Background:Chronic kidney disease(CKD)is common and ranks among the leading causes of mortality and morbidity.This analysis aimed to present global CKD estimates using the Global Burden of Diseases,Injuries,and Risk F...Background:Chronic kidney disease(CKD)is common and ranks among the leading causes of mortality and morbidity.This analysis aimed to present global CKD estimates using the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2023 to inform evidence-based policies for CKD identification and treatment.Methods:This analysis focused on adults aged 20 years and older over the period 1990 to 2023,from 204 countries and territories.展开更多
Objective:Knee osteoarthritis is one of the important causes of disability worldwide.This study aims to analyze the disease burden of knee osteoarthritis,attributable risk factors among Chinese residents from 1990 to ...Objective:Knee osteoarthritis is one of the important causes of disability worldwide.This study aims to analyze the disease burden of knee osteoarthritis,attributable risk factors among Chinese residents from 1990 to 2021,and predict the disease burden trend for 2035.Methods:Data related to knee osteoarthritis in China from 1990 to 2021,including the number of incident cases,incidence rate,number of prevalent cases,prevalence rate,and years lived with disability(YLDs),were collected from the Global Burden of Disease Study(GBD2021)database.Joinpoint regression analysis was used to assess time trends,and the Bayesian-Age-Period-Cohort(BAPC)regression model was employed for future predictions.Results:From 1990 to 2021,the number of incident cases of knee osteoarthritis among Chinese residents increased from 3.65 million to 8.51 million,a rise of 133.16%,with an average annual increase of 3.15%.The incidence rate increased from 310.33 per 100,000 to 598.31 per 100,000,a rise of 92.80%,with an average annual increase of 2.55%.The number of prevalent cases increased from 41.04 million to 110 million,a rise of 166.97%,with an average annual increase of 3.61%.The prevalence rate increased from 3488.78 per 100,000 to 7701.69 per 100,000,a rise of 120.76%,with an average annual increase of 3.00%.The number of YLDs increased from 1.34 million to 3.55 million,a rise of 165.32%,with an average annual increase of 3.59%.The YLD rate increased from 113.86 per 100,000 to 249.81 per 100,000,a rise of 119.39%,with an average annual increase of 2.99%.High BMI was the only significant attributable risk factor,with the proportion of YLDs it caused continuing to rise.Predictions for 2035:The number of incident cases is expected to decline slightly from 5.89 million in 2022 to 5.72 million in 2035.The number of prevalent cases is expected to peak at 72.42 million in 2029 and be around 72.69 million in 2035.The number of YLDs is expected to increase year by year,from 2.35 million in 2022 to 2.35 million in 2035.Conclusion:The study reveals the increasing prevalence and disease burden of knee osteoarthritis among Chinese residents,emphasizing the importance of interventions targeting controllable risk factors.Although the prediction shows a slight decline in the number of incident cases in 2035,the number of prevalent cases and years of disability are expected to remain high,indicating the need for continued monitoring and intervention.展开更多
Objective： To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors （RFs, including nulliparity, mean number of children, age at first birth and breastf...Objective： To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors （RFs, including nulliparity, mean number of children, age at first birth and breastfeeding）, use of oral contraceptives （OCs, restricted to the age group of 15-49 years）, and hormone replacement therapy （HRT）, as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005. Methods： We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China. In the case of RFs, we compared the exposure distributions in 2001 and counterfactual exposure. Results： Exposure of RFs in 2002 was found to account for 6.74% of breast cancer, corresponding to 9,617 cases and 2,769 deaths, and for 2.78% of ovarian cancer （712 cases, 294 deaths）. The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer. The prevalence of OC use was 1.74% and the population attributable fraction （PAF） of breast cancer was 0.71%, corresponding to 310 cases and 90 deaths. The PAF of breast cancer due to HRT was 0.31%, resulting in 297 cases and 85 deaths. Conclusion： RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.展开更多
Objective:There is little information about contributions of the well-known risk factors to the liver cancer burden.We conducted a comparative study to estimate the liver cancer burden attributable to major risk facto...Objective:There is little information about contributions of the well-known risk factors to the liver cancer burden.We conducted a comparative study to estimate the liver cancer burden attributable to major risk factors.Methods:Liver cancer deaths for adults were estimated from 978 county-level surveillance points in China in2014.Risk factors were identified from the International Agency for Research on Cancer and the World Cancer Research Fund International.Population attributable fraction(PAF)by age,sex,and province was calculated using multiple formulas.Results:In total,72.4%of liver cancer deaths could be attributable to the studied risk factors.Hepatitis B virus(HBV)was responsible for the largest fraction of liver cancer burden in both genders(PAF=55.6%in males,PAF=46.5%in females).PAFs for liver cancer burden attributable to smoking(15.7%vs.4.8%),and alcohol drinking(10.3%vs.1.6%)were significantly higher in males than in females.The burden of HBV-attributable deaths was the highest in Qinghai province.Conclusions:HBV still contributes to the majority of liver cancer burden than any other risk factors.Targeted preventive measures should be implemented based on the degree of contributions of risk factors to liver cancer deaths.展开更多
Objective： To evaluate the population attributable risks （PARs） between cigarette smoking and deaths of all causes, all cancers, lung cancer and other chronic diseases in urban Shanghai. Methods： In total, 61,480 ...Objective： To evaluate the population attributable risks （PARs） between cigarette smoking and deaths of all causes, all cancers, lung cancer and other chronic diseases in urban Shanghai. Methods： In total, 61,480 men aged 40-74 years from 2002 to 2006 and 74,941 women aged 40-70 years from 1997 to 2000 were recruited to undergo baseline surveys in urban Shanghai, with response rates of 74.0% and 92.3%, respectively. A Cox proportional hazards regression model was used to estimate relative risks （RRs） and 95% confidence intervals （95% CIs） of deaths associated with cigarette smoking. PARs and 95 % CIs for deaths were estimated from smoking exposure rates and the estimated RRs. Results： Cigarette smoking was responsible for 23.9% （95% CI： 19.4-28.3%） and 2.4% （95% Ch 1.6- 3.2%） of all deaths in men and women, respectively, in our study population. Respiratory disease had the highest PAR in men [37.5% （95% CI： 21.5-51.6%）], followed by cancer [31.3% （95% Ch 24.6-37.7%）] and cardiovascular disease （CVD） [24.1% （95% CI： 16.7-31.2%）]. While the top three PARs were 12.7% （95% CI： 6.1-19.3%）, 4.0% （95% CI： 2.4-5.6%）, and 1.1% （95% CI： 0.0-2.3%）, for respiratory disease, CVD, and cancer, respectively in women. For deaths of lung cancer, the PAR of smoking was 68.4% （95% CI： 58.2- 76.5%） in men. Conclusions： In urban Shanghai, 23.9% and 2.4% of all deaths in men and women could have been prevented if no people had smoked in the area. Effective control programs against cigarette smoking should be strongly advocated to reduce the increasing smoking-related death burden.展开更多
Objective：To provide an evidence-based and consistent assessment of the burden of cancer attributable to inadequate fruit and vegetable intake in China in 2005.Methods：The proportions of cancers attributable to low ...Objective：To provide an evidence-based and consistent assessment of the burden of cancer attributable to inadequate fruit and vegetable intake in China in 2005.Methods：The proportions of cancers attributable to low consumption of vegetable and fruit were calculated separately to estimate the burden of related cancers for the year 2005 in China.Data on the prevalence of exposure were derived from a Chinese nutrition and health survey.Data on relative risks were mainly derived from meta-analysis.Attributable fractions were calculated based on the counterfactual scenario which was a shift in the exposure distribution.Results：The total cancer burden attributable to inadequate consumption of fruit was up to 233,000 deaths （13.0% of all cancers） and 300,000 cases （11.6% of all cancers） in 2005.Increasing consumption of vegetable to the highest quintile could avoid total cancer deaths and cases by 3.6% （64,000 persons） and 3.4% （88,000 persons）.The contributions to cancer burden were higher in rural areas than in urban areas.They have greater influence on men than on women.The largest proportions of cancer burden attributable to low fruit and vegetable intake were for oral and pharyngeal cancers.Conclusion：This study showed that inadequate intake of fruit and vegetable makes a significant contribution to the cancer burden.Increasing consumption of fruit and vegetable could prevent many cancer deaths and save many lives.Promoting the consumption of fruit and vegetable is an important component in diet-based strategies for preventing cancer.展开更多
AIM To study the impact of hospital-acquired infections(HAIs)on cost and outcome from intensive care units(ICU)in India.METHODS Adult patients(>18 years)admitted over 1-year,to a 24-bed medical critical care unit i...AIM To study the impact of hospital-acquired infections(HAIs)on cost and outcome from intensive care units(ICU)in India.METHODS Adult patients(>18 years)admitted over 1-year,to a 24-bed medical critical care unit in India,were enrolled prospectively.Treatment cost and outcome data were collected.This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee.Only infections occurring during ICU stay were included.The impact of HAI on treatment cost and mortality was assessed.RESULTS The mean(±SD)age of the cohort(n=499)was42.3±16.5 years.Acute physiology and chronic health evaluation-Ⅱscore was 13.9(95%CI:13.3-14.5);86%were ventilated.ICU and hospital length of stay were 7.8±5.5 and 13.9±10 d respectively.Hospital mortality was 27.9%.During ICU stay,76(15.3%)patients developed an infection(ventilator-associated pneumonia 50;bloodstream infection 35;urinary tract infections 3),translating to 19.7 infections/1000 ICU days.When compared with those who did not develop an infection,an infection occurring during ICU stay was associated with significantly higher treatment cost[median(inter-quartile range,IQR)INR 92893(USD 1523)(IQR 57168-140286)vs INR 180469(USD 2958)(IQR 140030-237525);P<0.001 and longer duration of ICU(6.7±4.5 d vs 13.4±7.0 d;P<0.01)and hospital stay(12.4±8.2 d vs 21.8±13.9 d;P<0.001)].However ICU acquired infections did not impact hospital mortality(31.6%vs 27.2%;P=0.49).CONCLUSION An infection acquired during ICU stay was associated with doubling of treatment cost and prolonged hospitalization but did not significantly increase mortality.展开更多
With the largest ageing population in the world,China is faced with the huge chal-lenge of dementia.-However,previously reported estimates on the prevalence of dementia among Chinese older adults were inconsistent,var...With the largest ageing population in the world,China is faced with the huge chal-lenge of dementia.-However,previously reported estimates on the prevalence of dementia among Chinese older adults were inconsistent,varying from 2%to 13%.5°It is crucial for dementia prevention to determine the number of cases that could be delayed or prevented,but how to do this remains unclear.To address these research gaps,we aimed to provide population estimates of the prevalence of dementia in China and estimate the population attributable fractions(PAFs)of potentially modifiable risk factors.展开更多
Effect sizes are estimated from several study designs when the subjects are individually sampled. When the samples are the aggregate cluster of individuals, the within cluster correlation must be accounted for to cons...Effect sizes are estimated from several study designs when the subjects are individually sampled. When the samples are the aggregate cluster of individuals, the within cluster correlation must be accounted for to construct correct confidence intervals, and to conduct valid statistical inference. The purpose of this article is to propose and evaluate statistical procedures for the estimation of the variance of the estimated attributable risk in parallel groups of clusters, and in a design dividing each of k clusters into two segments creating multiple sub-clusters. The estimated variance is the first order approximation and is obtained by the delta method. We apply the methodology and propose a Wald type confidence interval on the difference between two correlated attributable risks. We also construct a test on the hypothesis of equality of two correlated attributable risks. We evaluate the power of the proposed test via Monte-Carlo simulations.展开更多
Population attributable fraction(PAF)refers to the proportion of all cases with a particular outcome in a population that could be prevented by eliminating a specific exposure.The authors of a recent paper evaluated t...Population attributable fraction(PAF)refers to the proportion of all cases with a particular outcome in a population that could be prevented by eliminating a specific exposure.The authors of a recent paper evaluated the prevalence and estimated the PAFs for risk factors of TB among elderly people in China[Inf Dis Poverty.2019;8:7].Confounding is inevitable in observational studies and Levin’s formula is of limited use in practice for unbiasedly estimating PAF.In a complex survey design,an unbiased estimation of the PAF can be calculated using a sample-weighted version of the Miettinen formula or a sample weighed parametric g-formula.With respect to causal interpretation of PAF in public health setting,computation of PAF is logical and practical when the exposure is amenable to intervention.展开更多
Succession is one of the most extensively studied ecological phenomena,yet debates persist about the importance of dispersal and external factors in driving this process.We aimed to quantify the influence of these fac...Succession is one of the most extensively studied ecological phenomena,yet debates persist about the importance of dispersal and external factors in driving this process.We aimed to quantify the influence of these factors by investigating how wing-related traits evolve across succession of blowfly(Diptera:Calliphoridae)communities in South Brazil.Rat carrion was placed in both forest and grassland habitats,and the associated blowfly communities were documented throughout the decomposition process.Using morphometric analysis,we measured wing and thorax traits and assessed trait changes over succession through mixed models.Our findings revealed that carrion succession follows distinct trajectories in forest and grassland environments.Specifically,we observed that Calliphora lopesi predominantly visited carcasses during the final phase of decomposition,resulting in significant differences in species composition and wing size between habitats.In forests,wing size increased toward the later stages of succession,whereas an opposite trend was observed in grasslands.Notably,these trait patterns were only evident at the species level,indicating that intraspecific trait variation is irrelevant.Stronger dispersers tend to arrive during the later stages of succession,suggesting that dispersal has a negligible role in shaping successional dynamics.Instead,environmental differences between habitats drive trait patterns throughout succession.Our results suggest that community composition in ephemeral resources is governed by deterministic processes and that successional stages can be predicted based on blowfly wing traits.Specifically,the presence of the large-winged C.lopesi indicates late decay,while the small-winged Chrysomia albiceps and Lucilia eximia are indicative of early decay.展开更多
Attribute-Based Encryption(ABE)has emerged as a fundamental access control mechanism in data sharing,enabling data owners to define flexible access policies.A critical aspect of ABE is key revocation,which plays a piv...Attribute-Based Encryption(ABE)has emerged as a fundamental access control mechanism in data sharing,enabling data owners to define flexible access policies.A critical aspect of ABE is key revocation,which plays a pivotal role in maintaining security.However,existing key revocation mechanisms face two major challenges:(1)High overhead due to ciphertext and key updates,primarily stemming from the reliance on revocation lists during attribute revocation,which increases computation and communication costs.(2)Limited universality,as many attribute revocation mechanisms are tailored to specific ABE constructions,restricting their broader applicability.To address these challenges,we propose LUAR(Lightweight and Universal Attribute Revocation),a novel revocation mechanism that leverages Intel Software Guard Extensions(SGX)while minimizing its inherent limitations.Given SGX’s constrained memory(≈90 MB in a personal computer)and susceptibility to side-channel attacks,we carefully manage its usage to reduce reliance while mitigating potential collusion risks between cloud service providers and users.To evaluate LUAR’s lightweight and universality,we integrate it with the classic BSW07 scheme,which can be seamlessly replaced with other ABE constructions.Experimental results demonstrate that LUAR enables secure attribute revocation with low computation and communication overhead.The processing time within the SGX environment remains stable at approximately 55 ms,regardless of the complexity of access policies,ensuring no additional storage or computational burden on SGX.Compared to the Hardware-based Revocable Attribute-Based Encryption(HR-ABE)scheme(IEEE S&P 2024),LUAR incurs a slightly higher computational cost within SGX;however,the overall time from initiating a data request to obtaining plaintext is shorter.As access policies grow more complex,LUAR’s advantages become increasingly evident,showcasing its superior efficiency and broader applicability.展开更多
The variation laws of runoff and sediment load under different climate,vegetation,and human activity scenarios are significantly different.Exploring the impacts of climate change and human activities on runoff and sed...The variation laws of runoff and sediment load under different climate,vegetation,and human activity scenarios are significantly different.Exploring the impacts of climate change and human activities on runoff and sediment load dynamics can provide a profound understanding of the mechanism of runoff and sediment load variability in basins,which is crucial for the sustainable development of regional ecosystems.This study investigates the Tao River Basin(TRB)on the Tibetan Plateau,as well as the Zuli River Basin(ZRB)and Jing River Basin(JRB)on the Loess Plateau,to differentiate the impacts of climate change and human activities on runoff and sediment load dynamics.The runoff and sediment load of the three watersheds have shown a decreasing trend over the past 40 years,and combined with the DMC(Dual mass curve)method,it was found that the slope of the runoff sediment gradually tends to flatten out.After the time period was divided,the CA(Cumulative anomaly)method was used for verification,which revealed good correspondence between the two before 2000 and then gradual deviations.The power function best represents the relationship between runoff and sediment load.During the initial period,climate had a significant impact on runoff variation in the TRB and JRB,with contribution rates of-54.93%and-63.02%,respectively.In the later period,human activities became the dominant influence,contributing more than-60%of the runoff variation.In the ZRB,human activities consistently dominated runoff variation,with contribution rates of-72.72%and-55.66%during both periods.In the early stages of research,the impact of climate change on sediment load was more severe in the TRB and JRB,and human activities played a significant role in the later stages.However,in the ZRB,human activities have always been the main contributor.Based on the actual local situation,runoff and sediment load in the TRB are influenced primarily by engineering measures,and vegetation and check dams exert greater impacts on the ZRB and JRB.This study explores the attribution of water and sediment load changes in different ecological geographic regions from a comparative perspective,providing a valuable theoretical basis and reference for understanding global runoff and sediment transport changes in similar areas.展开更多
Mountain communities in Nepal are increasingly exposed to climate-induced shifts in water availability,driven by glacial retreat,altered precipitation/snowmelt regimes,and declining groundwater sources.This study pres...Mountain communities in Nepal are increasingly exposed to climate-induced shifts in water availability,driven by glacial retreat,altered precipitation/snowmelt regimes,and declining groundwater sources.This study presents an integrated framework combining hydrological source analysis with socio-demographic survey data to evaluate seasonal water contributions and communitylevel water use patterns in the Upper Marsyangdi catchment,Manang District,Nepal.Isotopic(δ^(18)O)and geochemical(silica)tracers were used in a Bayesian mixing model to quantify the seasonal contributions of glacial melt,snow,rain,and groundwater to river flow.Findings indicate that groundwater dominates pre-monsoon flow(60%-70%)while post-monsoon discharge reflects more balanced inputs from all sources.In parallel,120 household surveys were analysed using Latent Class Analysis to characterise water use across domestic,agricultural,energy,and tourism sectors.Results reveal spatial and demographic gradients in water source dependency,including gender and occupation as important predictors of water use.Respondents reported perceived increases in spring flow,alongside reductions in the availability of snow for household and tourism use and deteriorating river water quality and quantity,particularly affecting hydropower operations.Adaptation strategies include increased reliance on water storage infrastructure and source switching.The study highlights the value of applying probabilistic methods to hydrological and sociocultural data to identify vulnerable populations and inform targeted,context-sensitive adaptation strategies.The proposed framework is transferable to other high-altitude regions,offering a robust approach for assessing climate resilience through the synthesis of scientific and local knowledge systems.展开更多
The global monsoon system,encompassing the Asian-Australian,African,and American monsoons,sustains two-thirds of the world’s population by regulating water resources and agriculture.Monsoon anomalies pose severe risk...The global monsoon system,encompassing the Asian-Australian,African,and American monsoons,sustains two-thirds of the world’s population by regulating water resources and agriculture.Monsoon anomalies pose severe risks,including floods and droughts.Recent research associated with the implementation of the Global Monsoons Model Intercomparison Project under the umbrella of CMIP6 has advanced our understanding of its historical variability and driving mechanisms.Observational data reveal a 20th-century shift:increased rainfall pre-1950s,followed by aridification and partial recovery post-1980s,driven by both internal variability(e.g.,Atlantic Multidecadal Oscillation)and external forcings(greenhouse gases,aerosols),while ENSO drives interannual variability through ocean-atmosphere interactions.Future projections under greenhouse forcing suggest long-term monsoon intensification,though regional disparities and model uncertainties persist.Models indicate robust trends but struggle to quantify extremes,where thermodynamic effects(warming-induced moisture rise)uniformly boost heavy rainfall,while dynamical shifts(circulation changes)create spatial heterogeneity.Volcanic eruptions and proposed solar radiation modification(SRM)further complicate predictions:tropical eruptions suppress monsoons,whereas high-latitude events alter cross-equatorial flows,highlighting unresolved feedbacks.The emergent constraint approach is booming in terms of correcting future projections and reducing uncertainty with respect to the global monsoons.Critical challenges remain.Model biases and sparse 20th-century observational data hinder accurate attribution.The interplay between natural variability and anthropogenic forcings,along with nonlinear extreme precipitation risks under warming,demands deeper mechanistic insights.Additionally,SRM’s regional impacts and hemispheric monsoon interactions require systematic evaluation.Addressing these gaps necessitates enhanced observational networks,refined climate models,and interdisciplinary efforts to disentangle multiscale drivers,ultimately improving resilience strategies for monsoon-dependent regions.展开更多
Primary human hepatocytes(PHH)are used as the FDA-recognized"gold standard"for liver-related studies in vitro.The world’s first PHH group standard(T/CSCB 0008–2021,CSCB standard)was released by Chinese Soc...Primary human hepatocytes(PHH)are used as the FDA-recognized"gold standard"for liver-related studies in vitro.The world’s first PHH group standard(T/CSCB 0008–2021,CSCB standard)was released by Chinese Society for Cell Biology in 2021.In order to justify this standard,six key quality attributes of ten different batches from commercial PHHs,including cell viability,cell morphology,cell markers,albumin secretion,drug metabolism function and bile secretion,were characterized using the designated test methods in the standard.The PHHs from various batches all exhibited typical hepatocytic morphology,high cell viability,and sufficient albumin secretion;whereas,tremendous variations in cell markers,drug metabolism functions,and bile secretion were unexpectedly detected across the board.Flow cytometric assessment of hepatocyte markers revealed the percentages of ALB^(+)or HNF4A^(+)cells in six batches of PHHs,ranging from 49.4%to 98.9%and from 37.7%to 91.4%,respectively.Single cell transcriptomic analysis also revealed significant cell heterogeneity across the different batches,with the proportions of hepatocytes ranging from 69.2%to 98.9%.Considerable heterogeneity in drug metabolism functions across the batches were also found in substrate clearance rate(SCR)and metabolite formation rate(MFR)for six representative CYP450 enzymes,while the results didn’t influence current SCR attribute of CYP3A4.Metabolic capacity and purity are two independent attributes for PHH.The varied biliary excretion indexes around criteria(30%)indicated heterogeneity of PHH biliary excretion capacity.These results confirmed the robustness of most quality attributes in current CSCB standard,while highlighting the need to refine remaining parameters to enhance its practical applicability.展开更多
Summary What is already known about this topic?Limited evidence on healthy longevity was provided in the world,and no studies investigated the fractions of healthy longevity attributed to modifiable factors.What is ad...Summary What is already known about this topic?Limited evidence on healthy longevity was provided in the world,and no studies investigated the fractions of healthy longevity attributed to modifiable factors.What is added by this report?Incidences of longevity and healthy longevity in China are provided.It reveals that the total weighted population attributable fractions for lifestyles and all modifiable factors were 32.8% and 83.7% for longevity,respectively,and 30.4% and 73.4% for healthy longevity,respectively.What are the implications for public health practice?China has a high potential for longevity and healthy longevity.Strategies may be targeted at education and residence in early life as well as healthy lifestyles,disease prevention,and functional optimization in late life.展开更多
Objective: This study aims to quantify the potential impact of controlling major risk factors on liver cancer deaths in China from 2021 to 2050 under various intervention scenarios.Methods: We developed a macro-level ...Objective: This study aims to quantify the potential impact of controlling major risk factors on liver cancer deaths in China from 2021 to 2050 under various intervention scenarios.Methods: We developed a macro-level simulation model based on comparative risk assessment to estimate population attributable fractions and avoidable liver cancer deaths. Risk factor prevalence data were obtained from national surveys and epidemiological estimates. Three intervention scenarios for each risk factor were projected:elimination(Scenario 1), ambitious reduction(Scenario 2), and manageable targets aligned with national/global goals(Scenario 3). The impact of secondary prevention through liver cancer screening at different coverage was evaluated.Results: Between 2021 and 2050, liver cancer deaths in China are projected to reach 9.44 million in males and4.29 million in females. Eliminating hepatitis B virus and hepatitis C virus could prevent 65.62%(57.47%-73.77%)and 28.47%(24.93%-32.00%) of liver cancer deaths, respectively. Achieving manageable targets in reducing the prevalence of smoking and alcohol drinking could prevent 6.57%(5.75%-7.38%) and 0.85%(0.75%-0.96%) of liver cancer deaths, with a more pronounced effect observed in males. Eliminating high body mass index(BMI)could avert 45,000 male and 25,000 female deaths annually by 2050, while diabetes elimination could prevent60,000 male and 21,000 female deaths. Secondary prevention through liver cancer screening with 80% coverage could reduce liver cancer deaths by 3.59%(3.14%-4.04%) for the total population. Combining all interventions under Scenario 1 could prevent up to 88.39%(76.65%-99.81%) of male and 77.80%(67.42%-87.88%) of female liver cancer deaths by 2050.Conclusions: Comprehensive risk factor control could prevent over 80% of liver cancer deaths in China by2050. Secondary prevention through screening may offer modest additional benefits. These findings provide strong quantitative support for targeted, evidence-based interventions and underscore the need for policy action to address key risk factors.展开更多
Extreme ozone pollution events(EOPEs)are associated with synoptic weather patterns(SWPs)and pose severe health and ecological risks.However,a systematic investigation of themeteorological causes,transport pathways,and...Extreme ozone pollution events(EOPEs)are associated with synoptic weather patterns(SWPs)and pose severe health and ecological risks.However,a systematic investigation of themeteorological causes,transport pathways,and source contributions to historical EOPEs is still lacking.In this paper,the K-means clustering method is applied to identify six dominant SWPs during the warm season in the Yangtze River Delta(YRD)region from 2016 to 2022.It provides an integrated analysis of the meteorological factors affecting ozone pollution in Hefei under different SWPs.Using the WRF-FLEXPART model,the transport pathways(TPPs)and geographical sources of the near-surface air masses in Hefei during EOPEs are investigated.The results reveal that Hefei experienced the highest ozone concentration(134.77±42.82μg/m^(3)),exceedance frequency(46 days(23.23%)),and proportion of EOPEs(21 instances,47.7%)under the control of peripheral subsidence of typhoon(Type 5).Regional southeast winds correlated with the ozone pollution in Hefei.During EOPEs,a high boundary layer height,solar radiation,and temperature;lowhumidity and cloud cover;and pronounced subsidence airflow occurred over Hefei and the broader YRD region.The East-South(E_S)patterns exhibited the highest frequency(28 instances,65.11%).Regarding the TPPs and geographical sources of the near-surface air masses during historical EOPEs.The YRD was the main source for land-originating air masses under E_S patterns(50.28%),with Hefei,southern Anhui,southern Jiangsu,and northern Zhejiang being key contributors.These findings can help improve ozone pollution early warning and control mechanisms at urban and regional scales.展开更多
Knee osteoarthritis(KOA),characterized by heterogeneous arthritic manifestations and complex peripheral joint disorder,is one of the leading causes of disability worldwide,which has become a high burden due to the mul...Knee osteoarthritis(KOA),characterized by heterogeneous arthritic manifestations and complex peripheral joint disorder,is one of the leading causes of disability worldwide,which has become a high burden due to the multifactorial nature and the deficiency of available disease-modifying treatments.The application of mesenchymal stem/stromal cells(MSCs)as therapeutic drugs has provided novel treatment options for diverse degenerative and chronic diseases including KOA.However,the complexity and specificity of the“live”cells have posed challenges for MSC-based drug development and the concomitant scale-up preparation from laboratory to industrialization.For instance,despite the considerable progress in ex vivo cell culture technology for fulfilling the robust development of drug conversion and clinical trials,yet significant challenges remain in obtaining regulatory approvals.Thus,there’s an urgent need for the research and development of MSC drugs for KOA.In this review,we provide alternative solution strategies for the preparation of MSC drugs on the basis of the principle of quality by design,including designing the cell production processes,quality control,and clinical applications.In detail,we mainly focus on the quality by design method for MSC manufacturing in standard cell-culturing factories for the treatment of KOA by using the Quality Target Product Profile as a starting point to determine potential critical quality attributes and to establish relationships between critical material attributes and critical process parameters.Collectively,this review aims to meet product performance and robust process design,and should help to reduce the gap between compliant products and the production of compliant good manufacturing practice.展开更多
文摘Background:Chronic kidney disease(CKD)is common and ranks among the leading causes of mortality and morbidity.This analysis aimed to present global CKD estimates using the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2023 to inform evidence-based policies for CKD identification and treatment.Methods:This analysis focused on adults aged 20 years and older over the period 1990 to 2023,from 204 countries and territories.
文摘Objective:Knee osteoarthritis is one of the important causes of disability worldwide.This study aims to analyze the disease burden of knee osteoarthritis,attributable risk factors among Chinese residents from 1990 to 2021,and predict the disease burden trend for 2035.Methods:Data related to knee osteoarthritis in China from 1990 to 2021,including the number of incident cases,incidence rate,number of prevalent cases,prevalence rate,and years lived with disability(YLDs),were collected from the Global Burden of Disease Study(GBD2021)database.Joinpoint regression analysis was used to assess time trends,and the Bayesian-Age-Period-Cohort(BAPC)regression model was employed for future predictions.Results:From 1990 to 2021,the number of incident cases of knee osteoarthritis among Chinese residents increased from 3.65 million to 8.51 million,a rise of 133.16%,with an average annual increase of 3.15%.The incidence rate increased from 310.33 per 100,000 to 598.31 per 100,000,a rise of 92.80%,with an average annual increase of 2.55%.The number of prevalent cases increased from 41.04 million to 110 million,a rise of 166.97%,with an average annual increase of 3.61%.The prevalence rate increased from 3488.78 per 100,000 to 7701.69 per 100,000,a rise of 120.76%,with an average annual increase of 3.00%.The number of YLDs increased from 1.34 million to 3.55 million,a rise of 165.32%,with an average annual increase of 3.59%.The YLD rate increased from 113.86 per 100,000 to 249.81 per 100,000,a rise of 119.39%,with an average annual increase of 2.99%.High BMI was the only significant attributable risk factor,with the proportion of YLDs it caused continuing to rise.Predictions for 2035:The number of incident cases is expected to decline slightly from 5.89 million in 2022 to 5.72 million in 2035.The number of prevalent cases is expected to peak at 72.42 million in 2029 and be around 72.69 million in 2035.The number of YLDs is expected to increase year by year,from 2.35 million in 2022 to 2.35 million in 2035.Conclusion:The study reveals the increasing prevalence and disease burden of knee osteoarthritis among Chinese residents,emphasizing the importance of interventions targeting controllable risk factors.Although the prediction shows a slight decline in the number of incident cases in 2035,the number of prevalent cases and years of disability are expected to remain high,indicating the need for continued monitoring and intervention.
基金supported by International Agency for Research on Cancer (Lyon, France) (No. CRA No GEE/08/19)supported in part by the Fogarty International Clinical Research Scholars and Fellows Program at Vanderbilt University (R24 TW007988)
文摘Objective： To provide an evidence-based, consistent assessment of the burden of breast cancer attributable to reproductive factors （RFs, including nulliparity, mean number of children, age at first birth and breastfeeding）, use of oral contraceptives （OCs, restricted to the age group of 15-49 years）, and hormone replacement therapy （HRT）, as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005. Methods： We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China. In the case of RFs, we compared the exposure distributions in 2001 and counterfactual exposure. Results： Exposure of RFs in 2002 was found to account for 6.74% of breast cancer, corresponding to 9,617 cases and 2,769 deaths, and for 2.78% of ovarian cancer （712 cases, 294 deaths）. The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer. The prevalence of OC use was 1.74% and the population attributable fraction （PAF） of breast cancer was 0.71%, corresponding to 310 cases and 90 deaths. The PAF of breast cancer due to HRT was 0.31%, resulting in 297 cases and 85 deaths. Conclusion： RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China.
基金supported by the National Natural Science Foundation of China(No.81974492)Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2019PT320027)Sanming Project of Medicine in Shenzhen(No.SZSM201911015)。
文摘Objective:There is little information about contributions of the well-known risk factors to the liver cancer burden.We conducted a comparative study to estimate the liver cancer burden attributable to major risk factors.Methods:Liver cancer deaths for adults were estimated from 978 county-level surveillance points in China in2014.Risk factors were identified from the International Agency for Research on Cancer and the World Cancer Research Fund International.Population attributable fraction(PAF)by age,sex,and province was calculated using multiple formulas.Results:In total,72.4%of liver cancer deaths could be attributable to the studied risk factors.Hepatitis B virus(HBV)was responsible for the largest fraction of liver cancer burden in both genders(PAF=55.6%in males,PAF=46.5%in females).PAFs for liver cancer burden attributable to smoking(15.7%vs.4.8%),and alcohol drinking(10.3%vs.1.6%)were significantly higher in males than in females.The burden of HBV-attributable deaths was the highest in Qinghai province.Conclusions:HBV still contributes to the majority of liver cancer burden than any other risk factors.Targeted preventive measures should be implemented based on the degree of contributions of risk factors to liver cancer deaths.
基金supported by the funds of Key Discipline and Specialty Foundation of Shanghai Municipal Commission of Health and Family Planningthe National Key Basic Research Program "973 project" (2015CB554000)grants from US National Institutes of Health (R37 CA070867, R01 CA82729, UM1CA173640, and UM1 CA182910)
文摘Objective： To evaluate the population attributable risks （PARs） between cigarette smoking and deaths of all causes, all cancers, lung cancer and other chronic diseases in urban Shanghai. Methods： In total, 61,480 men aged 40-74 years from 2002 to 2006 and 74,941 women aged 40-70 years from 1997 to 2000 were recruited to undergo baseline surveys in urban Shanghai, with response rates of 74.0% and 92.3%, respectively. A Cox proportional hazards regression model was used to estimate relative risks （RRs） and 95% confidence intervals （95% CIs） of deaths associated with cigarette smoking. PARs and 95 % CIs for deaths were estimated from smoking exposure rates and the estimated RRs. Results： Cigarette smoking was responsible for 23.9% （95% CI： 19.4-28.3%） and 2.4% （95% Ch 1.6- 3.2%） of all deaths in men and women, respectively, in our study population. Respiratory disease had the highest PAR in men [37.5% （95% CI： 21.5-51.6%）], followed by cancer [31.3% （95% Ch 24.6-37.7%）] and cardiovascular disease （CVD） [24.1% （95% CI： 16.7-31.2%）]. While the top three PARs were 12.7% （95% CI： 6.1-19.3%）, 4.0% （95% CI： 2.4-5.6%）, and 1.1% （95% CI： 0.0-2.3%）, for respiratory disease, CVD, and cancer, respectively in women. For deaths of lung cancer, the PAR of smoking was 68.4% （95% CI： 58.2- 76.5%） in men. Conclusions： In urban Shanghai, 23.9% and 2.4% of all deaths in men and women could have been prevented if no people had smoked in the area. Effective control programs against cigarette smoking should be strongly advocated to reduce the increasing smoking-related death burden.
基金supported by International Agency for Research on Cancer (Lyon, France) grant CRA No GEE/08/19
文摘Objective：To provide an evidence-based and consistent assessment of the burden of cancer attributable to inadequate fruit and vegetable intake in China in 2005.Methods：The proportions of cancers attributable to low consumption of vegetable and fruit were calculated separately to estimate the burden of related cancers for the year 2005 in China.Data on the prevalence of exposure were derived from a Chinese nutrition and health survey.Data on relative risks were mainly derived from meta-analysis.Attributable fractions were calculated based on the counterfactual scenario which was a shift in the exposure distribution.Results：The total cancer burden attributable to inadequate consumption of fruit was up to 233,000 deaths （13.0% of all cancers） and 300,000 cases （11.6% of all cancers） in 2005.Increasing consumption of vegetable to the highest quintile could avoid total cancer deaths and cases by 3.6% （64,000 persons） and 3.4% （88,000 persons）.The contributions to cancer burden were higher in rural areas than in urban areas.They have greater influence on men than on women.The largest proportions of cancer burden attributable to low fruit and vegetable intake were for oral and pharyngeal cancers.Conclusion：This study showed that inadequate intake of fruit and vegetable makes a significant contribution to the cancer burden.Increasing consumption of fruit and vegetable could prevent many cancer deaths and save many lives.Promoting the consumption of fruit and vegetable is an important component in diet-based strategies for preventing cancer.
文摘AIM To study the impact of hospital-acquired infections(HAIs)on cost and outcome from intensive care units(ICU)in India.METHODS Adult patients(>18 years)admitted over 1-year,to a 24-bed medical critical care unit in India,were enrolled prospectively.Treatment cost and outcome data were collected.This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee.Only infections occurring during ICU stay were included.The impact of HAI on treatment cost and mortality was assessed.RESULTS The mean(±SD)age of the cohort(n=499)was42.3±16.5 years.Acute physiology and chronic health evaluation-Ⅱscore was 13.9(95%CI:13.3-14.5);86%were ventilated.ICU and hospital length of stay were 7.8±5.5 and 13.9±10 d respectively.Hospital mortality was 27.9%.During ICU stay,76(15.3%)patients developed an infection(ventilator-associated pneumonia 50;bloodstream infection 35;urinary tract infections 3),translating to 19.7 infections/1000 ICU days.When compared with those who did not develop an infection,an infection occurring during ICU stay was associated with significantly higher treatment cost[median(inter-quartile range,IQR)INR 92893(USD 1523)(IQR 57168-140286)vs INR 180469(USD 2958)(IQR 140030-237525);P<0.001 and longer duration of ICU(6.7±4.5 d vs 13.4±7.0 d;P<0.01)and hospital stay(12.4±8.2 d vs 21.8±13.9 d;P<0.001)].However ICU acquired infections did not impact hospital mortality(31.6%vs 27.2%;P=0.49).CONCLUSION An infection acquired during ICU stay was associated with doubling of treatment cost and prolonged hospitalization but did not significantly increase mortality.
基金supported by the National Key R&D Program of China(2022YFC2010106)the Chinese Nutrition Society(CNS-NNSRG2021-61).
文摘With the largest ageing population in the world,China is faced with the huge chal-lenge of dementia.-However,previously reported estimates on the prevalence of dementia among Chinese older adults were inconsistent,varying from 2%to 13%.5°It is crucial for dementia prevention to determine the number of cases that could be delayed or prevented,but how to do this remains unclear.To address these research gaps,we aimed to provide population estimates of the prevalence of dementia in China and estimate the population attributable fractions(PAFs)of potentially modifiable risk factors.
文摘Effect sizes are estimated from several study designs when the subjects are individually sampled. When the samples are the aggregate cluster of individuals, the within cluster correlation must be accounted for to construct correct confidence intervals, and to conduct valid statistical inference. The purpose of this article is to propose and evaluate statistical procedures for the estimation of the variance of the estimated attributable risk in parallel groups of clusters, and in a design dividing each of k clusters into two segments creating multiple sub-clusters. The estimated variance is the first order approximation and is obtained by the delta method. We apply the methodology and propose a Wald type confidence interval on the difference between two correlated attributable risks. We also construct a test on the hypothesis of equality of two correlated attributable risks. We evaluate the power of the proposed test via Monte-Carlo simulations.
文摘Population attributable fraction(PAF)refers to the proportion of all cases with a particular outcome in a population that could be prevented by eliminating a specific exposure.The authors of a recent paper evaluated the prevalence and estimated the PAFs for risk factors of TB among elderly people in China[Inf Dis Poverty.2019;8:7].Confounding is inevitable in observational studies and Levin’s formula is of limited use in practice for unbiasedly estimating PAF.In a complex survey design,an unbiased estimation of the PAF can be calculated using a sample-weighted version of the Miettinen formula or a sample weighed parametric g-formula.With respect to causal interpretation of PAF in public health setting,computation of PAF is logical and practical when the exposure is amenable to intervention.
文摘Succession is one of the most extensively studied ecological phenomena,yet debates persist about the importance of dispersal and external factors in driving this process.We aimed to quantify the influence of these factors by investigating how wing-related traits evolve across succession of blowfly(Diptera:Calliphoridae)communities in South Brazil.Rat carrion was placed in both forest and grassland habitats,and the associated blowfly communities were documented throughout the decomposition process.Using morphometric analysis,we measured wing and thorax traits and assessed trait changes over succession through mixed models.Our findings revealed that carrion succession follows distinct trajectories in forest and grassland environments.Specifically,we observed that Calliphora lopesi predominantly visited carcasses during the final phase of decomposition,resulting in significant differences in species composition and wing size between habitats.In forests,wing size increased toward the later stages of succession,whereas an opposite trend was observed in grasslands.Notably,these trait patterns were only evident at the species level,indicating that intraspecific trait variation is irrelevant.Stronger dispersers tend to arrive during the later stages of succession,suggesting that dispersal has a negligible role in shaping successional dynamics.Instead,environmental differences between habitats drive trait patterns throughout succession.Our results suggest that community composition in ephemeral resources is governed by deterministic processes and that successional stages can be predicted based on blowfly wing traits.Specifically,the presence of the large-winged C.lopesi indicates late decay,while the small-winged Chrysomia albiceps and Lucilia eximia are indicative of early decay.
基金support from the National Key Research and Development Program of China(Grant No.2021YFF0704102)the Chongqing Education Commission Key Project of Science and Technology Research(Grant No.KJZD-K202400610)the Chongqing Natural Science Foundation General Project(Grant No.CSTB2025NSCQ-GPX1263).
文摘Attribute-Based Encryption(ABE)has emerged as a fundamental access control mechanism in data sharing,enabling data owners to define flexible access policies.A critical aspect of ABE is key revocation,which plays a pivotal role in maintaining security.However,existing key revocation mechanisms face two major challenges:(1)High overhead due to ciphertext and key updates,primarily stemming from the reliance on revocation lists during attribute revocation,which increases computation and communication costs.(2)Limited universality,as many attribute revocation mechanisms are tailored to specific ABE constructions,restricting their broader applicability.To address these challenges,we propose LUAR(Lightweight and Universal Attribute Revocation),a novel revocation mechanism that leverages Intel Software Guard Extensions(SGX)while minimizing its inherent limitations.Given SGX’s constrained memory(≈90 MB in a personal computer)and susceptibility to side-channel attacks,we carefully manage its usage to reduce reliance while mitigating potential collusion risks between cloud service providers and users.To evaluate LUAR’s lightweight and universality,we integrate it with the classic BSW07 scheme,which can be seamlessly replaced with other ABE constructions.Experimental results demonstrate that LUAR enables secure attribute revocation with low computation and communication overhead.The processing time within the SGX environment remains stable at approximately 55 ms,regardless of the complexity of access policies,ensuring no additional storage or computational burden on SGX.Compared to the Hardware-based Revocable Attribute-Based Encryption(HR-ABE)scheme(IEEE S&P 2024),LUAR incurs a slightly higher computational cost within SGX;however,the overall time from initiating a data request to obtaining plaintext is shorter.As access policies grow more complex,LUAR’s advantages become increasingly evident,showcasing its superior efficiency and broader applicability.
基金funding from the Natural Science Foundation of Shanxi Province(202403021222245,20240302121217)。
文摘The variation laws of runoff and sediment load under different climate,vegetation,and human activity scenarios are significantly different.Exploring the impacts of climate change and human activities on runoff and sediment load dynamics can provide a profound understanding of the mechanism of runoff and sediment load variability in basins,which is crucial for the sustainable development of regional ecosystems.This study investigates the Tao River Basin(TRB)on the Tibetan Plateau,as well as the Zuli River Basin(ZRB)and Jing River Basin(JRB)on the Loess Plateau,to differentiate the impacts of climate change and human activities on runoff and sediment load dynamics.The runoff and sediment load of the three watersheds have shown a decreasing trend over the past 40 years,and combined with the DMC(Dual mass curve)method,it was found that the slope of the runoff sediment gradually tends to flatten out.After the time period was divided,the CA(Cumulative anomaly)method was used for verification,which revealed good correspondence between the two before 2000 and then gradual deviations.The power function best represents the relationship between runoff and sediment load.During the initial period,climate had a significant impact on runoff variation in the TRB and JRB,with contribution rates of-54.93%and-63.02%,respectively.In the later period,human activities became the dominant influence,contributing more than-60%of the runoff variation.In the ZRB,human activities consistently dominated runoff variation,with contribution rates of-72.72%and-55.66%during both periods.In the early stages of research,the impact of climate change on sediment load was more severe in the TRB and JRB,and human activities played a significant role in the later stages.However,in the ZRB,human activities have always been the main contributor.Based on the actual local situation,runoff and sediment load in the TRB are influenced primarily by engineering measures,and vegetation and check dams exert greater impacts on the ZRB and JRB.This study explores the attribution of water and sediment load changes in different ecological geographic regions from a comparative perspective,providing a valuable theoretical basis and reference for understanding global runoff and sediment transport changes in similar areas.
基金funded by the Natural Environment Research Council’s Global Challenges Research Fund(NE/P016146/1)。
文摘Mountain communities in Nepal are increasingly exposed to climate-induced shifts in water availability,driven by glacial retreat,altered precipitation/snowmelt regimes,and declining groundwater sources.This study presents an integrated framework combining hydrological source analysis with socio-demographic survey data to evaluate seasonal water contributions and communitylevel water use patterns in the Upper Marsyangdi catchment,Manang District,Nepal.Isotopic(δ^(18)O)and geochemical(silica)tracers were used in a Bayesian mixing model to quantify the seasonal contributions of glacial melt,snow,rain,and groundwater to river flow.Findings indicate that groundwater dominates pre-monsoon flow(60%-70%)while post-monsoon discharge reflects more balanced inputs from all sources.In parallel,120 household surveys were analysed using Latent Class Analysis to characterise water use across domestic,agricultural,energy,and tourism sectors.Results reveal spatial and demographic gradients in water source dependency,including gender and occupation as important predictors of water use.Respondents reported perceived increases in spring flow,alongside reductions in the availability of snow for household and tourism use and deteriorating river water quality and quantity,particularly affecting hydropower operations.Adaptation strategies include increased reliance on water storage infrastructure and source switching.The study highlights the value of applying probabilistic methods to hydrological and sociocultural data to identify vulnerable populations and inform targeted,context-sensitive adaptation strategies.The proposed framework is transferable to other high-altitude regions,offering a robust approach for assessing climate resilience through the synthesis of scientific and local knowledge systems.
基金supported by the National Key Research and Development Program of China(Grant No.2020YFA0608904)the International Partnership Program of the Chinese Academy of Sciences(Grant Nos.060GJHZ2023079GC and 134111KYSB20160031)+1 种基金supported by the Office of Science,U.S.Department of Energy(DOE)Biological and Environmental Research as part of the Regional and Global Model Analysis program area through the Water Cycle and Climate Extremes Modeling(WACCEM)scientific focus areaoperated for DOE by Battelle Memorial Institute under contract DE-AC05-76RL01830。
文摘The global monsoon system,encompassing the Asian-Australian,African,and American monsoons,sustains two-thirds of the world’s population by regulating water resources and agriculture.Monsoon anomalies pose severe risks,including floods and droughts.Recent research associated with the implementation of the Global Monsoons Model Intercomparison Project under the umbrella of CMIP6 has advanced our understanding of its historical variability and driving mechanisms.Observational data reveal a 20th-century shift:increased rainfall pre-1950s,followed by aridification and partial recovery post-1980s,driven by both internal variability(e.g.,Atlantic Multidecadal Oscillation)and external forcings(greenhouse gases,aerosols),while ENSO drives interannual variability through ocean-atmosphere interactions.Future projections under greenhouse forcing suggest long-term monsoon intensification,though regional disparities and model uncertainties persist.Models indicate robust trends but struggle to quantify extremes,where thermodynamic effects(warming-induced moisture rise)uniformly boost heavy rainfall,while dynamical shifts(circulation changes)create spatial heterogeneity.Volcanic eruptions and proposed solar radiation modification(SRM)further complicate predictions:tropical eruptions suppress monsoons,whereas high-latitude events alter cross-equatorial flows,highlighting unresolved feedbacks.The emergent constraint approach is booming in terms of correcting future projections and reducing uncertainty with respect to the global monsoons.Critical challenges remain.Model biases and sparse 20th-century observational data hinder accurate attribution.The interplay between natural variability and anthropogenic forcings,along with nonlinear extreme precipitation risks under warming,demands deeper mechanistic insights.Additionally,SRM’s regional impacts and hemispheric monsoon interactions require systematic evaluation.Addressing these gaps necessitates enhanced observational networks,refined climate models,and interdisciplinary efforts to disentangle multiscale drivers,ultimately improving resilience strategies for monsoon-dependent regions.
基金supported by the Strategic Priority Research Program of Chinese Academy of Sciences(XDB1150102)National Science Foundation of China(82173878 and 82172001)Shanghai Municipal Science and Technology Major Project.
文摘Primary human hepatocytes(PHH)are used as the FDA-recognized"gold standard"for liver-related studies in vitro.The world’s first PHH group standard(T/CSCB 0008–2021,CSCB standard)was released by Chinese Society for Cell Biology in 2021.In order to justify this standard,six key quality attributes of ten different batches from commercial PHHs,including cell viability,cell morphology,cell markers,albumin secretion,drug metabolism function and bile secretion,were characterized using the designated test methods in the standard.The PHHs from various batches all exhibited typical hepatocytic morphology,high cell viability,and sufficient albumin secretion;whereas,tremendous variations in cell markers,drug metabolism functions,and bile secretion were unexpectedly detected across the board.Flow cytometric assessment of hepatocyte markers revealed the percentages of ALB^(+)or HNF4A^(+)cells in six batches of PHHs,ranging from 49.4%to 98.9%and from 37.7%to 91.4%,respectively.Single cell transcriptomic analysis also revealed significant cell heterogeneity across the different batches,with the proportions of hepatocytes ranging from 69.2%to 98.9%.Considerable heterogeneity in drug metabolism functions across the batches were also found in substrate clearance rate(SCR)and metabolite formation rate(MFR)for six representative CYP450 enzymes,while the results didn’t influence current SCR attribute of CYP3A4.Metabolic capacity and purity are two independent attributes for PHH.The varied biliary excretion indexes around criteria(30%)indicated heterogeneity of PHH biliary excretion capacity.These results confirmed the robustness of most quality attributes in current CSCB standard,while highlighting the need to refine remaining parameters to enhance its practical applicability.
基金Supported by the National Natural Science Foundation of China(grant numbers 82025030 and 81941023)Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(grant number 2021-JKCS-028)Claude D.Pepper Older Americans Independence Centers grant(grant number 5P30 AG028716 from NIA).
文摘Summary What is already known about this topic?Limited evidence on healthy longevity was provided in the world,and no studies investigated the fractions of healthy longevity attributed to modifiable factors.What is added by this report?Incidences of longevity and healthy longevity in China are provided.It reveals that the total weighted population attributable fractions for lifestyles and all modifiable factors were 32.8% and 83.7% for longevity,respectively,and 30.4% and 73.4% for healthy longevity,respectively.What are the implications for public health practice?China has a high potential for longevity and healthy longevity.Strategies may be targeted at education and residence in early life as well as healthy lifestyles,disease prevention,and functional optimization in late life.
基金supported by the Capital’s Funds for Health Improvement and Research (No. 2024-1G-4023)。
文摘Objective: This study aims to quantify the potential impact of controlling major risk factors on liver cancer deaths in China from 2021 to 2050 under various intervention scenarios.Methods: We developed a macro-level simulation model based on comparative risk assessment to estimate population attributable fractions and avoidable liver cancer deaths. Risk factor prevalence data were obtained from national surveys and epidemiological estimates. Three intervention scenarios for each risk factor were projected:elimination(Scenario 1), ambitious reduction(Scenario 2), and manageable targets aligned with national/global goals(Scenario 3). The impact of secondary prevention through liver cancer screening at different coverage was evaluated.Results: Between 2021 and 2050, liver cancer deaths in China are projected to reach 9.44 million in males and4.29 million in females. Eliminating hepatitis B virus and hepatitis C virus could prevent 65.62%(57.47%-73.77%)and 28.47%(24.93%-32.00%) of liver cancer deaths, respectively. Achieving manageable targets in reducing the prevalence of smoking and alcohol drinking could prevent 6.57%(5.75%-7.38%) and 0.85%(0.75%-0.96%) of liver cancer deaths, with a more pronounced effect observed in males. Eliminating high body mass index(BMI)could avert 45,000 male and 25,000 female deaths annually by 2050, while diabetes elimination could prevent60,000 male and 21,000 female deaths. Secondary prevention through liver cancer screening with 80% coverage could reduce liver cancer deaths by 3.59%(3.14%-4.04%) for the total population. Combining all interventions under Scenario 1 could prevent up to 88.39%(76.65%-99.81%) of male and 77.80%(67.42%-87.88%) of female liver cancer deaths by 2050.Conclusions: Comprehensive risk factor control could prevent over 80% of liver cancer deaths in China by2050. Secondary prevention through screening may offer modest additional benefits. These findings provide strong quantitative support for targeted, evidence-based interventions and underscore the need for policy action to address key risk factors.
基金supported by the National Natural Science Foundation of China(Nos.U19A2044,42105132,42030609,and 41975037)the National Key Research and Development Programof China(No.2022YFC3700303).
文摘Extreme ozone pollution events(EOPEs)are associated with synoptic weather patterns(SWPs)and pose severe health and ecological risks.However,a systematic investigation of themeteorological causes,transport pathways,and source contributions to historical EOPEs is still lacking.In this paper,the K-means clustering method is applied to identify six dominant SWPs during the warm season in the Yangtze River Delta(YRD)region from 2016 to 2022.It provides an integrated analysis of the meteorological factors affecting ozone pollution in Hefei under different SWPs.Using the WRF-FLEXPART model,the transport pathways(TPPs)and geographical sources of the near-surface air masses in Hefei during EOPEs are investigated.The results reveal that Hefei experienced the highest ozone concentration(134.77±42.82μg/m^(3)),exceedance frequency(46 days(23.23%)),and proportion of EOPEs(21 instances,47.7%)under the control of peripheral subsidence of typhoon(Type 5).Regional southeast winds correlated with the ozone pollution in Hefei.During EOPEs,a high boundary layer height,solar radiation,and temperature;lowhumidity and cloud cover;and pronounced subsidence airflow occurred over Hefei and the broader YRD region.The East-South(E_S)patterns exhibited the highest frequency(28 instances,65.11%).Regarding the TPPs and geographical sources of the near-surface air masses during historical EOPEs.The YRD was the main source for land-originating air masses under E_S patterns(50.28%),with Hefei,southern Anhui,southern Jiangsu,and northern Zhejiang being key contributors.These findings can help improve ozone pollution early warning and control mechanisms at urban and regional scales.
基金Supported by Taishan Scholar Special Funding,No.tsqnz20240858Medical and Health Technology Project of Shandong Province,No.202402050122+4 种基金Science and Technology Development Plan of Jinan Municipal Health Commission,No.2024301008Clinical Medical Science and Technology Innovation Program of Jinan Science and Technology Bureau,No.202430055Natural Science Foundation of Jiangxi Province,No.20224BAB206077Gansu Provincial Hospital Intra-Hospital Research Fund Project,No.22GSSYB-6and the 2022 Master/Doctor/Postdoctoral Program of National Health Commission Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor,No.NHCDP2022004 and No.NHCDP2022008.
文摘Knee osteoarthritis(KOA),characterized by heterogeneous arthritic manifestations and complex peripheral joint disorder,is one of the leading causes of disability worldwide,which has become a high burden due to the multifactorial nature and the deficiency of available disease-modifying treatments.The application of mesenchymal stem/stromal cells(MSCs)as therapeutic drugs has provided novel treatment options for diverse degenerative and chronic diseases including KOA.However,the complexity and specificity of the“live”cells have posed challenges for MSC-based drug development and the concomitant scale-up preparation from laboratory to industrialization.For instance,despite the considerable progress in ex vivo cell culture technology for fulfilling the robust development of drug conversion and clinical trials,yet significant challenges remain in obtaining regulatory approvals.Thus,there’s an urgent need for the research and development of MSC drugs for KOA.In this review,we provide alternative solution strategies for the preparation of MSC drugs on the basis of the principle of quality by design,including designing the cell production processes,quality control,and clinical applications.In detail,we mainly focus on the quality by design method for MSC manufacturing in standard cell-culturing factories for the treatment of KOA by using the Quality Target Product Profile as a starting point to determine potential critical quality attributes and to establish relationships between critical material attributes and critical process parameters.Collectively,this review aims to meet product performance and robust process design,and should help to reduce the gap between compliant products and the production of compliant good manufacturing practice.
