中国疾病预防控制中心

Avian influenza viruses (AIV) pose a major zoonotic threat with pandemic potential. Waterbirds facilitate AIV spillovers into farm animals and humans through exposure and virus reassortment. Here, we propose waterbird activity entropy (WAE), an indicator of waterbird activity intensity based on monthly distributions of 779 species worldwide. WAE demonstrated high explanative power (AUC = 0.87 ± 0.001) for global avian influenza cases, particularly for H5N1, revealing the potential of WAE for identifying AIV exposure hotspots which cover 14% of global land area. Notably, the AIV exposure hotspots in the USA, EU, China, and India contain 52% of the globally exposed human population, 41% cattle, and 51% poultry. Despite reporting <1% of global cases, sub-Saharan Africa contains >300 Mha of hotspots area (15% globally), highlighting considerable surveillance gaps. This WAE-based framework enhances AIV risk assessment by incorporating waterbird residency time, offering critical insights for anticipating AIV emergence and improving surveillance.

Background:The global macroeconomic impact of Tuberculosis (TB) lacks comprehensive quantification using standardized economic frameworks. Methods:This analysis utilized data from the Global Burden of Disease (GBD) 2021 to assess the economic burden of TB through the lens of the Value of a Statistical Life Year (VSLY) framework, integrating willingness-to-pay-based economic measures. The study monetized the total disability-adjusted life years (DALYs) associated with TB to estimate overall welfare losses. Country-specific gross domestic product (GDP) data, adjusted for purchasing power parity (PPP), were sourced from the World Bank and integrated with DALY estimates to calculate the Value of Lost Welfare (VLW). Results:In 2021, the global economic cost of TB, expressed as VLW, was estimated at US$1.98 trillion (95% uncertainty interval [UI]: 1.62, 2.45), representing 1.29% (95% UI: 1.05, 1.60) of global GDP. The economic impact of TB was disproportionately distributed across regions, with countries of low Socio-Demographic Index (SDI) facing the most severe burden, where VLW represented 7.83% (95% UI: 5.70, 11.20) of GDP. Lower-middle SDI regions experienced a VLW impact of 5.28% (95% UI: 4.30, 6.58). Sub-Saharan Africa (US$406.2 billion; 8.40% of GDP) and South Asia (US$822.5 billion; 5.70% of GDP) were identified as the most economically affected super-regions. India bore the highest absolute economic burden (US$477.5 billion). In contrast, high-SDI countries demonstrated a VLW-to-GDP ratio of just 0.10% (95% UI: 0.09, 0.12). Conclusions:Prioritizing TB control in economic policy is urgently needed. Equitable resource allocation to high-burden regions is vital to alleviate the disease's economic consequences and improve global health.

HepG2 cells were cultured into liver organoids (more native liver-like than 2D cultures) and integrated into a microfluidic chip, which regulates flow, nutrients, and waste to simulate in vivo hepatic microcirculation. Key findings: Cadmium (Cd) exposure shows a positive dose-response with liver damage; 40 ng/mL selenium (Se) alleviates 3 sets of liver biochemical dysfunctions under 40 μg/mL Cd co-exposure, but 160/640 ng/mL Se diminishes this protection. Metabolomics (40 μg/mL Cd vs. 640 ng/mL Se+Cd) identified two mechanisms: high Se induces oxidative stress and disrupts liver cellular metabolism. This study provides data/theory for rational Se use against Cd-induced liver dysfunction. The platform integrates organoid/organ-on-a-chip assessments with microfluidic metabolomics (a cross-scale toxicological system) and informs 3D cell model development.

Nickel exposure may increase the risk of adverse health outcome, but population-based data linking it to mortality in older adults are inconsistent and limited, especially neurological mortality. We enrolled 9727 adults aged 60 years and older from two cohorts. Urinary nickel levels were quantified via inductively coupled plasma mass spectrometry (ICP-MS). Participants (enrolled 2017/2018) were followed until death or December 31, 2024. The Kaplan-Meier (KM) method was used to analyze survival associations between urinary nickel and mortality. Cox proportional hazards models were applied to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Restricted cubic splines (RCS) were used to assess dose-response relationships, and subgroup analyses were performed to identify susceptible populations and potential effect modifiers. Over 4.75 years (mean follow-up), 2740 deaths (28.7%) occurred (1344 cardiovascular, 288 cancer, 312 respiratory, 163 neurological). A positive association was observed between higher urinary nickel levels and elevated risks of all-cause mortality (2.0% [0.8%-3.2%] per 1 μg/L increase) and neurological mortality (12.3% [8.4%-16.3%]). Dose-response analyses revealed a nonlinear inverted J-shaped pattern for all-cause and a non-monotonic upward pattern for neurological mortality. Subgroup analyses identified the oldest-old, women, and Han Chinese individuals as particularly susceptible to all-cause mortality, while neurological mortality risks were elevated across sexes, with the oldest-old and Han Chinese at higher risk. Refined neurological mortality analysis confirmed that each 1 μg/L increase in urinary nickel was significantly associated with higher mortality risks from AD (HR = 1.164, 95% CI: 1.029-1.316), other neurodegenerative diseases (NDD; HR = 1.120, 95% CI: 1.078-1.164), and non-NDD neurological diseases (HR = 1.135, 95% CI: 1.014-1.271). In conclusion, higher urinary nickel levels were associated with increased all-cause and neurological mortality, supporting nickel's role as a neurotoxicant. These findings demonstrate the public health risks of nickel exposure in aging populations, necessitating targeted interventions to reduce exposure in vulnerable groups.

Background Cardiovascular diseases (CVDs) are the leading cause of disability and death in China. Objectives The authors aimed to analyze the trends in the CVD burden across mainland China from 1990 to 2023 and to assess the contribution of modifiable risk factors. Methods We utilized data from the Global Burden of Disease 2023 analysis for mainland China, which involved estimates of overall and cause-specific health metrics for CVDs. Advanced statistical modeling and a wide array of data sources were used to evaluate the attributable burden of modifiable risk factors. Results In 2023, there were 11.1 million incident cases, 135.8 million prevalent cases, and 4.5 million deaths from all CVDs in China. CVDs with the highest incidence were lower extremity peripheral arterial disease, ischemic stroke, ischemic heart disease, intracerebral hemorrhage, and atrial fibrillation and flutter. The top contributors to disability-adjusted life years (DALYs) were ischemic heart disease, intracerebral hemorrhage, ischemic stroke, hypertensive heart disease, and subarachnoid hemorrhage. Age-standardized DALYs for CVDs significantly decreased from 10,065.7 per 100,000 population in 1990 to 4,059.3 in 2023, representing a decrease of 59.7%. The proportion of DALYs due to ischemic CVDs increased, whereas the proportion for hemorrhagic CVDs declined during 1990-2023. The 5 leading risk factors for CVDs were high systolic blood pressure, ambient particulate matter pollution, high low-density lipoprotein cholesterol, smoking, and lead exposure in 2023. Conclusions Despite notable progress in reducing age-standardized DALYs of CVDs in China, the overall enduring burden and the rising challenge of specific risk factors highlight the urgent need for tailored public health strategies.