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1.
Sci Total Environ ; 929: 172513, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38657798

RESUMO

Balancing water demand for socio-economic development and ecosystem stability presents a challenge for regional sustainable management, especially in drylands. Previous studies have indicated that large-scale ecological restoration projects (ERPs) lead to a decline in terrestrial water storage (TWS) in the Mu Us Sandyland (MUS). However, the effects of other human activities (e.g., cropland reclamation, coal mining) on water resources remain unclear, raising concerns regarding water crisis and human-natural system sustainability. Through the utilization of coal mine location data, we found that the impact of coal mass loss on the Gravity Recovery and Climate Experiment (GRACE) products cannot be ignored in MUS, especially in the coal-rich northeastern part. Combining these data with auxiliary datasets, we observed a significant (p < 0.05) decrease in TWS (-0.85 cm yr-1) and groundwater storage (GWS, -0.95 cm yr-1) in the MUS, with human activities accounting for 79.23 % of TWS and 90.45 % of GWS reductions, primarily due to increased agricultural and industrial water consumption. Agricultural water consumption increased 2.23 times from 2001 to 2020, attributed to enhanced water use intensity (62.6 %) and cropland expansion (37.4 %). Industrial water consumption in Shenmu, a representative coal county, experienced a 4.16-fold rise between 2001 and 2020. Despite these challenges, local governments have alleviated water stress, ensured food security, and increased household income by comprehensive management strategies, such as enhancing water-saving technology and enforcing stringent policies. Previous studies have overestimated the amount of water resources consumed by ERPs. However, ERPs has played a critical role in stabilizing the regional ecological environment and ensuring the region as a vital food and energy supplier. Our findings can guide for socio-economic development and water management policies in similar regions.

2.
Infect Drug Resist ; 17: 1215-1228, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38562405

RESUMO

Objective: To examine the risk factors linked with occupational blood exposure (OBE) among nursing staff (NS), we pinpoint deficiencies in the compliance with policies of infection prevention and control, and assess the expenditures associated with infection prevention and control. Methods: Healthcare workers that completed an "Occupational Blood Exposure Report Form" were divided into NS (observation) group and non-NS (control) group. Univariate and multivariable analyses were conducted to compare both groups in various aspects. We also explored design patents intended to minimize occupational exposure. Results: The highest incidence of OBE was observed in the department of neurosurgery. Among NS, OBE incidence was found to be influenced by independent risk factors, such as gender, age, occupational title, work location, and incidence of sharps injuries. Protective factors against OBEs included the use of arterial blood gas needles and suture needles. Personal protective equipment (PPE) usage rates were low in both groups prior to OBEs (0.74% vs 0.00%, P > 0.05). Correct emergency management could be improved promptly by both groups following an OBE (P > 0.05). However, the observation group exhibited a higher proportion of blood expression after a sharps injury and a higher re-evaluation rate at 6 months post-exposure compared to the control group (P < 0.05). In 2018, the per capita costs of infection prevention and control for NS were the Chinese Yuan (RMB) 339.43 per individual. In response to these findings, two utility model patents have been authorized. Conclusion: The risk and protective factors related to the occurrence of OBEs were investigated in this study, suggesting that there is a need for improvement in the rate of PPE usage and the re-evaluation rate of OBEs among NS. Additionally, focused training on emergency blood expression and compliance with policies among non-NS personnel is deemed necessary.

3.
Hum Vaccin Immunother ; 20(1): 2343199, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38647026

RESUMO

The "reemergence of pertussis" has elicited international concerns, occurring paradoxically amidst the expansion of immunization programs. This study was aimed to evaluate quantitatively the economic burden and identify the determinants that influence the cost associated with treating pertussis in Chinese children. We evaluated the economic burden by Chinese children diagnosed with pertussis at the Children's Hospital, Zhejiang University School of Medicine in 2022. Direct medical expenses and the utilization of medical resources attributed to pertussis were calculated. A generalized linear regression model was applied to analyze the determinants that were associated with the direct medical expenses among patients. Among the 1110 pertussis patients included in the study, 1060 were outpatients and 50 were inpatients. The average direct medical cost was ¥1878.70(i.e. $279.33). Living in urban areas (OR:1.27, p = .04), complications (OR:1.40, p < .001), hospitalization (OR:10.04, p < .001), and ≥ 3 medical visits (OR:3.71, p < .001) were associated with increased direct medical expenses. Having received four doses of the pertussis vaccine was associated with reduced direct medical expenses (OR:0.81, p = .04). This study underscores a substantial economic burden of pertussis in Hangzhou, with pronounced implications for patients residing in urban areas, experiencing complications, requiring hospitalization, having multiple medical consultations, or lacking comprehensive pertussis vaccination.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Hospitalização , Vacina contra Coqueluche , Coqueluche , Humanos , Coqueluche/economia , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , China/epidemiologia , Masculino , Feminino , Pré-Escolar , Lactente , Criança , Vacina contra Coqueluche/economia , Vacina contra Coqueluche/administração & dosagem , Custos de Cuidados de Saúde/estatística & dados numéricos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Adolescente , Vacinação/economia
4.
Environ Res ; 251(Pt 2): 118708, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38493858

RESUMO

The mode of action (MOA) framework is proposed to inform a biological link between chemical exposures and adverse health effects. Despite a significant increase in knowledge and awareness, the application of MOA in human health risk assessment (RA) remains limited. This study aims to discuss the adoption of MOA for health RA within a regulatory context, taking our previously proposed but not yet validated MOA for lead neurotoxicity as an example. We first conducted a quantitative weight of evidence (qWOE) assessment, which revealed that the MOA has a moderate confidence. Then, targeted bioassays were performed within an in vitro blood-brain barrier (BBB) model to quantitatively validate the scientific validity of key events (KEs) in terms of essentiality and concordance of empirical support (dose/temporal concordance), which increases confidence in utilizing the MOA for RA. Building upon the quantitative validation data, we further conducted benchmark dose (BMD) analysis to map dose-response relationships for the critical toxicity pathways, and the lower limit of BMD at a 5% response (BMDL5) was identified as the point of departure (POD) value for adverse health effects. Notably, perturbation of the Aryl Hydrocarbon Receptor (AHR) signaling pathway exhibited the lowest POD value, measured at 0.0062 µM. Considering bioavailability, we further calculated a provisional health-based guidance value (HBGV) for children's lead intake, determining it to be 2.56 µg/day. Finally, the health risk associated with the HBGV was assessed using the hazard quotient (HQ) approach, which indicated that the HBGV established in this study is a relative safe reference value for lead intake. In summary, our study described the procedure for utilizing MOA in health RA and set an example for MOA-based human health risk regulation.

5.
Artigo em Inglês | MEDLINE | ID: mdl-38502632

RESUMO

Skeleton-based exercise assessment focuses on evaluating the correctness or quality of an exercise performed by a subject. Skeleton data provide two groups of features (i.e., position and orientation), which existing methods have not fully harnessed. We previously proposed an ensemble-based graph convolutional network (EGCN) that considers both position and orientation features to construct a model-based approach. Integrating these types of features achieved better performance than available methods. However, EGCN lacked a fusion strategy across the data, feature, decision, and model levels. In this paper, we present an advanced framework, EGCN++, for rehabilitation exercise assessment. Based on EGCN, a new fusion strategy called MLE-PO is proposed for EGCN++; this technique considers fusion at the data and model levels. We conduct extensive cross-validation experiments and investigate the consistency between machine and human evaluations on three datasets: UI-PRMD, KIMORE, and EHE. Results demonstrate that MLE-PO outperforms other EGCN ensemble strategies and representative baselines. Furthermore, the MLE-PO's model evaluation scores are more quantitatively consistent with clinical evaluations than other ensemble strategies.

6.
Huan Jing Ke Xue ; 45(3): 1492-1501, 2024 Mar 08.
Artigo em Chinês | MEDLINE | ID: mdl-38471864

RESUMO

The concentrations, spatial-temporal distribution, and influencing factors of 16 polycyclic aromatic hydrocarbons (PAHs) in the sediments of Poyang Lake were studied, and a quantitative source analysis of PAHs in different areas of the lake was conducted. PAHs were widespread within the sediments. The concentrations of ∑16PAHs in the surface sediments of all sites ranged from 203 to 2 318 µg·kg-1. The concentrations of PAHs in the surface sediments of the lake body were higher than those in the surface sediments of the inlet rivers. The ratio of PAHs in Poyang Lake was 4 rings > 5 rings > 6 rings > 3 rings > 2 rings; the composition of 4-ring PAHs was dominant, and its content accounted for 86.11% of ∑16PAHs. The 2- and 3-ring and some 4-ring PAHs, including Flua and Pyr, were more susceptible to SOM, and the 4 through 6-ring PAHs were more susceptible to ORP and heavy metals and other environmental factors. Spatially, the higher concentration of ∑16PAHs occurred in the area of the lake adjacent to Duchang County and Poyang County, where the terrain was relatively closed, and the water exchange with the surrounding area was less than that in other sections, which was not conducive to the migration, transformation, and degradation of pollutants. In the temporal distribution, the changes in PAHs concentration level and the development of GDP in Jiangxi Province showed high consistency, and the influence of economic development and human activities might have been the main reason for the increasing PAHs concentration level. The main sources of PAHs in surface sediments of Poyang Lake included petroleum pollution and oil and coal and biomass combustion sources, and there were some spatial differences in PAHs sources in different regions. This study can provide a reference for PAHs pollution in surface sediments of Poyang Lake, which is important for the ecological environmental protection and management of Poyang Lake.

7.
Front Public Health ; 12: 1211220, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38389946

RESUMO

Aims: As people's standard of living improves, the incidence of colorectal cancer is increasing, and colorectal cancer hospitalization costs are relatively high. Therefore, predicting the cost of hospitalization for colorectal cancer patients can provide guidance for controlling healthcare costs and for the development of related policies. Methods: This study used the first page of medical record data on colorectal cancer inpatient cases of a tertiary first-class hospital in Shenzhen from 2018 to 2022. The impacting factors of hospitalization costs for colorectal cancer were analyzed. Random forest and support vector regression models were used to establish predictive models of the cost of hospitalization for colorectal cancer patients and to compare and evaluate. Results: In colorectal cancer inpatients, major procedures, length of stay, level of procedure, Charlson comorbidity index, age, and medical payment method were the important influencing factors. In terms of the test set, the R2 of the Random forest model was 0.833, the R2 of the Support vector regression model was 0.824; the root mean square error (RMSE) of the Random forest model was 0.029, and the RMSE of the Support vector regression model was 0.032. In the Random Forest model, the weight of the major procedure was the highest (0.286). Conclusion: Major procedures and length of stay have the greatest impacts on hospital costs for colorectal cancer patients. The random forest model is a better method to predict the hospitalization costs for colorectal cancer patients than the support vector regression.


Assuntos
Neoplasias Colorretais , Algoritmo Florestas Aleatórias , Humanos , Estudos Retrospectivos , Hospitalização , Neoplasias Colorretais/terapia , Aprendizado de Máquina
8.
mSphere ; 9(2): e0055323, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38299825

RESUMO

The bacteriophage is an effective adjunct to existing antibiotic therapy; however, in the course of bacteriophage therapy, host bacteria will develop resistance to bacteriophages, thus affecting the efficacy. Therefore, it is important to describe how bacteria evade bacteriophage attack and the consequences of the biological changes that accompany the development of bacteriophage resistance before the bacteriophage is applied. The specific bacteriophage vB3530 of Pseudomonas aeruginosa (P. aeruginosa) has stable biological characteristics, short incubation period, strong in vitro cleavage ability, and absence of virulence or resistance genes. Ten bacteriophage-resistant strains (TL3780-R) were induced using the secondary infection approach, and the plaque assay showed that vB3530 was less sensitive to TL3780-R. Identification of bacteriophage adsorption receptors showed that the bacterial surface polysaccharide was probably the adsorption receptor of vB3530. In contrast to the TL3780 parental strain, TL3780-R is characterized by the absence of long lipopolysaccharide chains, which may be caused by base insertion of wzy or deletion of galU. It is also intriguing to observe that, in comparison to the parent strain, the bacteriophage-resistant strains TL3780-R mostly exhibited a large cost of fitness (growth rate, biofilm formation, motility, and ability to produce enhanced pyocyanin). In addition, TL3780-R9 showed increased susceptibility to aminoglycosides and chlorhexidine, which may be connected to the loss and down-regulation of mexX expression. Consequently, these findings fully depicted the resistance mechanism of P. aeruginosa to vB3530 and the fitness cost of bacteriophage resistance, laying a foundation for further application of bacteriophage therapy.IMPORTANCEThe bacteriophage is an effective adjunct to existing antibiotic therapy; However, bacteria also develop defensive mechanisms against bacteriophage attack. Thus, there is an urgent need to deeply understand the resistance mechanism of bacteria to bacteriophages and the fitness cost of bacteriophage resistance so as to lay the foundation for subsequent application of the phage. In this study, a specific bacteriophage vB3530 of P. aeruginosa had stable biological characteristics, short incubation period, strong in vitro cleavage ability, and absence of virulence or resistance genes. In addition, we found that P. aeruginosa may lead to phage resistance due to the deletion of galU and the base insertion of wzy, involved in the synthesis of lipopolysaccharides. Simultaneously, we showed the association with the biological state of the bacteria after bacteria acquire bacteriophage resistance, which is extremely relevant to guide the future application of therapeutic bacteriophages.


Assuntos
Bacteriófagos , Infecções por Pseudomonas , Humanos , Bacteriófagos/genética , Pseudomonas aeruginosa , Infecções por Pseudomonas/terapia , Infecções por Pseudomonas/microbiologia , Antibacterianos/farmacologia , Virulência
9.
J Affect Disord ; 351: 507-517, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38307135

RESUMO

BACKGROUND: Depressive symptoms are a serious public mental health problem, and dietary intake is often considered to be associated with depressive symptoms. However, the relationship between the quality of dietary carbohydrates and depressive symptoms remains unclear. Therefore, this study aimed to investigate the relationship between high and low-quality carbohydrates and depressive symptoms and to attempt to construct an integrated model using machine learning to predict depressive symptoms. METHODS: A total of 4982 samples from the National Health and Nutrition Examination Survey (NHANES) were included in this study. Carbohydrate intake was assessed by a 24-h dietary review, and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ9). Variance inflation factor (VIF) and Relief-F algorithms were used for variable feature selection. RESULTS: The results of multivariate linear regression showed a negative association between high-quality carbohydrates and depressive symptoms (ß: -0.147, 95 % CI: -0.239, -0.056, p = 0.002) and a positive association between low-quality carbohydrates and depressive symptoms (ß: 0.018, 95 % CI: 0.007, 0.280, p = 0.001). Subsequently, we used the XGboost model to produce a comprehensive depressive symptom evaluation model and developed a corresponding online tool (http://8.130.128.194:5000/) to evaluate depressive symptoms clinically. LIMITATIONS: The cross-sectional study could not yield any conclusions regarding causality, and the model has not been validated with external data. CONCLUSIONS: Carbohydrate quality is associated with depressive symptoms, and machine learning models that combine diet with socioeconomic factors can be a tool for predicting depression severity.


Assuntos
Depressão , Dieta , Humanos , Inquéritos Nutricionais , Depressão/diagnóstico , Dieta/psicologia , Fatores Socioeconômicos , Carboidratos
10.
J Nanobiotechnology ; 22(1): 52, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38321555

RESUMO

Bacterial cystitis, a commonly occurring urinary tract infection (UTI), is renowned for its extensive prevalence and tendency to recur. Despite the extensive utilization of levofloxacin as a conventional therapeutic approach for bacterial cystitis, its effectiveness is impeded by adverse toxic effects, drug resistance concerns, and its influence on the gut microbiota. This study introduces Lev@PADM, a hydrogel with antibacterial properties that demonstrates efficacy in the treatment of bacterial cystitis. Lev@PADM is produced by combining levofloxacin with decellularized porcine acellular dermal matrix hydrogel and exhibits remarkable biocompatibility. Lev@PADM demonstrates excellent stability as a hydrogel at body temperature, enabling direct administration to the site of infection through intravesical injection. This localized delivery route circumvents the systemic circulation of levofloxacin, resulting in a swift and substantial elevation of the antimicrobial agent's concentration specifically at the site of infection. The in vivo experimental findings provide evidence that Lev@PADM effectively prolongs the duration of levofloxacin's action, impedes the retention and invasion of E.coli in the urinary tract, diminishes the infiltration of innate immune cells into infected tissues, and simultaneously preserves the composition of the intestinal microbiota. These results indicate that, in comparison to the exclusive administration of levofloxacin, Lev@PADM offers notable benefits in terms of preserving the integrity of the bladder epithelial barrier and suppressing the recurrence of urinary tract infections.


Assuntos
Derme Acelular , Cistite , Infecções Urinárias , Suínos , Animais , Levofloxacino , Hidrogéis
11.
PLoS One ; 19(2): e0297939, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38363737

RESUMO

BACKGROUND: The RESCUE BT2 trial recently showcased the efficacy of tirofiban in treating acute ischemic stroke (AIS) without large or medium-sized vessel occlusion. To further assess the value of tirofiban from the perspectives of Chinese and US healthcare system, a study was conducted to evaluate its cost-effectiveness. METHODS: A hybrid model, integrating a short-term decision tree with a long-term Markov model, was developed to assess cost-effectiveness between tirofiban and aspirin for stroke patients without large or medium-sized vessel occlusion. Efficacy data for tirofiban was sourced from the RESCUE BT2 trial, while cost information was derived from published papers. Outcomes measured included respective cost, effectiveness, and incremental cost-effectiveness ratio (ICER). We conducted a one-way sensitivity analysis to assess the robustness of the results. Additionally, we performed probabilistic sensitivity analysis (PSA) through 10,000 Monte Carlo simulations to evaluate the uncertainties associated with the results. RESULTS: The study revealed that tirofiban treatment in AIS patients without large or medium-sized vessel occlusion led to a considerable reduction of 2141 Chinese Yuan (CNY) in total cost, along with a lifetime gain of 0.14 quality-adjusted life years (QALYs). In the US settings, tirofiban also exhibited a lower cost ($197,055 versus $201,984) and higher effectiveness (4.15 QALYs versus 4.06 QALYs) compared to aspirin. One-way sensitivity analysis revealed that post-stroke care costs and stroke utility had the greatest impact on ICER fluctuation in both Chinese and US settings. However, these variations did not exceed the willingness-to-pay threshold. PSA demonstrated tirofiban's superior acceptability over aspirin in over 95% of potential scenarios. CONCLUSION: Tirofiban treatment for AIS without large or medium-sized vessel occlusion appeared dominant compared to aspirin in both China and the US.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Humanos , AVC Isquêmico/tratamento farmacológico , Tirofibana/uso terapêutico , Análise Custo-Benefício , Acidente Vascular Cerebral/tratamento farmacológico , Aspirina/uso terapêutico , Anos de Vida Ajustados por Qualidade de Vida
12.
Artigo em Inglês | MEDLINE | ID: mdl-38270837

RESUMO

Indigenous populations have experienced inequality of accessing mental health services compared with their non-Indigenous counterparts, although the way of measuring mental health service accessibility for Indigenous populations is unclear. This systematic review examines measures of mental health service accessibility for Indigenous people, including the diversity of mental health services that are available to them and the barriers to accessing mental healthcare. Using a systematic search procedure, we identified 27 studies that explored Indigenous populations' mental health service access. Our review shows that 18 studies used interview-based methods to explore how Indigenous people use mental health services, and only nine studies used quantitative methods to measure the uptake of mental health services. While advanced methods for quantifying geographical access to healthcare services are widely available, these methods have not been applied in the current literature to explore the potential access to mental health services by Indigenous populations. This is partially due to limited understanding of how Indigenous populations seek mental healthcare, barriers that prevent Indigenous people from accessing diverse types of mental health services, and scarcity of data that are available to researchers. Future research could focus on developing methods to support spatially explicit measuring of accessibility to mental health services for Indigenous populations.

13.
Environ Sci Pollut Res Int ; 31(7): 10717-10736, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38200197

RESUMO

The goal of "carbon peak and carbon neutrality" is the key to coping with global warming and achieving high-quality development. Producer services and manufacturing co-agglomeration (Coagglo) is an important path to achieve low-carbon development. Therefore, the relationship between industrial co-agglomeration and carbon emission efficiency (CEE) needs to be discussed. Based on the panel data of 114 cities along the eastern coast of China from 2006 to 2021, this study uses a panel quantile regression model and dynamic spatial Durbin model to evaluate the impact and spatial effect of Coagglo on CEE. The results show that there is a nonlinear relationship between Coagglo and CEE. When it exceeds the 50th quantile, the degree of influence decreases slightly, but it still shows a significant positive correlation. When considering industry heterogeneity, we find that the co-agglomeration of warehousing and postal industry (TRA) and manufacturing has the most significant impact on CEE, while the co-agglomeration of leasing and commercial service industry (LEA) and manufacturing has the least impact on CEE. Regional heterogeneity shows that the Coagglo has a greater impact on carbon emission efficiency in the northern region than in the southern region. In addition, Coagglo promotes the spillover of knowledge and technology and has a positive spatial spillover effect on CEE. This conclusion provides a theoretical reference for carbon emission reduction in eastern coastal areas of China.


Assuntos
Comércio , Indústrias , China , Carbono , Cidades , Desenvolvimento Econômico , Eficiência
14.
J Environ Manage ; 352: 120074, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38266521

RESUMO

Urban waterlogging patches reflect spatial patterns indicative of drainage system limitations and management challenges, and help pinpoint potential waterlogging impacts and spread risks. Therefore, by constructing an urban waterlogging model to simulate the extent and depth of waterlogging, the Number of Patches index (NP) is used to reflect the number of waterlogging patches, the Related Circumscribing Circle index (Circle) is used to evaluate the potential impact range of waterlogging, the Euclidean Nearest-Neighbor Distance index (ENN) is used to assess the potential connectivity of waterlogging, and the Interspersion and Juxtaposition Index (IJI) is used to assess the difficulty of retrofitting vulnerable points. Finally, the improvement of waterlogging structure is achieved by utilizing Vehicle-mounted Drainage Pump (VDPs). The research results demonstrate that as the return period increases, the waterlogging area (TA) and NP index show an upward trend, while the ENN index shows a downward trend. The Circle index initially decreases and then increases, reaching its lowest point at a one-year return period (1yr). The IJI index is related to the growth of TA, and in the two-year return period (2yr) and fifty-year return period (50yr) design scenarios, both TA and IJI indexshow significant growth. After the deployment of VDPs, the maximum area of waterlogging elimination reaches 0.46 km2 at a five-year return period (5yr). The drainage system reaches its drainage limit at 2yr, and the VDPs achieves its drainage limit at 5yr. The NP index does not decrease significantly, but in the case of a 5yr, the high-density area decreases by 1.66 km2. The Circle index values decrease across the board, and in the case of a 5yr, the potential impact range decreases by 1.92 km2, with 134 roads restored for traffic. The change in the ENN index decreased from 23.35 to 0.82, indicating that the spread of waterlogging can be more effectively controlled at lower return periods. The changes in the IJI index are more complex, with negative adjustments between 5 and 20yr, reducing the degree of mixing of different levels of waterlogging in the remaining return periods. Overall, with the increase of rainfall return period, the waterlogging area increases, the number of patches increases, the shape becomes irregular, the distance between patches decreases, and the potential connectivity increases. After the deployment of VDPs, the system integrity is improved, the waterlogging impact range is reduced, the impact on pedestrians and facilities is mitigated, and the risk of pollutant propagation and expansion of waterlogging area is reduced. This study contributes to reducing the potential risk of waterlogging, improving urban drainage effectiveness, and enhancing the resilience and emergency response capability of cities.


Assuntos
Poluentes Ambientais , Cidades , China
15.
J Affect Disord ; 348: 1-7, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38070746

RESUMO

BACKGROUND: Depression is a significant, pervasive, global public health problem, associated with many factors, such as diet, social factors, and lifestyle habits. We aimed to evaluate the association between eating breakfast, dietary inflammatory index (DII) and depression, and to verify the mediating role of DII on the effect of eating breakfast on depression. METHODS: 21,865 participants from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 were included in this study. Binary logistic regression and mediated effect analysis were conducted to analyze the associations between eating breakfast, DII and depression. Dietary inflammation was divided into pro-inflammatory diet and anti-inflammatory diet according to the DII. RESULTS: Both pro-inflammatory diet and skipping breakfast were risk factors for depression. After adjusting for covariables, compared with participants reporting breakfast in both recalls, reporting breakfast in one recall had a higher OR 95%CI (1.54(1.20, 1.98)) of depression. These associations in stratified analysis and sensitivity analysis without cardiovascular diseases (CVD) and diabetes were robust. DII mediated the association between eating breakfast and depression, the proportion of participants who reported breakfast in one recall and no recall was 26.15 % and 26.67 %, respectively. LIMITATIONS: This was a cross-sectional study that couldn't argue for the cause-effect relationship. Moreover, the confounding factor regarding medication use was not accounted for due to limited data. CONCLUSIONS: Skipping breakfast may increase the risk of depression by raising DII. And our study supported the essential role of regular breakfast and the anti-inflammatory diet in reducing the risk of depression.


Assuntos
Desjejum , Depressão , Humanos , Inquéritos Nutricionais , Depressão/epidemiologia , Depressão/etiologia , Estudos Transversais , Dieta/efeitos adversos , Inflamação/epidemiologia , Anti-Inflamatórios
16.
Chest ; 165(2): 446-460, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37806491

RESUMO

BACKGROUND: This study investigated the impact of epidemiologic and sociodemographic changes in tracheal, bronchus, and lung cancer associated with residential radon, solid fuels, and particulate matter. RESEARCH QUESTION: What are the influencing factors of tracheal, bronchus, and lung cancer disease burden attributable to the three pollutants? STUDY DESIGN AND METHODS: Data were obtained from the Global Burden of Disease 2019. Age-standardized mortality rate (ASMR) and sociodemographic index (SDI) values were collected from 21 regions, and restricted cubic splines and quantile regression were used to investigate the relationship between ASMR or age-standardized disability-adjusted life years rate (ASDR), and SDI. Additionally, five countries with different SDIs were selected, and the Bayesian age-period-cohort model was used to predict the ASMR trends from 2020 to 2030. RESULTS: High SDI quintiles were associated with increased residential radon pollution. The disease burden attributed to these three pollutants was particularly severe in the middle SDI quintiles. Older adults aged 80 to 89 years had the highest age-specific mortality, and the disease burden was greater in male patients than in female patients with these cancers attributed to the pollutants. The highest ASMR attributable to particulate matter when the SDI was 0.7. As the SDI increased, the disease burden caused by radon increased, whereas the burden caused by solid fuels decreased. Projections have indicated a rise in the death burden in patients with this cancer from particulate pollution in China, India, and Uganda over the next decade. INTERPRETATION: The disease burden of tracheal, bronchus, and lung cancer attributed to the three pollutants was influenced by SDI, sex, and age. Older men are more susceptible to be affected. More preventive interventions may be required for men at younger ages to reduce the high death burden of older men. However, it is necessary to give due attention to women in specific countries in the future.


Assuntos
Poluentes Ambientais , Neoplasias Pulmonares , Humanos , Masculino , Feminino , Idoso , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Material Particulado/efeitos adversos , Teorema de Bayes , Carga Global da Doença , Efeitos Psicossociais da Doença , Saúde Global , Brônquios , Anos de Vida Ajustados por Qualidade de Vida
17.
Biol Trace Elem Res ; 202(1): 332-345, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37086355

RESUMO

Red swamp crayfish (Procambarus clarkia) is an exposed species to heavy metals due to their lifestyle of direct contact with sediments. Based on the complete crayfish industry, we focus on the presence of heavy metals in crayfish from different circulation links, which provides a new idea for the investigation of heavy metals in food. To analyze the exposure levels of heavy metals in crayfish during aquaculture and circulation, the five elements (Cd, Pb, Hg, Cr, Cu) in crayfish from 126 sampling sites were investigated. Cultured environmental samples were collected for Spearman correlation analysis. Monte Carlo simulation was used to analyze the uncertain health risks of heavy metals in crayfish. The results indicated that the average heavy metal concentrations in crayfish were all below the limit threshold values. The hepatopancreas was the main target organ for heavy metal accumulation (Cd: 0.3132 mg/kg; Pb: 0.0258 mg/kg; Hg: 0.0072 mg/kg; Cr: 0.1720 mg/kg; Cu: 10.6816 mg/kg). The positive correlation of heavy metal content between crayfish and sediments was not significant under the crayfish-rice coculture model. The 95th HI values for adults and children ranged from 0.022 to 0.042 and 0.071 to 0.137, well below 1, indicating that heavy metals do not pose a noncarcinogenic risk to humans. The potential carcinogenic risk of Cd and Cr in crayfish should be taken seriously, as the 95th CR values for children have reached 4.299 × 10-5 and 6.509 × 10-5, respectively.


Assuntos
Mercúrio , Metais Pesados , Poluentes Químicos da Água , Criança , Adulto , Animais , Humanos , Astacoidea , Rios , Cádmio/análise , Chumbo/análise , Monitoramento Ambiental , Metais Pesados/análise , Alimentos Marinhos/análise , Mercúrio/análise , Medição de Risco , China , Poluentes Químicos da Água/análise
18.
Graefes Arch Clin Exp Ophthalmol ; 262(3): 913-926, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37792068

RESUMO

PURPOSE: To clarify the interocular asymmetry of corneal morphological descriptors and evaluate its discriminant ability of keratoconus (KC). METHODS: This retrospective study recruited 344 normal participants and 290 KC patients, randomized to training and validation datasets. Interocular correlation and agreement were evaluated on 44 corneal morphological descriptors derived from Schiempflug tomography. Logistic regression models were constructed using binocular data and of which diagnostic performance was evaluated using the area under receiver operating characteristics curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). RESULTS: Interocular agreement of corneal descriptors is better in the normal than in KC except for dimensions of cornea and anterior chamber. The interocular asymmetry increases along with the severity of KC. Interocular asymmetry in maximum anterior keratometry, mean anterior keratometry and higher-order aberrations of anterior surface show high AUC above 0.950. Binocular logistic regression index reaches an AUC of 0.963 with high specificity (95.2%) and brings gain to monocular parameters in distinguishing the normal eyes from KC (NRI = 0.080 (0.042 ~ 0.118), P < 0.001) and IDI = 0.071 (0.049 ~ 0.092), P < 0.001). Interocular asymmetry benefits even more in subclinical keratoconus (SKC) detection reflected by NRI (0.4784 (0.2703-0.6865), P < 0.001) and IDI (0.2680 (0.1495-0.3866), P < 0.001) measures. CONCLUSION: Interocular asymmetry is a well-characterized feature of KC and related to the severity. It is feasible to apply the interocular asymmetry in diagnosis of KC and SKC as a replenishment of monocular parameters and in progression tracking.


Assuntos
Ceratocone , Humanos , Câmara Anterior , Córnea , Ceratocone/diagnóstico , Exame Físico , Estudos Retrospectivos
19.
Clin Gastroenterol Hepatol ; 22(4): 760-767.e1, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37544418

RESUMO

BACKGROUND: The overall value of hepatocellular carcinoma screening is defined by the balance of benefits and harms. Studies have only reported physical harms with none describing financial harms. METHODS: We conducted a multicenter pragmatic randomized clinical trial of hepatocellular carcinoma screening outreach among 2872 patients with cirrhosis from March 2018 to April 2021. Patients with positive or indeterminate results and matched patients with negative results completed surveys at baseline and at follow-up measuring financial harms via Cancer Self-Administered Questionnaire and financial burden via Comprehensive Score for Financial Toxicity Functional Assessment of Chronic Illness Therapy. Univariable and multivariable longitudinal regression analyses were performed to compare changes in financial harms across groups: true positive, true negative, false positive, and indeterminate. Semistructured interviews were conducted in a subset of patients, sampled by center and test result. RESULTS: Of 311 patients who completed at least 1 follow-up survey (75% response rate), 37 had true positive, 133 true negative, 64 false positive, and 77 indeterminate results. Financial harms increased in true positive and false positive patients with no significant changes noted among those with true negative or indeterminate results. At follow-up, 21.8% of patients reported moderate-severe financial burden, which was not significantly associated with test results. Semistructured interviews revealed variation in the frequency and severity of financial harms based on test results, with increased harm in those with false positive results. CONCLUSIONS: Financial harms of hepatocellular carcinoma screening vary by test result and can pose a barrier that must be considered when determining the optimal screening program.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/diagnóstico , Neoplasias Hepáticas/diagnóstico , Estresse Financeiro , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico
20.
Sci Total Environ ; 912: 168859, 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38040355

RESUMO

Organophosphate flame retardants (OPFRs), a novel class of persistent pollutants, are widely distributed in the environment, and their potential health risks have garnered significant global attention in recent years. Crayfish is a popular freshwater crustacean product in China primarily sourced from the middle and lower reaches of the Yangtze River. The purpose of this study was to investigate the exposure levels of OPFRs in crayfish, assess the health and safety risks associated with crayfish consumption, and explore the bioaccumulation of OPFRs in environmental water and sediment on crayfish. Ultra-high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) was employed to analyze 7 common OPFRs in 106 crayfish samples and 76 environmental samples. The results revealed that OPFRs were detected at a high frequency of 100 % in crayfish, with tripropyl phosphate (TPP) being the predominant pollutant found in edible portions while also exhibiting secondary contamination within the crayfish food chain. Monte Carlo modeling combined with @risk risk assessment software demonstrated that TPP present in crayfish muscles had the most substantial impact on health effects, however, overall OPFR exposure did not pose significant risks to human health. Furthermore, analysis of OPFRs bioenrichment ability indicated that crayfish predominantly accumulated these compounds within their edible parts from surrounding environmental water sources, particularly highlighting TPP's potential for bioaccumulation.


Assuntos
Poluentes Ambientais , Retardadores de Chama , Animais , Humanos , Organofosfatos/análise , Retardadores de Chama/análise , Astacoidea , Bioacumulação , Cromatografia Líquida , Rios/química , Espectrometria de Massas em Tandem/métodos , Poluentes Ambientais/análise , Fosfatos/análise , Água/análise , Medição de Risco
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