Pancreatic cancer is a serious growing health issue in developed countries.For patients diagnosed with pancreatic cancer,the five year survival rate is below 5%.One major important reason leads to the poor survival ra...Pancreatic cancer is a serious growing health issue in developed countries.For patients diagnosed with pancreatic cancer,the five year survival rate is below 5%.One major important reason leads to the poor survival rate is lack of early detection of pancreatic cancer.Over 80% of the patients are diagnosed in advanced disease stages.Screening for pancreatic cancer is a desirable option for high risk individuals to allow early detection and treatment of curable pancreatic neoplasms at a pre-invasive stage.This article highlights the need,endpoint,population,method,diagnostic yield,and the problems of current screening programs.展开更多
A study of precancerous gastric lesion was conducted in a randomly selected high risk population in Linqu, Shandong Province of China. 849 subjects aged from 30-64 were examined bioptically. There were 8 cases of gast...A study of precancerous gastric lesion was conducted in a randomly selected high risk population in Linqu, Shandong Province of China. 849 subjects aged from 30-64 were examined bioptically. There were 8 cases of gastric cancer, the prevalence rate was 0.9%. 169 subjects were diagnosed to be dysplasia, the prevalence rate of dysplasia was increased significantly with age. The regression equation was Y=0.47X-0.25. The prevalence of CAG was found in 36 per cent of the studied subjects and both dysplasia and CAG were more serious in the antrum than the. fundus. The results showed a natural history of precancerous gastric lesions in a high risk population in a high risk area.展开更多
A prospective study was done by the examination of nasopharyngoscope, reaction of EB virus's antigens and antibodies, nasopharyngofibroscope, pathological and EB virus's DNA, EBERs, etc. of about 100000 person...A prospective study was done by the examination of nasopharyngoscope, reaction of EB virus's antigens and antibodies, nasopharyngofibroscope, pathological and EB virus's DNA, EBERs, etc. of about 100000 persons in high risk area of NPC in Guangdong Province, China from 1986 to 1995. If any one of the following four conditions is present in some persons, i.e., (1) EBV VCA/IgA titer>1:80, (2) EBV EDAb>60%, (3) Dual or triple positiveness in VCA/IgA, EA/IgA and EDAb, (4) Any one of VCA/IgA, EA/IgA and EDAb keeps high titer or going up, they should be regarded as in precancerosis of NPC. The moderate or severe heteroplasia and heterometaplasia of nasopharyngeal mucosa are the precancerous lesions of NPC. Some individual who is in precancerosis or with precancerous lesion should be regarded as the high risk population of NPC. The results are of important scientific basis for screening and second degree prevention of NPC.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
Dear Editor： Increased homocysteine levels due to vitamin B6 or B12 deficiency or genetic defects in folate pathway genes are associated with an increased incidence of non-syndromic cleft lip with or without cleft p...Dear Editor： Increased homocysteine levels due to vitamin B6 or B12 deficiency or genetic defects in folate pathway genes are associated with an increased incidence of non-syndromic cleft lip with or without cleft palate （NSCLP）tlj. Thymidylate synthase （TS） is a folate-dependent enzyme that catalyzes methylation of 2＇-deoxyuridine-5＇-monophosphate （dUMP） to 2＇-deox- ythymidine-5＇-monophosphate （dTMP）, a rate-limiting step in DNA synthesis,展开更多
Objectives Mu Lao Zu population.Methods A total of 1055 subjects of Mu Lao Zu were studied by a stratified randomized cluster sampling.Blood pressure,body height, body weight,waist circumference and serum lipid and ap...Objectives Mu Lao Zu population.Methods A total of 1055 subjects of Mu Lao Zu were studied by a stratified randomized cluster sampling.Blood pressure,body height, body weight,waist circumference and serum lipid and apolipoprotein(Apo) levels were measured.The data were compared with those in 969 subjects of Han Chinese from the same region.In order to evaluate the association of hyperlipidemia with nine possible riks factors,multivariate logistic regression analysis was also performed in the combined population of Mu Lao Zu and Han,Mu Lao Zu,and Han;respectively. Results The levels of total cholesterol,triglyceride, low-density lipoprotein cholesterol and ApoB in Mu Lao Zu were significantly higher than those in Han(P【0.05-0.001); but the levels of high-density lipoprotein cholesterol,ApoA1 and ApoA1/Apo were significantly lower than those in Han (P【0.001 ).The prevalence of hyperlipidemia and Hypercholesterolemia was also significantly higher in Mu Lao Zu than in Han(53.0%vs.46.1%,P【0.001) and(44.5%vs. 37.5%,P【0.001).There was no difference in the prevalence of hypertriglyceridemia between the both ethnic groups (22.8%vs.19.4%,P】0.05).Hyperlipidemia was positively correlated with age,BMI,and systolic blood pressureMu Lao Zu(P【0.05),whereas it was positively correlated with BMI and hypertension in Han(P【0.05 for each).Conclusions The serum lipid profiles,the prevalence of hyperlipidemia and the risk factors are different between the Mu Lao Zu and Han populations.The differences in serum lipid profiles between the two ethnic groups might result from different dietary habit,life style,as well as genetic factors,in ? To determine the serum lipid levels and their risk factors in the Guangxi.展开更多
In this study,the future landslide population amount risk(LPAR)is assessed based on integrated machine learning models(MLMs)and scenario simulation techniques in Shuicheng County,China.Firstly,multiple MLMs were selec...In this study,the future landslide population amount risk(LPAR)is assessed based on integrated machine learning models(MLMs)and scenario simulation techniques in Shuicheng County,China.Firstly,multiple MLMs were selected and hyperparameters were optimized,and the generated 11 models were crossintegrated to select the best model to calculate landslide susceptibility;by calculating precipitation for different extreme precipitation recurrence periods and combining the susceptibility results to assess the landslide hazard.Using the town as the basic unit,the exposure and vulnerability of the future landslide population under different Shared Socioeconomic Pathways(SSPs)scenarios in each town were assessed,and then combined with the hazard to estimate the LPAR in 2050.The results showed that the integrated model with the optimized random forest model as the combination strategy had the best comprehensive performance in susceptibility assessment.The distribution of hazard classes is similar to susceptibility,and with an increase in precipitation,the low-hazard area and high-hazard decrease and shift to medium-hazard and very high-hazard classes.The high-risk areas for future landslide populations in Shuicheng County are mainly concentrated in the three southwestern towns with high vulnerability,whereas the northern towns of Baohua and Qinglin are at the lowest risk class.The LPAR increased with the intensity of extreme precipitation.The LPAR differs significantly among the SSPs scenarios,with the lowest in the“fossil-fueled development(SSP5)”scenario and the highest in the“regional rivalry(SSP3)”scenario.In summary,the landslide susceptibility model based on integrated machine learning proposed in this study has a high predictive capability.The results of future LPAR assessment can provide theoretical guidance for relevant departments to cope with future socioeconomic development challenges and make corresponding disaster prevention and mitigation plans to prevent landslide risks from a developmental perspective.展开更多
Familial colorectal cancer constitutes a heterogeneous group of patients in whom the underlying molecular mechanism is still unknown.Predisposition to a such neoplasms in this setting seems to be due to common low-pen...Familial colorectal cancer constitutes a heterogeneous group of patients in whom the underlying molecular mechanism is still unknown.Predisposition to a such neoplasms in this setting seems to be due to common low-penetrance genetic components,but the role of genetic testing in clinical practice has to be determined.Although screening guidelines in this moderate-risk population are empiric,data obtained in epidemiologic,meta-analyses and cohort studies and,more recently,the increased risk of advanced adenomas in first degree relatives who underwent screening colonoscopy support the need to include these individuals in specific screening programs.However,data to determine what test to use,how often to use and which organizational strategy to implement are needed.At present,screening uptake in this population is less than optimal;offering the opportunity to access to screening and improving screening uptake is a first significant step.展开更多
Background:Solid fuel use is the major source of household air pollution(HAP)and accounts for a substantial burden of morbidity and mortality in low and middle income countries.To evaluate and compare childhood mortal...Background:Solid fuel use is the major source of household air pollution(HAP)and accounts for a substantial burden of morbidity and mortality in low and middle income countries.To evaluate and compare childhood mortality attributable to HAP in four South Asian countries.Methods:A series of Demographic and Health Survey(DHS)datasets for Bangladesh,India,Nepal and Pakistan were used for analysis.Estimates of relative risk and exposure prevalence relating to use of cooking fuel and under-five mortality were used to calculate population attributable fractions(PAFs)for each country.Potential impact fractions(PIFs)were also calculated assessing theoretical scenarios based on published interventions aiming to reduce exposure prevalence.Results:There are an increased risk of under-five mortality in those exposed to cooking fuel compared to those not exposed in the four South Asian countries(OR=1.30,95%CI=1.07-1.57,P=0.007).Combined PAF estimates for South Asia found that 66%(95%CI:43.1-81.5%)of the 13,290 estimated cases of under-five mortality was attributable to HAP.Joint PIF estimates(assuming achievable reductions in HAP reported in intervention studies conducted in South Asia)indicates 47%of neonatal and 43%of under-five mortality cases associated with HAP could be avoidable in the four South Asian countries studied.Conclusions:Elimination of exposure to use of cooking fuel in the household targeting valuable intervention strategies(such as cooking in separate kitchen,improved cook stoves)could reduce substantially under-five mortality in South Asian countries.展开更多
Coping with extreme climate events and its related climatic disasters caused by climate change has become a global issue and drew wide attention from scientists, policy-makers and public. This paper calculated the exp...Coping with extreme climate events and its related climatic disasters caused by climate change has become a global issue and drew wide attention from scientists, policy-makers and public. This paper calculated the expected annual multiple climatic hazards intensity index based on the results of nine climatic hazards including tropical cyclone, flood, landslide, storm surge, sand-dust storm, drought, heat wave, cold wave and wildfire. Then a vulnerability model involving the coping capacity indicator with mortality rate, affected population rate and GDP loss rate, was developed to estimate the expected annual affected population, mortality and GDP loss risks. The results showed that： countries with the highest risks are also the countries with large population or GDP. To substantially reduce the global total climatic hazards risks, these countries should reduce the exposure and improving the governance of integrated climatic risk; Without considering the total exposure, countries with the high mortality rate, affected population rate or GDP loss rate, which also have higher or lower coping capacity, such as the Philippines, Bangladesh and Vietnam, are the hotspots of the planning and strategy making for the climatic disaster risk reduction and should focus on promoting the coping capacity.展开更多
Objective: To investigate the prevalence of term low birth weight (TLBW) and its risk factors. Methods: A follow-up study with 7, 872 couples was conducted from 1987 to 199o beginning from the time they got marriage l...Objective: To investigate the prevalence of term low birth weight (TLBW) and its risk factors. Methods: A follow-up study with 7, 872 couples was conducted from 1987 to 199o beginning from the time they got marriage licenses in two districts defined in Shanghai. They were interviewed in the third month and again in the fifteenth month and in the fifth to sixth year afterwards individually at home. The total follow up rate reached 98%. Couple’s background characteristics as well as the information on their general health. reproductivc history and contraceptive use etc.. were collected dynamically. All of the single live births with term delivery were Included for data analysis in this paper. Adjusted odd ratios and population attributable risk (PAR%) were computed. Results: The prevalence of TLBW in Shanghai single term live births was 2. 0% (134,/6.573), represents 54. 7% (134/245) of the total low birth weights in our sam pie. Significant social and behaviour risk factors relating with TI-BW were wife’s dissat- isfaction with marriage; low education level of husband; co-residence with parents during pregnancy; heavy housework done by the wife while being pregnant. Significant biomedical risky factors were menarche age greater than 16 years old; maternal age at delivery greater than 29 years old; maternal body mass index less than 19. 8; wife suf- fered from serious disease prior to conceiving; having pregnancy complication; gestational weight gain less than 20 % of pre-pregnancy weight; having abortion, stillbirth and fetal death history. Conclusion: TL.BW constituted over half of all low birth weights in Shanghai. Special attention should be paid to the determinants mentioned above in TLBW intervention program. Improving couples’ economic and living condition and husband ’s education at tainment, and caloric supplementation with women while being pregnant would all be particularly effective in reducing the occurrence of TLBW in Shnaghai.展开更多
Objective To study the differences in blood pressure (BP) levels and the main factors raising BP among the population in Guangdong Province. Methods The data analyzed stem from the sampling survey of hypertension in G...Objective To study the differences in blood pressure (BP) levels and the main factors raising BP among the population in Guangdong Province. Methods The data analyzed stem from the sampling survey of hypertension in Guangdong Province in 1991, covering 42, 894 subjects over 15 years old. Individual characteristics included age, sex, occupation, education, smoking, alcohol drinking and body mass index (BMI) . Results Systolic and diastolic BP increased with age. The hypertension prevalence rate in male is higher than in female. The age - adjusted prevalence rate in office personnel is the highest (12.9 % ) among all occupations. It was increased with education level and BMI (in people educated at university and over is 13. 1 % ), and higher in smokers and alcohol-drinkers than non-smokers and non -alcohol-drinkers. Conclusions Age, occupation, education, smoking, alcohol drinking and BMI all effect BP. These risk factors should be reduced in the Guangdong population.展开更多
Objective To explore the relationship between hypertriglyceridemic-waist(HTWC)phenotype and clustering of cardiovascular risk factors in middle and aged population.Methods A community-based cross-sectional survey was ...Objective To explore the relationship between hypertriglyceridemic-waist(HTWC)phenotype and clustering of cardiovascular risk factors in middle and aged population.Methods A community-based cross-sectional survey was conducted in 5 communities of Chengdu city from 2013-10 to 2014-05 and 1004 subjects from(40-79)years of age were investigated.HTWC was de-展开更多
In recent years,the issue of PM_(2.5)-O_(3)compound pollution has become a significant global environmental concern.This study examines the spatial and temporal patterns of global PM_(2.5)-O_(3)compound pollution and ...In recent years,the issue of PM_(2.5)-O_(3)compound pollution has become a significant global environmental concern.This study examines the spatial and temporal patterns of global PM_(2.5)-O_(3)compound pollution and exposure risks,firstly at the global and urban scale,using spatial statistical regression,exposure risk assessment,and trend analyses based on the datasets of daily PM_(2.5)and surface O_(3)concentrations monitored in 120 cities around the world from 2019 to 2022.Additionally,on the basis of the common emission sources,spatial heterogeneity,interacting chemical mechanisms,and synergistic exposure risk levels between PM_(2.5)and O_(3)pollution,we proposed a synergistic PM_(2.5)-O_(3)control framework for the joint control of PM_(2.5)and O3.The results indicated that:(1)Nearly 50%of cities worldwide were affected by PM_(2.5)-O_(3)compound pollution,with China,South Korea,Japan,and India being the global hotspots for PM2.5-O3 compound pollution;(2)Cities with PM_(2.5)-O_(3)compound pollution have exposure risk levels dominated by ST t ST(Stabilization)and ST t HR(High Risk).Exposure risk levels of compound pollution in developing countries are significantly higher than those in developed countries,with unequal exposure characteristics;(3)The selected cities showed significant positive spatial correlations between PM_(2.5)and O_(3)concentrations,which were consistent with the spatial distribution of the precursors NOx and VOCs;(4)During the study period,52.5%of cities worldwide achieved synergistic reductions in annual average PM_(2.5)and O_(3)concentrations.The average PM_(2.5)concentration in these cities decreased by 13.97%,while the average O_(3)concentration decreased by 19.18%.This new solution offers the opportunity to construct intelligent and healthy cities in the upcoming low–carbon transition.展开更多
Screening for liver cancer(hepatocellular carcinoma)in China started in early 1970s with the application of alpha-fetoprotein(AFP)in high-incidence regions.It has been extended to nationwide areas,emerging from the co...Screening for liver cancer(hepatocellular carcinoma)in China started in early 1970s with the application of alpha-fetoprotein(AFP)in high-incidence regions.It has been extended to nationwide areas,emerging from the concepts of conducting screening in populations at-risk with positive hepatitis B surface antigen to the practice programs in rural and urban areas,and finally to the development of recommendations to guide medical practice for health care providers.The implementation of screening for liver cancer has resulted in earlier detection and hence the early curable treatment for patients who have gained short-or long-term survival,and even reduction in mortality rates,although these outcomes are more anecdotal than rigorously evidence-based.AFP or ultrasound examination has been considered as sensitive and specific methods for early detection but are with limitations.The combined use of these two modalities for screening populations at-risk every six months seems to have been reached consensus.The feasibility of screening for liver cancer is still debated because of differing opinions and even opposition to the choice of targeted sub-populations,the intrinsic necessity,and the contributions of the main risk factors among Western countries and China/Asian areas.Yet,the over 51%of global burden of liver cancer is in China,the solution to the early detection and treatment of liver cancer should fully consider the actual situation in China.The effectiveness of screening for liver cancer is worthy of anticipation.展开更多
Objective: Stroke is the leading cause of death and disability, and is closely related to a lack of exercise. Currently, most Chinese medical staff members lack exercise and may be at risk for stroke. We sought to det...Objective: Stroke is the leading cause of death and disability, and is closely related to a lack of exercise. Currently, most Chinese medical staff members lack exercise and may be at risk for stroke. We sought to determine the risk factors for stroke and study the significance of health-related physical fitness testing in stroke prevention among Chinese medical staff members. Methods: A total of 627 subjects from Urumqi, Xinjiang, China, were included in the study and a survey was conducted from 1st January 2016 to 1st February 2016. Stroke screening and health-related physical fitness testing were completed according to the standard protocol, and the related data were analyzed. Results: Based on the screening, 27.6%(n=173) of the subjects were at high risk for stroke. The top risk factors for stroke in these subjects were dyslipidemia, lack of exercise or mild physical activity, being overweight or obese, and high blood pressure. Body weight, body mass index, body fat, visceral fat area, body fat percentage, and basal metabolic rate were significantly higher (P<0.01) in subjects at high risk for stroke than in subjects who were not at high risk. Lung capacity, step index, grip test, vertical jump, and sit-up/push-up index were significantly lower (P<0.01) in subjects at high risk for stroke than in subjects who were not at high risk. Conclusions: A large proportion of China's on-the-job medical personnel is at high risk for stroke. This may be related to the nature of the profession and warrants more attention from the society. The health-related physical fitness measurement parameters in subjects at high risk for stroke were significantly different from those in subjects who were not at high risk. Screening and health-related physical fitness testing in medical staff members may contribute to stroke prevention. More rigorous controlled clinical trials will be needed in the future.展开更多
Purpose–The purpose of this paper is to investigate the influence of driver demographic characteristics on the driving safety involving cell phone usages.Design/methodology/approach–A total of 1,432 crashes and 19,71...Purpose–The purpose of this paper is to investigate the influence of driver demographic characteristics on the driving safety involving cell phone usages.Design/methodology/approach–A total of 1,432 crashes and 19,714 baselines were collected for the Strategic Highway Research Program 2 naturalistic driving research.The authors used a case-control approach to estimate the prevalence and the population attributable risk percentage.The mixed logistic regression model is used to evaluate the correlation between different driver demographic characteristics(age,driving experience or their combination)and the crash risk regarding cell phone engagements,as well as the correlation among the likelihood of the cell phone engagement during the driving,multiple driver demographic characteristics(gender,age and driving experience)and environment conditions.Findings–Senior drivers face an extremely high crash risk when distracted by cell phone during driving,but they are not involved in crashes at a large scale.On the contrary,cell phone usages account for a far larger percentage of total crashes for young drivers.Similarly,experienced drivers and experienced-middle-aged drivers seem less likely to be impacted by the cell phone while driving,and cell phone engagements are attributed to a lower percentage of total crashes for them.Furthermore,experienced,senior or male drivers are less likely to engage in cell phone-related secondary tasks while driving.Originality/value–The results provide support to guide countermeasures and vehicle design.展开更多
文摘Pancreatic cancer is a serious growing health issue in developed countries.For patients diagnosed with pancreatic cancer,the five year survival rate is below 5%.One major important reason leads to the poor survival rate is lack of early detection of pancreatic cancer.Over 80% of the patients are diagnosed in advanced disease stages.Screening for pancreatic cancer is a desirable option for high risk individuals to allow early detection and treatment of curable pancreatic neoplasms at a pre-invasive stage.This article highlights the need,endpoint,population,method,diagnostic yield,and the problems of current screening programs.
文摘A study of precancerous gastric lesion was conducted in a randomly selected high risk population in Linqu, Shandong Province of China. 849 subjects aged from 30-64 were examined bioptically. There were 8 cases of gastric cancer, the prevalence rate was 0.9%. 169 subjects were diagnosed to be dysplasia, the prevalence rate of dysplasia was increased significantly with age. The regression equation was Y=0.47X-0.25. The prevalence of CAG was found in 36 per cent of the studied subjects and both dysplasia and CAG were more serious in the antrum than the. fundus. The results showed a natural history of precancerous gastric lesions in a high risk population in a high risk area.
文摘A prospective study was done by the examination of nasopharyngoscope, reaction of EB virus's antigens and antibodies, nasopharyngofibroscope, pathological and EB virus's DNA, EBERs, etc. of about 100000 persons in high risk area of NPC in Guangdong Province, China from 1986 to 1995. If any one of the following four conditions is present in some persons, i.e., (1) EBV VCA/IgA titer>1:80, (2) EBV EDAb>60%, (3) Dual or triple positiveness in VCA/IgA, EA/IgA and EDAb, (4) Any one of VCA/IgA, EA/IgA and EDAb keeps high titer or going up, they should be regarded as in precancerosis of NPC. The moderate or severe heteroplasia and heterometaplasia of nasopharyngeal mucosa are the precancerous lesions of NPC. Some individual who is in precancerosis or with precancerous lesion should be regarded as the high risk population of NPC. The results are of important scientific basis for screening and second degree prevention of NPC.
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funding from the Indian Council of Medical Research(ICMR),Government of India(Project Ref.No.56/15/2007-BMS)
文摘Dear Editor： Increased homocysteine levels due to vitamin B6 or B12 deficiency or genetic defects in folate pathway genes are associated with an increased incidence of non-syndromic cleft lip with or without cleft palate （NSCLP）tlj. Thymidylate synthase （TS） is a folate-dependent enzyme that catalyzes methylation of 2＇-deoxyuridine-5＇-monophosphate （dUMP） to 2＇-deox- ythymidine-5＇-monophosphate （dTMP）, a rate-limiting step in DNA synthesis,
文摘Objectives Mu Lao Zu population.Methods A total of 1055 subjects of Mu Lao Zu were studied by a stratified randomized cluster sampling.Blood pressure,body height, body weight,waist circumference and serum lipid and apolipoprotein(Apo) levels were measured.The data were compared with those in 969 subjects of Han Chinese from the same region.In order to evaluate the association of hyperlipidemia with nine possible riks factors,multivariate logistic regression analysis was also performed in the combined population of Mu Lao Zu and Han,Mu Lao Zu,and Han;respectively. Results The levels of total cholesterol,triglyceride, low-density lipoprotein cholesterol and ApoB in Mu Lao Zu were significantly higher than those in Han(P【0.05-0.001); but the levels of high-density lipoprotein cholesterol,ApoA1 and ApoA1/Apo were significantly lower than those in Han (P【0.001 ).The prevalence of hyperlipidemia and Hypercholesterolemia was also significantly higher in Mu Lao Zu than in Han(53.0%vs.46.1%,P【0.001) and(44.5%vs. 37.5%,P【0.001).There was no difference in the prevalence of hypertriglyceridemia between the both ethnic groups (22.8%vs.19.4%,P】0.05).Hyperlipidemia was positively correlated with age,BMI,and systolic blood pressureMu Lao Zu(P【0.05),whereas it was positively correlated with BMI and hypertension in Han(P【0.05 for each).Conclusions The serum lipid profiles,the prevalence of hyperlipidemia and the risk factors are different between the Mu Lao Zu and Han populations.The differences in serum lipid profiles between the two ethnic groups might result from different dietary habit,life style,as well as genetic factors,in ? To determine the serum lipid levels and their risk factors in the Guangxi.
基金supported by“The National Key Research and Development Program of China(2018YFC1508804)The Key Scientific and Technology Program of Jilin Province(20170204035SF)+2 种基金The Key Scientific and Technology Research and Development Program of Jilin Province(20200403074SF)The Key Scientific and Technology Research and Development Program of Jilin Province(20180201035SF)National Natural Science Fund for Young Scholars of China(41907238)”.
文摘In this study,the future landslide population amount risk(LPAR)is assessed based on integrated machine learning models(MLMs)and scenario simulation techniques in Shuicheng County,China.Firstly,multiple MLMs were selected and hyperparameters were optimized,and the generated 11 models were crossintegrated to select the best model to calculate landslide susceptibility;by calculating precipitation for different extreme precipitation recurrence periods and combining the susceptibility results to assess the landslide hazard.Using the town as the basic unit,the exposure and vulnerability of the future landslide population under different Shared Socioeconomic Pathways(SSPs)scenarios in each town were assessed,and then combined with the hazard to estimate the LPAR in 2050.The results showed that the integrated model with the optimized random forest model as the combination strategy had the best comprehensive performance in susceptibility assessment.The distribution of hazard classes is similar to susceptibility,and with an increase in precipitation,the low-hazard area and high-hazard decrease and shift to medium-hazard and very high-hazard classes.The high-risk areas for future landslide populations in Shuicheng County are mainly concentrated in the three southwestern towns with high vulnerability,whereas the northern towns of Baohua and Qinglin are at the lowest risk class.The LPAR increased with the intensity of extreme precipitation.The LPAR differs significantly among the SSPs scenarios,with the lowest in the“fossil-fueled development(SSP5)”scenario and the highest in the“regional rivalry(SSP3)”scenario.In summary,the landslide susceptibility model based on integrated machine learning proposed in this study has a high predictive capability.The results of future LPAR assessment can provide theoretical guidance for relevant departments to cope with future socioeconomic development challenges and make corresponding disaster prevention and mitigation plans to prevent landslide risks from a developmental perspective.
文摘Familial colorectal cancer constitutes a heterogeneous group of patients in whom the underlying molecular mechanism is still unknown.Predisposition to a such neoplasms in this setting seems to be due to common low-penetrance genetic components,but the role of genetic testing in clinical practice has to be determined.Although screening guidelines in this moderate-risk population are empiric,data obtained in epidemiologic,meta-analyses and cohort studies and,more recently,the increased risk of advanced adenomas in first degree relatives who underwent screening colonoscopy support the need to include these individuals in specific screening programs.However,data to determine what test to use,how often to use and which organizational strategy to implement are needed.At present,screening uptake in this population is less than optimal;offering the opportunity to access to screening and improving screening uptake is a first significant step.
文摘Background:Solid fuel use is the major source of household air pollution(HAP)and accounts for a substantial burden of morbidity and mortality in low and middle income countries.To evaluate and compare childhood mortality attributable to HAP in four South Asian countries.Methods:A series of Demographic and Health Survey(DHS)datasets for Bangladesh,India,Nepal and Pakistan were used for analysis.Estimates of relative risk and exposure prevalence relating to use of cooking fuel and under-five mortality were used to calculate population attributable fractions(PAFs)for each country.Potential impact fractions(PIFs)were also calculated assessing theoretical scenarios based on published interventions aiming to reduce exposure prevalence.Results:There are an increased risk of under-five mortality in those exposed to cooking fuel compared to those not exposed in the four South Asian countries(OR=1.30,95%CI=1.07-1.57,P=0.007).Combined PAF estimates for South Asia found that 66%(95%CI:43.1-81.5%)of the 13,290 estimated cases of under-five mortality was attributable to HAP.Joint PIF estimates(assuming achievable reductions in HAP reported in intervention studies conducted in South Asia)indicates 47%of neonatal and 43%of under-five mortality cases associated with HAP could be avoidable in the four South Asian countries studied.Conclusions:Elimination of exposure to use of cooking fuel in the household targeting valuable intervention strategies(such as cooking in separate kitchen,improved cook stoves)could reduce substantially under-five mortality in South Asian countries.
基金The Innovative Research Group Project of National Natural Science Foundation of China,No.41321001The National Basic Research Program(973 Program),No.2012CB955404The Program for Introducing Talents of Disciplines to Universities funded by the Ministry of Education and State Administration of Foreign Experts Affairs,China,No.B08008
文摘Coping with extreme climate events and its related climatic disasters caused by climate change has become a global issue and drew wide attention from scientists, policy-makers and public. This paper calculated the expected annual multiple climatic hazards intensity index based on the results of nine climatic hazards including tropical cyclone, flood, landslide, storm surge, sand-dust storm, drought, heat wave, cold wave and wildfire. Then a vulnerability model involving the coping capacity indicator with mortality rate, affected population rate and GDP loss rate, was developed to estimate the expected annual affected population, mortality and GDP loss risks. The results showed that： countries with the highest risks are also the countries with large population or GDP. To substantially reduce the global total climatic hazards risks, these countries should reduce the exposure and improving the governance of integrated climatic risk; Without considering the total exposure, countries with the high mortality rate, affected population rate or GDP loss rate, which also have higher or lower coping capacity, such as the Philippines, Bangladesh and Vietnam, are the hotspots of the planning and strategy making for the climatic disaster risk reduction and should focus on promoting the coping capacity.
文摘Objective: To investigate the prevalence of term low birth weight (TLBW) and its risk factors. Methods: A follow-up study with 7, 872 couples was conducted from 1987 to 199o beginning from the time they got marriage licenses in two districts defined in Shanghai. They were interviewed in the third month and again in the fifteenth month and in the fifth to sixth year afterwards individually at home. The total follow up rate reached 98%. Couple’s background characteristics as well as the information on their general health. reproductivc history and contraceptive use etc.. were collected dynamically. All of the single live births with term delivery were Included for data analysis in this paper. Adjusted odd ratios and population attributable risk (PAR%) were computed. Results: The prevalence of TLBW in Shanghai single term live births was 2. 0% (134,/6.573), represents 54. 7% (134/245) of the total low birth weights in our sam pie. Significant social and behaviour risk factors relating with TI-BW were wife’s dissat- isfaction with marriage; low education level of husband; co-residence with parents during pregnancy; heavy housework done by the wife while being pregnant. Significant biomedical risky factors were menarche age greater than 16 years old; maternal age at delivery greater than 29 years old; maternal body mass index less than 19. 8; wife suf- fered from serious disease prior to conceiving; having pregnancy complication; gestational weight gain less than 20 % of pre-pregnancy weight; having abortion, stillbirth and fetal death history. Conclusion: TL.BW constituted over half of all low birth weights in Shanghai. Special attention should be paid to the determinants mentioned above in TLBW intervention program. Improving couples’ economic and living condition and husband ’s education at tainment, and caloric supplementation with women while being pregnant would all be particularly effective in reducing the occurrence of TLBW in Shnaghai.
文摘Objective To study the differences in blood pressure (BP) levels and the main factors raising BP among the population in Guangdong Province. Methods The data analyzed stem from the sampling survey of hypertension in Guangdong Province in 1991, covering 42, 894 subjects over 15 years old. Individual characteristics included age, sex, occupation, education, smoking, alcohol drinking and body mass index (BMI) . Results Systolic and diastolic BP increased with age. The hypertension prevalence rate in male is higher than in female. The age - adjusted prevalence rate in office personnel is the highest (12.9 % ) among all occupations. It was increased with education level and BMI (in people educated at university and over is 13. 1 % ), and higher in smokers and alcohol-drinkers than non-smokers and non -alcohol-drinkers. Conclusions Age, occupation, education, smoking, alcohol drinking and BMI all effect BP. These risk factors should be reduced in the Guangdong population.
文摘Objective To explore the relationship between hypertriglyceridemic-waist(HTWC)phenotype and clustering of cardiovascular risk factors in middle and aged population.Methods A community-based cross-sectional survey was conducted in 5 communities of Chengdu city from 2013-10 to 2014-05 and 1004 subjects from(40-79)years of age were investigated.HTWC was de-
文摘In recent years,the issue of PM_(2.5)-O_(3)compound pollution has become a significant global environmental concern.This study examines the spatial and temporal patterns of global PM_(2.5)-O_(3)compound pollution and exposure risks,firstly at the global and urban scale,using spatial statistical regression,exposure risk assessment,and trend analyses based on the datasets of daily PM_(2.5)and surface O_(3)concentrations monitored in 120 cities around the world from 2019 to 2022.Additionally,on the basis of the common emission sources,spatial heterogeneity,interacting chemical mechanisms,and synergistic exposure risk levels between PM_(2.5)and O_(3)pollution,we proposed a synergistic PM_(2.5)-O_(3)control framework for the joint control of PM_(2.5)and O3.The results indicated that:(1)Nearly 50%of cities worldwide were affected by PM_(2.5)-O_(3)compound pollution,with China,South Korea,Japan,and India being the global hotspots for PM2.5-O3 compound pollution;(2)Cities with PM_(2.5)-O_(3)compound pollution have exposure risk levels dominated by ST t ST(Stabilization)and ST t HR(High Risk).Exposure risk levels of compound pollution in developing countries are significantly higher than those in developed countries,with unequal exposure characteristics;(3)The selected cities showed significant positive spatial correlations between PM_(2.5)and O_(3)concentrations,which were consistent with the spatial distribution of the precursors NOx and VOCs;(4)During the study period,52.5%of cities worldwide achieved synergistic reductions in annual average PM_(2.5)and O_(3)concentrations.The average PM_(2.5)concentration in these cities decreased by 13.97%,while the average O_(3)concentration decreased by 19.18%.This new solution offers the opportunity to construct intelligent and healthy cities in the upcoming low–carbon transition.
基金This work was supported partially by the China Cancer Foundation Programand by Chinese National Key Projects(2012ZX10002009,2018ZX10732202-001).
文摘Screening for liver cancer(hepatocellular carcinoma)in China started in early 1970s with the application of alpha-fetoprotein(AFP)in high-incidence regions.It has been extended to nationwide areas,emerging from the concepts of conducting screening in populations at-risk with positive hepatitis B surface antigen to the practice programs in rural and urban areas,and finally to the development of recommendations to guide medical practice for health care providers.The implementation of screening for liver cancer has resulted in earlier detection and hence the early curable treatment for patients who have gained short-or long-term survival,and even reduction in mortality rates,although these outcomes are more anecdotal than rigorously evidence-based.AFP or ultrasound examination has been considered as sensitive and specific methods for early detection but are with limitations.The combined use of these two modalities for screening populations at-risk every six months seems to have been reached consensus.The feasibility of screening for liver cancer is still debated because of differing opinions and even opposition to the choice of targeted sub-populations,the intrinsic necessity,and the contributions of the main risk factors among Western countries and China/Asian areas.Yet,the over 51%of global burden of liver cancer is in China,the solution to the early detection and treatment of liver cancer should fully consider the actual situation in China.The effectiveness of screening for liver cancer is worthy of anticipation.
基金This project was funded by the Science and Tech-nology Project of Xinjiang Uygur Autonomous Region，the Xinjiang Uygur Autonomous Region Natural Science Foundation，the National Natural Science Foundation of China
文摘Objective: Stroke is the leading cause of death and disability, and is closely related to a lack of exercise. Currently, most Chinese medical staff members lack exercise and may be at risk for stroke. We sought to determine the risk factors for stroke and study the significance of health-related physical fitness testing in stroke prevention among Chinese medical staff members. Methods: A total of 627 subjects from Urumqi, Xinjiang, China, were included in the study and a survey was conducted from 1st January 2016 to 1st February 2016. Stroke screening and health-related physical fitness testing were completed according to the standard protocol, and the related data were analyzed. Results: Based on the screening, 27.6%(n=173) of the subjects were at high risk for stroke. The top risk factors for stroke in these subjects were dyslipidemia, lack of exercise or mild physical activity, being overweight or obese, and high blood pressure. Body weight, body mass index, body fat, visceral fat area, body fat percentage, and basal metabolic rate were significantly higher (P<0.01) in subjects at high risk for stroke than in subjects who were not at high risk. Lung capacity, step index, grip test, vertical jump, and sit-up/push-up index were significantly lower (P<0.01) in subjects at high risk for stroke than in subjects who were not at high risk. Conclusions: A large proportion of China's on-the-job medical personnel is at high risk for stroke. This may be related to the nature of the profession and warrants more attention from the society. The health-related physical fitness measurement parameters in subjects at high risk for stroke were significantly different from those in subjects who were not at high risk. Screening and health-related physical fitness testing in medical staff members may contribute to stroke prevention. More rigorous controlled clinical trials will be needed in the future.
基金supported in part by the Joint Laboratory for Internet of Vehicles,Ministry of Education-China Mobile Communications Corporation under Grant ICV-KF2018-01in part by the National Natural Science Foundation of China underGrant 51975194 and 51905161.
文摘Purpose–The purpose of this paper is to investigate the influence of driver demographic characteristics on the driving safety involving cell phone usages.Design/methodology/approach–A total of 1,432 crashes and 19,714 baselines were collected for the Strategic Highway Research Program 2 naturalistic driving research.The authors used a case-control approach to estimate the prevalence and the population attributable risk percentage.The mixed logistic regression model is used to evaluate the correlation between different driver demographic characteristics(age,driving experience or their combination)and the crash risk regarding cell phone engagements,as well as the correlation among the likelihood of the cell phone engagement during the driving,multiple driver demographic characteristics(gender,age and driving experience)and environment conditions.Findings–Senior drivers face an extremely high crash risk when distracted by cell phone during driving,but they are not involved in crashes at a large scale.On the contrary,cell phone usages account for a far larger percentage of total crashes for young drivers.Similarly,experienced drivers and experienced-middle-aged drivers seem less likely to be impacted by the cell phone while driving,and cell phone engagements are attributed to a lower percentage of total crashes for them.Furthermore,experienced,senior or male drivers are less likely to engage in cell phone-related secondary tasks while driving.Originality/value–The results provide support to guide countermeasures and vehicle design.
