195 countries and territories, 2007-2017: findings from the Global Burden of Disease Study 2017.

BACKGROUND: Cervical cancer is one of the most common cancers among women worldwide. The formulation or evaluation on prevention strategies all require an accurate understanding of the burden for cervical cancer burden. We aimed to report the up-to-date estimates of cervical cancer burden at global, regional, and national levels. METHODS: Data were extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 study. The counts, age-standardized rates, and percentage changes of incidence, disability-adjusted life-years (DALYs), and death attributed to cervical cancer at the global, regional, and national levels in all 195 countries and territories from 21 regions during 2007 to 2017 by age and by Socio-demographic Index (SDI) were measured. All estimates were reported with 95% uncertainty intervals (UIs). RESULTS: In 2017, 601,186 (95% UI 554,455 to 625,402) incident cases of cervical cancer were reported worldwide, which caused 8,061,667 (7,527,014 to 8,401,647) DALYs and 259,671 (241,128 to 269,214) deaths. The age-standardized rates for incidence, DALYs and death decreased by - 2.8% (- 7.8% to 0.6%), - 7.1% [- 11.8% to - 3.9%] and - 6.9% [- 11.5% to - 3.7%] from 2007 to 2017, respectively. The highest age-standardized incidence, DALYs and death rates in 2017 were observed in the low SDI quintile, Oceania, Central and Eastern Sub-Saharan Africa. During 2007 to 2017, only East Asia showed increase in these rates despite not significant. At the national level, the highest age-standardized rates for incidence, DALYs, and death in 2017 were observed in Kiribati, Somalia, Eritrea, and Central African Republic; and Georgia showed the largest increases in all these rates during 2007 to 2017. CONCLUSION: Although the age-standardized rates for incidence, DALYs, and death of cervical cancer have decreased in most parts of the world from 2007 to 2017, cervical cancer remains a major public health concern in view of the absolute number of cervical cancer cases, DALYs, and deaths increased during this period. The challenge is more prone to in the low SDI quintile, Oceania, Central and Eastern Sub-Saharan Africa, East Asia, and some countries, suggesting an urgent to promote human papillomavirus vaccination in these regions.

[Pollution Characteristics and Health Risk Assessment of Volatile Organic Compounds (VOCs) and Semi-volatile Organic Compounds (SVOCs) in Qiantang River's Hangzhou Section During a Water Odor Pollution Event].

For surface water samples collected from the Hangzhou section of Qiantang River (before, during, or after the occurrence of a water odor pollution event), 125 kinds of volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs)were quantitatively determined via purge&trap-gas chromatography-mass spectrometry and liquid-liquid extraction-gas chromatography-triple quadrupole mass spectrometry. Then, the pollution characteristics of the VOCs and SVOCs were analyzed, and the health risk of these compounds was assessed. The results showed that 17 VOCs and SVOCs in the surface water samples of 4 monitoring sections were detected, in a concentration range of 0.01-1.21 µg·L-1, which is a low pollution level. The concentration of dichloromethane was the highest of 17 VOCs and SVOCs, accounting for 36.3%, and it was thus clear that dichloromethane was the main contributing factor. During the water odor pollution event, the concentrations of VOCs and SVOCs were significantly higher than they were in the three months before or after the occurrence of the event, by 2.1-4.6 times, reflecting the strong external source input. In addition, human health risk assessment of ingestion through drinking water and absorption through skin contact was performed using US EPA recommended methods. It indicated that the total non-carcinogenic and total carcinogenic risks (∑HI and ∑R) caused by VOCs and SVOCs are 2.4×10-3-3.6×10-2 and 1.9×10-7-1.0×10-6, respectively, both of which belong to the acceptable risk level. Therefore, although ∑HI and ∑R during the occurrence of the odor event were significantly higher than those in the three months before or after the event, the VOCs and SVOCs detected will not cause obvious non-carcinogenic nor carcinogenic health effects on humans.

Follow-up assessment of two cases of trichloroethylene hypersensitivity syndrome: A case report.

The present study aimed to explore the stability, curability and sequelae of cases of Trichloroethylene (TCE) Hypersensitivity Syndrome (THS), and to investigate the causal allergens of THS. Two cases of THS were followed-up in the current study; both cases were healing following glucocorticoid therapy and were discharged >10 weeks prior to follow-up. A questionnaire investigation, health examination and patch test were performed. Allergens of TCE and its metabolites, including chloral hydrate, trichloroethanol (TCOH) and trichloroacetic acid, were applied in the patch test; 4 controls were included. The two subjects were experiencing itching, pigmentation and xerosis of the skin, and had abnormal results in the ophthalmology Schirmer I test and tear break-up time. The body temperature, liver function, superficial lymph nodes, blood, urine routine and autoimmune antibodies of two subjects were shown to be normal, and no new rashes had appeared. All mass concentration of chloral hydrate and TCOH were positive; 5.0% trichloroacetic acid was weakly positive, 0.5% trichloroacetic acid and all mass concentration of TCE were negative. All patch tests were negative in the 4 control subjects. The results suggest that THS was stable following treatment with glucocorticoid therapy. Dry eye syndrome may continue as a sequelae of THS. The patch test demonstrated that the mechanism underlying THS is delayed-type hypersensitivity induced by TCE. In addition, as the hypersensitivity state in a THS rehabilitee could be sustained over a long period of time, it suggests that the metabolites of TCE, not TCE itself, are responsible for THS. Therefore, patients with THS should avoid contact with TCE and its metabolites, and avoid using hypnotic and anticonvulsive drugs containing chloral hydra as the primary ingredient.

Residues and potential health risks of DDTs and HCHs in commercial seafoods from two coastal cities near Yangtze River Estuary.

Five species of commercial seafoods collected from the local markets in two coastal cities near Yangtze River Estuary (Ningbo and Zhoushan) in 2010 were analyzed to study the residues, potential sources, and health risks of dichlorodiphenyltrichloroethanes (DDTs) and hexachlorocyclohexanes (HCHs) in these areas. The total levels of DDTs and HCHs in the samples ranged from 1.13-20.2 ng g(-1) and 1.23-3.05 ng g(-1) wet weight, respectively, and were at a middle level compared with those from other marine systems. Results from one-way analysis of variance (ANOVA) indicated species-specific distributions of DDTs and HCHs in the seafoods of the studied area, which may be related to their different lipid contents and ecological characteristics. Compositional analysis suggested that historical usage dominates in this area, and fresh inputs of lindane and dicofol may also have part contributions. With respect to DDTs, it can be metabolized into both DDD and DDE simultaneously in seafoods tested. Assessment based on maximum residue levels, acceptable or tolerable daily intakes, and hazard ratios for non-carcinogens suggested no obvious adverse health effects, while the lifetime cancer risks may be increased from dietary exposure to DDTs and HCHs.

Impact of periodic health examination on surgical treatment for uterine fibroids in Beijing: a case-control study.

BACKGROUND: During the past 2 decades, there has been a rapid proliferation of "health examination center (HEC)" across China. The effects of their services on public's health have not been systemically investigated. This study aimed to assess the impact of periodic health examination (PHE) at HEC on surgical treatment for uterine fibroids in Beijing residents. METHODS: We identified 224 patients with a primary diagnosis of uterine fibroids who had surgical treatment at four Level-1 general hospitals in Beijing, from June 1, 2009 to October 20, 2009. Controls were women who did not have surgery for uterine fibroids, matched (1:1 ratio) for age (within 2 years). A standard questionnaire was used to inquire about whether participants had PHE at HEC during the previous 2 years. RESULTS: PHE at HEC within 2 years were associated with surgical treatment for uterine fibroids. Odds ratios was 4.05 (95% CI, 2.61-6.29 P < 0.001), after adjustment for marital status, whether have children, annual family income, health insurance, education level and self-rated uterine fibroids-related symptom severity. CONCLUSIONS: Our study showed PHE currently provided at HEC in China were associated with significantly increased use of surgical treatment for uterine fibroids in women. Further studies are needed to assess the effects of PHE on clinical as well as on broad societal outcomes in Chinese in contemporary medical settings.