Heat exposure and hospitalizations for chronic kidney disease in China: a nationwide time series study in 261 major Chinese cities.

BACKGROUND: Climate change profoundly shapes the population health at the global scale. However, there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease (CKD). METHODS: In the present study, we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018. Standard time-series regression models and random-effects meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span, respectively. RESULTS: A total of 768,129 hospitalizations for CKD was recorded during the study period. The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD, especially in sub-tropical cities. With a 1 °C increase in daily mean temperature, the cumulative relative risks (RR) over lag 0-7 d were 1.008 [95% confidence interval (CI) 1.003-1.012] for nationwide. The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%. Stronger associations were observed among younger patients and those with obstructive nephropathy. Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days (RR = 1.116, 95% CI 1.069-1.166) above the effect of daily mean temperature. CONCLUSIONS: Short-term heat exposure may increase the risk of hospitalization for CKD. Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.

Traditional Chinese Medicine (TCM) Domain Ontology: Current Status and Rethinking for the Future Development.

The past twenty years have seen the increasingly important role of ontology in traditional Chinese medicine (TCM). However, the development of TCM ontology faces many challenges. Since the epistemologies dramatically differ between TCM and contemporary biomedicine, it is hard to apply the existing top-level ontology mechanically. "Data silos" are widely present in the currently available terminology standards, term sets, and ontologies. The formal representation of ontology needs to be further improved in TCM. Therefore, we propose a unified basic semantic framework of TCM based on in-depth theoretical research on the existing top-level ontology and a re-study of important concepts in TCM. Under such a framework, ontologies in TCM sub-domains should be built collaboratively and be represented formally in a common format. Besides, extensive cooperation should be encouraged by establishing ontology research communities to promote ontology peer review and reuse.