BackgroundThere is a synergistic effect between sarcopenia and obesity, and they are important factors affecting cognitive function. It's essential to explore the complex relationship among the three.ObjectiveTo explore the mediating effect of waist circumference in the relationship between sarcopenia and cognitive function.MethodsA total of 5577 participants aged 60 years and older from CHARLS (China Health and Retirement Longitudinal Study) were included. Cognitive function was assessed via episodic memory and mental integrity. Sarcopenia status was diagnosed according to the criteria of the AWGS 2019. General linear regression models were applied to investigate the association between WC, sarcopenia, their combined effects and cognitive function. Mediation analysis was used to access the mediating effect of WC in the relationship between sarcopenia and cognitive function. The nonlinear association between WC and cognitive function was explored by using the restricted cubic spline model.ResultsAmong 5577 participants, the average cognitive score was 12.41. After controlling for confounding factors, participants with central obesity and severe sarcopenia had the worst cognitive scores (β = -3.22, 95%CI = -4.81, -1.61). WC mediated 16.95% of the association between sarcopenia and cognitive scores, and 9.26% of the association between severe sarcopenia and cognitive scores. The strongest positive association was found between WC and cognitive scores when WC was 96.74 cm in men.ConclusionsCentral obesity was associated with better cognitive function. However, central obesity accompanied by sarcopenia or severe sarcopenia was associated with lower cognitive function. There were significant differences in the mediating effect of WC between different sarcopenia status and cognitive function.

Background: The disparities in Alzheimer's disease and other dementias (ADOD) burden across global regions have been further exacerbated following the COVID-19 pandemic, necessitating urgent systematic research into its changing trends and driving factors. Objective: To evaluate trends and driving factors of ADOD burden over the past 32 years and analyze changes during the COVID-19 pandemic. Methods: Data were extracted from the Global Burden of Disease 2021. We used the average annual percentage change to assess ADOD burden trends from 1990 to 2021, and quantified the drivers of burden through decomposition analysis. We further utilized frontier analysis to explore the relationship between socio-demographic index (SDI) and disability-adjusted life-years (DALYs), and employed the Bayesian age-period-cohort (BAPC) model to project DALYs trends for ADOD from 2022 to 2050. Results: From 1990 to 2021, global age-standardized rates (ASRs) of prevalence, incidence, years lived with disability, and DALYs for ADOD showed increasing trends, while the ASRs of death remained stable. Females consistently bore a higher burden than males. However, during the COVID-19 pandemic, global ASRs of all these indicators increased significantly. High-middle and middle SDI regions experienced marked increases across all epidemiological metrics. Decomposition analysis revealed population growth as the primary driver of ADOD burden escalation. BAPC predicted that DALYs in each age group showed varying degrees of upward trends, with the fastest increase in 85-89 years old group. Conclusions: The COVID-19 pandemic triggered a sharp rise in ADOD burden. As global aging and population growth persist, ADOD burden is likely to escalate, necessitating urgent public health interventions.

Background The study aimed to analyze the long-term trends in the global burden of Alzheimer's disease and other dementias(ADOD) in different regions, and assess the association between socio-demographic index(SDI) and disease burden. Methods We extracted data on the incidence, mortality, disability-adjusted life-years(DALYs), and age-standardized rates related to ADOD, as disease burden measures from 1990 to 2021. The joinpoint regression, quantile regression and restricted cubic splines were adopted to estimate the temporal trends and relationships with SDI. Risk factors for deaths and DALYs were also analyzed. Results Globally, 9.84 million cases of ADOD occurred in 2021, with 1.95 million ADOD-related deaths, causing 36.33 million DALYs. ADOD incidence, mortality and DALYs all increased from 1990 to 2021. Regional and sex variations persisted, with the fastest increase in age-standardized death rate in low-middle SDI quintiles, experienced the highest estimated annual percentage changes (0.41[0.31,0.52]). The incidence of ADOD increased more rapidly as SDI increased in areas that have historically shown lower incidence compared to other areas. In regions with higher mortality or DALYs burden, these indicators decreased relatively faster as SDI increased. High fasting plasma glucose was the main risk factor, particularly in high SDI region, with an increasing trend in attributable burden. The burden attributable to high BMI was increasing, whereas the burden associated with smoking steadily decreased. Conclusion ADOD poses a significant and escalating challenge to healthcare sustainability, with persistent regional and gender disparities. By learning from successful ADOD management in certain nations, we can proactively reduce health burdens and bridge disparities between countries at various developmental levels.

BACKGROUND:Chronic Obstructive Pulmonary Disease (COPD) remains a significant global public health challenge, contributing to substantial morbidity and mortality worldwide. This study aims to analyze global trends in COPD from 1990 to 2021, with a focus on age, sex, and regional variations. By assessing the global burden of COPD and its association with key risk factors, this research provides critical insights into progress toward health-related Sustainable Development Goals (SDGs) and underscores the urgent need to prioritize COPD in public health agendas. METHODS:Utilizing data from the Global Burden of Disease (GBD) study, this research conducted a comprehensive ecological analysis of COPD epidemiology from 1990 to 2021. Key measures included incidence, mortality, and age-standardized rates, alongside an examination of risk factors such as smoking and ambient particulate matter pollution, quantified using country-level summary exposure values (SEV). Statistical analyses, including descriptive analysis, annual rate of change (ARC), and correlation analysis, were applied to assess the burden of COPD and investigate its ecological associations with major risk factors. RESULTS:In 2021, COPD accounted for 16.90 million new cases and 3.70 million deaths globally. The age-standardized incidence rate was 197.37 (95% UI: 181.6-213.42) per 100,000 person-years, while the age-standardized mortality rate was 45.22 (95% UI: 40.61-49.70) per 100,000 person-years. Although global COPD incidence rates declined by 2% from 1990 to 2021, the pace and extent of this decline varied, with some age groups, sexes, and regions experiencing slower reductions or even increases. Higher COPD burden was observed in areas with elevated smoking prevalence, air pollution and greater socioeconomic development. CONCLUSIONS:This study highlights the ongoing global burden of COPD and its varying trends from 1990 to 2021 across age groups, sexes, and regions. While incidence and mortality rates have slightly declined, disparities persist, particularly among older adults, men, and regions with higher smoking prevalence and air pollution. These findings emphasize the urgent need to integrate COPD into public health priorities, focusing on targeted interventions to reduce key risk factors. Sustained efforts are essential to achieving health-related Sustainable Development Goals (SDGs) and improving global COPD outcomes.

New cases and deaths of gastrointestinal cancers are predicted to increase significantly by 2040. This study aims to explore cross-country inequalities and trends in global burdens of colon and rectum cancer (CRC), esophageal cancer (EC) and gastric cancer (GC). Data from the Global Burden of Diseases Study 2019 were analyzed to examine trends in disability-adjusted life-years (DALYs) for three gastrointestinal cancers with estimated annual percentage change (EAPC) and Joinpoint analysis. Inequality in their DALYs rates was assessed with the slope index of inequality and the concentration index, based on the Socio-Demographic Index (SDI). From 1990 to 2019, the age standardized DALYs rate of CRC decreased in these countries from high and high-middle SDI regions, with the EAPC values of − 1.018

The disability weight quantifies the severity of health states from diseases and injuries. It is a fundamental index to estimate the disability-adjusted life year in the Global Burden of Disease studies. Disability weight estimates have been shown to vary across different national populations, suggesting the influence of cultural differences. However, survey data of disability weights in the Global Burden of Disease study is still limited worldwide. To more accurately reflect the true health conditions of global populations, this study aims to systematically summarize the disability weight values from international authoritative surveys, and explore the influential factors of disability weight estimates. Based on the Global Burden of Disease study, surveys used paired comparison questions wherein respondents considered two hypothetical individuals with different health states and specified which person was healthier. This study comprehensively searched multiple databases, including PubMed, Web of Science, Science Direct, and Google Scholar. We identified disability weight studies that utilized the paired comparison method and were conducted in national populations, published in international peer-reviewed journals. A meta-regression analysis was conducted to estimate the overall summary effect of disability weight values for 235 unique health states. These health states were estimated for all non-fatal consequences of disease and injury, including infectious diseases, cancer, cardiovascular diseases, diabetes, chronic respiratory diseases, neurological disorders, mental, behavior, and substance use disorders, hearing and vision loss, musculoskeletal diseases, injuries and others. Heterogeneity was assessed using the I2 statistics. Univariate meta-regression analysis was conducted to explore the impact of age, sex, education, population composition, and survey regions, respectively, on the summarized effect of each health state. The total analysis sample consisted of 610,818 respondents from the Global Burden of Disease 2013 disability weight surveys, the Japanese disability weight survey, and the Chinese disability weight survey. The summarized disability weights of health states ranged from mild anaemia (summarized disability weight = 0.008, 95

Background: ZhuRiHeng Drop Pill (ZRH) is a traditional Mongolian medicinal preparation. Despite its long history of use for the treatment of coronary heart disease, there have been few toxicological studies of the safety profile of ZRH.Purpose: In order to comprehensively elucidate the underlying mechanisms behind the observed toxicity of ZRH on rat livers in the 180-day repeated oral toxicity study, we conducted a comprehensive analysis by integrating transcriptomic and metabolomic data.Methods: High-resolution mass spectrometry was conducted to evaluate the constituents of ZRH. For the acute oral toxicity study, mice were administered a dose of 32 g/(kg·d) of ZRH, while rats were instead orally administered 0.934, 1.868, or 3.736 g/(kg·d) of ZRH over a 180-day period in a 180-day repeated oral toxicity study. Conventional index and organ weights/histology were then monitored to detect any potential ZRH treatment-related toxicity. To identify key genes and metabolites involved in ZRH toxicological processes, we performed transcriptomic and metabolomic analyses of liver tissue upon ZRH treatment using RNA-seq techniques, qPCR and liquid chromatography-mass spectrometry analyses.Results: A total of 60 compounds in ZRH were identified and speculated in positive and negative ion modes. Mice in the acute toxicity study exhibited no signs of ZRH-related toxicity. In a protracted oral toxicity investigation spanning 180 days, discernible elevations in liver ratios were noted in both male and female rats across all three dose cohorts, relative to the control group (p < 0.05 or p < 0.01). Upon subjecting to ZRH treatment, our transcriptomic and qPCR analyses unveiled notable upregulation of crucial genes, exemplified by Abcb1b and Cyp2b2, known for theirs involvement in liver drug transport and metabolism function. Furthermore, our untargeted metabolomic analysis provided supplementary insights, revealing significant regulation in pyrimidine metabolism, as well as alanine, aspartate, and glutamate metabolism pathways.Conclusion: Our study unveils a panoramic understanding of the temporal, dosage-specific, and gene dimensions surrounding the metabolic and transcriptional shifts induced by ZRH exposure. As we peer into the future, recommendations emerge for further exploration, encompassing aspects such as time dynamics, dosage considerations, and gene-centric avenues to enhance therapeutic efficacy.

Background This study aims to assess the long-term trends in the burden of three major gynecologic cancers(GCs) stratified by social-demographic status across the world from 1990 to 2019. To assess the trends of risk factor attributed mortality, and to examine the specific effects of age, period, cohort behind them in different regions.Methods We extracted data on the mortality, disability-adjusted life years(DALYs), and age-standardized rates(ASRs) of cervical cancer(CC), uterine cancer(UC), and ovarian cancer(OC) related to risks from 1990 to 2019, as GCs burden measures. Age-period-cohort analysis was used to analyze trends in attributable mortality rates.Results The number of deaths and DALYs for CC, UC and OC increased since 1990 worldwide, while the ASDRs decreased. Regionally, the ASDR of CC was the highest in low SDI region at 15.05(11.92, 18.46) per 100,000 in 2019, while the ASDRs of UC and OC were highest in high SDI region at 2.52(2.32,2.64), and 5.67(5.16,6.09). The risk of CC death caused by unsafe sex increased with age and then gradually stabilized, with regional differences. The period effect of CC death attributed to smoking showed a downward trend. The cohort effect of UC death attributed to high BMI decreased in each region, especially in the early period in middle, low-middle and low SDI areas.Conclusions Global secular trends of attributed mortality for the three GCs and their age, period, and cohort effects may reflect the diagnosis and treatment progress, rapid socioeconomic transitions, concomitant changes in lifestyle and behavioral patterns in different developing regions. Prevention and controllable measures should be carried out according to the epidemic status in different countries, raising awareness of risk factors to reduce future burden.

Purpose To explore cross-country inequalities in global disease burdens of colon and rectum cancer (CRC), esophageal cancer (EC) and gastric cancer (GC). Methods Data from the Global Burden of Diseases Study 2019 were analyzed to examine trends in disability-adjusted life-years (DALYs) for three cancers using Estimated Annual Percentage Change (EAPC) and Joinpoint analysis. Inequality in DALYs rates was assessed with the Slope Index of Inequality and the Concentration Index, based on the Socio-Demographic Index (SDI). Results From 1990 to 2019, age standardized DALYs rate of CRC decreased in high and high-middle SDI regions, with the EAPC values of -1.018 and − 0.161, but increased among low, low-middle and middle SDI regions (EAPC = 1.035, 0.926 and 0.406, respectively). The DALYs rates of EC and GC decreased in all SDI regions. For CRC, the slope index changed from 358.42 (95% confidence interval: 343.28 to 370.49) to 245.13 (217.47 to 271.24); from − 63.88 (-87.48 to -48.28) to -1.36 (-32.44 to 25.87) for EC; from 126.37 (101.97 to 146.47) to 58.04 (20.54 to 96.12) for GC. The concentration index for CRC moved from 29.56 (28.99 to 29.84) to 23.90 (23.19 to 24.26); from − 9.47 (-10.30 to -9.24) to -14.64 (-15.35 to -14.24) for EC; from 8.44 (7.85 to 8.72) to -6.42 (-7.65 to -6.12) for GC. Conclusion This study suggests strong heterogeneity in global DALYs for gastrointestinal cancers across different SDI regions. Higher SDI regions faced a greater burden of CRC, while the burdens of EC and GC were more prevalent in lower SDI regions.

INTRODUCTION This study explores the association of individual cognition and social environment of smoking with autonomy over tobacco, providing evidence and insights to help smokers effectively prevent and reduce tobacco dependence. METHODS Data were collected from 1389 participants, aged >= 15 years, by face-toface interviews from June 2018 to November 2019 in central China. We assessed autonomy over tobacco using the Autonomy Over Smoking Scale (AUTOS), including Withdrawal Symptoms (WS), Psychological Dependence (PD) and Cueinduced Cravings (CC), and examined factors of individual cognition and social environment, as well as covariates, including demographic characteristics, health status, and smoking behavior. RESULTS AUTOS total score was 16.92 +/- 9.05, WS score was the lowest (4.40 +/- 3.36) in the three subscales, and CC score was the highest (6.88 +/- 3.2). After adjustment, WS score of having a greater awareness of smoking hazards to one's own health was lower than those who had no awareness (beta=0.14; 95% CI: -0.31- 0.00), and the total score of AUTOS, the score of PD and CC for those who thought smoking was 'more helpful (high)' to interpersonal communication were higher than 'not helpful (not at all)' (beta=0.14; 95% CI: 0.01-0.28 with beta=0.16; 95% CI: 0.02-0.29; and beta=0.14; 95% CI: 0.00-0.28; respectively). Having a greater difficulty in smoking cessation was associated with higher AUTOS total and subscale scores (p<0.001). Notably, none of the social-environmental factors included had a significant association with AUTOS scores. CONCLUSIONS Interventions targeting individual cognitive factors of tobacco dependence seem to be more effective in smoking cessation. Future research may explore the influence of family and workplace among social environmental factors, which may reveal the effect of a binding force.

BACKGROUND AND OBJECTIVES:It is recommended by Asian Working Group for Sarcopenia to early identify people at risk for sarcopenia using simple screening tools like SARC-F. The modified version SARC-F+EBM showed higher diagnostic performance. However, this cut-off value of body mass index (BMI) remained uncertain to be used in Chinese population. In this study, we used appropriate BMI recommended for Chinese older population and further modified SARC-F+EBM by combining calf circumference. METHODS AND STUDY DESIGN:Diagnostic tests were performed and the receiver operating characteristics analyses were conducted between the SARC-F, SARC-F+EBM (cut-off of BMI: ≤ 21 kg/m2), SARC-F+EBM (CN) (cut-off of BMI: ≤ 22 kg/m2), SARC-CalF and SARC-CalF+EBM (CN) (cut-off of BMI: ≤ 22 kg/m2) in 1660 community-dwelling participants aged ≥ 65 years from China. RESULTS:The participants had an average age of 71.7±5.1 years, of which 56.8% were women. All the modified models could enhance the areas under the receiver operating characteristic curve (AUC) of original SARC-F (all p<0.001). The SARC-F+EBM (CN) also showed a significantly higher sensitivity of 47.4% (p<0.001) and an AUC of 0.809 (p=0.005) than SARC-F+EBM. SARC-CalF+EBM (CN) was validated to be of great diagnostic value of the highest AUC of 0.88 among these sarcopenia screening tools, including SARC-F, SARC-CalF and SARC-F+EBM (CN) (all p<0.001). Using this study population as a reference, the optimal cut-off value of SARC-CalF+EBM (CN) is ≥12 points, with a sensitivity of 79.3% and a specificity of 80.7%. CONCLUSIONS:The SARC-F+EBM (CN) and SARC-CalF+EBM (CN) could enhance the diagnostic performance of SARC-F and SARC-F+EBM and are suitable sarcopenia screening tools for Chinese population.

Due to the common characteristics of major communicable and non-communicable chronic diseases targeted by major disease prevention and control measures-such as variability and ambiguity-both face common challenges in the implementation of group strategy.Additionally,these strategies must be conducted within the units/institutions/communities where people work,study,and live,focusing on groups rather than individuals,thus inherently involving organizational behavior.This paper proposes addressing the common issues of group prevention and control of major diseases from the perspective of organizational behavior,leveraging collective power through organizational roles.Moreover,based on relevant studies,it preliminarily introduces four organizational behavior elements aimed at addressing these common issues and analyzes the interrelationships among these four elements.

Background Measurement of the Chinese burden of disease with disability-adjusted life-years (DALYs) requires disability weight (DW) that quantify health losses for all non-fatal consequences of disease and injury. The Global Burden of Disease (GBD) 2013 DW study indicates that it is limited by lack of geographic variation in DW data and by the current measurement methodology. We aim to estimate DW for a set of health states from major diseases in the Wuhan population. Methods We conducted the DW measurement study for 206 health states through a household survey with computer-assisted face-to-face interviews and a web-based survey. Based on GBD 2013 DW study, paired comparison (PC) and Population health equivalence (PHE) method was used and different PC/PHE questions were randomly assigned to each respondent. In statistical analysis, the PC data was analyzed by probit regression. The probit regression results will be anchored by results from the PHE data analyzed by interval regression on the DW scale units between 0 (no loss of health) and 1 (loss equivalent to death). Results A total of 2610 and 3140 individuals were included in the household and web-based survey, respectively. The results from the total pooled data showed health state “mild anemia” (DW = 0.005, 95% UI 0.000–0.027) or “allergic rhinitis (hay fever)” (0.005, 95% UI 0.000–0.029) had the lowest DW and “heroin and other opioid dependence, severe” had the highest DW (0.699, 95% UI 0.579–0.827). A high correlation coefficient (Pearson’s r = 0.876; P < 0.001) for DWs of same health states was observed between Wuhan’s survey and GBD 2013 DW survey. Health states referred to mental symptom, fatigue, and the residual category of other physical symptoms were statistically significantly associated with a lower Wuhan’s DWs than the GBD’s DWs. Health states with disfigurement and substance use symptom had a higher DW in Wuhan population than the GBD 2013 study. Conclusions This set of DWs could be used to calculate local diseases burden for health policy-decision in Wuhan population. The DW differences between the GBD’s survey and Wuhan’s survey suggest that there might be some contextual or culture factors influencing assessment on the severity of diseases.

Background and aims: The disease burden attributable to metabolic risk factors is rapidly increasing in China, especially in older people. The objective of this study was to (i) estimate the pattern and trend of six metabolic risk factors and attributable causes in China from 1990 to 2019, (ii) ascertain its association with societal development, and (iii) compare the disease burden among the Group of 20 (G20) countries. Methods: The main outcome measures were disability-adjusted life-years (DALYs) and mortality (deaths) attributable to high fasting plasma glucose (HFPG), high systolic blood pressure (HSBP), high low-density lipoprotein (HLDL) cholesterol, high body-mass index (HBMI), kidney dysfunction (KDF), and low bone mineral density (LBMD). The average annual percent change (AAPC) between 1990 and 2019 was analyzed using Joinpoint regression. Results: For all sixmetabolic risk factors, the rate of DALYs and death increased with age, accelerating for individuals older than 60 and 70 for DALYs and death, respectively. The AAPC value in rate of DALYs and death were higher in male patients than in female patients across 20 age groups. A double-peak pattern was observed for AAPC in the rate of DALYs and death, peaking at age 20-49 and at age 70-95 plus. The age-standardized rate of DALYs increased for HBMI and LBMD, decreased for HFPG, HSBP, KDF, and remained stable for HLDL from 1990 to 2019. In terms of age-standardized rate of DALYs, there was an increasing trend of neoplasms and neurological disorders attributable to HFPG; diabetes and kidney diseases, neurological disorders, sense organ diseases, musculoskeletal disorders, neoplasms, cardiovascular diseases, digestive diseases to HBMI; unintentional injuries to LBMD; and musculoskeletal disorders to KDF. Among 19 countries of Group 20, in 2019, the age-standardized rate of DALYs and death were ranked fourth to sixth for HFPG, HSBP, and HLDL, but ranked 10th to 15th for LBMD, KDF, and HBMI, despite the number of DALYs and death ranked first to second for sixmetabolic risk factors. Conclusions: Population aging continuously accelerates the metabolic risk factor driven disease burden in China. Comprehensive and tight control of metabolic risk factors before 20 and 70 may help to mitigate the increasing disease burden and achieve healthy aging, respectively.

ObjectivesThe aim of this study was to investigate differences in the burden of ischemic heart disease (IHD)-related mortality and disability-adjusted life years (DALYs) caused by dietary factors, as well as the influencing factors with age, period, and cohort effects, in regions with different social-demographic status from 1990 to 2019. MethodsWe extracted data on IHD mortality, DALYs, and age-standardized rates (ASRs) related to dietary risks from 1990 to 2019 as IHD burden measures. Hierarchical age-period-cohort analysis was used to analyze age- and time-related trends and the interaction between different dietary factors on the risk of IHD mortality and DALYs. ResultsGlobally, there were 9.2 million IHD deaths and 182 million DALYs in 2019. Both the ASRs of death and DALYs declined from 1990 to 2019 (percentage change: -30.8% and -28.6%, respectively), particularly in high and high-middle socio-demographic index (SDI) areas. Low-whole-grain, low-legume, and high-sodium diets were the three main dietary factors that increased the risk of IHD burden. Advanced age [RR (95%CI): 1.33 (1.27, 1.39)] and being male [1.11 (1.06, 1.16)] were independent risk factors for IHD mortality worldwide and in all SDI regions. After controlling for age effects, IHD risk showed a negative period effect overall. Poor diets were positively associated with increased risk of death but were not yet statistically significant. Interactions between dietary factors and advanced age were observed in all regions after adjusting for related variables. In people aged 55 and above, low intake of whole grains was associated with an increased risk of IHD death [1.28 (1.20, 1.36)]. DALY risks showed a similar but more obvious trend. ConclusionIHD burden remains high, with significant regional variations. The high IHD burden could be attributed to advanced age, sex (male), and dietary risk factors. Dietary habits in different SDI regions may have varying effects on the global burden of IHD. In areas with lower SDI, it is recommended to pay more attention to dietary problems, particularly in the elderly, and to consider how to improve dietary patterns in order to reduce modifiable risk factors.

Background: Short-term exposure to ambient PM2.5 and PM10 (particulate matter with aerodynamic diameters <= 2.5 mu m and 10 mu m, respectively) has been linked with hospitalization and mortality from stroke. However, the effect of PM1 (<= 1 mu m) exposure on the risk of hospitalization from stroke and its subtypes has rarely been investigated, in particular, on the basis of fine-scale exposure assessment at the individual level.Methods: We collected data on hospital admissions due to stroke and its subtypes in Guangzhou, China from January 1, 2014 to December 31, 2018. Daily exposures to PM1, PM2.5, and PM10 were assessed from satellite-derived estimates at a 1-km2 spatial resolution based on residential addresses. A time-stratified case-crossover analysis combined with a con-ditional logistic regression model was performed to examine the associations of stroke hospitalization risks with short-term exposure to size-fractional particles. We conducted stratified analyses by sex, age, season, and ambient temperature. Results: A total of 178,586 stroke hospitalizations were recorded during the study period, among which 141,709 cases were ischemic stroke and 25,255 cases were hemorrhagic stroke. The mean concentrations on the day of hospitalization were 20.0 mu g/m3 (control days: 19.9 mu g/m3) for PM1, 37.6 mu g/m3 (37.4 mu g/m3) for PM2.5, and 59.3 mu g/m3 (59.0 mu g/m3) for PM10. Short-term exposure to size-fractional particles was significantly associated with increased risks of hospital ad-mission for overall stroke and ischemic stroke, whereas null or negative associations were observed for hemorrhagic stroke. Compared with PM2.5 and PM10, PM1 was associated with greater excess risks of stroke hospitalizations. For each 10-mu g/m3 increase in PM1, PM2.5, and PM10 exposure at lag 03-day, the odds ratios were 1.016 (95% confidence interval: 1.008, 1.024), 1.007 (1.003, 1.011), and 1.007 (1.004, 1.010) for overall stroke hospitalization, and were 1.023 (1.014, 1.033), 1.010 (1.005, 1.014), and 1.009 (1.006, 1.013) for ischemic stroke, respectively. These associations were robust to co-pollutant adjustments and did not vary by sex and age, while significantly elevated risks were identified in cold months (October to March of the next year) and low-temperature days (<23.8 degrees C) only. Conclusions: Short-term exposure to particulate matter air pollution, particularly PM1, was associated with increased risks of hospitalization for overall stroke and ischemic stroke.

IntroductionThe evidence on eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake status and long-term mortality among people with diabetes is scarce. This study aimed to investigate the relationship between EPA and DHA intakes with all-cause and cause-specific mortality in adults with diabetes.MethodsThis study included 2,991 adults with diabetes from the National Health and Nutrition Examination Survey (NHANES) 1999–2008. Death outcomes were ascertained by linkage to the database records through 31 December 2015. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality from all causes, cardiovascular disease (CVD), and coronary heart disease (CHD) in patients with diabetes.ResultsAmong 2,991 patients with diabetes, the mean age was 61.9 years (55.2% males). During the mean follow-up duration of 9.4 years, a total of 1,091 deaths were documented, of which 273 were due to CVD, including 227 CHD deaths. EPA and DHA intakes were associated with lower mortality risks, especially that of CVD. After adjusting for demographic, major lifestyle factors, overall dietary intake patterns, and history of hypertension and dyslipidemia, the multivariable HRs (95% CIs) of mortality risk comparing Q4 to Q1 of EPA intake were 0.55 (0.33–0.92; P-trend = 0.019) for CHD, 0.55 (0.36–0.83; P-trend = 0.005) for CVD, and 0.91 (0.70–1.18; P-trend = 0.264) for all-cause. The respective HRs (95% CIs) comparing Q4 to Q1 of DHA were 0.60 (0.37–0.98; P-trend = 0.051) for CHD, 0.58 (0.38–0.89; P-trend = 0.014) for CVD, and 0.92 (0.72–1.18; P-trend = 0.481) for all-cause. In subgroup analysis, we found that the association trends of EPA and DHA intakes with death risk remained robust among patients with diabetes, especially among those who are old, female, those with higher BMI, and dyslipidemia patients with CVD and CHD.DiscussionIn the USA, higher EPA and DHA intakes were associated with a lower risk of CHD and CVD mortality in patients with diabetes. Our study supports the benefits of adequate EPA and DHA intakes in promoting the health of patients with diabetes.

BackgroundPrecise breast cancer–related mortality forecasts are required for public health program and healthcare service planning. A number of stochastic model–based approaches for predicting mortality have been developed. The trends shown by mortality data from various diseases and countries are critical to the effectiveness of these models. This study illustrates the unconventional statistical method for estimating and predicting the mortality risk between the early-onset and screen-age/late-onset breast cancer population in China and Pakistan using the Lee–Carter model.MethodsLongitudinal death data for female breast cancer from 1990 to 2019 obtained from the Global Burden of Disease study database were used to compare statistical approach between early-onset (age group, 25–49 years) and screen-age/late-onset (age group, 50–84 years) population. We evaluated the model performance both within (training period, 1990–2010) and outside (test period, 2011–2019) data forecast accuracy using the different error measures and graphical analysis. Finally, using the Lee–Carter model, we predicted the general index for the time period (2011 to 2030) and derived corresponding life expectancy at birth for the female breast cancer population using life tables.ResultsStudy findings revealed that the Lee–Carter approach to predict breast cancer mortality rate outperformed in the screen-age/late-onset compared with that in the early-onset population in terms of goodness of fit and within and outside forecast accuracy check. Moreover, the trend in forecast error was decreasing gradually in the screen-age/late-onset compared with that in the early-onset breast cancer population in China and Pakistan. Furthermore, we observed that this approach had provided almost comparable results between the early-onset and screen-age/late-onset population in forecast accuracy for more varying mortality behavior over time like in Pakistan. Both the early-onset and screen-age/late-onset populations in Pakistan were expected to have an increase in breast cancer mortality by 2030. whereas, for China, it was expected to decrease in the early-onset population.ConclusionThe Lee–Carter model can be used to estimate breast cancer mortality and so to project future life expectancy at birth, especially in the screen-age/late-onset population. As a result, it is suggested that this approach may be useful and convenient for predicting cancer-related mortality even when epidemiological and demographic disease data sets are limited. According to model predictions for breast cancer mortality, improved health facilities for disease diagnosis, control, and prevention are required to reduce the disease’s future burden, particularly in less developed countries.

After harvest, paddy rice may encounter frozen conditions during the storage and transportation periods. However, the effect of frozen storage on quality of paddy rice remains unclear. In this research, two moisture contents of paddy rice (13.5% and 15.1%) were stored at two frozen temperatures (-18 & DEG;C and -30 & DEG;C) for two months and then evaluated for quality attributes, including germination rate, peroxidase and polyphenol oxidase activities, fat acidity, milling quality, pasting property, cooking property, and texture of the cooked rice. The results showed that the frozen storage generally decreased the germination rate, activities of peroxidase and polyphenol oxidase, husked rice yield, head rice yield of paddy rice, reduced the water uptake ratio and volume expansion rate of milled rice during cooking, and lowered the hardness of cooked rice. At frozen condition, the decrease of temperature and the increase of moisture content led to a more pronounced reduction in germination rate and peroxidase activity. Frozen treatment of paddy rice did not significantly affect the pasting temperature of milled rice flour, but decreased the peak viscosity. Fat acidity of paddy rice slightly increased after frozen storage.