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1.
BMC Public Health ; 24(1): 1269, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38725017

RESUMEN

BACKGROUND: Over the past three decades, China has experienced significant changes in urban-rural, gender, and age-specific suicide mortality patterns. This study aimed to investigate the long-term trends in suicide mortality in China from 1987 to 2020. METHODS: Suicide mortality data were obtained from China's National Health Commission. Joinpoint regression analysis was used to examine changes in trends and age-period-cohort modeling to estimate age, period, and cohort effects on suicide mortality from 1987 to 2020. Net drift, local drift, longitudinal age curves, and period relative risks were also calculated. RESULTS: Crude and age-standardized suicide mortality in China showed continuing downward trends from 1987 to 2020, with a more pronounced decrease in rural areas (net drift = -7.07%, p<0.01) compared to urban areas (net drift = -3.41%, p<0.01). The decline curve of urban areas could be divided into three substages. Period and cohort effects were more prominent in rural areas. Suicide risk was highest among individuals aged 20-24 and gradually increased after age 60. Females, particularly those of childbearing age, had higher suicide risk than males, with a reversal observed after age 50. This gender reversal showed distinct patterns in urban and rural areas, with a widening gap in urban areas and a relatively stable gap in rural areas. CONCLUSIONS: Suicide mortality in China has consistently declined over the past three decades. However, disparities in age, gender, and urban-rural settings persist, with new patterns emerging. Targeted suicide prevention programs are urgently needed for high-risk groups, including females of childbearing age and the elderly, and to address the slower decrease and reversing urban-rural gender trends.


Asunto(s)
Población Rural , Suicidio , Población Urbana , Humanos , China/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Suicidio/tendencias , Suicidio/estadística & datos numéricos , Adulto Joven , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Anciano , Mortalidad/tendencias , Disparidades en el Estado de Salud
2.
Nat Commun ; 15(1): 4031, 2024 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-38740772

RESUMEN

The rapid global distribution of COVID-19 vaccines, with over a billion doses administered, has been unprecedented. However, in comparison to most identified clinical determinants, the implications of individual genetic factors on antibody responses post-COVID-19 vaccination for breakthrough outcomes remain elusive. Here, we conducted a population-based study including 357,806 vaccinated participants with high-resolution HLA genotyping data, and a subset of 175,000 with antibody serology test results. We confirmed prior findings that single nucleotide polymorphisms associated with antibody response are predominantly located in the Major Histocompatibility Complex region, with the expansive HLA-DQB1*06 gene alleles linked to improved antibody responses. However, our results did not support the claim that this mutation alone can significantly reduce COVID-19 risk in the general population. In addition, we discovered and validated six HLA alleles (A*03:01, C*16:01, DQA1*01:02, DQA1*01:01, DRB3*01:01, and DPB1*10:01) that independently influence antibody responses and demonstrated a combined effect across HLA genes on the risk of breakthrough COVID-19 outcomes. Lastly, we estimated that COVID-19 vaccine-induced antibody positivity provides approximately 20% protection against infection and 50% protection against severity. These findings have immediate implications for functional studies on HLA molecules and can inform future personalised vaccination strategies.


Asunto(s)
Alelos , Anticuerpos Antivirales , Vacunas contra la COVID-19 , COVID-19 , Antígenos HLA , Polimorfismo de Nucleótido Simple , SARS-CoV-2 , Humanos , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/administración & dosificación , COVID-19/inmunología , COVID-19/prevención & control , COVID-19/genética , COVID-19/virología , SARS-CoV-2/inmunología , SARS-CoV-2/genética , Anticuerpos Antivirales/inmunología , Anticuerpos Antivirales/sangre , Antígenos HLA/genética , Antígenos HLA/inmunología , Formación de Anticuerpos/genética , Formación de Anticuerpos/inmunología , Masculino , Femenino , Genotipo , Vacunación , Persona de Mediana Edad , Adulto , Variación Genética , Cadenas beta de HLA-DQ/genética , Cadenas beta de HLA-DQ/inmunología , Infección Irruptiva
3.
Sci Adv ; 10(18): eadl3747, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38701212

RESUMEN

Early-life tobacco exposure serves as a non-negligible risk factor for aging-related diseases. To understand the underlying mechanisms, we explored the associations of early-life tobacco exposure with accelerated biological aging and further assessed the joint effects of tobacco exposure and genetic susceptibility. Compared with those without in utero exposure, participants with in utero tobacco exposure had an increase in Klemera-Doubal biological age (KDM-BA) and PhenoAge acceleration of 0.26 and 0.49 years, respectively, but a decrease in telomere length of 5.34% among 276,259 participants. We also found significant dose-response associations between the age of smoking initiation and accelerated biological aging. Furthermore, the joint effects revealed that high-polygenic risk score participants with in utero exposure and smoking initiation in childhood had the highest accelerated biological aging. There were interactions between early-life tobacco exposure and age, sex, deprivation, and diet on KDM-BA and PhenoAge acceleration. These findings highlight the importance of reducing early-life tobacco exposure to improve healthy aging.


Asunto(s)
Envejecimiento , Predisposición Genética a la Enfermedad , Efectos Tardíos de la Exposición Prenatal , Humanos , Femenino , Masculino , Efectos Tardíos de la Exposición Prenatal/genética , Envejecimiento/genética , Adulto , Embarazo , Nicotiana/efectos adversos , Nicotiana/genética , Fumar/efectos adversos , Factores de Riesgo , Persona de Mediana Edad
4.
Arch Gerontol Geriatr ; 124: 105482, 2024 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-38735224

RESUMEN

OBJECTIVES: This study aimed to examine the association between sensory impairment and the discordance between subjective/objective cognitive function among older adults and test the mediating effect of loneliness. METHODS: We used data from four cohort studies conducted in 16 countries (N = 19,119). Sensory impairment and subjective cognitive impairment were self-reported. Objective cognitive impairment was measured in three dimensions. Generalized estimating equations were conducted to examine the association between sensory impairment and discordance in subjective/objective cognitive function. Cross-lagged panel model and a bootstrap method with 2,000 samples were employed to verify the mediating effect. RESULTS: Sensory impairment was related to an increased risk of subjective cognitive impairment (OR = 4.70, 95 % CI 4.33-5.10), objective impairment (OR = 1.51, 95 %CI 1.31-1.74), as well as the discordance in subjective/objective cognitive function (OR = 1.35, 95 %CI 1.06-1.71 for older adults with normal subjective cognitive function). In contrast, sensory impairment was associated with a decreased risk of discordant subjective/objective cognitive function among those with subjective cognitive impairment (OR = 0.79, 95 %CI 0.66-0.94). Moreover, loneliness mediated the association between sensory impairment and subjective cognitive impairment (standardized indirect effect = 0.002, 95 %CI 0.001-0.004), objective cognitive impairment (standardized indirect effect = 0.005, 95 %CI 0.003-0.007) as well as the discordance in subjective/objective cognitive function (standardized indirect effect = 0.001, 95 %CI 0.001-0.003 for older adults with normal subjective cognitive function). CONCLUSIONS: Significant association between sensory impairment and discordance in subjective/objective cognitive function and the mediating role of loneliness were revealed, varying by subjective cognitive function. Early screening on sensory impairment and targeted interventions on loneliness should be considered in future policies on cognitive impairment.

5.
PLoS Negl Trop Dis ; 18(4): e0012053, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38557981

RESUMEN

BACKGROUND: Mosquito-borne arboviruses are expanding their territory and elevating their infection prevalence due to the rapid climate change, urbanization, and increased international travel and global trade. Various significant arboviruses, including the dengue virus, Zika virus, Chikungunya virus, and yellow fever virus, are all reliant on the same primary vector, Aedes aegypti. Consequently, the occurrence of arbovirus coinfection in mosquitoes is anticipated. Arbovirus coinfection in mosquitoes has two patterns: simultaneous and sequential. Numerous studies have demonstrated that simultaneous coinfection of arboviruses in mosquitoes is unlikely to exert mutual developmental influence on these viruses. However, the viruses' interplay within a mosquito after the sequential coinfection seems intricated and not well understood. METHODOLOGY/PRINCIPAL FINDINGS: We conducted experiments aimed at examining the phenomenon of arbovirus sequential coinfection in both mosquito cell line (C6/36) and A. aegypti, specifically focusing on dengue virus (DENV, serotype 2) and Zika virus (ZIKV). We firstly observed that DENV and ZIKV can sequentially infect mosquito C6/36 cell line, but the replication level of the subsequently infected ZIKV was significantly suppressed. Similarly, A. aegypti mosquitoes can be sequentially coinfected by these two arboviruses, regardless of the order of virus exposure. However, the replication, dissemination, and the transmission potential of the secondary virus were significantly inhibited. We preliminarily explored the underlying mechanisms, revealing that arbovirus-infected mosquitoes exhibited activated innate immunity, disrupted lipid metabolism, and enhanced RNAi pathway, leading to reduced susceptibility to the secondary arbovirus infections. CONCLUSIONS/SIGNIFICANCE: Our findings suggest that, in contrast to simultaneous arbovirus coinfection in mosquitoes that can promote the transmission and co-circulation of these viruses, sequential coinfection appears to have limited influence on arbovirus transmission dynamics. However, it is important to note that more experimental investigations are needed to refine and expand upon this conclusion.


Asunto(s)
Aedes , Arbovirus , Coinfección , Virus del Dengue , Dengue , Infección por el Virus Zika , Virus Zika , Animales , Coinfección/epidemiología , Mosquitos Vectores , Dengue/epidemiología
6.
Asian J Psychiatr ; 95: 103996, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38471415

RESUMEN

OBJECTIVES: We investigated the variations in the trends of mental disorders mortality by age, period, and cohort, over a 33-year period from 1987 to 2020, to reveal the relationship between age, period, cohort, and mental disorders mortality, as well as providing guidance for resource allocation to prevent mental disorders-related deaths in vulnerable target populations. METHODS: The data of mental disorders mortality 1987-2020 were from five administrative organizations, which collected from the National Health Commission in China with national monitoring by sex and age, covering 31 provinces in China. The International Classification of Diseases (ICD), its 9th Revision (ICD-9) and its 10th Revision were used to code the mental diseases. From 1987-2002, ICD-9 was used, and ICD-10 was used from 2003 to 2020. The age standardized mortality rates (ASMRs) were calculated using the World Standard Population as the reference. We used joinpoint models to assess the trends of mental disorders mortality in China for the period 1987-2020. And the age-period-cohort models were employed to estimate the age-period-cohort effect on mental disorders mortality. RESULTS: The age-standardized overall mental disorders mortality rate (ASMR) showed a downward trend from 1987 to 2020. Further, the ASMR of individuals in urban was higher than that in rural from 1987 to 2001, but, post-2002, this urban-rural disparity in ASMR showed a less clear pattern, with urban areas occasionally surpassing rural areas and vice versa. ASMR is less prevalent among females compared to males overall. The contribution of age effects to mental disorders mortality gradually increases with advancing age, the period effects of mental disorders mortality gradually decrease over time. The cohort effect's contribution to mental disorders mortality decreases in the newly born population, while in the older birth cohorts, the cohort effect's contribution to the mortality rate of mental disorders increases. CONCLUSIONS: The ASMR exhibits a decreasing trend from 1987 to 2020, and these change trend showed urban-rural and sex differences. The primary factors contributing to this overall decline are period effects and cohort effects. Our results provide valuable information for shaping mental health policies, designing targeted interventions, and preparing for future changes in disease mortality rates. The focus on different demographic factors allows for a nuanced and tailored approach to mental health promotion and intervention strategies.


Asunto(s)
Trastornos Mentales , Población Rural , Humanos , China/epidemiología , Trastornos Mentales/mortalidad , Trastornos Mentales/epidemiología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Anciano , Adolescente , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Población Urbana/tendencias , Niño , Mortalidad/tendencias , Preescolar , Anciano de 80 o más Años , Factores de Edad , Lactante
7.
Subst Use Addctn J ; : 29767342241238837, 2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38551080

RESUMEN

BACKGROUND: Community correctional experiences among individuals receiving methadone treatment (MT) for opioid use disorder (OUD) are poorly understood. We qualitatively investigated perceptions of community corrections and treatment experiences among individuals with criminal-legal system experience currently receiving outpatient MT. METHODS: From January to December 2017, we recruited 42 individuals with history of criminal-legal system involvement enrolled in outpatient MT at a low-barrier nonprofit organization operating multiple clinics in Connecticut. An experienced qualitative research team conducted one-to-one, in-person, semistructured interviews about incarceration and treatment experiences with individuals receiving MT. Participants completed a demographics survey. The interviews were audiorecorded, transcribed, de-identified, and independently coded using NVivo. RESULTS: Participants described the community corrections system as restrictive and abstinence-focused. Most participants described positive perceptions of and experiences with community corrections officers (CCOs), yet described negative perceptions of and experiences with the community corrections system overall. Participants perceived CCOs to have limited knowledge of OUD and MT. Participants described a range of CCO judgment toward their OUD, with some appearing understanding and nonjudgmental while others were perceived to have stigma and prejudice. Few participants noted assistance from CCOs with seeking MT or community-based substance use disorder care. Some participants desired improved treatment facilitation, but viewed forced or coercive treatment negatively. CONCLUSION: To our knowledge, this is the first qualitative study to examine community corrections experience among people receiving outpatient medication for OUD. While individuals receiving MT have negative experiences with the community corrections system, they perceive individual CCOs positively. Interventions addressing gaps in CCOs knowledge of OUD and MT are needed to optimize support for individuals on probation or parole with OUD. Provision of OUD treatment facilitation appears desirable to some individuals in community supervision.

8.
Nat Commun ; 15(1): 1980, 2024 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-38438367

RESUMEN

The sterile insect technique is based on the overflooding of a target population with released sterile males inducing sterility in the wild female population. It has proven to be effective against several insect pest species of agricultural and veterinary importance and is under development for Aedes mosquitoes. Here, we show that the release of sterile males at high sterile male to wild female ratios may also impact the target female population through mating harassment. Under laboratory conditions, male to female ratios above 50 to 1 reduce the longevity of female Aedes mosquitoes by reducing their feeding success. Under controlled conditions, blood uptake of females from an artificial host or from a mouse and biting rates on humans are also reduced. Finally, in a field trial conducted in a 1.17 ha area in China, the female biting rate is reduced by 80%, concurrent to a reduction of female mosquito density of 40% due to the swarming of males around humans attempting to mate with the female mosquitoes. This suggests that the sterile insect technique does not only suppress mosquito vector populations through the induction of sterility, but may also reduce disease transmission due to increased female mortality and lower host contact.


Asunto(s)
Aedes , Infertilidad Masculina , Humanos , Femenino , Masculino , Animales , Ratones , Reproducción , Comunicación Celular , Insectos
9.
Biosci Trends ; 18(1): 73-82, 2024 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-38325825

RESUMEN

Relatively little is known about education placements for children with autism spectrum disorder (ASD) in China. While disparities in ASD diagnoses and services for the population broadly are often documented, the presence and determinants of differences in the educational placement of ASD children are less studied and understood. By identifying who is likely to be in segregated settings, we can discern how to best support them and facilitate a possible transition to a less restrictive setting. This study describes four placements (regular schools, special schools, institutions, homes) and their influencing factors retrospectively in a large sample (n = 2,190) of Chinese primary school-aged children (6-12 years old). We divided ASD into severe and mild to moderate categories for analysis. Children with ASD were more likely to study in a regular school (48.60%), while 13.88% were in a special school. Children with severe ASD were placed in less regular settings than children with mild to moderate ASD. However, families with higher socioeconomic status (SES) were more likely to place their children in regular schools than lower SES families if their children experienced mild to moderate symptoms. Children with severe ASD were more likely to be placed in expensive institutions for families with higher SES than those with lower SES. SES disparities in educational placement existed and had two manifestations. It is important to characterize educational placements of students with ASD to determine the extent to which they are placed in general education settings, which are often the preferred placement.


Asunto(s)
Trastorno del Espectro Autista , Niño , Humanos , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/diagnóstico , Disparidades Socioeconómicas en Salud , Estudios Retrospectivos , China/epidemiología , Instituciones Académicas
10.
Front Public Health ; 12: 1289188, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38406497

RESUMEN

Objective: To investigate the prevalence of cataract-induced visual disability and its association with individual-level socioeconomic status (SES) among older adults in China. Methods: Using the data of 354,743 older adults (60 years and older) from the Second China National Sample Survey on Disability in 2006. Cross-sectional study design was applied. The differences in visual disability prevalence of cataracts among sociodemographic subgroups were analyzed by the chi-square test, and the association between individual-level SES and cataract-induced visual disability was investigated by the multivariate logistic regression model. Results: The weighted visual disability prevalence of cataracts was 4.84% in 2006. Older people with a higher household income per capita (OR = 0.83, 95% CI: 0.81-0.85), higher education level (primary school vs. illiteracy: OR = 0.80, 95% CI: 0.76-0.83; ≥undergraduate college vs. illiteracy: OR = 0.31, 95% CI: 0.25-0.39), and occupation (OR = 0.53, 95% CI: 0.50-0.56) were less likely to suffer from cataract-induced visual disability. Household income per capita and education level increase played a greater role in decreasing the risk of visual disability caused by cataracts in urban areas, while having occupation contributed more to reducing the risk of disability in rural areas. Conclusion: The gap in individual-level SES is closely related to the visual health inequities among older Chinese people and there are two distinct mechanisms in rural and urban areas. Strategies to promote collaborative healthcare development regionally, strengthen safeguards for disadvantaged groups, and increase public awareness of visual disability prevention are warranted.


Asunto(s)
Catarata , Pueblos del Este de Asia , Trastornos de la Visión , Anciano , Humanos , Catarata/complicaciones , Catarata/economía , Catarata/epidemiología , Estudios Transversales , Personas con Discapacidad , Clase Social , China/epidemiología
11.
Interdiscip Sci ; 2024 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-38368575

RESUMEN

With the advent of single-cell RNA sequencing (scRNA-seq) technology, many scRNA-seq data have become available, providing an unprecedented opportunity to explore cellular composition and heterogeneity. Recently, many computational algorithms for predicting cell type composition have been developed, and these methods are typically evaluated on different datasets and performance metrics using diverse techniques. Consequently, the lack of comprehensive and standardized comparative analysis makes it difficult to gain a clear understanding of the strengths and weaknesses of these methods. To address this gap, we reviewed 20 cutting-edge unsupervised cell type identification methods and evaluated these methods comprehensively using 24 real scRNA-seq datasets of varying scales. In addition, we proposed a new ensemble cell-type identification method, named scEM, which learns the consensus similarity matrix by applying the entropy weight method to the four representative methods are selected. The Louvain algorithm is adopted to obtain the final classification of individual cells based on the consensus matrix. Extensive evaluation and comparison with 11 other similarity-based methods under real scRNA-seq datasets demonstrate that the newly developed ensemble algorithm scEM is effective in predicting cellular type composition.

12.
Schizophr Res ; 264: 519-525, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38295748

RESUMEN

BACKGROUND: Schizophrenia occurs worldwide, and the health, and economic burden is substantial. As one of the common proxies of socioeconomic status (SES), education was reported to be associated with the risk of developing schizophrenia. However, there is no causal evidence about the relationship. This paper explores the health benefits of college education for schizophrenia. METHOD: Based on exogenous variation in college enrollment across regions and cohorts induced by college enrollment expansion policy, we use instrument variable (IV) estimate strategy to estimate impacts of college education on the risk of schizophrenia with the data from Second National Sample Survey on Disability. RESULTS: We find that college education reduces the risk of developing schizophrenia by 4.2 percentage points. Some further analyses suggest the causal protective effect is only found among men, rural, and low-income individuals. CONCLUSIONS: These findings provide new evidence for the causal relationship between college education and schizophrenia, and add to the literature on the health benefits of education.


Asunto(s)
Esquizofrenia , Masculino , Humanos , Esquizofrenia/epidemiología , Esquizofrenia/prevención & control , Clase Social , Escolaridad , China/epidemiología , Políticas
13.
J Hazard Mater ; 465: 133455, 2024 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-38211521

RESUMEN

Microplastics (MPs) commonly coexist with other contaminants and alter their toxicity. Perfluorooctanoic acid (PFOA), an emerging pollutant, may interact with MPs but remain largely unknown about the joint toxicity of PFOA and MPs. Hence, this research explored the single and joint effects of PFOA and polystyrene microplastics (PS-MPs) on microalgae (Chlorella sorokiniana) at the cellular and molecular levels. Results demonstrated that PS-MPs increased PFOA bioavailability by altering cell membrane permeability, thus aggravating biotoxicity (synergistic effect). Meanwhile, the defense mechanisms (antioxidant system modulation and extracellular polymeric substances secretion) of Chlorella sorokiniana were activated to alleviate toxicity. Additionally, transcriptomic analysis illustrated that co-exposure had more differential expression genes (DEGs; 4379 DEGs) than single-exposure (PFOA: 2533 DEGs; PS-MPs: 492 DEGs), which were mainly distributed in the GO terms associated with the membrane composition and antioxidant system. The molecular regulatory network further revealed that PS-MPs and PFOA primarily regulated the response mechanisms of Chlorella sorokiniana by altering the ribosome biogenesis, photosynthesis, citrate cycle, oxidative stress, and antioxidant system (antioxidant enzyme, glutathione-ascorbate cycle). These findings elucidated that PS-MPs enhanced the effect of PFOA, providing new insights into the influences of MPs and PFOA on algae and the risk assessment of multiple contaminants. ENVIRONMENTAL IMPLICATION: MPs and PFAS, emerging contaminants, are difficult to degrade and pose a non-negligible threat to organisms. Co-pollution of MPs and PFAS is ubiquitous in the aquatic environment, while risks of co-existence to organisms remain unknown. The present study revealed the toxicity and defense mechanisms of microalgae exposure to PS-MPs and PFOA from cellular and molecular levels. According to biochemical and transcriptomic analyses, PS-MPs increased PFOA bioavailability and enhanced the effect of PFOA on Chlorella sorokiniana, showing a synergistic effect. This research provides a basis for assessing the eco-environmental risks of MPs and PFAS.


Asunto(s)
Caprilatos , Chlorella , Fluorocarburos , Microalgas , Contaminantes Químicos del Agua , Microplásticos/toxicidad , Poliestirenos/toxicidad , Plásticos/metabolismo , Antioxidantes/metabolismo , Contaminantes Químicos del Agua/toxicidad , Fluorocarburos/metabolismo , Microalgas/metabolismo
14.
Asian J Psychiatr ; 92: 103877, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38176313

RESUMEN

OBJECTIVE: The economic burden of autism spectrum disorder (ASD) on individuals, their families and society as a whole is poorly understood. Accurate figures are crucial for economic estimates and service planning. METHODS: The total lifetime individual costs and annual societal costs of ASD in China were estimated with a prevalence-based, gross cost of illness approach and data from multiple sources. The direct medical costs in outpatient and inpatient settings from the electronic health records (EHRs) of hospitals, and direct nonmedical costs from a national survey were included. The indirect costs were from both the national survey and the estimation using human capital methods. Age-specific lifetime incremental societal costs were measured. Comorbidity-related and unrelated costs were analyzed separately. RESULTS: The discounted lifetime cost for an individual with ASD in China was $2.65 million (at 2020 prices, $) for those without intellectual disability (ID) and $4.61 million (at 2020 prices, $) for those with ID. The total cost of ASD amounted to $41.8 billion in 2020. Productivity loss were major cost drivers for ASD individuals without ID. Direct nonmedical costs (rehabilitation or adult care costs etc.) were major drivers for ASD individuals with ID. In a lifetime course, the total annual costs for middle aged and elderly (>42 years) were highest, followed by transitional adults (18-29 years) and preschoolers, both for individuals with or without ID. The distribution of costs over the lifespan varied by the cost category. CONCLUSIONS: ASD imposes a substantial economic burden on families and health care systems. Sectors and services coordination should be given policy considerations.


Asunto(s)
Trastorno del Espectro Autista , Discapacidad Intelectual , Adulto , Persona de Mediana Edad , Anciano , Humanos , Trastorno del Espectro Autista/epidemiología , Costo de Enfermedad , Discapacidad Intelectual/epidemiología , Estrés Financiero , China/epidemiología , Costos de la Atención en Salud
15.
Interdiscip Sci ; 16(1): 1-15, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37815679

RESUMEN

Single-cell RNA sequencing technology is one of the most cost-effective ways to uncover transcriptomic heterogeneity. With the rapid rise of this technology, enormous amounts of scRNA-seq data have been produced. Due to the high dimensionality, noise, sparsity and missing features of the available scRNA-seq data, accurately clustering the scRNA-seq data for downstream analysis is a significant challenge. Many computational methods have been designed to address this issue; nevertheless, the efficacy of the available methods is still inadequate. In addition, most similarity-based methods require a number of clusters as input, which is difficult to achieve in real applications. In this study, we developed a novel computational method for clustering scRNA-seq data by considering both global and local information, named GCFG. This method characterizes the global properties of data by applying concept factorization, and the regularized Gaussian graphical model is utilized to evaluate the local embedding relationship of data. To learn the cell-cell similarity matrix, we integrated the two components, and an iterative optimization algorithm was developed. The categorization of single cells is obtained by applying Louvain, a modularity-based community discovery algorithm, to the similarity matrix. The behavior of the GCFG approach is assessed on 14 real scRNA-seq datasets in terms of ACC and ARI, and comparison results with 17 other competitive methods suggest that GCFG is effective and robust.


Asunto(s)
Análisis de la Célula Individual , Análisis de Expresión Génica de una Sola Célula , Análisis de Secuencia de ARN/métodos , Análisis de la Célula Individual/métodos , Perfilación de la Expresión Génica/métodos , Algoritmos , Análisis por Conglomerados
16.
Am J Prev Med ; 66(4): 735-743, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38123028

RESUMEN

INTRODUCTION: As one of the world's most populous countries, China persistently confronts a significant multimorbidity burden. This study aimed to elucidate the multimorbidity burden experienced by Chinese older adults, explore its interplay with socioeconomic disparity, and investigate potential correlations between these provincial disparities and health services availability. METHODS: The fourth wave of China's national Urban and Rural Elderly Population study, conducted in 2015, was used to construct a multimorbidity index and elucidate the geographic differences in the multimorbidity burden. Incorporating macrolevel indicators about socioeconomic and health services availability, quantile regression and Spearman correlation analyses were employed to investigate the relationship between multimorbidity and socioeconomic disparities and examine the potential linkages between these provincial disparities and health services availability. Analyses were performed in 2023. RESULTS: The final analysis included a total of 213,857 older adults. At the provincial level, significant geographic disparities in multimorbidity burden were identified. After adjusting for individual social determinants of health, an independent association was found between the human development index and a higher multimorbidity index (coefficient= -0.22; 95% CI= -0.24, -0.19). Furthermore, a significant positive correlation emerged between human development index and both population and geographic densities of health services availability. Notably, geographic density displayed greater inequality (Gini coefficients=0.45-0.48) than population density (Gini coefficients=0.03-0.10). CONCLUSIONS: This study demonstrates that multimorbidity burden in China is linked to provincial socioeconomic disparities and that inequality in health services availability may account for this, which would advocate for a need to reduce disparities in health services availability.


Asunto(s)
Servicios de Salud , Multimorbilidad , Humanos , Anciano , Factores Socioeconómicos , China/epidemiología
17.
Qual Manag Health Care ; 33(2): 86-93, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38102751

RESUMEN

BACKGROUND AND OBJECTIVES: Data are lacking on the estimated costs of pharmacist prescription reviews (PPRs) for hospitalized internal medicine patients. This study investigates the estimated costs of drug-related problems (DRPs) prevented by PPRs among hospitalized internal medicine patients. METHODS: We reviewed all medication orders for patients at an academic teaching hospital in China for 2 years. DRPs were categorized using the Pharmaceutical Care Network Europe classification. The severity of the potential harm of DRPs was assessed by the Harm Associated with Medication Error Classification (HAMEC) tool. The estimated cost of PPRs was calculated. RESULTS: A total of 162426 medication orders for 4314 patients were reviewed, and 1338 DRPs were identified by pharmacists who spent 2230 hours performing PPRs. Among the 1080 DRPs that were prospectively intervened upon, 703 were resolved. The HAMEC tool showed that 47.1% of DRPs were assessed as level 2, 30.4% as level 3, 20.6% as level 1, and 0.6% carried a life-threatening risk. Pharmacist interventions contributed to the prevention of DRP errors and a reduction of $339 139.44. This resulted in a mean cost saving of $482.42 per patient at an input cost of $21 495.06 over the 2 years. The benefit-cost ratio was 15.8. CONCLUSION: PPRs are beneficial for detecting potential DRPs and creating potential cost savings among hospitalized internal medicine patients.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Humanos , Hospitales de Enseñanza , Errores de Medicación/prevención & control , Farmacéuticos , Prescripciones
18.
Brain Behav Immun ; 115: 250-257, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37884160

RESUMEN

BACKGROUND: Neuroinflammation and aberrant immune regulation are increasingly implicated in the pathophysiology of white matter hyperintensities (WMH), an imaging marker of cerebrovascular pathologies and predictor of cognitive impairment. The role of human leukocyte antigen (HLA) genes, critical in immunoregulation and associated with susceptibility to neurodegenerative diseases, in WMH pathophysiology remains unexplored. METHODS: We performed association analyses between classical HLA alleles and WMH volume, derived from MRI scans of 38 302 participants in the UK Biobank. To identify independent functional alleles driving these associations, we conducted conditional forward stepwise regression and lasso regression. We further investigated whether these functional alleles showed consistent associations with WMH across subgroups characterized by varying levels of clinical determinants. Additionally, we validated the clinical relevance of the identified alleles by examining their association with cognitive function (n = 147 549) and dementia (n = 460 029) in a larger cohort. FINDINGS: Four HLA alleles (DQB1*02:01, DRB1*03:01, C*07:01, and B*08:01) showed an association with reduced WMH volume after Bonferroni correction for multiple comparisons. Among these alleles, DQB1*02:01 exhibited the most significant association (ß = -0.041, 95 % CI: -0.060 to -0.023, p = 1.04 × 10-5). Forward selection and lasso regression analyses indicated that DQB1*02:01 and C*07:01 primarily drove this association. The protective effect against WMH conferred by DQB1*02:01 and C*07:01 persisted in clinically relevant subgroups, with a stronger effect observed in older participants. Carrying DQB1*02:01 and C*07:01 was associated with higher cognitive function, but no association with dementia was found. INTERPRETATION: Our population-based findings support the involvement of immune-associated mechanisms, particularly both HLA class I and class II genes, in the pathogenesis of WMH and subsequent consequence of cognitive functions.


Asunto(s)
Demencia , Sustancia Blanca , Anciano , Humanos , Alelos , Cognición/fisiología , Estudios de Cohortes , Demencia/genética , Frecuencia de los Genes , Predisposición Genética a la Enfermedad/genética , Haplotipos , Antígenos HLA-C/genética , Cadenas HLA-DRB1/genética
19.
China CDC Wkly ; 5(50): 1131-1134, 2023 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-38124884
20.
China CDC Wkly ; 5(50): 1120-1124, 2023 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-38124885

RESUMEN

What is already known about this topic?: Diabetes mellitus poses a significant public health concern for older adults in China, resulting in increased mortality rates. What is added by this report?: This study investigates the evolving pattern of mortality associated with diabetes mellitus and analyzes the contributions of age, period, and cohort effects from 1987 to 2021. The results demonstrate a consistent rise in diabetes mellitus mortality over the last 30 years, notably in rural regions. What are the implications for public health practice?: This research offers valuable insights to aid policymakers in developing targeted intervention strategies that address the specific needs of higher-risk populations, such as women, older adults, and individuals in rural areas.

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