High sodium diet intake and cardiovascular diseases: An attributable death study in Tianjin, China.

There is clear evidence that high sodium intake is associated with many health issues including hypertension and cardiovascular diseases (CVDs). Several national and worldwide studies have estimated deaths from CVDs attributable to high sodium. But how to evaluate the impact of high sodium intake on diseases using regional routine monitoring and investigation data is necessary and important. Our study aimed to quantitatively evaluate the high sodium intake attributed to CVDs deaths based on the routine monitoring data from China National Nutrition and Health Survey (CNNHS) in Tianjin, China. The population attributable fractions (PAF) were calculated by comparing the observed systolic blood pressure (SBP) distribution with the theoretical minimum or counterfactual distribution by sex and age groups. The results showed that CVDs deaths due to elevated SBP were 22728 (95% uncertainty intervals: 22679-23050), accounting for 62.8% of total CVDs deaths. According to sodium intake recommended by World Health Organization (WHO), PAF of CVDs deaths attributable to high sodium diet in our study was 14.6% of total CVDs deaths, accounting for 5228 (95% UI: 5005-5998) cases. The dietary sodium intake of residents is nearly three times than sodium intake recommended by WHO. If sodium intake was reduced to reference level, the potential avoidable CVD deaths attributable to the SBP-raising effect were more than 5200 among adults 25 aged and over in Tianjin. This evaluation method can be extended to other cities.

Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study.

BACKGROUND: The purpose of this study was to retrospectively analyze clinical characteristics and prognostic risk factors of urosepsis patients admitted to two intensive care units in Shanghai, China. METHODS: Clinical data from patients diagnosed with urosepsis were retrospectively retrieved and analyzed from ICU in two regional medical centers from January 2015 to December 2019. RESULTS: Two hundred two patients were included in the subsequent analysis eventually, with an average age of 72.02 ± 9.66 years, 79.21% of the patients were female and the mortality rate of 15.84%.The proportion of patients with chronic underlying diseases such as diabetes and hypertension was relatively high (56.44, 49.50%, respectively), and the incidence of shock was also high (41.58%) correspondingly. The most common pathogen isolated was Escherichia coli (79.20%), of which the extended-spectrumß-lactamases (ESBLs)(+) accounted for 42.57%. In multivariate analysis, the strongest predictors for death were mechanical ventilation (OR 7.260, 95% CI 2.200-23.963; P = 0.001),chronic kidney disease (CKD) (OR 5.140, 95% CI 1.596-16.550; P = 0.006), APACHE II score (OR 1.321, 95% CI 1.184-1.473; P < 0.001) and lactate (OR 1.258, 95% CI 1.037-1.527; P = 0.020). Both APACHE II score and lactate had the ideal predictive value, with the area under the ROC curve (AUC) of 0.858 and 0.805 respectively. CONCLUSION: The patients with urosepsis were characterized by a higher proportion of female, older age, more percentage of comorbidities in this region, and patients with ESBLs (+) Escherichia coli infection were more prone to shock. Mechanical ventilation, comorbidity with CKD, APACHE II score and lactate were independent risk factors for death in urosepsis patient, but lactate level and APACHE II score had better predictive value for prognosis.

External validation and comparison of two versions of simplified sequential organ failure assessment scores to predict prognosis of septic patients.

BACKGROUND: Evidence shows that simplified SOFA scoring system has better clinical practice. OBJECTIVE: This study aimed to validate and compare the scores acquired with simplified organ dysfunction criteria optimized for electronic health records (eSOFA), and simplified and accurate sequential organ failure assessment (sa-SOFA) for their accuracies in predicting the prognosis of septic patients. METHODS: This retrospective observational study was conducted at three major academic hospitals. Clinical data from 574 patients diagnosed with sepsis following the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)were retrospectively retrieved and analysed. Scores from the quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA) were used as reference scores. The area under the receiver operating characteristic curve (AUROC) was used to assess the performance of eSOFA and sa-SOFA scores in predicting in-hospital mortality. RESULTS: AUROC analysis demonstrated the predictability of the four scoring systems for sepsis surveillance, listed in descending order as: sa-SOFA, 0.790 (95% confidence interval [CI]: 0.754-0.822); SOFA, 0.774 (95% CI: 0.738-0.808); eSOFA, 0.729 (95% CI: 0.691-0.765); and qSOFA, 0.618 (95% CI: 0.577-0.658). Moreover, sa-SOFA and SOFA scores (Z = 1.950, P = .051) did not significantly differ from each other in discriminatory power, but the sa-SOFA score had a higher power than eSOFA score (P values < .001). CONCLUSION: sa-SOFA appeared to have performed better than eSOFA score for predicting in-hospital mortality in patients' sepsis. Further large prospective studies are needed to externally validate.

Study on environmental performance evaluation of different linkage development types of the logistics and manufacturing industries considering the unexpected output.

According to the different organizational forms of logistics in manufacturing, the types of linkage development between the logistics and manufacturing industries include two different logistics service modes: logistics outsourcing and logistics self-operation. This study considers two manufacturing clusters for comparison: the northeast region in China, mainly state-owned and self-operated, and the Yangtze River Delta region in China, mainly focusing on logistics outsourcing services. First, we construct a parallel network system considering heterogeneity and an unexpected super-efficiency slacks-based measure: the Grey Relational Analysis model. Second, considering the unexpected output, this study evaluates the environmental performance of the linkage development of the logistics and manufacturing industries and explains the types of linkage development between them. Finally, the spatial and temporal characteristics of linkage efficiency under different linkage modes are studied using an exploratory spatial data analysis method. The research results show that the efficiency of the two-industry linkage in different linkage types that consider the unexpected output presents different development characteristics. Regarding time characteristics and trends, we compare the development efficiency of the two-industry linkage at the overall level of the northeast and the Yangtze River Delta regions from 2009 to 2016. The Yangtze River Delta region showed a higher state of linkage while the northeast region showed a medium linkage state. Regarding spatial pattern evolution, the effect of the technical efficiency of the linkage between the two industries in the three northeastern provinces showed continuous evolution from the medium linkage stage to the weak linkage stage, and the Yangtze River Delta showed continuous evolution from the medium linkage to the strong linkage stage.Implications: Due to data availability, references to the relevant achievements of the research on the linkage between the manufacturing and logistics industries, the transportation industry, warehousing, and postal and telecommunications industry data are generally used as logistics industry data. Manufacturing data are replaced by industrial data. The manufacturing industry is the core industry of industrial systems. Its output value accounts for more than 90% of the industrial output. Thus, it can reflect the development trend of the manufacturing industry in general.

Smoking and Mortality in Tianjin, China: A Death Registry-Based Case-Control Study, 2010-2014.

INTRODUCTION: We conducted a mortality case-control study to assess the risks of all-cause and major causes of death attributable to smoking in Tianjin from 2010 through 2014. The death registry-based study used data from The Tianjin All Causes of Death Surveillance System, which collects information routinely on smoking of the deceased in the death certificate of Tianjin Centers for Disease Control and Prevention. METHODS: Cases (n = 154,086) and controls (n = 25,476) were deaths at 35 to 79 years from smoking-related and nonsmoking-related causes, respectively. Mortality rate ratios (RRs) for ever smokers versus never smokers, with adjustment for sex, 5-year age group, education, marital status, and year of death, and smoking-attributed fractions were calculated. RESULTS: The RRs in men were 1.38 (95% confidence interval [CI], 1.33-1.43) for all causes and 3.07 (95% CI, 2.91-3.24) for lung cancer, and in women were 1.46 (95% CI, 1.39-1.54) and 4.07 (95% CI, 3.81-4.35). The smoking-attributed fractions for all causes and for lung cancer in men were 15.4% and 50.2%, respectively, and in women were 7.3% and 32.7%, respectively. Smoking annually caused an average of 3,756 (9.4%) deaths, mostly from lung cancer in men (47.4%) and women (66.9%). Women who started smoking before 30 had a higher RR (1.79; 95% CI, 1.63-1.97) than men who did so (1.48; 95% CI, 1.41-1.56). CONCLUSION: Lung cancer was the main cause of smoking-induced deaths in both sexes. Tobacco use is a major cause of premature deaths in men aged 35 to 79 years. Young women must be urged to not start smoking because they could have greater risk of all-cause and lung cancer deaths than men do.