Association between synoptic types in Beijing and acute myocardial infarction hospitalizations: A comprehensive analysis of environmental factors.

BACKGROUND: Environmental factors like air pollution and temperature can trigger acute myocardial infarction (AMI). However, the link between large-scale weather patterns (synoptic types) and AMI admissions has not been extensively studied. This research aimed to identify the different synoptic air types in Beijing and investigate their association with AMI occurrences. METHODS: We analyzed data from Beijing between 2013 and 2019, encompassing 2556 days and 149,632 AMI cases. Using principal component analysis and hierarchical clustering, classification into distinct synoptic types was conducted based on weather and pollution measurements. To assess the impact of each type on AMI risk over 14 days, we employed a distributed lag non-linear model (DLNM), with the reference being the lowest risk type (Type 2). RESULTS: Four synoptic types were identified: Type 1 with warm, humid weather; Type 2 with warm temperatures, low humidity, and long sunshine duration; Type 3 with cold weather and heavy air pollution; and Type 4 with cold temperatures, dryness, and high wind speed. Type 4 exhibited the greatest cumulative relative risk (CRR) of 1.241 (95%CI: 1.150, 1.339) over 14 days. Significant effects of Types 1, 3, and 4 on AMI events were observed at varying lags: 4-12 days for Type 1, 1-6 days for Type 3, and 1-11 days for Type 4. Females were more susceptible to Types 1 and 3, while individuals younger than 65 years old showed increased vulnerability to Types 3 and 4. CONCLUSION: Among the four synoptic types identified in Beijing from 2013 to 2019, Type 4 (cold, dry, and windy) presented the highest risk for AMI hospitalizations. This risk was particularly pronounced for males and people under 65. Our findings collectively highlight the need for improved methods to identify synoptic types. Additionally, developing a warning system based on these synoptic conditions could be crucial for prevention.

Temperature fluctuation and acute myocardial infarction in Beijing: an extended analysis of temperature ranges and differences.

Purpose: Few studies examined the relationship between temperature fluctuation metrics and acute myocardial infarction (AMI) hospitalizations within a single cohort. We aimed to expand knowledge on two basic measures: temperature range and difference. Methods: We conducted a time-series analysis on the correlations between temperature range (TR), daily mean temperature differences (DTDmean), and daily mean-maximum/minimum temperature differences (TDmax/min) and AMI hospitalizations, using data between 2013 and 2016 in Beijing, China. The effects of TRn and DTDmeann over n-day intervals were compared, respectively. Subgroup analysis by age and sex was performed. Results: A total of 81,029 AMI hospitalizations were included. TR1, TDmax, and TDmin were associated with AMI in J-shaped patterns. DTDmean1 was related to AMI in a U-shaped pattern. These correlations weakened for TR and DTDmean with longer exposure intervals. Extremely low (1st percentile) and high (5°C) DTDmean1 generated cumulative relative risk (CRR) of 2.73 (95% CI: 1.56-4.79) and 2.15 (95% CI: 1.54-3.01). Extremely high TR1, TDmax, and TDmin (99th percentile) correlated with CRR of 2.00 (95% CI: 1.73-2.85), 1.71 (95% CI: 1.40-2.09), and 2.73 (95% CI: 2.04-3.66), respectively. Those aged 20-64 had higher risks with large TR1, TDmax, and TDmin, while older individuals were more affected by negative DTDmean1. DTDmean1 was associated with a higher AMI risk in females. Conclusion: Temperature fluctuations were linked to increased AMI hospitalizations, with low-temperature extremes having a more pronounced effect. Females and the older adult were more susceptible to daily mean temperature variations, while younger individuals were more affected by larger temperature ranges.

Appropriateness of Percutaneous Coronary Interventions: A Systematic Review and Meta-Analysis.

BACKGROUND: Since the foundation of appropriate use criteria (AUC) for coronary revascularization, the proportion of inappropriate (later revised as "rarely inappropriate") percutaneous coronary interventions (PCIs) varied in different populations. However, the pooled inappropriate PCI rate remains unknown. METHODS: We searched the PubMed, Cochrane, Embase, and Sinomed databases for studies related to AUC and PCIs. Studies that reported inappropriate/rarely appropriate PCI rates were included. A random effects model was employed in the meta-analysis because of the high statistical heterogeneity. RESULTS: Thirty-seven studies were included in our study, of which eight studies reported the appropriateness of acute PCIs or PCIs in acute coronary syndrome (ACS) patients, 25 studies reported the appropriateness of non-acute/elective PCIs or PCIs in non-ACS/stable ischemic heart disease (SIHD) patients, and 15 studies reported both acute and non-acute PCIs or did not distinguish the urgency of PCI. The pooled inappropriate PCI rate was 4.3% (95% CI: 2.6-6.4%) in acute scenarios, 8.9% (95% CI: 6.7-11.0%) in non-acute scenarios, and 6.1% (95% CI: 4.9-7.3%) overall. The inappropriate/rarely appropriate PCI rate was significantly higher in non-acute than acute scenarios. No difference in the inappropriate PCI rate was detected based on the study location, the country's level of development, or the presence of chronic total occlusion (CTO). CONCLUSIONS: The worldwide inappropriate PCI rate is generally identical but comparatively high, especially under non-acute scenarios.

Association between the temperature difference and acute exacerbations of chronic obstructive pulmonary disease: A time-series analysis with 143,318 hospital admissions in Beijing, China.

Purpose: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has the adverse influence on quality of life and creates significant healthcare costs. However, there were sparse studies investigating the correlation between AECOPD hospital admissions and temperature change. Therefore, it is noteworthy to investigate the impact of various temperature differences and recognize the susceptible population. The purpose of this study was to investigate the impact of temperature differences on AECOPD hospital admissions, and to give potentially helpful material for disease preventative efforts. Methods: The distributed lag non-linear model was adopted to characterize the exposure-response relationship and to assess the impact of temperature difference. The stratified analysis and sensitivity analysis were also conducted to determine the susceptible populations and examine the robustness of the results. Results: There were 143,318 AECOPD hospital admissions overall during the study period. The AECOPD hospital admissions had significant association with the daily mean temperature difference (DTDmean) such as the extreme-cold temperature difference (1st DTDmean), the ultra-cold temperature difference (5th DTDmean), the ultra-hot temperature difference (95th DTDmean) and the extreme-hot temperature difference (99th DTDmean). Besides, there was the "U-shaped" association between DTDmean and 21 days cumulative relative risk of AECOPD. Conclusion: The AECOPD hospital admissions was correlated with the DTDmean temperature differences, especially the extreme-cold and extreme-hot temperature difference. Moreover, people older than 65 years were more susceptible to the extreme-hot and extreme-cold temperature difference.

Hsa_circ_0129047 sponges miR-665 to attenuate lung adenocarcinoma progression by upregulating protein tyrosine phosphatase receptor type B.

Compelling evidence has demonstrated the critical role of circular RNAs (circRNAs) during lung adenocarcinoma (LUAD) progression. Herein, we explored a novel circRNA, circ_0129047, and detailed its mechanism of action. The expression of circ 0129047, microRNA-665 (miR-665), and protein tyrosine phosphatase receptor type B (PTPRB) in LUAD tissues and cells was determined using reverse transcription quantitative polymerase chain reaction and Western blotting. Cell Counting Kit-8 and colony formation assays were conducted to detect LUAD cell proliferation, and western blotting was performed to quantify apoptosis-related proteins (Bcl-2 and Bax). Luciferase reporter and RNA immunoprecipitation assays were used to validate the predicted interaction between miR-665 and circ_0129047 or PTPRB. A xenograft assay was used for the in vivo experiments. Circ_0129047 and PTPRB were downregulated in LUAD tissues and cells, whereas miR-665 expression was upregulated. Overexpression of circ_0129047 suppresses LUAD growth in vivo and in vitro. Circ_0129047 is the target of miR-665, and the miR-665 mimic ablated the antiproliferative and pro-apoptotic phenotypes of LUAD cells by circ_0129047 augmentation. MiR-665 targets the 3'UTR of PTPRB and downregulates PTPRB expression. PTPRB overexpression offsets the pro-proliferative potential of miR-665 in LUAD cells. Circ_0129047 sequestered miR-665 and upregulated PTPRB expression, thereby reducing LUAD progression, suggesting a promising approach for preventing LUAD.

Total bilirubin is associated with all-cause mortality in patients with acute respiratory distress syndrome: a retrospective study.

Background: Acute respiratory distress syndrome (ARDS) is a life-threatening disease for which biomarkers to predict mortality are needed. Total bilirubin (TBIL), an end-product of hemoglobin catabolism in mammals reflecting liver dysfunction, has been demonstrated as an independent risk indicator for critically ill patients. This study aimed to examine whether TBIL on intensive care unit (ICU) admission is associated with ARDS mortality. Methods: We analyzed the data of patients diagnosed with ARDS according to the Berlin definition from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The primary endpoint was 30-day ICU mortality after admission to the ICU, and the second endpoint was in-hospital mortality. Multivariable logistic analysis adjusted for potential confounders was used to determine the association between TBIL and short-term mortality. Results: Of 1,539 ARDS patients enrolled, 261 patients died within 30 days of admission to the ICU. In the multivariable logistic analysis, each 1 g/dL increase in TBIL levels led to a 4% increase in the odds of 30-day ICU mortality [adjusted odds ratio (OR) =0.04; 95% confidence interval (CI): 0.01 to 0.08] and a 4% increase in the odds of in-hospital mortality (adjusted OR =0.04; 95% CI: 0.01 to 0.07). Furthermore, TBIL levels ≥2 mg/dL were significantly associated with 30-day ICU mortality (adjusted OR =1.51, 95% CI: 1.02 to 1.07) and in-hospital mortality (OR =1.41; 95% CI: 1.01 to 1.87). Similarly, associations between serum TBIL levels and 30-day ICU mortality were found in all subgroups stratified by comorbidities, the severity of ARDS, and other variables. Conclusions: A higher serum TBIL on ICU admission was independently associated with mortality in ARDS patients. Intensive care and observation should be provided to ARDS patients with increased TBIL.

Association of extreme precipitation with hospitalizations for acute myocardial infarction in Beijing, China: A time-series study.

Background: In the context of global climate changes, increasing extreme weather events have aroused great public concern. Limited evidence has focused on the association between extreme precipitation and hospitalizations for acute myocardial infarction (AMI). Our study aimed to examine the effect of extreme precipitation on AMI hospitalizations. Methods: Daily AMI hospitalizations, weather variables and air pollution data in Beijing from 2013 to 2018 were obtained. We used a time-series analysis with a distributed lag model to evaluate the association of extreme precipitation (≥95th percentile of daily precipitation) with AMI hospitalizations. Subgroup analysis was conducted to identify the vulnerable subpopulations and further assessed the attributable burden. Results: Extreme precipitation increased the risk of AMI hospitalizations with significant single-day effects from Lag 4 to Lag 11, and the maximum cumulative effects at Lag 0-14 (CRR = 1.177, 95% CI: 1.045, 1.326). Older people (≥65 years) and females were more vulnerable to extreme precipitation. The attributable fraction and numbers of extreme precipitation on AMI hospitalizations were 0.68% (95% CI: 0.20%, 1.12%) and 854 (95% CI: 244, 1,395), respectively. Conclusion: Extreme precipitation is correlated with a higher risk of AMI hospitalizations. The elderly (≥65 years) and females are more susceptible to AMI triggered by extreme precipitation.

Higher Serum 25-Hydroxyvitamin D Is Associated with Lower All-Cause and Cardiovascular Mortality among US Adults with Nonalcoholic Fatty Liver Disease.

AIMS: We aimed to assess the association between serum 25-hydroxyvitamin D (25(OH)D) levels with all-cause and cardiovascular mortality in patients with nonalcoholic fatty liver disease (NAFLD). METHODS: We performed a retrospective cohort study based on the US National Health and Nutrition Examination Survey 2001-2016 on adults aged ≥20 years. NAFLD was determined as a US Fatty Liver Index score ≥ 30 in the absence of other liver conditions. Weighted Cox proportional hazards regression models were applied to explore the relationship between serum 25(OH)D levels and mortality. RESULTS: 898 all-cause deaths and 305 cardiovascular deaths were recorded over a median follow-up of 8.7 years. Compared with those in the severe deficiency group (below 25.0 nmol/L), the fully adjusted HRs and 95% CIs of NAFLD patients with sufficient serum 25(OH)D concentrations (≥75.0 nmol/L) were 0.36 (0.22, 0.60) for all-cause mortality and 0.14 (0.07, 0.29) for cardiovascular mortality. Each one-unit increase in the natural log-transformed serum 25(OH)D concentration was related to a 41% lower risk for all-cause deaths (HR = 0.59, 95% CI: 0.46, 0.77) and a 65% lower risk for cardiovascular deaths (HR = 0.35, 95% CI: 0.22, 0.58). CONCLUSIONS: Among NAFLD patients, increased serum 25(OH)D levels were independently associated with reduced risk for all-cause and cardiovascular deaths.

Increased Risk of Hospital Admission for Asthma from Short-Term Exposure to Low Air Pressure.

Purpose: Asthma has a major impact on patients' quality of life, mortality, and healthcare burden. Some evidence suggests that environmental factors may trigger asthma. However, there has been limited research on the relationship between air pressure and asthma hospital admissions, especially in China. Thus, we aimed to study the influence of air pressure and identify potentially susceptible populations. Methods: The study data were gathered from hospitalization records with a primary diagnosis of asthma from all secondary and tertiary hospitals in Beijing from January 1, 2013, to December 31, 2016. The study examined the association between the risk of asthma and air pressure using a distributed lag non-linear model (DLNM). We also performed a stratified analysis to identify the susceptible populations. Results: A total of 23,697 asthma hospital admissions were included in the study. We found that the relative risk (RR) and the 7-day cumulative relative risk (CRR) of asthma had an approximate negative correlation with air pressure. At the same time, we found that the association was most apparent on the day of exposure (lag = 0). Conclusion: Ambient air pressure had an approximately negative correlation with daily asthma hospital admissions in Beijing, China. That means the risk of hospital admission for asthma would be increased by low air pressure. Furthermore, air pressure has a significant effect on asthma only on the day of exposure. It is possibly significant to protect the vulnerable on days with low air pressure, especially those younger than 65 years.

Effects of indoor and outdoor temperatures on blood pressure and central hemodynamics in a wintertime longitudinal study of Chinese adults.

OBJECTIVES: We aimed to estimate the effects of indoor and outdoor temperature on wintertime blood pressure (BP) among peri-urban Beijing adults. METHODS: We enrolled 1279 adults (ages: 40-89 years) and conducted measurements in two winter campaigns in 2018-2019 and 2019-2020. Study staff traveled to participant homes to administer a questionnaire and measure brachial and central BP. Indoor temperature was measured in the 5 min prior to BP measurement. Outdoor temperature was estimated from regional meteorological stations. We used multivariable mixed-effects regression models to estimate the within-individual and between-individual effects of indoor and outdoor temperatures on BP. RESULTS: Indoor and outdoor temperatures ranged from 0.0 to 28 °C and -14.3 to 6.4 °C, respectively. In adjusted models, a 1 °C increase in indoor temperature was associated with decreased SBP [-0.4 mmHg, 95% confidence interval (CI): -0.7 to -0.1 (between-individual; brachial and central BP); -0.5 mmHg, 95% CI: -0.8 to -0.2 (within-individual, brachial BP); -0.4 mmHg, 95% CI: -0.7 to -0.2 (within-individual, central BP)], DBP [-0.2 mmHg, 95% CI:-0.4 to -0.03 (between-individual); -0.3 mmHg, 95% CI: -0.5 to -0.04 (within-individual)], and within-individual pulse pressure [-0.2 mmHg, 95% CI: -0.4 to -0.04 (central); -0.3 mmHg, 95% CI: -0.4 to -0.1 (brachial)]. Between-individual SBP estimates were larger among participants with hypertension. There was no evidence of an effect of outdoor temperature on BP. CONCLUSION: Our results support previous findings of inverse associations between indoor temperature and BP but contrast with prior evidence of an inverse relationship with outdoor temperature. Wintertime home heating may be a population-wide intervention strategy for high BP and cardiovascular disease in China.

Hsa_circ_0129047 regulates the miR-375/ACVRL1 axis to attenuate the progression of lung adenocarcinoma.

BACKGROUND: Circular RNAs (circRNAs) are attractive candidates to be used as biomarkers of human cancers, including lung adenocarcinoma (LUAD). Our study aimed to investigate the functions and regulatory mechanisms of hsa_circ_0129047 in the tumorigenesis of LUAD. METHODS: Reverse transcription-quantitative polymerase chain reaction was performed to determine the circRNA, microRNA (miRNA), and mRNA expression levels in LUAD cell lines and tissues. Tumor xenografts were established in nude mice to evaluate whether hsa_circ_0129047 affected LUAD tumor development in vivo. Cell counting kit-8 and transwell assays were performed to assess the mechanisms by which hsa_circ_0129047 influenced the viability and migration of LUAD cells, respectively. Apoptosis was evaluated via determination of the levels of the apoptotic markers, B-cell lymphoma-2, and Bcl-2-associated X, via Western blotting. Dual-luciferase reporter assay, RNA immunoprecipitation assay, and Pearson's correlation analysis were performed to determine the relationships among miR-375 and hsa_circ_0129047 and activin A receptor-like type 1 (ACVRL1). RESULTS: Downregulation of hsa_circ_0129047 levels was observed in LUAD cell lines and tissues. Meanwhile, the upregulation of hsa_circ_0129047 levels repressed the proliferative, migratory, and survival capacities of LUAD cells in vitro. Hsa_circ_0129047 exerted antitumor effects during in vivo tumor development. Finally, we demonstrated that hsa_circ_0129047 sponged miR-375. This interaction facilitated the expression of the downstream target of miR-375, ACVRL1, whose upregulation inhibited the development and malignancy of LUAD. CONCLUSION: These findings demonstrate that hsa_circ_0129047 functions as a tumor inhibitor in LUAD by modulating the miR-375/ACVRL1 axis. Hence, hsa_circ_0129047 may be a promising biomarker and gene target for LUAD treatment.

Household solid fuel use with diabetes and fasting blood glucose levels among middle-aged and older adults in China.

To explore the impacts of household solid fuel use for cooking and heating on diabetes and fasting blood glucose (FBG) levels, we used data from the China Health and Retirement Longitudinal Study, a national survey including middle-aged and older adults. Multivariable logistic and linear regression models were used to explore the relationship between household solid fuel use (coal, crop residue, and wood) for cooking and heating with diabetes and FBG levels. Subgroup analyses were also performed based on age, sex, region of residence, smoking status, and body mass index to examine potential interactions between the variables and household solid fuel use. Among the 6195 participants, 75.4% and 61.4%, respectively, used solid fuels for heating and cooking. Relative to clean fuel users, solid fuel users had higher odds of diabetes (heating: OR, 1.21; 95% CI, 1.01-1.44; cooking: OR, 1.31; 95% CI, 1.12-1.53) and higher FBG levels (heating: ß = 3.23; 95% CI, 1.10-5.36; cooking: ß = 2.86; 95% CI, 0.95-4.77). Simultaneous use of solid fuels for cooking/heating was also positively associated with diabetes (OR, 1.31; 95% CI, 1.07-1.61) and FBG (ß = 4.30; 95% CI, 1.82-6.78). No significant interactions were detected between subgroup variables and the impacts of solid fuel use on diabetes and FBG. Household solid fuel use is positively associated with diabetes and FBG levels. These findings imply that inhibiting household solid fuel use may contribute to decreasing diabetes development in China.

Evaluation of impact of "2+26″ regional strategies on air quality improvement of different functional districts in Beijing based on a long-term field campaign.

Consecutive measurements of ambient fine particulate matter (PM2.5) from February 2016 to April 2018 have been performed at four representative sites of Beijing to evaluate the impact of "2 + 26" regional strategies implemented in 2017 for air quality improvement in non-heating period (2017NH) and heating period (2017H). The decrease of PM2.5 were significant both in 2017NH (20.2% on average) and 2017H (43.7% on average) compared to 2016NH and 2016H, respectively. Eight sources were resolved at each site from the PMF source apportionment including secondary nitrate, traffic, coal combustion, soil dust, road dust, sulfate, biomass/waste burning and industrial process. The results show that the reductions of industrial process, soil dust, and coal combustion were most effective among all sources at each site after the regional strategies implementation with the large reductions in potential source areas. The decrease of coal combustion in 2017NH were larger than 2017H at all sites while that of soil dust and industrial sources were the opposite. Insignificant reduction of coal combustion contribution at the suburban site in the heating period indicated that rural residential coal burning need further control. The industrial source control in the suburbs were least effective compared with other districts. Traffic was the largest contributer at each site and control of traffic emissions were more effective in 2017H than 2017NH. The local nature and increase of biomass/waste burning contributions emphasized the effect of fireworks and bio-fuel use in rural areas and incinerator emissions in urban districts. Secondary nitrate and sulfate were mainly impacted by the regional transport from southern adjacent areas and favorable meteorological conditions played an important part in the PM2.5 abatements of 2017H. Secondary nitrate became a more major role in the air pollution process because of the larger decrease of sulfate. Finally suggestions for future control are made in this study.

Association of sunshine duration with acute myocardial infarction hospital admissions in Beijing, China: A time-series analysis within-summer.

BACKGROUND: Over the years, various epidemiological studies found that acute myocardial infarction (AMI) often shows seasonal rhythm patterning, which is usually influenced by the variations of environmental factors, such as air pollution, ambient temperature, solar activity, relative humidity. However, there are few studies on the impact of sunlight-induced AMI especially in developing countries, and they had inconsistent results. This study aimed to examine within-summer variations in the temporal association between sun exposure and AMI. METHODS: We obtained hospitalization data for AMI of Beijing during 2013-2019. We used a distributed lag non-linear model (DLNM) combined with a quasi-Poisson regression model to estimate the non-linear lag effects of sunshine duration on AMI incidences. We evaluated the overall effect of AMI admissions with exposure to sunshine duration in the lag 0-21 days. RESULTS: A total of 45,301 AMI cases were enrolled in our study during summer (June-September). The minimum of the morbidity was during days with a sunshine duration of 3.9 h. We found significant and U-shaped associations between sunshine duration and AMI, and the overall estimated relative risk was 1.29 (95% CI: 1.02,1.62) and 1.69 (95% CI: 1.28,2.24) for short (1st percentile) and long (99th percentile) sunshine duration, respectively. The males and younger people (<65 years) were most susceptible to these effects. CONCLUSION: Our results suggest that both short and long sunshine duration could increase the risk of AMI admissions, especially for males and younger people. We suggest that public health policymakers should fully consider the balance of the pros and cons of solar exposure, and provide appropriate public health recommendations accordingly to gain the greatest benefits from sunlight.

Associations between ambient temperature and adult asthma hospitalizations in Beijing, China: a time-stratified case-crossover study.

BACKGROUND: Studies on the associations between ambient temperature and asthma hospitalizations are limited, and the results are controversial. We aimed to assess the short-term effects of ambient temperature on the risk of asthma hospitalizations and quantify the hospitalization burdens of asthma attributable to non-optimal temperature in adults in Beijing, China. METHODS: We collected daily asthma hospitalizations, meteorological factors and air quality data in Beijing from 2012 to 2015. We applied a time-stratified case-crossover design and fitted a distributed lag non-linear model with a conditional quasi-Poisson regression to explore the association between ambient temperature and adult asthma hospitalizations. The effect modifications of these associations by gender and age were assessed by stratified analyses. We also computed the attributable fractions and numbers with 95% empirical confidence intervals (eCI) of asthma hospitalizations due to extreme and moderate temperatures. RESULTS: From 2012 to 2015, we identified a total of 18,500 hospitalizations for asthma among adult residents in Beijing, China. Compared with the optimal temperature (22 °C), the cumulative relative risk (CRR) over lag 0-30 days was 2.32 with a 95% confidence interval (CI) of 1.57-3.42 for extreme cold corresponding to the 2.5th percentile (- 6.5 °C) of temperature distribution and 2.04 (95% CI 1.52-2.74) for extreme heat corresponding to the 97.5th percentile (29 °C) of temperature distribution. 29.1% (95% eCI 17.5-38.0%) of adult asthma hospitalizations was attributable to non-optimum temperatures. Moderate cold temperatures yielded most of the burdens, with an attributable fraction of 20.3% (95% eCI 9.1-28.7%). The temperature-related risks of asthma hospitalizations were more prominent in females and younger people (19-64 years old). CONCLUSIONS: There was a U-shaped association between ambient temperature and the risk of adult asthma hospitalizations in Beijing, China. Females and younger patients were more vulnerable to the effects of non-optimum temperatures. Most of the burden was attributable to moderate cold. Our findings may uncover the potential impact of climate changes on asthma exacerbations.

Triglyceride to high-density lipoprotein cholesterol ratio and cardiovascular events in the general population: A systematic review and meta-analysis of cohort studies.

AIMS: The ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) has been regarded as a novel surrogate indicator of insulin resistance and the atherogenic index of plasma. This meta-analysis aimed to evaluate the association between the TG/HDL-C ratio and the incidence of cardiovascular events in the general population. DATA SYNTHESIS: Cohort studies reporting the association between the TG/HDL-C ratio and cardiovascular events in the general population were obtained by a systematic literature search of PubMed, Embase and Web of Science databases until April 11, 2021. 13 cohort studies with a total of 207,515 participants were included in this meta-analysis. In a random-effects model, compared with those with the lowest category of the TG/HDL-C ratio, participants with the highest category were independently associated with a higher risk of cardiovascular events (pooled HR: 1.43, 95%CI: 1.26-1.62, I2 = 72.9%). For the presence of publication bias detected by the Egger's test (p = 0.011), correction for publication bias using the trim-and-fill method reduced the HR to 1.26 (95%CI: 1.11-1.44). This result was consistent with the finding of the TG/HDL-C ratio analyzed as a continuous variable (pooled HR per unit increment of the TG/HDL-C ratio: 1.08, 95%CI: 1.04-1.12, I2 = 67.0%). Subgroup analyses indicated that population gender, geographical region, duration of follow-up, adjustment for other lipid parameters, adjustment for diabetes and categorical number did not significantly vary the relationship. CONCLUSION: Elevated TG/HDL-C ratio may be independently associated with an increased risk of cardiovascular events in the general population. More well-designed studies are needed to confirm the current findings. REGISTRATION NUMBER IN PROSPERO: CRD42021244583.

Increased hospital admissions for asthma from short-term exposure to cold spells in Beijing, China.

BACKGROUND: There is a paucity of studies investigating extreme cold events and asthma exacerbations. This study examined whether an association exists between cold spells and daily hospital admissions for asthma in Beijing, China from 2012 to 2016. METHODS: Daily hospital admissions for asthma, meteorological variables and air quality data were collected during 2012-2016 in Beijing. A cold spell was defined as a period of at least two consecutive days with the daily mean temperature below or at the 5th percentile (-7 °C) in cold seasons (November to March) during the study period. We applied a time-series design using quasi-Poisson regression combined with a distributed lag model to estimate the risk of asthma hospital admissions associated with cold spells. Stratified analyses by gender and age groups were conducted to identify the potential susceptible subpopulations to cold spells. We also explored the effect modification by air quality by dividing the daily air quality index (AQI) into two levels (high and low) based on the median value. RESULTS: Cold spells increased the risk of asthma hospital admissions, with the maximum cumulative relative risk (CRR) over three weeks (Lag0-21) in the total population. The highest single-day relative risk (RR) was found on the days of cold spells (Lag0) with the RR = 1.059 (95% CI: 1.008-1.113), and the CRR at Lag0-21 was 1.333 (95% CI: 1.049-1.693). Across different gender and age groups, younger people (<65 years) were more sensitive to cold spells. No significant effect modification by AQI was detected. CONCLUSION: Short-term exposure to cold spells is associated with an increased risk of hospital admissions for asthma in Beijing. During the cold spells, younger people aged <65 years were at particular risk for asthma exacerbations. Our results suggest that extreme cold events have a significant impact on asthma.

Association between the triglyceride-glucose index and abdominal aortic calcification in adults: A cross-sectional study.

BACKGROUND AND AIMS: The triglyceride-glucose (TyG) index is a reliable marker of insulin resistance, which is a substantial risk factor for cardiovascular diseases. Abdominal aortic calcification (AAC) is significantly associated with subclinical atherosclerotic diseases. The present study investigated the relationship between the TyG index and extensive AAC in middle-aged and elderly populations in the United States (US). METHODS AND RESULTS: We performed cross-sectional analyses of data from 1419 participants from the National Health and Nutrition Examination Survey 2013-2014. AAC was detected using dual-energy X-ray absorptiometry on Hologic Discovery model A densitometer, and quantified using the Kauppila score system. Extensive AAC was defined as a Kauppila score ≥5. Multivariable logistic regression models were used to determine the association between AAC and the TyG index. The restricted cubic spline model was used for the dose-response analysis. Extensive AAC was detected in 196 (13.8%) participants. The odds of extensive AAC increased by 41% per unit increase in the TyG index (adjusted odds ratios [OR] = 1.41, 95% confidence interval [CI]: 1.04-1.91). The multivariable-adjusted OR and 95% CI of the highest TyG index tertile compared with the lowest tertile was 1.80 (95% CI: 1.11-2.94). Extensive AAC showed a more robust association with the TyG index than with triglycerides or glycemia. The subgroup analyses indicated that the association was consistent irrespective of age, sex, hypertension, diabetes, hypercholesteremia and smoking status. CONCLUSION: The TyG index was independently associated with the presence of extensive AAC in the study population. Further studies are required to confirm this relationship.

Demographic, signs and symptoms, imaging characteristics of 2126 patients with COVID-19 pneumonia in the whole quarantine of Wuhan, China.

OBJECTIVE: The accurate knowledge of demographic, signs and symptoms, imaging characteristics of coronavirus disease 2019 (COVID-19) is essential for the accurate management of these patients. However, the claims between the previous papers are not always consistent and may even contradict each other, for example, some claims the virus infects more men than women in Wuhan. In this large-scale cohort study, we aimed to update the demographic, signs and symptoms, imaging characteristics of patients with COVID-19 in the whole quarantine of Wuhan, China. METHODS: A cohort of 2126 patients with a diagnosis of COVID-19 pneumonia (confirmed by real-time reverse transcriptase-polymerase chain reaction, RT-PCR) who were admitted to one hospital in Wuhan were retrospectively enrolled. Data were collected between January 13, 2020, and April 8, 2020, the end of Wuhan quarantine. Demographic, signs and symptoms, imaging characteristics were analyzed. CT imaging characteristics associated with respiratory failure or death were identified. RESULTS: Of the 2126 patients with COVID-19, 1051 (49.44%) were men and 1075 (50.56%) were women, 1933 (90.92%) have fever and 1328 (62.46%) have dry cough. The mean age was 57.43 years of age (range 1-95). The CT imaging findings were bilateral pneumonia (1883[88.57%]), unilateral pneumonia (243[11.43%]), ground-glass opacity (GGO) or consolidation (1175[55.27%]), pleural effusion (69[3.25%]). Patients with respiratory failure or death were more likely to have pleural effusion on CT than patients without respiratory failure or death (p < 0.05). CONCLUSION: Men and women have been infected by SARS-CoV-2 in roughly equal numbers. Fever and cough are the most prevalent symptoms at disease onset in patients. Other prevalent symptoms include fatigue, and sputum production. COVID-19 patients with bilateral pneumonia and pleural effusion are more likely to develop respiratory failure or death.

Short-term effects of cold spells on hospitalisations for acute exacerbation of chronic obstructive pulmonary disease: a time-series study in Beijing, China.

OBJECTIVES: Our work aimed at exploring the relationship between cold spells and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalisations in Beijing, China, and assessing the moderating effects of the intensities and the durations of cold spells, as well as identifying the vulnerable. DESIGN: A time-series study. SETTING: We obtained time-series data of AECOPD hospitalisations, meteorological variables and air quality index in Beijing, China during 2012-2016. PARTICIPANTS: All AECOPD hospitalisations among permanent residents in Beijing, China during the cold seasons (November-March) of 2012-2016 were included (n=84 571). PRIMARY AND SECONDARY OUTCOME MEASURES: A quasi-Poisson regression with a distributed lag model was fitted to investigate the short-term effects of cold spells on AECOPD hospitalisations by comparing the counts of AECOPD admissions during cold spell days with those during non-cold spell days. RESULTS: Cold spells under different definitions were associated with increased risk of AECOPD hospitalisations, with the maximum cumulative relative risk (CRR) over 3 weeks (lag0-21). The cumulative effects at lag0-21 increased with the intensities and the durations of cold spells. Under the optimal definition, the most significant single-day relative risk (RR) was found on the days of cold spells (lag0) with an RR of 1.042 (95% CI 1.013 to 1.072), and the CRR at lag0-21 was 1.394 (95% CI 1.193 to 1.630). The elderly (aged ≥65) were more vulnerable to the effects of cold spells on AECOPD hospitalisations. CONCLUSION: Cold spells are associated with increased AECOPD hospitalisations in Beijing, with the cumulative effects increased with intensities and durations. The elderly are at particular risk of AECOPD hospitalisations triggered by cold spells.