The influence of ambient air pollution on psoriasis is acknowledged; however, data from inland northwestern China is scarce. We correlated 21,458 outpatient consultations for psoriasis from two tertiary medical facilities in Shihezi, China, between 2015 and 2024 with daily air quality and weather data. A distributed lag non-linear model (DLNM) served as the principal analytical framework to evaluate the immediate lagged and cumulative relationships of PM2.5, PM10, NO2, SO2, CO, and O₃ with outpatient visits across a 7-day lag interval. Complementary autoregressive integrated moving average model (ARIMAX) were employed as robustness checks to address temporal autocorrelation and significant external interventions. In the initial DLNM evaluations, PM2.5, PM10, NO2, and SO2 were positively associated with outpatient consultations for psoriasis. The strongest cumulative association was found for NO2 for lag 0–1 (relative risk 1.082, 95% confidence interval 1.023–1.145). The exposure-response relationships were non-linear, and all associations became non-significant after co-pollutant correction in 2-pollutant models. In the supplementary ARIMAX evaluations, solely the weighted cumulative SO2 exposure exhibited statistical significance in the main model (relative risk 1.046, 95% confidence interval 1.002–1.092), although this association lacked robustness in various alternative ARIMAX model configurations. These results offer localized evidence that brief exposure to various combustion-related pollutants may elevate psoriasis outpatient visits in Shihezi, while the ARIMAX-derived SO2 finding should be regarded with caution, as it is model-dependent rather than a strong independent association.

OBJECTIVE:This study applied two-sample Mendelian randomization (MR) to elucidate causal relationships between sleep-related phenotypes and childhood asthma risk. METHODS:Instrumental variables for daytime napping, sleep disorders, chronotype, and fatigue were selected from European ancestry genome-wide association studies. Causal estimates were primarily derived using inverse-variance weighting (IVW), supplemented by sensitivity analyses including MR-Egger and MR-PRESSO. Instrument validity, heterogeneity, pleiotropy, and directionality were rigorously evaluated. RESULTS:IVW results demonstrated that genetic susceptibility to daytime napping (OR = 1.76; 95% CI: 1.07-2.88; p < .05), sleep disorders (OR = 1.35; 95% CI: 1.12-1.61; p < .05), and frequent fatigue (OR = 2.94; 95% CI: 1.61-5.38; p < .05) significantly increased asthma risk, whereas morning chronotype was protective (OR = 0.76; 95% CI: 0.61-0.98; p = .015). Sensitivity analyses supported these findings, with no evidence of pleiotropy or reverse causation. CONCLUSIONS:These results suggest that sleep behaviors causally influence childhood asthma risk and may represent modifiable targets for prevention and management.

JOURNAL/mgres/04.03/01612956-202612000-00012/figure1/v/2026-07-23T200825Z/r/image-tiff After knee cartilage injury, the self-repair capability is limited, making it prone to progression into osteoarthritis. Recently, gas signaling molecules such as nitric oxide and oxygen, along with reactive oxygen species and other factors associated with oxygen metabolism, have increasingly demonstrated critical roles in the field of knee cartilage injury and repair. However, there are few reports on the evolving research hotspots in this field. Based on the Web of Science Core Collection database, this study conducted a bibliometric and visualization analysis of 245 publications related to the roles of gas molecules and other factors associated with knee cartilage injury and repair. The results reveal a clear evolutionary trend in the research hotspots of this field, characterized by a transition from basic mechanism exploration to translational application transformation. (1) Basic mechanism exploration stage: The keyword co-occurrence network identified a tightly-knit cluster comprising core nodes such as "nitric oxide," "chondrocytes," "apoptosis," "reactive oxygen species," "oxidative stress," and "hypoxia." Co-citation analysis revealed that classic studies had demonstrated that nitric oxide mediates chondrocyte injury and matrix degradation through the inducible nitric oxide synthase-nitric oxide-apoptosis signaling pathway. Subsequent research further clarified the dual regulatory roles of oxygen and reactive oxygen species, confirming the significance of the hypoxia-inducible factor pathway in cartilage metabolism. Burst detection revealed that core literature from this period, such as studies on inducible nitric oxide synthase inhibition and hypoxic culture, maintained a high citation rate for 5-8 years, thereby forming a long-term, stable knowledge foundation in the field. (2) Translational application transformation stage: Emerging translational and biomaterial-related nodes, including "graphene oxide," "cartilage tissue engineering," and "nanomedicine," together with gas-based interventions such as "ozone therapy," have surged and formed strong interdisciplinary connections with "osteoarthritis" and "cartilage repair." This shift illustrates a change in perspective from "injury mechanisms" to "repair interventions." Co-citation analysis confirmed that the most significant recent literature focuses on the relationship between reactive oxygen species, cartilage aging, and osteoarthritis, as well as on nanoscale drug delivery systems for directly clearing nitric oxide and reactive oxygen species. Burst detection revealed that "synergistic intervention of materials and gases" has emerged as the most active frontier hotspot. These findings suggest that gas signaling molecules and oxygen metabolism-related factors are core mediators regulating knee cartilage injury and repair. Research hotspots have shifted from exploring the inducible nitric oxide synthase-nitric oxide-apoptosis signaling pathway and oxidative stress in cartilage injury to translational applications in nanomedicine and biomaterials for cartilage repair. Future research may benefit from elucidating the mechanisms underlying multi-factor interactive networks and promoting the clinical translation of gas-targeted regulatory strategies.

OBJECTIVE:The present study aims to evaluate the prevalence and risk factors of asthma in children through a meta-analysis. DATA SOURCES:The PubMed, Embase, Cochrane, and Web of Science databases were comprehensively retrieved for studies on the prevalence and risk factors of childhood asthma (CA) published between January 1, 2015, and July 8, 2024. Studies were screened and selected based on predefined eligibility criteria, and pertinent data were extracted. The quality of eligible studies was evaluated through the Newcastle-Ottawa Scale (NOS). Statistical analyses were undertaken via Stata 16 and R 4.4.1. STUDY SELECTION:45 studies comprising 647,414 participants were included. RESULTS:The pooled prevalence of CA was 11.9% (95% CI: 8.8-15.8%). The meta-analysis identified several risk factors for CA, including prenatal exposure to per- and polyfluoroalkyl substances (PFAS) (OR = 0.89, 95% CI: 0.80-0.98, P = 0.021), prenatal exposure to acid-suppressive medications (OR = 1.11, 95% CI: 1.04-1.19, P = 0.002), maternal folic acid supplementation during pregnancy (OR = 1.18, 95% CI: 1.10-1.27, p < 0.001), as well as Helicobacter pylori infection in childhood (OR = 2.07, 95% CI: 1.35-3.15, p = 0.001). CONCLUSIONS:The prevalence rate of asthma among children was approximately 11.9%. Prenatal exposure to PFAS and acid-suppressive medications, Helicobacter pylori infection in childhood were proved to be risk factors for asthma. Folic acid supplementation during pregnancy is positively associated with a reduced risk of asthma in children. Further large-scale prospective research is warranted to unveil the roles and significance of these factors.

Background: Hysteroscopic surgery has been widely used in clinical practice for more than 30 years due to its advantages of less trauma, less bleeding, and direct vision. The aim of this study was to compare hysteroscopic morcella-tion versus conventional resectoscopy for removal of endometrial lesions. Material/Methods: For the database search, we used the keywords "morcellator," "morcellators," "morcellate," "morcellation," and "morcellated" combined with "hysteroscopy," "uteroscope," and "transcervical". The last search was conduct-ed on February 1, 2022. Randomized controlled trials (RCTs) were included in the meta-analysis. Results: According to our retrieval scheme and the inclusion and exclusion criteria, we found 6 studies including 565 patients. For enumeration data, we calculated the effect size as relative risk (RR) and 95% confidence interval (95% CI), while for quantitative data we used the weighted mean difference (WMD) and 95% confidence in-terval (95% CI). There was no significant difference between success rate of hysteroscopic morcellation and conventional resectoscopy (relative risk and 95% confidence interval 1.05(0.97,1.13); P=0.232). Procedure time was also shorter with hysteroscopic morcellation, the procedure time of the hysteroscopic morcellation group was 3.43 min shorter compared with the conventional resectoscopy group, and the operating time in the hys-teroscopic morcellation group was 2.81 min shorter. In terms of fluid deficit, there was no statistically signifi-cant difference in fluid loss between the 2 groups (P=0.209). Conclusions: Hysteroscopic morcellation is associated with a shorter procedure time and operative time among patients with endometrial lesions compared with resectoscopy.

The associations of air pollution and meteorological factors with the outpatient visits of urticaria remain poorly studied. This study aimed to assess the association between air pollution, meteorological factors, and daily outpatient visits for urticaria in Shijiazhuang, China, during 2014-2019. Daily recordings of air pollutant concentrations, meteorological data, and outpatient visits data for urticaria were collected during the 6 years. Descriptive research methods were used to describe the distribution characteristics and demographic features of urticaria. A combination of the generalized linear regression model (GLM) and distribution lag nonlinear model (DLNM) was used to evaluate the lag association between environmental factors and daily outpatient visits for urticaria. Stratified analyses by gender (male; female) and age (< 18 years; 18-39 years; > 39 years) were further conducted. The dose-response relationship between daily urticaria visits and CO, NO2, O3, temperature, and relative humidity was nonlinear. High concentrations of CO, NO2, O3, and high temperatures increased the risk of urticaria outpatient visits. The maximum cumulative association of high concentrations of CO, NO2, and O3 was lag 0-14 days (CO: RR = 1.10, 95%CI: 1.06, 1.31; NO2: RR = 1.09, 95%CI: 1.01, 1.08; O3: RR = 1.16, 95%CI: 1.08, 1.25), and high temperatures was lag 0-7 days (RR = 1.27, 95%CI: 1.14, 1.41). Low concentrations of NO2, O3, and high humidity, on the other hand, act as protective factors for urticaria outpatient. The maximum cumulative association of low concentrations of NO2 was the 0-day lag (RR = 0.97, 95%CI: 0.95, 0.99), O3 was lag 0-5 days (RR = 0.94, 95%CI: 0.88, 0.99), and high humidity was lag 0-10 days (RR = 0.93, 95%CI: 0.89, 0.98). Stratified analyses showed that the risk of urticaria outpatient visits was higher for the males and in the < 18 years age group. In conclusion, we found that the development of urticaria in Shijiazhuang has a distinct seasonal and cyclical nature. Air pollutants and meteorological factors had varying degrees of influence on the risk of urticaria outpatient visits. This study provides indirect evidence for a link between air pollution, meteorological factors, and urticaria outpatient visits.

Background: Air pollutants have an impact on the occurrence of spine fractures, hip fractures, proximal humerus fractures and forearm fractures. This study aimed at evaluating the short-term impact of particulate matter with aerodynamic diameters of less than 2.5 mu m (PM2.5) on the occurrence of those fractures in Shijiazhuang, Hebei, China. Methods: The daily meteorological, pollution, and fracture data of Shijiazhuang from 2014 to 2019 were collected. Distribution characteristics of fractures were described using descriptive epidemiological methods. The distributed lag nonlinear model (DLNM) was used to reveal the description of those fractures in the exposed and lag dimensions at the same time. Based on gender and age ( < 18 years old, 18-69 years old and > 69 years old), stratified analysis was performed. Sensitivity analysis was performed to ascertain the robustness of the results. Results: Between 2014 and 2019, fracture incidences in Shijiazhuang exhibited an overall increasing trend, with an obvious seasonality. PM2.5 was positively related to daily fracture cases and the effects were more obvious in women, adolescents and people of working age. When PM2.5 concentrations increased by one interquartile range (IQR) (70 mu g/m3), RR exhibited a unimodal distribution. Its peak appeared on the 16th day of lag (RR = 1.005987, 95% CI:1.002472,1.009652), and the RRs were also statistically significant from the 10th to 22nd day of lag. Similarly, cumulative effects of each increase in the concentration of PM2.5 IQR also showed a unimodal distribution. The largest cumulative effect occurred on the 28th day of lag (RR = 1.084457, 95% CI:1.012207,1.161864), and the cumulative RRs were also statistically significant from the 19th day to 30nd days. In the dose-response relationship, as PM2.5 concentrations increased, RR increased. Conclusion: Year by year, fractures in Shijiazhuang City exhibited an increasing trend. PM2.5 can affect the occurrence of those fractures. The impact on women, adolescents and people of working age is even greater. The supervision of PM2.5 should be strengthened while large-scale emissions should be limited.(c) 2022 Elsevier Ltd. All rights reserved.

Abstract Objective: The associations of air pollutants and meteorological factors with the outpatient visits of urticaria remain poorly studied. This study aimed to assess the short-term effects of air pollutants and meteorological factors on daily outpatient visits for urticaria in Shijiazhuang, China, during 2014-2019.Methods: Daily recordings of air pollutants concentrations, meteorological data, and the outpatient visits data for urticaria were collected during the 6 years. Descriptive research methods were used to describe the distribution characteristics and demographic features of urticaria. A combination of the generalized linear regression model (GLM) and distribution lag nonlinear model (DLNM) was used to evaluate the lag effect of environmental factors on daily outpatient visits for urticaria. Results: The dose-response relationship between daily urticaria visits and CO, NO2, O3, temperature, and relative humidity was nonlinear. High concentrations of CO, NO2, O3, and high temperatures increased the risk of urticaria outpatient visits. The maximum cumulative effect of high concentrations of CO, NO2, and O3 was lag 0-14 days (CO: RR = 1.10, 95%CI: 1.06, 1.31; NO2: RR = 1.09, 95%CI: 1.01, 1.08; O3: RR = 1.16, 95%CI: 1.08, 1.25), and high temperatures was lag 0-7 days (RR = 1.27, 95%CI: 1.14, 1.41). Low concentrations of NO2, O3, and high humidity, on the other hand, act as protective factors for the urticaria outpatient. The maximum cumulative effect of low concentrations of NO2 was the 0-day lag (RR = 0.97, 95%CI: 0.95, 0.99), O3 was lag 0-5 days (RR = 0.94, 95%CI: 0.88, 0.99), and high humidity was lag 0-10 days (RR = 0.93, 95%CI: 0.89, 0.98).Conclusions: In conclusion, we found that the development of urticaria in Shijiazhuang has a distinct seasonal and cyclical nature. Air pollutants and meteorological factors had varying degrees of influence on the risk of urticaria outpatient visits.

Most of the studies are focused on influenza and meteorological factors for influenza. There are still few studies focused on the relationship between pollution factors and influenza, and the results are not consistent. This study conducted distributed lag nonlinear model and attributable risk on the relationship between influenza and pollution factors, aiming to quantify the association and provide a basis for the prevention of influenza and the formulation of relevant policies. Environmental data in Shijiazhuang from 2014 to 2019, as well as the data on hospital-confirmed influenza, were collected. When the concentration of PM2.5 was the highest (621 μg/m3), the relative risk was the highest (RR: 2.39, 95

Some studies have shown that maternal exposure to perfluoroalkyl substances (PFASs) may be associated with early attention deficit hyperactivity disorder (ADHD) in children. The purpose of this systematic review and meta-analysis is to verify this association by reviewing existing studies and to provide a strong basis for preventing ADHD. The researchers searched electronic databases such as PubMed, Science Direct, Scopus, Google Scholar, Web of Science, and Embase for all studies published before October 2020. Finally, we included nine articles for analysis. Our meta-analysis showed that maternal exposure to PFASs was not significantly associated with the prevalence rate of early childhood ADHD (perfluorooctanoic acid (PFOA), odds ratio (OR) = 1.00, 95% confidence interval (95% CI) = 0.75-1.25; perfluorooctane sulfonate (PFOS), OR = 1.01, 95% CI = 0.88-1.14; perfluorohexane sulfonate (PFHxS), OR = 1.08, 95% CI = 0.80-1.09; perfluorononanoic acid (PFNA), OR = 1.13, 95% CI = 0.99-1.28; perfluorodecanoic acid (PFDA), OR = 1.23, 95% CI = 0.15-2.32). Due to significant heterogeneity, we subsequently performed subgroup analysis and sensitivity analysis. Through subgroup analysis, we found that PFOS concentration of children's blood and the prevalence rate of early childhood ADHD were statistically positively correlated, and there was also a positive correlation between PFOS exposure and the prevalence rate of early childhood ADHD in the America. Moreover, there was also a statistically positive correlation between PFNA concentration in maternal blood and the prevalence rate of early childhood ADHD. Sensitivity analysis showed that the final results did not change much, the sensitivity was low, and the results were relatively stable. In conclusion, a causal relationship between maternal PFASs exposure and ADHD in children was unlikely. Among them, PFOS, PFNA, and ADHD might have positive associations worthy of further investigation.

Some studies have shown that maternal perfluoroalkylated substances (PFAS) exposure may be associated with low birth weight (LBW) of offspring. We conducted a meta-analysis to assess the association between maternal PFASs exposure and LBW in offspring. The researchers searched PubMed, Science Direct, Scopus, Google Scholar, Web of Science, and Embase to find all the articles before October 2020. The Newcastle-Ottawa Scale was used to evaluate the quality of the studies. Finally, six articles were included for meta-analysis. Our meta-analysis showed no significant correlation between maternal perfluorooctanoic acid (PFOA) exposure and LBW of offspring: odds ratio (OR) = 0.90, 95% confidence interval (95% CI) = 0.80-1.01, with low heterogeneity (I-2 = 18.4%, P = 0.289); there was a significant positive correlation between maternal perfluorooctane sulfonate (PFOS) exposure and LBW of offspring (OR = 1.32, 95% CI = 1.09-1.55) with no heterogeneity (I-2 = 0.00%, P = 0.570). The grouping analysis of PFOS showed was a significant positive correlation between maternal PFOS exposure and LBW of offspring in American (OR = 1.44, 95% CI = 1.15-1.72). This study provided a systematic review and meta-analysis evidence for the relationship between maternal PFASs exposure and LBW of offspring through a small number of studies. Researchers should conduct further studies between different regions.