Global, regional, national burden and gender disparity of cataract: findings from the global burden of disease study 2019.

BACKGROUND: To evaluate the global burden of cataracts by year, age, region, gender, and socioeconomic status using disability-adjusted life years (DALYs) and prevalence from the Global Burden of Disease (GBD) study 2019. METHODS: Global, regional, or national DALY numbers, crude DALY rates, and age-standardized DALY rates caused by cataracts, by year, age, and gender, were obtained from the Global Burden of Disease Study 2019. Socio-demographic Index (SDI) as a comprehensive indicator of the national or regional development status of GBD countries in 2019 was obtained from the GBD official website. Kruskal-Wallis test, linear regression, and Pearson correlation analysis were performed to explore the associations between the health burden with socioeconomic levels, Wilcoxon Signed-Rank Test was used to investigate the gender disparity. RESULTS: From 1990 to 2019, global DALY numbers caused by cataracts rose by 91.2%, crude rates increased by 32.2%, while age-standardized rates fell by 11.0%. Globally, age-standardized prevalence and DALYs rates of cataracts peaked in 2017 and 2000, with the prevalence rate of 1283.53 [95% uncertainty interval (UI) 1134.46-1442.93] and DALYs rate of 94.52 (95% UI 67.09-127.24) per 100,000 population, respectively. The burden was expected to decrease to 1232.33 (95% UI 942.33-1522.33) and 91.52 (95% UI 87.11-95.94) by 2050. Southeast Asia had the highest blindness rate caused by cataracts in terms of age-standardized DALY rates (99.87, 95% UI: 67.18-144.25) in 2019. Gender disparity has existed since 1990, with the female being more heavily impacted. This pattern remained with aging among different stages of vision impairments and varied through GBD super regions. Gender difference (females minus males) of age-standardized DALYs (equation: Y = -53.2*X + 50.0, P < 0.001) and prevalence rates (equation: Y = - 492.8*X + 521.6, P < 0.001) was negatively correlated with SDI in linear regression. CONCLUSION: The global health of cataracts is improving but the steady growth in crude DALY rates suggested that health progress does not mean fewer demands for cataracts. Globally, older age, females, and lower socioeconomic status are associated with higher cataract burden. The findings of this study highlight the importance to make gender-sensitive health policies to manage global vision loss caused by cataracts, especially in low SDI regions.

Effect of TEMPO-oxidized bacterial cellulose nanofibers stabilized Pickering emulsion of cinnamon essential oil on structure and properties of gelatin composite films.

Pure gelatin film often exhibits high hydrophilicity and a lack of antibacterial activity, hindering its practical application in the field of food preservation. To address these issues, we incorporated 2,2,6,6-tetramethylpiperidine-1-oxyl radical (TEMPO)-oxidized bacterial cellulose (TOBC) nanofibers stabilized cinnamon essential oil (CEO) Pickering emulsions into the gelatin matrix to develop active food packaging films. The study revealed that the good distribution of emulsion droplets in the film matrix. While with increasing Pickering emulsion proportion, the microstructures of composite films were more heterogeneous, showing some pores or cavities. In addition, the insertion of TOBC-stabilized CEO emulsions could improve the elongation at break (EAB), water-resistance, UV blocking ability, and antibacterial activity of film, but reduced its tensile strength (TS) and water vapor barrier properties (WVP). Notably, the film prepared with 4 % TOBC-stabilized CEO Pickering emulsion demonstrated enhanced preservation of strawberries. Overall, the as-prepared gelatin-based active composite films have considerable potential for food packaging.

[Eighteen cases of 2009 influenza A H1N1 associated with respiratory failure in adults].

OBJECTIVE: To investigate the clinical feature, treatment and outcome of respiratory failure in patients with 2009 influenza A H1N1 infection in critically ill adults. METHODS: A prospective observational study of 18 patients with respiratory failure suffering from 2009 influenza A H1N1 infection admitted between November 22, 2009 and January 16, 2010. Their clinical data were analyzed. RESULTS: Respiratory failure occurred in 18 patients with confirmed (n=9) or probable (n=9) 2009 influenza A H1N1. Among the 18 patients 8 patients were male, 10 patients were female (7 were pregnant or postpartum). Eight patients had pre-existing medical conditions. Twelve patients were between 20 and 40 years of age, the mean age was 37.1 years. Three were obese with body mass index over 30 kg/m (2). The 28-day mortality was 33.3% (6/18) with 1 additional late death. The median duration from the onset of the illness to hospital admission was 4.1 days (1-5 days) and from the onset to first dose of oseltamivir was 5.5 days (2-12 days), from onset to mechanical ventilation initiation was 6.8 days (4-12 days). Seventeen patients had primary viral pneumonia and 1 patient had an asthma exacerbation and 3 patients experienced multiple organ dysfunction syndrome (MODS). Twelve patients received corticosteroids, 10 patients required vasopressors. All patients were mechanically ventilated, 1 patient underwent extracorporeal membrane oxygenation (ECMO). Patients who died had higher acute physiology and chronic health evaluation II score compared to survivors (29.2 + or - 7.3 vs. 18.6 + or - 6.4, P=0.02). All deceased patients received high-level ventilation settings [peak inspiratory pressure > or = 35 cm H(2)O (1 cm H(2)O=0.098 kPa) and positive end-expiratory pressure > or = 18 cm H(2)O] within the first 7 days of ventilation, and the hypoxemia [oxygenation index < or = 60 mm Hg (1 mm Hg=0.133 kPa)] lasted 24 hours. In contrast only 1 among survivors did (9.1% vs. 100.0%, P<0.01). Compared with survivors, acute kidney injury and barotrauma occurred more frequently in non-survivors (42.9% vs. 27.3%, 28.6% vs. 9.1%, both P<0.05). Whereas all deceased patients received vasopressors, only 4 survivors required vasopressor support (100.0% vs. 36.4%, P<0.05). CONCLUSION: Severe acute respiratory distress syndrome is the most common manifestation in critically ill patients with 2009 influenza A H1N1 infection in adult. Failure to obtain satisfactory oxygenation with high-level ventilation settings within the first 7-days, onset of acute kidney injury and barotrauma, and continuous need for vasopressors portend a poor prognosis.