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BACKGROUND: Evidence linking ozone to depression and anxiety disorders remains sparse and results are heterogeneous. It remains unknown whether omega-3 fatty acid, or genetic susceptibility of mental disorders modify the impacts of ozone. The aim is to assess the associations of ambient ozone with depression and anxiety, and further explore the potential modification effects of omega-3 fatty acid and genetic susceptibility. METHODS: In total of 257,534 participants were enrolled from 2006 to 2010 and followed up to 2016. Depression and anxiety were assessed using mental health questionnaires, primary care records and hospital admission records. The annual average concentrations of ozone were calculated and linked to individuals by home address. Dietary intake and plasma concentration were selected to reflect levels of omega-3 fatty acid. Polygenetic risk scores were selected to reflect genetic susceptibility. We examined the associations of ozone and incident mental disorders, and potential modification of omega-3 fatty acid and genetic susceptibility. RESULTS: Incidences of depression (N = 6957) and anxiety (N = 6944) was associated with increase of ozone. Higher levels of omega-3 fatty acid might attenuate the ozone related depression risk. However, the modification effects of genetic susceptibility were not found. CONCLUSIONS: Long-term exposure to ambient ozone increase the risk of mental disorders among the middle aged and older adults, and omega-3 fatty acid could reduce the adverse effects of ozone on mental health. Higher intake of omega-3 fatty acid is a potential strategy to prevent the risks caused by ozone on public mental health.
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Ácidos Graxos Ômega-3 , Transtornos Mentais , Ozônio , Pessoa de Meia-Idade , Humanos , Idoso , Ozônio/toxicidade , Biobanco do Reino Unido , Bancos de Espécimes Biológicos , Transtornos Mentais/induzido quimicamente , Transtornos Mentais/epidemiologia , Predisposição Genética para DoençaRESUMO
BACKGROUND: Arterial stiffness (AS) is an important predicting factor for cardiovascular disease. However, no epidemiological studies have ever explored the mediating role of biomarkers in the association between ozone and AS, nor weather fish oil modified such association. METHODS: Study participants were drawn from the UK biobank, and a total of 95,699 middle-aged and older adults were included in this study. Ozone was obtained from Community Multiscale Air Quality (CMAQ) model matched to residential addresses, fish oil from self-reported intake, and arterial stiffness was based on device measurements. First, we applied a double robust approach to explore the association between ozone or fish oil intake and arterial stiffness, adjusting for potential confounders at the individual and regional levels. Then, how triglycerides, apolipoprotein B (Apo B)/apolipoprotein A (ApoA) and non-high-density lipoprotein cholesterol (Non-HDL-C) mediate the relationship between ozone and AS. Last, the modifying role of fish oil was further explored by stratified analysis. RESULTS: The mean age of participants was 55 years; annual average ozone exposure was associated with ASI (beta:0.189 [95%CI: 0.146 to 0.233], P < 0.001), and compared to participants who did not consume fish oil, fish oil users had a lower ASI (beta: 0.061 [95%CI: -0.111 to -0.010], P = 0.016). The relationship between ozone exposure and AS was mediated by triglycerides, ApoB/ApoA, and Non-HDL-C with mediation proportions ranging from 10.90% to 18.30%. Stratified analysis showed lower estimates on the ozone-AS relationship in fish oil users (P = 0.011). CONCLUSION: Ozone exposure was associated with higher levels of arterial stiffness, in contrast to fish oil consumption, which showed a protective association. The association between ozone exposure and arterial stiffness was partially mediated by some biomarkers. In the general population, fish oil consumption might provide protection against ozone-related AS.
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Óleos de Peixe , Ozônio , Rigidez Vascular , Humanos , Ozônio/análise , Ozônio/efeitos adversos , Pessoa de Meia-Idade , Óleos de Peixe/administração & dosagem , Masculino , Feminino , Rigidez Vascular/efeitos dos fármacos , Idoso , Suplementos Nutricionais , Poluentes Atmosféricos/análise , Reino Unido , Triglicerídeos/sangueRESUMO
BACKGROUND: In the wake of China's relaxed zero-COVID policy, there was a surge in coronavirus disease 2019 (COVID-19) infections. This study aimed to examine the infection status and health service utilization among Beijing residents during a widespread outbreak, and to explore the factors that affected utilization of health services due to COVID-19. METHODS: A cross-sectional survey was conducted among Beijing residents from 13 January to 13 February 2023, collecting information on socio-demographic characteristics, health behaviours, COVID-19 infection status, utilization of health services and depressive symptoms. Multivariate Tobit regression was used for data analysis. RESULTS: Among the 53 924 participants, 14.7% were older than 60 years, 63.7% were female and 84.8% were married. In total, 44 992 of the 53 924 individuals surveyed (83.4%) contracted COVID-19 during 2020-2023, and 25.2% (13 587) sought corresponding health services. The majority of individuals (85.6%) chose in-person healthcare, while 14.4% chose internet-based healthcare. Among those who chose in-person healthcare, 58.6% preferred primary healthcare institutions and 41.5% were very satisfied with the treatment. Factors affecting health service utilization include being female (ß = -0.15, P < 0.001), older than 60 years (ß = 0.23, P < 0.01), non-healthcare workers (ß = -0.60, P < 0.001), rich self-rated income level (ß = 0.59, P < 0.001), having underlying disease (ß = 0.51, P < 0.001), living alone (ß = -0.19, P < 0.05), depressive symptoms (ß = 0.06, P < 0.001) and healthy lifestyle habits, as well as longer infection duration, higher infection numbers and severe symptoms. CONCLUSION: As COVID-19 is becoming more frequent and less severe, providing safe and accessible healthcare remains critical. Vulnerable groups such as the elderly and those with underlying conditions need reliable health service. Prioritizing primary healthcare resources and online medical services have played a vital role in enhancing resource utilization efficiency.
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COVID-19 , Idoso , Humanos , Feminino , Masculino , Estudos Transversais , Pequim/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Instalações de SaúdeRESUMO
BACKGROUND: According to animal and human epidemiologic studies, exposure to outdoor light at night (LAN) may cause circadian disruption, which may disturb sleep quality and lead to incident type 2 diabetes mellitus (T2DM). METHODS: We followed 283,374 persons from 2006 through 2020. Outdoor LAN exposure was estimated using satellite data for individual address with 500 m2 scale buffer during follow-up. Incidence of T2DM was confirmed by hospital inpatient records. We identified potential confounders by a directed acyclic graph, including demographic, genetic, individual and regional level socioeconomic status, and environmental risk factors, and calculated hazard ratios (HRs) and 95% confidence intervals (CIs) through time-varying Cox proportional hazard model. Furthermore, we examined the association of outdoor LAN with a defined health sleep scores and moderation of genetic predisposition and shift work on the relationship of outdoor LAN and incident T2DM. RESULTS: We identified 7,775 incident T2DM cases over 3,027,505 person-years. Higher outdoor LAN exposures were significantly associated with higher risk of T2DM. The estimated HR for incident T2DM with an interquartile range (IQR: 11.22 nW/cm2/sr) increase in outdoor LAN was 1.05 (95%CI: 1.01, 1.09) in the fully adjusted model. Participants who lived in the highest quarter of outdoor LAN area were more likely to develop T2DM (HR: 1.14,95%CI: 1.02, 1.27). Besides, those who were exposed to higher levels of outdoor LAN had poorer sleep quality. No moderation role of PRS on outdoor LAN-induced T2DM observed both on the multiplicated and additive scale. The hazards of outdoor LAN were observed in those who never owned a night shift work. CONCLUSION: Although further work is required to clarify potential mechanisms, our findings indicate that exposure to residential outdoor LAN may contribute to T2DM risk and low sleep quality.
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Diabetes Mellitus Tipo 2 , Distúrbios do Início e da Manutenção do Sono , Animais , Humanos , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/genética , Estudos Prospectivos , Predisposição Genética para Doença , Fatores de Risco , LuzRESUMO
BACKGROUND: Exposure to air pollution may increase the risk of obesity, but living in greener space may reduce this risk. Epidemiological evidence, however, is inconsistent. METHODS: Using data from the China Health and Retirement Longitudinal Study (2011-2015), we conducted a nationwide cohort study of 7424 adults. We measured overweight/obesity according to body mass index. We used annual average ground-level air pollutants, including ozone (O3), nitrogen dioxide (NO2), and particulate matter with aerodynamic diameters ≤2.5 µm (PM2.5), to demonstrate air pollution levels. We used the Normalized difference vegetation index (NDVI) to measure greenness exposure. We used time-varying Cox proportional hazard regression models to analyze the connections among air pollution, greenness, and the development of overweight/obesity in middle-aged and older adults in China. We also conducted mediation analyses to examine the mediating effects of air pollution. RESULTS: We found that lower risk of overweight/obesity was associated with more greenness exposure and lower levels of air pollution. We identified that an interquartile increment in NDVI was correlated with a lower hazard ratio (HR) of becoming overweight or obese (HR = 0.806, 95% confidence interval [CI]: 0.754-0.862). Although a 10 µg/m3 increase in PM2.5 and NO2 was correlated with higher risks (HR = 1.049, 95% CI = 1.022-1.075, HR = 1.376, 95% CI = 1.264-1.499). Effects of PM2.5 on being overweight or obese were stronger in men than in women. According to the mediation analysis, PM2.5 and NO2 mediated 8.85% and 19.22% of the association between greenness and being overweight or obese. CONCLUSIONS: An increased risk of being overweight or obese in middle-aged and older adults in China was associated with long-term exposure to higher levels of PM2.5 and NO2. This risk was reduced through NDVI exposure, and the associations were partially mediated by air pollutants. To verify these findings, fine-scale studies are needed.
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Poluentes Atmosféricos , Poluição do Ar , Pessoa de Meia-Idade , Masculino , Feminino , Humanos , Idoso , Dióxido de Nitrogênio/análise , Sobrepeso/epidemiologia , Sobrepeso/induzido quimicamente , Estudos de Coortes , Estudos Longitudinais , Exposição Ambiental/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Material Particulado/análise , Poluentes Atmosféricos/análise , China/epidemiologia , Obesidade/epidemiologia , Obesidade/induzido quimicamenteRESUMO
BACKGROUND: Intracerebral hemorrhage (ICH) is a subtype of stroke that would cause high mortality and disability. Environmental factors may play an important role in the incident risk of ICH. Evidence on how long-term road traffic noise exposure affects incident ICH is still scarce, and whether green space has a modification effect is unknown. We conducted a prospective analysis based on UK Biobank to assess the longitudinal association between road traffic noise exposure and incident ICH, and the potential modification of green space. METHODS: Algorithms based on medical records and linkage were utilized to identify ICH incident cases in the UK Biobank. The Common Noise Assessment Methods in Europe noise model was used to calculate the road traffic noise exposure at the residential level. The relationship between weighted average 24-h road traffic noise level (Lden) and incident ICH was assessed using Cox proportional hazard models, and the modification effect of green space was examined using stratified analysis with interaction terms. RESULTS: Over a median follow-up of 12.5 years, 1 459 incident ICH cases were ascertained in the 402 268 baseline individuals. After adjustment for potential confounders, Lden was significantly related to an elevated risk of incident ICH with a hazard ratio (HR) of 1.14 (95% CI: 1.01, 1.28) for a 10 dB [A] increment. The detrimental influence of Lden on ICH remained stable after adjustment for air pollution. Furthermore, green space modified the association between Lden exposure and incident ICH (Pinteraction = 0.035), and no association was found for higher green space. CONCLUSIONS: Long-term residential road traffic noise exposure was associated with an increased risk of ICH, but only for those who live in areas with less green space, indicating that green space may alleviate the negative impacts of road traffic noise exposure on ICH.
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Poluição do Ar , Ruído dos Transportes , Humanos , Ruído dos Transportes/efeitos adversos , Estudos Prospectivos , Parques Recreativos , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Poluição do Ar/efeitos adversos , Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/etiologiaRESUMO
BACKGROUND: Ambient air pollutant exposure can change the composition of gut microbiota at 6-months of age, but there is no epidemiological evidence on the impacts of exposure to particulate matter with an aerodynamic diameter ≤1 µm (PM1) during pregnancy on gut microbiota in mothers and neonates. We aimed to determine if gestational PM1 exposure is associated with the gut microbiota of mothers and neonates. METHODS: Leveraging a mother-infant cohort from the central region of China, we estimated the exposure concentrations of PM1 during pregnancy based on residential address records. The gut microbiota of mothers and neonates was analyzed using 16 S rRNA V3-V4 gene sequences. Functional pathway analyses of 16 S rRNA V3-V4 bacterial communities were conducted using Tax4fun. The impact of PM1 exposure on α-diversity, composition, and function of gut microbiota in mothers and neonates was evaluated using multiple linear regression, controlling for nitrogen dioxide (NO2) and ozone (O3). Permutation multivariate analysis of variance (PERMANOVA) was used to analyze the interpretation degree of PM1 on the sample differences at the OTU level using the Bray-Curtis distance algorithm. RESULTS: Gestational PM1 exposure was positively associated with the α-diversity of gut microbiota in neonates and explained 14.8% (adj. P = 0.026) of the differences in community composition among neonatal samples. In contrast, gestational PM1 exposure had no impact on the α- and ß-diversity of gut microbiota in mothers. Gestational PM1 exposure was positively associated with phylum Actinobacteria of gut microbiota in mothers, and genera Clostridium_sensu_stricto_1, Streptococcus, Faecalibacterium of gut microbiota in neonates. At Kyoto Encyclopedia of Genes and Genomes pathway level 3, the functional analysis results showed that gestational PM1 exposure significantly down-regulated Nitrogen metabolism in mothers, as well as Two-component system and Pyruvate metabolism in neonates. While Purine metabolism, Aminoacyl-tRNA biosynthesis, Pyrimidine metabolism, and Ribosome in neonates were significantly up-regulated. CONCLUSIONS: Our study provides the first evidence that exposure to PM1 has a significant impact on the gut microbiota of mothers and neonates, especially on the diversity, composition, and function of neonatal meconium microbiota, which may have important significance for maternal health management in the future.
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Poluentes Atmosféricos , Microbioma Gastrointestinal , Gravidez , Recém-Nascido , Lactente , Feminino , Humanos , Mães , Poluentes Atmosféricos/toxicidade , Material Particulado/toxicidade , Mecônio , BactériasRESUMO
BACKGROUND: Lower extremity deep vein thrombosis (LEDVT) after surgical operations is a common and fatal disease leading to unfavorable outcomes including death. Nevertheless, there has been insufficient evidence on the associations between ambient air pollution and LEDVT, particularly studies from developing regions. METHODS: Based on 302 LEDVT cases and 302 controls in a general hospital in Beijing, China, this unmatched retrospective case-control study investigated the associations of fine particulate matter (PM2.5), inhalable particulate matter (PM10), and ozone (O3) with odds of LEDVT. RESULTS: Per 10 µg/m3 increase in PM2.5, PM10, and O3 at 3-month, 6-month, and 2-year average was associated with increased LEDVT odds [odds ratios (ORs) for PM2.5: 1.10 (95%CI: 1.05, 1.14), 1.14 (95%CI: 1.09, 1.18), and 1.30 (95%CI: 1.06, 1.61); ORs for PM10: 1.06 (95%CI: 1.02, 1.10), 1.12 (95%CI: 1.08, 1.16), and 1.29 (95%CI: 1.03, 1.61); ORs for O3: 1.00 (95%CI: 0.96, 1.04), 1.16 (95%CI: 1.02, 1.31), and 2.08 (95%CI: 1.03, 4.18), respectively]. The stratified analyses, exposure-responses curves, and sensitivity analyses further highlighted the robustness of our findings. CONCLUSIONS: Long-term exposures to ambient PM2.5, PM10, and O3 may increase the risk of LEDVT in patients after surgical operations. The results may be implicated in the prevention and control of adverse clinical outcomes of surgical patients associated with ambient air pollution.
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Poluentes Atmosféricos , Poluição do Ar , Ozônio , Humanos , Material Particulado/efeitos adversos , Material Particulado/análise , Ozônio/efeitos adversos , Ozônio/análise , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Estudos Retrospectivos , Estudos de Casos e Controles , Pequim , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , China/epidemiologia , Dióxido de Nitrogênio/análise , Extremidade Inferior/cirurgiaRESUMO
OBJECTIVES: Recent studies have linked exposure to road traffic noise or air pollution with incident type 2 diabetes (T2D), but investigation on their co-exposure was limited and underlying mechanisms remain unclear. We hypothesized that long-term co-exposure to road traffic noise and air pollution increases the risk of incident T2D via the development of metabolic syndrome (MetS). METHODS: This prospective study included 390,834 participants in UK Biobank. Cumulative risk index (CRI), the health-based weighted levels of multiple exposures, was applied to characterize the co-exposure to 24-hour road traffic noise (Lden), particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5), and nitrogen dioxide (NO2). Lden was modeled by the Common Noise Assessment Methods in Europe and air pollutant levels were measured by the Land Use Regression model at participants' residential addresses. Incident T2D was ascertained through linkages to inpatient hospital records. MetS was defined by five (central obesity, triglycerides, HDL cholesterol, glucose, and blood pressure) or six factors (C-reactive protein additionally). Cox proportional hazard models were used to assess the association between environmental exposures and incident T2D, and mediation analyses were applied to investigate the role of MetS. RESULTS: After a median of 10.9 years of follow-up, 13,214 (3.4%) incident T2D cases were ascertained. The exposure to Lden, PM2.5, and NO2, as well as their co-exposure, were significantly associated with an elevated risk of incident T2D, with HRs of 1.03 (95%CI: 1.00, 1.05) per 3.5 dB(A) increase in Lden, 1.05 (95%CI: 1.01, 1.10) per 1.3 µg/m3 increase in PM2.5, 1.07 (95%CI: 1.02, 1.11) per 9.8 µg/m3 increase in NO2, and 1.06 (95%CI: 1.02, 1.09) per interquartile range increase in CRI. MetS significantly mediated 43.5%- 54.7% of the CRI-T2D relationship. CONCLUSIONS: Long-term co-exposure to road traffic noise and air pollution is associated with an elevated risk of incident T2D, which may partly be mediated by MetS.
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Poluentes Atmosféricos , Poluição do Ar , Diabetes Mellitus Tipo 2 , Síndrome Metabólica , Ruído dos Transportes , Humanos , Ruído dos Transportes/efeitos adversos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Estudos Prospectivos , Dióxido de Nitrogênio/efeitos adversos , Dióxido de Nitrogênio/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Material Particulado/efeitos adversos , Material Particulado/análise , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análiseRESUMO
BACKGROUND: Greenness is an emerging modifiable environmental factor of high blood pressure and hypertension. However, current evidence is inconsistent, and high-quality studies are urgently needed, especially in developing country with high disease burden of hypertension. METHODS: A longitudinal study was designed and 9,649 participants (aged ≥45 years) with 22,854 number of visits among three waves between 2011 and 2015 were included based on the China Health and Retirement Longitudinal Study. Long term greenness exposure was assessed by annual normalized difference vegetation index (NDVI). Linear and generalized linear mixed effect models were used to estimate the associations between greenness and blood exposure level and hypertension risk, respectively. RESULTS: The median NDVI level was 0.51, with a range from 0.09 to 0.74. An interquartile range (0.15) increase in NDVI was related to 1.05 mmHg reduction (95% CI: -1.65, -0.45) of systolic blood pressure, 0.72 mmHg reduction (95% CI: -1.06, -0.37) of diastolic blood pressure, and 12% (95% CI: 1%, 22%) lower odds of hypertension risk. The association of greenness and blood pressure was significantly stronger in the younger (<60 years) than in the older (≥60 years), and partially mediated by body mass index. CONCLUSIONS: These findings highlight the protective effect of greenness on blood pressure and hypertension in Chines middle-aged and elderly population, especially in the younger (<60 years), and suggest policy makers to take greenness level into special consideration in the process of urbanization.
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Hipertensão , Idoso , Pressão Sanguínea , Índice de Massa Corporal , China/epidemiologia , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Estudos Longitudinais , Pessoa de Meia-IdadeRESUMO
It is unclear whether Gross Domestic Product (GDP) and greenness have additional modifying effects on the association between air pollution and respiratory system disease. Utilizing a time-stratified case-crossover design with a distributed lag linear model, we analyzed the association between six pollutants (PM2.5, PM10, NO2, SO2, O3, and CO) and 555,498 respiratory hospital admissions in Beijing from 1st January 2016 to 31st December 2019. We employed conditional logistic regression, adjusting for meteorological conditions, holidays and influenza, to calculate percent change of hospitalization risk. Subsequently, we performed subgroup analysis to investigate potential effect modifications using a two-sample z test. Every 10 µg/m3 increase in PM2.5, PM10, NO2, SO2, and O3 led to increases of 0.26% (95%CI: 0.17%, 0.35%), 0.15% (95%CI: 0.09%, 0.22%), 0.61% (95%CI: 0.44%, 0.77%), 1.72% (95%CI: 1.24%, 2.21%), and 0.32% (95%CI: 0.20%, 0.43%) in admissions, respectively. Also, a 1 mg/m3 increase in CO levels resulted in a 2.50% (95%CI: 1.96%, 3.04%) rise in admissions. The links with NO2 (p < 0.001), SO2 (p < 0.001), O3 (during the warm season, p < 0.001), and CO (p < 0.001) were significantly weaker among patients residing in areas with higher levels of greenness. No significant modifying role of GDP was observed. Greenness can help mitigate the effects of air pollutants, while the role of GDP needs further investigation.
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BACKGROUND: Green space is a newly modifiable environmental factor which would bring health benefits, and identifying potential pathways is important to better promote public health. Nowadays, limited evidence is available on residential green space and risk of incident type 2 diabetes (T2D). To evaluate the longitudinal association between residential green space and incident T2D, and further illustrate the role of air pollution, we conducted a prospective analysis in UK Biobank. METHODS: Incident cases of T2D were ascertained through medical linkage of hospital admissions. Residential green space indicated by percentage of green space at 300 m buffer was estimated using land use data. Annual average air pollution was modelled using Land Use Regression model. Cox proportional hazard regression models were used to determine the association between the exposure and incident T2D. Effect modification of air pollution was assessed using log-likelihood tests. Casual mediation analysis including interaction of green space and air pollution was used to quantity pure natural indirect effect of air pollution. RESULTS: Of 379,238 participants at baseline, 15564 incident T2D cases were identified with 12.4 years of follow-up. In main models, individuals who exposed to residential green space at 300 m buffer in high level (≥75 %) had 14.4 % (95 % CI: 8.0 %, 20.3 %) lower risk of incident T2D compared with those in low level (<25 %). This association was modified by NO2, with green space indicating higher protective effect in low NO2 level (Pinteraction = 0.098). PM2.5 had a high mediation effect of 37.0 % in the association. CONCLUSION: Elevated residential green space level was associated with lower risk of incident T2D, and air pollution played an important role in this association. These findings would contribute to policy making and healthy city construction to take air pollution into consideration while planning green space, which would maximize public health benefits.
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Poluentes Atmosféricos , Poluição do Ar , Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/epidemiologia , Parques Recreativos , Dióxido de Nitrogênio/análise , Bancos de Espécimes Biológicos , Exposição Ambiental/análise , Poluição do Ar/análise , Reino Unido/epidemiologia , Poluentes Atmosféricos/análise , Material Particulado/análiseRESUMO
BACKGROUND: Focal therapy, including cryotherapy, reduces overtreatment in low- and intermediate-risk prostate cancer (PCa) patients with multiple comorbidities, which seems to increase in popularity compared with whole gland treatment. However, there is currently no consensus regarding the medium-term outcomes of cryosurgery as a prospective alternative to radiotherapy (RT) for such patients. Our study aims to find the available evidence that directly compares the medium-term overall survival (OS) and cancer-specific mortality (CSM) outcomes between cryotherapy and RT in patients with low- and intermediated-risk PCa. MATERIALS AND METHOD: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 47,787 patients with low- and intermediate-risk PCa diagnosed between 2004 and 2015, of which 46,853 (98%) received treatment with RT, while only 934 (2.0%) received treatment with cryotherapy. Kaplan-Meier methods were used to estimateOS and cancer-specific survival (CSS) between the 2 groups. We performed multivariable Cox regression analysis to assess overall mortality (OM), while the cumulative incidence function (CIF) was used to illustrate cancer-specific mortality (CSM) and noncancer-specific mortality (non-CSM) for all patients. Additionally, competing risks regression (Fine-Gray) was implemented to evaluate any differences. After propensity score matching (PSM), all the aforementioned analyses were repeated. After the inverse probability of treatment weighting (IPTW), we repeated Kaplan-Meier methods on OS and CSS, and performed multivariable Cox regression analysis to assess OM in cryotherapy versus RT. Sensitivity analyses were conducted by excluding patients who died of cardiovascular disease. RESULTS: After applying 1:4 PSM to the cryotherapy group with the RT group, the resulting RT cohort consisted of 3,736 patients who were matched with 934 patients in the cryotherapy cohort. The 5-year OS and cumulative CSM rates for PS-matched groups (N = 4670) receiving cryotherapy (N = 934) or RT (N = 3736) were 89% versus 91.8%, 0.65% versus 0.57, respectively. Multivariable Cox regression analysis demonstrated that cryotherapy was associated with a poorer OS outcome compared to RT (hazard ratio [HR] 1.29, 95% confidence interval [CI]: 1.07-1.55, p < .01). Multivariate competing risk regression analysis revealed that both treatments were not associated with CSS, with HR = 1.07 (95% CI: 0.55-2.08, p = .85). IPTW-adjusted analyses showed that the 5-years OS rates were 89.6% versus 91.8% for cryotherapy versus RT, respectively. Multivariate regression analysis for OS demonstrated that cryotherapy was more likely to have inferior OS in comparison to RT (HR = 1.30; 95%CI: 1.09-1.54; p < .01). The outcome of sensitivity analyses indicates that there was no significant difference in OS and CSS between the 2 groups. CONCLUSION: For low- and intermediate-risk PCa patients treated by cryotherapy or RT, we could not demonstrate a survival difference. Cryotherapy may be a feasible option as a viable alternative to traditional radiation therapy.
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Neoplasias da Próstata , Masculino , Humanos , Estudos Prospectivos , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/epidemiologia , Modelos de Riscos Proporcionais , Comorbidade , CrioterapiaRESUMO
Phosphorus-solubilizing microorganisms release organic acids that can chelate mineral ions or reduce the pH to solubilize insoluble phosphates for use by plants; it is important to study potential phosphorus-solubilizing microorganisms for use in agriculture. In this study, PSF7 was isolated from the soil of the Wengfu Phosphorus Tailings Dump in Fuquan City, Guizhou Province, China. PSF7 was identified as Paecilomyces lilacinus, based on morphological characterization and ITS sequencing analysis. The relationship between the phosphorus-solubilizing capacity and pH variation of PSF7 under liquid fermentation was studied. The results showed that there was a significant negative correlation (-0.784) between the soluble phosphorus content of PSF7 and the pH value. When PSF7 was placed under low phosphorus stress, eight organic acids were determined from fermentation broth using HPLC, of which tartaric acid and formic acid were the main organic acids. Different optimization parameters of medium components were analyzed using response surface methodology. The optimized medium components were 23.50 g/L sucrose, 1.64 g/L ammonium sulfate and soybean residue, 1.07 g/L inorganic salts, and 9.16 g/L tricalcium phosphate, with a predicted soluble phosphorus content of 123.89 mg/L. Under the optimum medium composition, the actual phosphorus-solubilizing content of PSF7 reached 122.17 mg/L. Moreover, scanning electron microscopy analysis of the sample was carried out to characterize the phosphate-solubilizing efficiency of PSF7 on mineral phosphate. The results provide useful information for the future application of PSF7 as a biological fertilizer.
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Temperature is increasingly understood to impact mental health. However, evidence of the long-term effect of temperature exposure on the risk of depressive symptoms is still scarce. Based on the China Health and Retirement Longitudinal Study (CHARLS), this study estimated associations between long-term apparent temperature, extreme temperature, and depressive symptoms in middle-aged and older adults. Results showed that a 1 °C increase or decrease from optimum apparent temperature (12.72 °C) was associated with a 2.7% (95% CI: 1.3%, 4.1%) and 2.3% (95% CI: 1.1%, 3.5%) increased risk of depressive symptoms, respectively. This study also found that each percent increase in annual change in ice days, cool nights, cool days, cold spell durations, and tropical nights was associated with higher risk of depressive symptoms, with HRs (95%CI) of 1.289 (1.114-1.491), 2.064 (1.507-2.825), 1.315 (1.061-1.631), 1.645 (1.306-2.072), and 1.344 (1.127-1.602), respectively. The results also indicated that people living in northern China have attenuated risk of low apparent temperature. Older people were also observed at higher risk relating to more cool nights. Middle-aged people, rural residents, and people with lower household income might have higher related risk of depressive symptoms due to increased tropical nights. Given the dual effect of climate change and global aging, these findings have great significance for policy making and adaptive strategies for long-term temperature and extreme temperature exposure.
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Depressão , Aposentadoria , Pessoa de Meia-Idade , Humanos , Idoso , Estudos Longitudinais , Depressão/psicologia , Temperatura , Aposentadoria/psicologia , ChinaRESUMO
Global climate change has increased the probability and intensity of extreme weather events. The adverse health effect of extreme temperature has gone through a temporal variation over years. Time-series data including city-level daily cardiovascular death records and meteorological data were collected from 136 Chinese cities during 2006 and 2019. A time-varying distributed lag model with interaction terms was applied to assess the temporal change of mortality risk and attributable mortality of heat wave and cold spell. The mortality effect of heat wave generally increased and that of cold spell decreased significantly in the total population during the study period. The heat wave effect increased especially among the female and people aged 65 to 74. As for the cold spell, the reduced susceptibility was detected both in the temperate and cold climatic zone. Our findings appeal for counterpart measures corresponding to sub-populations and regions responding to future extreme climate events from the public and individuals.
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Frio Extremo , Calor Extremo , Mortalidade , Feminino , Humanos , Povo Asiático , Cidades/epidemiologia , Temperatura , IdosoRESUMO
Particulate matter (PM) is an important component of air pollutants and is associated with various health risks. However, the impact of PM on toddlers' gut microbiota is rarely investigated. This study aimed to assess the cumulative and lagged effects of varying-sized PMs on toddlers' gut microbiota. We collected demographic information, stool samples, and exposure to PM from 36 toddlers aged 2-3 years. The toddlers were divided into warm season group and cooler season group according to the collection time of stool samples. The gut microbiota was processed and analyzed using 16S rRNA V3-V4 gene regions. The concentration of PM was calculated using China High Air Pollutants (CHAP) database. To assess the mixed effects of varying-sized PM, multiple-PM models were utilized. There were significant differences between the community composition, α- and ß-diversity between two groups. In multiple-PM models, there was a significant effect of weight quantile sum (PM1, PM2.5, and PM10) on α-diversity indices. In weight quantile sum models, after adjusting for a priori confounders, we found a negative effect of weight quantile sum on Enterococcus (ß = -0.134, 95% CI -0.263 to -0.006), positive effects of weight quantile sum on unclassified_f__Ruminococcaceae (ß = 0.247, 95% CI 0.102 to 0.393), Ruminococcus_1 (ß = 0.444, 95% CI 0.238 to 0.650), unclassified_f__Lachnospiraceae (ß = 0.278, 95% CI 0.099 to 0.458), and Family_XIII_AD_3011_group (ß = 0.254, 95% CI 0.086 to 0.422) in WSG and CSG. In lagged weight quantile sum models, the correlation between lag time PM levels and the gut microbiota showed seasonal trends, and weights of PM changed with lag periods. This is the first study to highlight that cumulative and lagged effects of PMs synergistically affect the diversities (α- and ß-diversity) and abundance of the gut microbiota in toddlers. Further research is needed to explore the mediating mechanism of varying-sized PMs exposure on the gut microbiota in toddlers.
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BACKGROUND: Epidemiologic evidence on whether iron accumulation in brain modified the association between artificial light at night (ALAN) and incident mental disorders is lacking. The authors aims to investigate modification of brain iron deposition on the associations of ALAN with multiple mental disorders in the middle-aged and older adults. METHODS: This prospective study used data from the UK Biobank. ALAN was drawn from satellite datasets. Susceptibility-weighted magnetic resonance imaging was used to ascertain iron content of each brain region. T2* signal loss was used as indices of iron deposition. The main outcomes are impacts of ALAN exposure on onset of wide spectrum of physician-diagnosed mental disorders, which was estimated by time-varying Cox proportional hazard model. The authors further conducted stratified analyses by levels of iron brain deposition to examine the potential modifying effects. RESULTS: Among 298,283 participants followed for a median of 10.91 years, higher ALAN exposure was associated with increased risk of mental disorders. An IQR (11.37 nW/cm2/sr) increase in annual levels of ALAN was associated with an HR of 1.050 (95 % CI: 1.034,1.066) for any mental disorder, 1.076 (95 % CI: 1.053,1.099) for substance use disorder, and 1.036 (95 % CI: 1.004,1.069) for depression disorder in fully adjusted models. The exposure-response curves showed steeper trends at lower ALAN levels and a plateau at higher exposures. The associations were stronger in participants with high iron deposition in left hippocampus, left accumbens and left pallidum. CONCLUSIONS: ALAN was associated with multiple mental disorders in the middle-aged and older adults, and the findings indicated stricter standards of ALAN is needed and targeted preventive measures are warranted, especially with high brain iron deposition.
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Poluição Luminosa , Transtornos Mentais , Pessoa de Meia-Idade , Humanos , Idoso , Incidência , Estudos Prospectivos , Transtornos Mentais/epidemiologia , Imageamento por Ressonância Magnética , Encéfalo/diagnóstico por imagem , LuzRESUMO
What is already known about this topic?: Long-term temperature variability (TV) has been examined to be associated with cardiovascular disease (CVD). TV-related dyslipidemia helps us understand the mechanism of how climate change affects CVD. What is added by this report?: Based on the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, this study estimated the long-term effect of TV on dyslipidemia in middle-aged and elderly adults. What are the implications for public health practice?: This study suggested that long-term TV may increase the risk of dyslipidemia. With the threat of climate change, these findings have great significance for making policies and adaptive strategies to reduce relevant risk of CVD.
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BACKGROUND: Ozone (O3) has become a prominent air pollutant problem as other pollutants concentrations have decreased obviously since China published Air Pollution Action Plan Pollution Prevention Action Plan in 2013. Few studies examined the association between O3 and diabetes especially in developing countries. This study was designed to investigate the above topic in China. METHODS: We conducted a prospective cohort study based on a nationwide survey of 13,548 adults from China Health and Retirement Longitudinal Study. City-level exposure to ozone for each participant was matched through ChinaHighO3 dataset. Time-varying cox proportional hazard regression model was applied to determine the association. Stratification analyses were conducted to explore potential effect modification. RESULTS: The annual mean concentration of O3 was 86.6 µg/m3. A 10 µg/m3 increase in 1-year average O3 concentration was associated with 5.7% (95% CI: 1.004-1.114) relative increment in hazards ratio of diabetes incidence in the fully adjusted model. Results stayed stable when controlling for physical activity, PM2.5 and mean temperature. CONCLUSIONS: Our findings provided initial support for a positive and robust association between long-term exposure to O3 and diabetes incidence in a developing country. More scientific and social attention should be attached to the ozone-induced risks of diabetes occurrence.