Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and prematu...Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and premature mortality,which increased by 3%between 2000 and 2019.2 Evidence is strong that maintaining a healthy diet,engaging in regular physical activity(PA),and preventing obesity can prevent or delay the incidence of T2D.展开更多
Human genetic variants have long been known to play an important role in both Mendelian disorders and common diseases. Notably, pathogenic variants are not limited to single-nucleotide variants. It has become apparent...Human genetic variants have long been known to play an important role in both Mendelian disorders and common diseases. Notably, pathogenic variants are not limited to single-nucleotide variants. It has become apparent that human diseases can also be caused by copy number variations （CNVs）, especially patient- specific novel CNVs （lafrate et al., 2004; Sebat et al., 2004; Redon et al., 2006; LuDski, 2007; Zhan~ et al.. 2009： Wu et al.. 2015）.展开更多
A survey involving 6103 participants from five Chinese provinces was conducted to evaluate the threshold value of urinary cadmium （UCd） for renal dysfunction as benchmark dose low （BMDL）. The urinary N-acetyl-13-D...A survey involving 6103 participants from five Chinese provinces was conducted to evaluate the threshold value of urinary cadmium （UCd） for renal dysfunction as benchmark dose low （BMDL）. The urinary N-acetyl-13-D-glucosaminidase （UNAG） was chosen as an effect biomarker. The UCd BMDLs for UNAG ranged from 2.18μg/g creatinine （cr） to 4.26μg/g cr in the populations of different provinces. The selection of the sample population and area affect the evaluation of the BMDL. The reference level of UCd for renal effects was further evaluated based on the data of all 6103 subjects. With benchmark responses （BMR） of 10%/5%, the overall UCd BMDLs for males in the total population were 3.73/2.08 μg/g cr. The BMD was slightly lower in females, thereby indicating that females may be relatively more sensitive to Cd exposure than are males.展开更多
Antenatal depression is a significant contributor to maternal morbidity in the perinatal period[1].It has also been associated with an increased risk for premature delivery,decreased rates of breastfeeding initiation,...Antenatal depression is a significant contributor to maternal morbidity in the perinatal period[1].It has also been associated with an increased risk for premature delivery,decreased rates of breastfeeding initiation,and a broad range of adverse child out-comes,including emotional problems,externalizing difficulties,attachment issues,and poorer cognitive development[2-6]Depression in the antenatal period may persist postnatally and increase in severity further exacerbating the negative conse-quences.There are considerable geographical differences in ante-natal depression prevalence rates across China,ranging from 9.8%to 35.4%,which is likely due to variations in demographic,lifestyle,social,and economic factors[7,8].Heterogeneity in study design and data source has also resulted in these wide variations.Further,previous Chinese studies examining antenatal depression have been limited due to relatively small sample sizes,short study peri-ods,and a focus on only one specific geographical district.Limited prevalence data in China suggest that a large-scale multi-center study is warranted.展开更多
Chronic body pain and depression,two major global health concerns,frequently co-occur and collectively impair individuals'well-being,compromising their ability to maintain an independent lifestyle and social relat...Chronic body pain and depression,two major global health concerns,frequently co-occur and collectively impair individuals'well-being,compromising their ability to maintain an independent lifestyle and social relationships[1].A global study of pain prevalence among 52 countries indicated the overall prevalence of pain was estimated to be 27.5%[2],with significant variation across countries(9.9%-50.3%).展开更多
17ɑ-hydroxylase/17,20-lyase deficiency(17OHD)was caused by mutations in the CYP17A1 gene.It was a rare form of congenital adrenal hyperplasia with an estimated incidence of about 1:50,000.The clinical manifestation o...17ɑ-hydroxylase/17,20-lyase deficiency(17OHD)was caused by mutations in the CYP17A1 gene.It was a rare form of congenital adrenal hyperplasia with an estimated incidence of about 1:50,000.The clinical manifestation of 17OHD includes hypertension and hypokalemia due to excessive synthesis of mineralocorticoid precursors,undermasculinized external genitalia in 46,XY males,and primary amenorrhea in 46,XX females.展开更多
Background:Breast cancer is the most common malignancy and a leading cause of cancer‐related deaths among women worldwide.Although treatment advances have improved outcomes,the 5‐year survival rate for metastatic br...Background:Breast cancer is the most common malignancy and a leading cause of cancer‐related deaths among women worldwide.Although treatment advances have improved outcomes,the 5‐year survival rate for metastatic breast cancer remains low.Understanding the anatomical distribution,associated risks,and prognostic features of metastases in patients with newly diagnosed stage IV breast cancer is essential for improving clinical management.This study aims to comprehensively investigate these aspects using data from the SEER database.Methods:This study utilized a retrospective cohort design,examining data from the Surveillance,Epidemiology,and End Results(SEER)database.The investigation considered patients diagnosed with stage IV breast cancer from SEER database.Using logistic regression,odds ratios(ORs)were calculated to determine the risk of various metastases,stratified based on sociodemographic and clinicopathological variables.Survival analyses were executed with Kaplan–Meier methodology in tandem with Cox regression analyses.Results:Out of 356,789 breast cancer patients considered,18,036(5.06%)were diagnosed with de novo stage IV disease.Bone metastasis predominated with a composition ratio of 42.6%.Patients with the HR−/HER2+subtype exhibited the highest metastasis incidence at the time of diagnosis,constituting 8.7%of the entire cohort.Male patients displayed heightened susceptibility to bone,lung,and brain metastases compared to female counterparts.Hispanic individuals exhibited the highest propensity for brain metastases.Relative to other subtypes,the HR−/HER2−patients were more inclined toward lung metastases.Those with bone metastasis had a median survival period of 27 months.Grade III patients with brain or liver metastases faced the most adverse prognoses.A comprehensive profile detailing metastasis patterns by demographics,tumor site and stage,biology,and treatment was presented.Conclusions:This study represents the most comprehensive analysis of metastasis'anatomical distribution and prognosis in breast cancer,offering invaluable insights into metastatic tendencies and characteristics.展开更多
AIM:To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease(NAFLD).METHODS:Authors performed a cross-sectional study involving participants of a medical health c...AIM:To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease(NAFLD).METHODS:Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography.This study involved 11 714 apparently healthy Japanese men and women,18 to 83 years of age.NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d,known liver disease,or current use of medication.The revised criteria of the National Cholesterol Education Program Adult Treatment PanelⅢ were used to characterize the metabolic syndrome.RESULTS:NAFLD was detected in 32.2%(95%CI:31.0%-33.5%)of men(n=1874 of 5811)and in 8.7%(95%CI:8.0%-9.5%)of women(n=514 of 5903).Among obese people,the prevalence of NAFLD was as high as 67.3%(95%CI:64.8%-69.7%)in men and 45.8%(95%CI:41.7%-50.0%)in women.Although NAFLD was thought of as being the liver phenotype of metabolic syndrome,the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women.66.8%of men and 70.4%of women with NAFLD were not diagnosed with the metabolic syndrome.48.2%of men with NAFLD and 49.8%of women with NAFLD weren't overweight[body mass index(BMI)≥25 kg/m2].In the same way,68.6%of men with NAFLD and 37.9%of women with NAFLD weren't satisfied with abdominal classification(≥90 cm for men and≥80 cm for women).Next,authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome.The sensitivity of the definition"at least 1 criterion"was as good as 84.8%in men and 86.6%in women.Separating subjects by BMI,the sensitivity was higher in obese men and women than in non-obese men and women(92.3%vs 76.8%in men,96.1%vs 77.0%in women,respectively).CONCLUSION:Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome.展开更多
Objective:Olfactory dysfunction is known to have significant social,psychological,and safety implications.Despite increasingly recognized prevalence,potential risk factors for olfactory loss have been arbitrarily docu...Objective:Olfactory dysfunction is known to have significant social,psychological,and safety implications.Despite increasingly recognized prevalence,potential risk factors for olfactory loss have been arbitrarily documented and knowledge is limited in scale.The aim of this study is to identify potential demographic and exposure variables correlating with olfactory dysfunction.Methods:Cross-sectional analysis of the 2011-2012 and 2013-2014 editions of the National Health Examination and Nutrition Survey was performed.The utilized survey reports from a nationally representative sample of about 5000 persons each year located in counties across the United States.There is an interview and physical examination component which includes demographic,socioeconomic,dietary,and health-related questions as well as medical,dental,physiologic measurements,and laboratory tests.3594 adult respondents from 2011 to 2012 and 3708 respondents from 2013 to 2014 were identified from the above population-based database.The frequency of self-reported disorders as well as performance on odor identification testing was determined in relation to demographic factors,occupational or environmental exposures,and urinary levels of environmental and industrial compounds.Results:In both subjective and objective analysis,smell disorders were significantly more common with increasing age.While the non-Hispanic Black and non-Hispanic Asian populations were less likely to report subjective olfactory loss,they,along with Hispanics,performed more poorly on odor identification than Caucasians.Those with limited education had a decreased prevalence of hyposmia.Women outperformed men on smell testing.Those reporting exposure to vapors were more likely to experience olfactory dysfunction,and urinary levels of manganese,2-Thioxothiazolidine-4-carboxylic acid,and 2-Aminothiazoline-4-carboxylic acid were lower among respondents with subjective smell disturbance.In odor detection,elevated serum levels of lead and urinary levels of 2,4 dichlorophenol were associated with anosmia and hyposmia,respectively.Conclusions:This study provides current,population-based data identifying demographic and exposure elements related to smell disturbances in U.S.adults.Age,race,gender,education,exposure to vapors,urinary levels of manganese,2-Thioxothiazolidine-4-carboxylic acid,2-Aminothiazoline-4-carboxylic acid,2,4 dichlorophenol,and serum lead levels were all implicated in smell disturbance.Care should be taken in interpretation due to lack of consistency between subjective and objective measures of olfaction as well as limitations related to population-based data.Prospective trials are indicated to further elucidate these relationships.展开更多
Background The neonatal period is the most vulnerable period during childhood,with the risk of death being the highest even in developed countries/regions.Hong Kong’s neonatal mortality(1‰)is among the world’s lowe...Background The neonatal period is the most vulnerable period during childhood,with the risk of death being the highest even in developed countries/regions.Hong Kong’s neonatal mortality(1‰)is among the world’s lowest and has remained similar for 15 years.This study aimed to explore neonatal deaths in Hong Kong in detail and determine whether neonatal mortality is reducible at such a low level.Methods Live births in public hospitals in Hong Kong during 01 Jan 2006–31 Dec 2017 were included.Relevant data were extracted from the electronic medical records.Gestational age-specific mortality was calculated,and the trends were analyzed using the Cochran–Armitage trend test.Causes of death were summarized,and risk factors were identified in multivariate logistic regression analysis.Results In 490,034 live births,755 cases(1.54‰)died during the neonatal period,and 293(0.6‰)died during the post-neonatal period.The neonatal mortality remained similar overall(P=0.17)and among infants born at 24–29 weeks’gestation(P=0.4),while it decreased in those born at 23(P=0.04),30–36(P<0.001)and≥37(P<0.001)weeks’gestation.Neonates born at<27 weeks’gestation accounted for a significantly increased proportion among cases who died(27.6%to 51.9%),with hemorrhagic conditions(24%)being the leading cause of death.Congenital anomalies were the leading cause of death in neonates born≥27 weeks’gestation(52%),but its cause-specific mortality decreased(P=0.002,0.6‰to 0.41‰),with most of the decrease attributed to trisomy 13/18 and multiple anomalies.Conclusion Reduction of neonatal mortality in developed regions may heavily rely on improved quality of perinatal and neonatal care among extremely preterm infants.展开更多
BACKGROUND The implementation of a colorectal cancer(CRC)screening programme may increase the awareness of Primary Care Physicians,reduce the diagnostic delay in CRC detected outside the scope of the screening program...BACKGROUND The implementation of a colorectal cancer(CRC)screening programme may increase the awareness of Primary Care Physicians,reduce the diagnostic delay in CRC detected outside the scope of the screening programme and thus improve prognosis.AIM To determine the effect of implementation of a CRC screening programme on diagnostic delays and prognosis of CRC detected outside the scope of a screening programme.METHODS We performed a retrospective intervention study with a pre-post design.We identified 322 patients with incident and confirmed CRC in the pre-implantation cohort(June 2014–May 2015)and 285 in the post-implantation cohort(June 2017-May 2018)in the Cancer Registry detected outside the scope of a CRC screening programme.In each patient we calculated the different healthcare diagnostics delays:global,primary and secondary healthcare,referral and colonoscopyrelated delays.In addition,we collected the initial healthcare that evaluated the patient,the home location(urban/rural),and the CRC stage at diagnosis.We determined the two-year survival and we performed a multivariate proportional hazard regression analysis to determine the variables associated with survival.RESULTS We did not detect any differences in the patient or CRC baseline-related variables.A total of 20.1%of patients was detected with metastatic disease.There was a significant increase in direct referral to colonoscopy from primary healthcare(25.5%,35.8%;P=0.04)in the post-implantation cohort.Diagnostic delay was reduced by 24 d(106.64±148.84 days,82.84±109.31 d;P=0.02)due to the reduction in secondary healthcare delay(46.01±111.65 d;29.20±60.83 d;P=0.02).However,we did not find any differences in CRC stage at diagnosis or in two-year survival(70.3%;P=0.9).Variables independently associated with twoyear risk of death were age(Hazard Ratio-HR:1.06,95%CI:1.04-1.07),CRC stage(II HR:2.17,95%CI:1.07-4.40;III HR:3.07,95%CI:1.56-6.08;IV HR:19.22,95%CI:9.86-37.44;unknown HR:9.24,95%CI:4.27-19.99),initial healthcare consultation(secondary HR:2.93,95%CI:1.01-8.55;emergency department HR:2.06,95%CI:0.67-6.34),hospitalization during the diagnostic process(HR:1.67,95%CI:1.17-2.38)and urban residence(HR:1.44,95%CI:1.06-1.98).CONCLUSION Although implementation of a CRC screening programme can reduce diagnostic delays for CRC detected in symptomatic patients,this has no effect on CRC stage or survival.展开更多
Based on the noise survey in China ,the formula (H=H+N-HN/120 ) of ISO/DIS 1999.2 (' Acoustics - Determination of Occupational noise exposure and estimation of noise induced hearing impairment ' , 1985) was ap...Based on the noise survey in China ,the formula (H=H+N-HN/120 ) of ISO/DIS 1999.2 (' Acoustics - Determination of Occupational noise exposure and estimation of noise induced hearing impairment ' , 1985) was applied to the calculation of the hearing threshold level associated with age and noise (HTLAN) of the noise - impaired people . According to the Gausscian distribution , when the noise - exposure level LEX8h was 85 ,90 ,95, 100 dB and the hearing threshold frequency is from 0.5k to 6kHz , the HTLAN of noise - exposed people withdifferent duration of exposure and its relation values to the hearing threshold frequency associated with age (HTLA) were obtained . The ISO /DIS 1999.2 has been proved to be applicable in China .展开更多
Background: Population-based cancer survival is a key metric in evaluating the overall effectiveness of health services and cancer control activities. Advancement in information technology enables accurate vital statu...Background: Population-based cancer survival is a key metric in evaluating the overall effectiveness of health services and cancer control activities. Advancement in information technology enables accurate vital status tracking through multi-source data linkage. However, its reliability for survival estimates in China is unclear.Methods: We analyzed data from Dalian Cancer Registry to evaluate the reliability of multi-source data linkage for population-based cancer survival estimates in China. Newly diagnosed cancer patients in 2015 were included and followed until June 2021. We conducted single-source data linkage by linking patients to Dalian Vital Statistics System, and multi-source data linkage by further linking to Dalian Household Registration System and the hospital medical records. Patient vital status was subsequently determined through active follow-up via telephone calls, referred to as comprehensive follow-up, which served as the gold standard. Using the cohort method, we calculated 5-year observed survival and age-standardized relative survival for 20 cancer types and all cancers combined.Results: Compared to comprehensive follow-up, single-source data linkage overestimated 5-year observed survival by 3.2% for all cancers combined, ranging from 0.1% to 8.6% across 20 cancer types. Multi-source data linkage provided a relatively complete patient vital status, with an observed survival estimate of only 0.3% higher for all cancers, ranging from 0% to1.5% across 20 cancer types.Conclusion: Multi-source data linkage contributes to reliable population-based cancer survival estimates in China. Linkage of multiple databases might be of great value in improving the efficiency of follow-up and the quality of survival data for cancer patients in developing countries.展开更多
Objective As populations age,multimorbidity and frailty have emerged as major health challenges.While their associations with disability and mortality are well documented,their impact on quality of life(QoL)in sub-Sah...Objective As populations age,multimorbidity and frailty have emerged as major health challenges.While their associations with disability and mortality are well documented,their impact on quality of life(QoL)in sub-Saharan Africa remains underexplored.We examined the associations between frailty,multimorbidity and QoL among older adults in Rwanda.Design A cross-sectional population-based study.Multimorbidity was defined as having two or more chronic conditions,including hypertension,diabetes,heart disease and mental health conditions.Frailty scores were derived using the Fried phenotype,and QoL was measured using the European Health Instrument Survey-Quality of Life index(scaled 0%–100%).Sequential linear regression models were used to examine independent associations.Setting Rural and urban settings of Rwanda.Participant We analysed data from 4369 adults(≥40 years).Results The mean QoL score was 48.2%(±15.6).Frailty and multimorbidity prevalence were 14.5%(95%CI 13.5 to 15.6)and 55.2%(95%CI 53.7 to 56.6),respectively,while 55.0%(95%CI 53.3 to 56.3)were classified as prefrail.Frailty and multimorbidity are independently associated with poorer QoL.Compared with robust individuals,prefrail and frail individuals experienced a 3.66(95%CI−4.63 to–2.70)and 7.30(95%CI−8.76 to–5.83)percentage point reduction in QoL,respectively.Multimorbidity was associated with a 4.66%(95%CI−5.54 to–3.79)point decrease in QoL.Impairments in activities of daily living partly mediated these associations.Conclusions Frailty and multimorbidity showed a strong negative association with QoL,with frailty having a stronger effect.These findings underscore the need for age-responsive healthcare strategies,including frailty screening and integrated chronic care,to enhance QoL among older adults in Rwanda.展开更多
论著/OriginalArticle肝移植对糖尿病患者原有降糖药物的影响:一项基于人群的队列研究The effect of liver transplantation on anti-glycaemic agents in patients with pre-existing diabetes mellitus:A population-based cohort stu...论著/OriginalArticle肝移植对糖尿病患者原有降糖药物的影响:一项基于人群的队列研究The effect of liver transplantation on anti-glycaemic agents in patients with pre-existing diabetes mellitus:A population-based cohort study Amy Coulden,Christina Antza,Orighomisan Awala,Nihit Shah,Leelavathy Kandaswamy.展开更多
Introduction:Addressing the healthcare needs of the growing number of patients with herpes zoster(HZ)presents considerable challenges.This study examined the unmet healthcare needs and associated factors among people ...Introduction:Addressing the healthcare needs of the growing number of patients with herpes zoster(HZ)presents considerable challenges.This study examined the unmet healthcare needs and associated factors among people with HZ across 25 provincial-level administrative divisions(PLADs)and cities in China from 2019–2024.Methods:The study conducted a nationwide population-based survey using probabilityproportional-to-size sampling.The structured questionnaire incorporated validated diagnostic criteria for HZ,HZ health service utilization-related questions,and sociodemographic information.Unmet healthcare needs were categorized as unmet outpatient and hospitalization care needs.Odds ratio(OR)was estimated from multivariable logistic regression modeling to assess the associations between HZ unmet healthcare needs and sociodemographic characteristics of individuals.This study ultimately completed 21,750 adult surveys(≥16 years old)in 25 PLADs across the country.Among them,a healthcare utilization survey was conducted for patients who had developed HZ in the past five years of the survey period,totaling 813 individuals.Results:Among 813 participants with HZ,28.78%had unmet outpatient care needs,and 36.36%of those who met the hospitalization criteria had unmet inpatient needs.Older adults had significantly lower odds of unmet outpatient needs,with an OR of 0.57[95%confidence interval(CI):0.40,0.81],compared with younger adults.In addition,urban residents had higher odds of unmet inpatient needs,with an OR of 2.18(95%CI:1.00–4.75).Conclusions:The findings indicate substantial unmet healthcare needs among patients with HZ,with significant variations observed across different age groups and residential regions.This study highlights the necessity of enhancing health literacy,with particular emphasis on improving the standardized diagnosis of HZ in rural areas and the standardized treatment among working-age residents with HZ.展开更多
Adaptive Traffic Signal Control(ATSC)adjusts signal timings to real-time traffic measure ments,increasing operational efficiency within a network.However,ATSC is both expen sive to install and operate making it infeas...Adaptive Traffic Signal Control(ATSC)adjusts signal timings to real-time traffic measure ments,increasing operational efficiency within a network.However,ATSC is both expen sive to install and operate making it infeasible to deploy at all signalized intersections within a network.This study presents a bi-level optimization framework that applies heuristic methods to identify a limited set of locations for ATSC deployment within an urban network.At the upper-level,the Population Based Incremental Learning(PBIL)algo rithm is employed to generate,evaluate,learn,and update different ATSC configurations.The lower-level uses the delay-based Max-Pressure algorithm to simulate the ATSC config uration within a microsimulation platform.The study proposes improvements to the PBIL algorithm by considering constraints on the maximum number of intersections for ATSC deployment and incorporates prior information about the intersection performance(i.e.,informed search).Simulation results on the traffic network of State College,PA reveal that the proposed PBIL algorithm consistently outperforms baseline methods that select loca tions only based on queue-lengths or delays in terms of reducing overall network travel times.The study also reveals that intersections experiencing the highest delays or longest queues are not always the best candidates for ATSC.Moreover,applying ATSC at all inter sections does not always provide the best performance;in fact,ATSC applied to some loca tions could increase travel times by contributing additional congestion downstream.Additionally,the modified PBIL algorithm with the informed search strategy is more effi cient at identifying promising solutions suggesting it can be readily applied to more gen eralized optimization problems.展开更多
In this paper, we review recent emerging theoretical and technological advances of artificial intelligence （AI） in the big data settings. We conclude that integrating data-driven machine learning with human knowled...In this paper, we review recent emerging theoretical and technological advances of artificial intelligence （AI） in the big data settings. We conclude that integrating data-driven machine learning with human knowledge （common priors or implicit intuitions） can effectively lead to explainable, robust, and general AI, as follows： from shallow computation to deep neural reasoning; from merely data-driven model to data-driven with structured logic rules models; from task-oriented （domain-specific） intelligence （adherence to explicit instructions） to artificial general intelligence in a general context （the capability to learn from experience）. Motivated by such endeavors, the next generation of AI, namely AI 2.0, is positioned to reinvent computing itself, to transform big data into structured knowledge, and to enable better decision-making for our society.展开更多
We read with great interest the recent article titled“Prevalence and related factors of antenatal depression in 11 provinces and cities of China:a 100,000 population-based study”[1],published in Science Bulletin.We ...We read with great interest the recent article titled“Prevalence and related factors of antenatal depression in 11 provinces and cities of China:a 100,000 population-based study”[1],published in Science Bulletin.We would like to make several comments that may enhance the interpretation of the findings and inform future research in this area.展开更多
文摘Type 2 diabetes(T2D)is a global public health issue.In 2021,537 million adults were diagnosed with T2D,corresponding to 10.5%of adults aged 20 and older.^(1)T2D increases the risks for morbidity,disability,and premature mortality,which increased by 3%between 2000 and 2019.2 Evidence is strong that maintaining a healthy diet,engaging in regular physical activity(PA),and preventing obesity can prevent or delay the incidence of T2D.
基金supported by the National Basic Research Program of China(No.2012CB944600)the National Key Research and Development Program of China(No.2016YFC0905100)+1 种基金the National Natural Science Foundation of China(Nos.31521003,31625015,31571297,31601046,31525014 and 91331204)the Science and Technology Commission of Shanghai Municipality(No.16YF1413900)
文摘Human genetic variants have long been known to play an important role in both Mendelian disorders and common diseases. Notably, pathogenic variants are not limited to single-nucleotide variants. It has become apparent that human diseases can also be caused by copy number variations （CNVs）, especially patient- specific novel CNVs （lafrate et al., 2004; Sebat et al., 2004; Redon et al., 2006; LuDski, 2007; Zhan~ et al.. 2009： Wu et al.. 2015）.
基金financially supported by Special Funds of the State Environmental Protection Public Welfare Industry(201009049201309049)+1 种基金National Key Technology Research and Development Program of the Ministry of Science and Technology of China(2013BAI12B03)the Fundamental Research Funds for the Central Universities(2015JBM108)
文摘A survey involving 6103 participants from five Chinese provinces was conducted to evaluate the threshold value of urinary cadmium （UCd） for renal dysfunction as benchmark dose low （BMDL）. The urinary N-acetyl-13-D-glucosaminidase （UNAG） was chosen as an effect biomarker. The UCd BMDLs for UNAG ranged from 2.18μg/g creatinine （cr） to 4.26μg/g cr in the populations of different provinces. The selection of the sample population and area affect the evaluation of the BMDL. The reference level of UCd for renal effects was further evaluated based on the data of all 6103 subjects. With benchmark responses （BMR） of 10%/5%, the overall UCd BMDLs for males in the total population were 3.73/2.08 μg/g cr. The BMD was slightly lower in females, thereby indicating that females may be relatively more sensitive to Cd exposure than are males.
基金supported by the STI2030-Major Projects(2021ZD0200700)the National Key Research and Development Program of China(2021YFC2701600 and 2022YFC2703500)+10 种基金the National Natural Science Foundation of China(82088102 and 82301719)Science and Technology Innovation Fund of Shanghai Jiao Tong University(YG2020YQ29)Collaborative Innovation Program of Shanghai Municipal Health Commission(2020CXJQ01)Shanghai Municipal Commission of Health(20224Y0085 and 202340222)Open Fund Project of Guangdong Academy of Medical Sciences(YKY-KF202202)CAMS Innovation Fund for Medical Sciences(2019-I2M-5-064)Shanghai Clinical Research Center for Gynecological Diseases(22MC1940200)Shanghai Urogenital Sys-tem Diseases Research Center(2022ZZ01012)Key Discipline Con-struction Project(2023-2025)of Three-Year Initiative Plan for Strengthening Public Health System Construction in Shanghai(GWVI-11.1-35 and GWVI-11.2-YQ29)Shanghai Sailing Program(22YF1453100)Shanghai Frontiers Science Research Base of Reproduction and Development.
文摘Antenatal depression is a significant contributor to maternal morbidity in the perinatal period[1].It has also been associated with an increased risk for premature delivery,decreased rates of breastfeeding initiation,and a broad range of adverse child out-comes,including emotional problems,externalizing difficulties,attachment issues,and poorer cognitive development[2-6]Depression in the antenatal period may persist postnatally and increase in severity further exacerbating the negative conse-quences.There are considerable geographical differences in ante-natal depression prevalence rates across China,ranging from 9.8%to 35.4%,which is likely due to variations in demographic,lifestyle,social,and economic factors[7,8].Heterogeneity in study design and data source has also resulted in these wide variations.Further,previous Chinese studies examining antenatal depression have been limited due to relatively small sample sizes,short study peri-ods,and a focus on only one specific geographical district.Limited prevalence data in China suggest that a large-scale multi-center study is warranted.
基金supported by Shandong Province Traditional Chinese Medicine Science and Technology Program(M-2022254)Shandong First Medical University(Shandong Academy of Medical Sciences)Youth Science Fund Cultivation and Support Program(202201-127)+1 种基金High Level Key Discipline Construction Project of the State Administration of Traditional Chinese Medicine(zyyzdxk-2023123)the Major Science and Technology Innovation Project of Shandong Province(2022CXGC020510,2024CXGC010609).
文摘Chronic body pain and depression,two major global health concerns,frequently co-occur and collectively impair individuals'well-being,compromising their ability to maintain an independent lifestyle and social relationships[1].A global study of pain prevalence among 52 countries indicated the overall prevalence of pain was estimated to be 27.5%[2],with significant variation across countries(9.9%-50.3%).
基金supported by the National Natural Science Foundation of China(No.82470820)Innovative Research Team of High-level Local Universities in Shanghai(China)(No.SHSMU-ZDCX20212501)+2 种基金Cross-disciplinary Research Fund of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine(China)(No.JYJC202412)Natural Science Foundation of Shanghai(China)(No.22ZR1436600)Clinical Research Program of 9th People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine(China)(No.JYLJ202307).
文摘17ɑ-hydroxylase/17,20-lyase deficiency(17OHD)was caused by mutations in the CYP17A1 gene.It was a rare form of congenital adrenal hyperplasia with an estimated incidence of about 1:50,000.The clinical manifestation of 17OHD includes hypertension and hypokalemia due to excessive synthesis of mineralocorticoid precursors,undermasculinized external genitalia in 46,XY males,and primary amenorrhea in 46,XX females.
基金supported by the Noncommunicable Chronic Diseases‐National Science and Technology Major Project(No.2023ZD0502602)the CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2024‐I2M‐C&T‐B‐057)+1 种基金the Beijing Natural Science Foundation(Grant No.L234043)the Natural Science Foundation of China(Grant Nos.81872160,82102887,82103047,and 82173328).
文摘Background:Breast cancer is the most common malignancy and a leading cause of cancer‐related deaths among women worldwide.Although treatment advances have improved outcomes,the 5‐year survival rate for metastatic breast cancer remains low.Understanding the anatomical distribution,associated risks,and prognostic features of metastases in patients with newly diagnosed stage IV breast cancer is essential for improving clinical management.This study aims to comprehensively investigate these aspects using data from the SEER database.Methods:This study utilized a retrospective cohort design,examining data from the Surveillance,Epidemiology,and End Results(SEER)database.The investigation considered patients diagnosed with stage IV breast cancer from SEER database.Using logistic regression,odds ratios(ORs)were calculated to determine the risk of various metastases,stratified based on sociodemographic and clinicopathological variables.Survival analyses were executed with Kaplan–Meier methodology in tandem with Cox regression analyses.Results:Out of 356,789 breast cancer patients considered,18,036(5.06%)were diagnosed with de novo stage IV disease.Bone metastasis predominated with a composition ratio of 42.6%.Patients with the HR−/HER2+subtype exhibited the highest metastasis incidence at the time of diagnosis,constituting 8.7%of the entire cohort.Male patients displayed heightened susceptibility to bone,lung,and brain metastases compared to female counterparts.Hispanic individuals exhibited the highest propensity for brain metastases.Relative to other subtypes,the HR−/HER2−patients were more inclined toward lung metastases.Those with bone metastasis had a median survival period of 27 months.Grade III patients with brain or liver metastases faced the most adverse prognoses.A comprehensive profile detailing metastasis patterns by demographics,tumor site and stage,biology,and treatment was presented.Conclusions:This study represents the most comprehensive analysis of metastasis'anatomical distribution and prognosis in breast cancer,offering invaluable insights into metastatic tendencies and characteristics.
基金Supported by Young Scientists(B)(23790791)from Japan Society for the Promotion of Science
文摘AIM:To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease(NAFLD).METHODS:Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography.This study involved 11 714 apparently healthy Japanese men and women,18 to 83 years of age.NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d,known liver disease,or current use of medication.The revised criteria of the National Cholesterol Education Program Adult Treatment PanelⅢ were used to characterize the metabolic syndrome.RESULTS:NAFLD was detected in 32.2%(95%CI:31.0%-33.5%)of men(n=1874 of 5811)and in 8.7%(95%CI:8.0%-9.5%)of women(n=514 of 5903).Among obese people,the prevalence of NAFLD was as high as 67.3%(95%CI:64.8%-69.7%)in men and 45.8%(95%CI:41.7%-50.0%)in women.Although NAFLD was thought of as being the liver phenotype of metabolic syndrome,the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women.66.8%of men and 70.4%of women with NAFLD were not diagnosed with the metabolic syndrome.48.2%of men with NAFLD and 49.8%of women with NAFLD weren't overweight[body mass index(BMI)≥25 kg/m2].In the same way,68.6%of men with NAFLD and 37.9%of women with NAFLD weren't satisfied with abdominal classification(≥90 cm for men and≥80 cm for women).Next,authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome.The sensitivity of the definition"at least 1 criterion"was as good as 84.8%in men and 86.6%in women.Separating subjects by BMI,the sensitivity was higher in obese men and women than in non-obese men and women(92.3%vs 76.8%in men,96.1%vs 77.0%in women,respectively).CONCLUSION:Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome.
文摘Objective:Olfactory dysfunction is known to have significant social,psychological,and safety implications.Despite increasingly recognized prevalence,potential risk factors for olfactory loss have been arbitrarily documented and knowledge is limited in scale.The aim of this study is to identify potential demographic and exposure variables correlating with olfactory dysfunction.Methods:Cross-sectional analysis of the 2011-2012 and 2013-2014 editions of the National Health Examination and Nutrition Survey was performed.The utilized survey reports from a nationally representative sample of about 5000 persons each year located in counties across the United States.There is an interview and physical examination component which includes demographic,socioeconomic,dietary,and health-related questions as well as medical,dental,physiologic measurements,and laboratory tests.3594 adult respondents from 2011 to 2012 and 3708 respondents from 2013 to 2014 were identified from the above population-based database.The frequency of self-reported disorders as well as performance on odor identification testing was determined in relation to demographic factors,occupational or environmental exposures,and urinary levels of environmental and industrial compounds.Results:In both subjective and objective analysis,smell disorders were significantly more common with increasing age.While the non-Hispanic Black and non-Hispanic Asian populations were less likely to report subjective olfactory loss,they,along with Hispanics,performed more poorly on odor identification than Caucasians.Those with limited education had a decreased prevalence of hyposmia.Women outperformed men on smell testing.Those reporting exposure to vapors were more likely to experience olfactory dysfunction,and urinary levels of manganese,2-Thioxothiazolidine-4-carboxylic acid,and 2-Aminothiazoline-4-carboxylic acid were lower among respondents with subjective smell disturbance.In odor detection,elevated serum levels of lead and urinary levels of 2,4 dichlorophenol were associated with anosmia and hyposmia,respectively.Conclusions:This study provides current,population-based data identifying demographic and exposure elements related to smell disturbances in U.S.adults.Age,race,gender,education,exposure to vapors,urinary levels of manganese,2-Thioxothiazolidine-4-carboxylic acid,2-Aminothiazoline-4-carboxylic acid,2,4 dichlorophenol,and serum lead levels were all implicated in smell disturbance.Care should be taken in interpretation due to lack of consistency between subjective and objective measures of olfaction as well as limitations related to population-based data.Prospective trials are indicated to further elucidate these relationships.
文摘Background The neonatal period is the most vulnerable period during childhood,with the risk of death being the highest even in developed countries/regions.Hong Kong’s neonatal mortality(1‰)is among the world’s lowest and has remained similar for 15 years.This study aimed to explore neonatal deaths in Hong Kong in detail and determine whether neonatal mortality is reducible at such a low level.Methods Live births in public hospitals in Hong Kong during 01 Jan 2006–31 Dec 2017 were included.Relevant data were extracted from the electronic medical records.Gestational age-specific mortality was calculated,and the trends were analyzed using the Cochran–Armitage trend test.Causes of death were summarized,and risk factors were identified in multivariate logistic regression analysis.Results In 490,034 live births,755 cases(1.54‰)died during the neonatal period,and 293(0.6‰)died during the post-neonatal period.The neonatal mortality remained similar overall(P=0.17)and among infants born at 24–29 weeks’gestation(P=0.4),while it decreased in those born at 23(P=0.04),30–36(P<0.001)and≥37(P<0.001)weeks’gestation.Neonates born at<27 weeks’gestation accounted for a significantly increased proportion among cases who died(27.6%to 51.9%),with hemorrhagic conditions(24%)being the leading cause of death.Congenital anomalies were the leading cause of death in neonates born≥27 weeks’gestation(52%),but its cause-specific mortality decreased(P=0.002,0.6‰to 0.41‰),with most of the decrease attributed to trisomy 13/18 and multiple anomalies.Conclusion Reduction of neonatal mortality in developed regions may heavily rely on improved quality of perinatal and neonatal care among extremely preterm infants.
基金by the Spain’s Carlos III Health Care Institute by means of project PI17/00837(Co-funded by European Regional Development Fund/European Social Fund"A way to make Europe"/"Investing in your future").
文摘BACKGROUND The implementation of a colorectal cancer(CRC)screening programme may increase the awareness of Primary Care Physicians,reduce the diagnostic delay in CRC detected outside the scope of the screening programme and thus improve prognosis.AIM To determine the effect of implementation of a CRC screening programme on diagnostic delays and prognosis of CRC detected outside the scope of a screening programme.METHODS We performed a retrospective intervention study with a pre-post design.We identified 322 patients with incident and confirmed CRC in the pre-implantation cohort(June 2014–May 2015)and 285 in the post-implantation cohort(June 2017-May 2018)in the Cancer Registry detected outside the scope of a CRC screening programme.In each patient we calculated the different healthcare diagnostics delays:global,primary and secondary healthcare,referral and colonoscopyrelated delays.In addition,we collected the initial healthcare that evaluated the patient,the home location(urban/rural),and the CRC stage at diagnosis.We determined the two-year survival and we performed a multivariate proportional hazard regression analysis to determine the variables associated with survival.RESULTS We did not detect any differences in the patient or CRC baseline-related variables.A total of 20.1%of patients was detected with metastatic disease.There was a significant increase in direct referral to colonoscopy from primary healthcare(25.5%,35.8%;P=0.04)in the post-implantation cohort.Diagnostic delay was reduced by 24 d(106.64±148.84 days,82.84±109.31 d;P=0.02)due to the reduction in secondary healthcare delay(46.01±111.65 d;29.20±60.83 d;P=0.02).However,we did not find any differences in CRC stage at diagnosis or in two-year survival(70.3%;P=0.9).Variables independently associated with twoyear risk of death were age(Hazard Ratio-HR:1.06,95%CI:1.04-1.07),CRC stage(II HR:2.17,95%CI:1.07-4.40;III HR:3.07,95%CI:1.56-6.08;IV HR:19.22,95%CI:9.86-37.44;unknown HR:9.24,95%CI:4.27-19.99),initial healthcare consultation(secondary HR:2.93,95%CI:1.01-8.55;emergency department HR:2.06,95%CI:0.67-6.34),hospitalization during the diagnostic process(HR:1.67,95%CI:1.17-2.38)and urban residence(HR:1.44,95%CI:1.06-1.98).CONCLUSION Although implementation of a CRC screening programme can reduce diagnostic delays for CRC detected in symptomatic patients,this has no effect on CRC stage or survival.
文摘Based on the noise survey in China ,the formula (H=H+N-HN/120 ) of ISO/DIS 1999.2 (' Acoustics - Determination of Occupational noise exposure and estimation of noise induced hearing impairment ' , 1985) was applied to the calculation of the hearing threshold level associated with age and noise (HTLAN) of the noise - impaired people . According to the Gausscian distribution , when the noise - exposure level LEX8h was 85 ,90 ,95, 100 dB and the hearing threshold frequency is from 0.5k to 6kHz , the HTLAN of noise - exposed people withdifferent duration of exposure and its relation values to the hearing threshold frequency associated with age (HTLA) were obtained . The ISO /DIS 1999.2 has been proved to be applicable in China .
基金supported by the National Key R&D Program of China (2022YFC3600805 and 2021YFC2501900)
文摘Background: Population-based cancer survival is a key metric in evaluating the overall effectiveness of health services and cancer control activities. Advancement in information technology enables accurate vital status tracking through multi-source data linkage. However, its reliability for survival estimates in China is unclear.Methods: We analyzed data from Dalian Cancer Registry to evaluate the reliability of multi-source data linkage for population-based cancer survival estimates in China. Newly diagnosed cancer patients in 2015 were included and followed until June 2021. We conducted single-source data linkage by linking patients to Dalian Vital Statistics System, and multi-source data linkage by further linking to Dalian Household Registration System and the hospital medical records. Patient vital status was subsequently determined through active follow-up via telephone calls, referred to as comprehensive follow-up, which served as the gold standard. Using the cohort method, we calculated 5-year observed survival and age-standardized relative survival for 20 cancer types and all cancers combined.Results: Compared to comprehensive follow-up, single-source data linkage overestimated 5-year observed survival by 3.2% for all cancers combined, ranging from 0.1% to 8.6% across 20 cancer types. Multi-source data linkage provided a relatively complete patient vital status, with an observed survival estimate of only 0.3% higher for all cancers, ranging from 0% to1.5% across 20 cancer types.Conclusion: Multi-source data linkage contributes to reliable population-based cancer survival estimates in China. Linkage of multiple databases might be of great value in improving the efficiency of follow-up and the quality of survival data for cancer patients in developing countries.
文摘Objective As populations age,multimorbidity and frailty have emerged as major health challenges.While their associations with disability and mortality are well documented,their impact on quality of life(QoL)in sub-Saharan Africa remains underexplored.We examined the associations between frailty,multimorbidity and QoL among older adults in Rwanda.Design A cross-sectional population-based study.Multimorbidity was defined as having two or more chronic conditions,including hypertension,diabetes,heart disease and mental health conditions.Frailty scores were derived using the Fried phenotype,and QoL was measured using the European Health Instrument Survey-Quality of Life index(scaled 0%–100%).Sequential linear regression models were used to examine independent associations.Setting Rural and urban settings of Rwanda.Participant We analysed data from 4369 adults(≥40 years).Results The mean QoL score was 48.2%(±15.6).Frailty and multimorbidity prevalence were 14.5%(95%CI 13.5 to 15.6)and 55.2%(95%CI 53.7 to 56.6),respectively,while 55.0%(95%CI 53.3 to 56.3)were classified as prefrail.Frailty and multimorbidity are independently associated with poorer QoL.Compared with robust individuals,prefrail and frail individuals experienced a 3.66(95%CI−4.63 to–2.70)and 7.30(95%CI−8.76 to–5.83)percentage point reduction in QoL,respectively.Multimorbidity was associated with a 4.66%(95%CI−5.54 to–3.79)point decrease in QoL.Impairments in activities of daily living partly mediated these associations.Conclusions Frailty and multimorbidity showed a strong negative association with QoL,with frailty having a stronger effect.These findings underscore the need for age-responsive healthcare strategies,including frailty screening and integrated chronic care,to enhance QoL among older adults in Rwanda.
文摘论著/OriginalArticle肝移植对糖尿病患者原有降糖药物的影响:一项基于人群的队列研究The effect of liver transplantation on anti-glycaemic agents in patients with pre-existing diabetes mellitus:A population-based cohort study Amy Coulden,Christina Antza,Orighomisan Awala,Nihit Shah,Leelavathy Kandaswamy.
文摘Introduction:Addressing the healthcare needs of the growing number of patients with herpes zoster(HZ)presents considerable challenges.This study examined the unmet healthcare needs and associated factors among people with HZ across 25 provincial-level administrative divisions(PLADs)and cities in China from 2019–2024.Methods:The study conducted a nationwide population-based survey using probabilityproportional-to-size sampling.The structured questionnaire incorporated validated diagnostic criteria for HZ,HZ health service utilization-related questions,and sociodemographic information.Unmet healthcare needs were categorized as unmet outpatient and hospitalization care needs.Odds ratio(OR)was estimated from multivariable logistic regression modeling to assess the associations between HZ unmet healthcare needs and sociodemographic characteristics of individuals.This study ultimately completed 21,750 adult surveys(≥16 years old)in 25 PLADs across the country.Among them,a healthcare utilization survey was conducted for patients who had developed HZ in the past five years of the survey period,totaling 813 individuals.Results:Among 813 participants with HZ,28.78%had unmet outpatient care needs,and 36.36%of those who met the hospitalization criteria had unmet inpatient needs.Older adults had significantly lower odds of unmet outpatient needs,with an OR of 0.57[95%confidence interval(CI):0.40,0.81],compared with younger adults.In addition,urban residents had higher odds of unmet inpatient needs,with an OR of 2.18(95%CI:1.00–4.75).Conclusions:The findings indicate substantial unmet healthcare needs among patients with HZ,with significant variations observed across different age groups and residential regions.This study highlights the necessity of enhancing health literacy,with particular emphasis on improving the standardized diagnosis of HZ in rural areas and the standardized treatment among working-age residents with HZ.
基金This research was supported by NSF Grant CMMI-1749200.
文摘Adaptive Traffic Signal Control(ATSC)adjusts signal timings to real-time traffic measure ments,increasing operational efficiency within a network.However,ATSC is both expen sive to install and operate making it infeasible to deploy at all signalized intersections within a network.This study presents a bi-level optimization framework that applies heuristic methods to identify a limited set of locations for ATSC deployment within an urban network.At the upper-level,the Population Based Incremental Learning(PBIL)algo rithm is employed to generate,evaluate,learn,and update different ATSC configurations.The lower-level uses the delay-based Max-Pressure algorithm to simulate the ATSC config uration within a microsimulation platform.The study proposes improvements to the PBIL algorithm by considering constraints on the maximum number of intersections for ATSC deployment and incorporates prior information about the intersection performance(i.e.,informed search).Simulation results on the traffic network of State College,PA reveal that the proposed PBIL algorithm consistently outperforms baseline methods that select loca tions only based on queue-lengths or delays in terms of reducing overall network travel times.The study also reveals that intersections experiencing the highest delays or longest queues are not always the best candidates for ATSC.Moreover,applying ATSC at all inter sections does not always provide the best performance;in fact,ATSC applied to some loca tions could increase travel times by contributing additional congestion downstream.Additionally,the modified PBIL algorithm with the informed search strategy is more effi cient at identifying promising solutions suggesting it can be readily applied to more gen eralized optimization problems.
文摘In this paper, we review recent emerging theoretical and technological advances of artificial intelligence （AI） in the big data settings. We conclude that integrating data-driven machine learning with human knowledge （common priors or implicit intuitions） can effectively lead to explainable, robust, and general AI, as follows： from shallow computation to deep neural reasoning; from merely data-driven model to data-driven with structured logic rules models; from task-oriented （domain-specific） intelligence （adherence to explicit instructions） to artificial general intelligence in a general context （the capability to learn from experience）. Motivated by such endeavors, the next generation of AI, namely AI 2.0, is positioned to reinvent computing itself, to transform big data into structured knowledge, and to enable better decision-making for our society.
文摘We read with great interest the recent article titled“Prevalence and related factors of antenatal depression in 11 provinces and cities of China:a 100,000 population-based study”[1],published in Science Bulletin.We would like to make several comments that may enhance the interpretation of the findings and inform future research in this area.
