Meteorological factors are associated with hemorrhagic fever with renal syndrome in Jiaonan County,China, 2006–2011

This study examined the effect of meteorological factors on the occurrence of hemorrhagic fever with renal syndrome (HFRS) using a generalized additive model with penalized smoothing splines in Jiaonan, China, from 2006 to 2011. The dose–response relationship was first examined, and then the association between daily meteorological variables and HFRS occurrence was investigated according to the dose–response curves. There were two linear segments in the temperature–HFRS relationship curve. When daily temperature was lower than 17 °C, a positive association was found [with excessive risk (ER) for 1 °C increase on the current day being 2.56 %, 95 % confidence interval (CI): 0.36 % to 4.80 %]. An inverse association was found when daily temperature was higher than 17 °C [ER for 1 °C increase on the current day was ?12.82 % (95 % CI: ?17.51 % to ?7.85 %)]. Inverse associations were observed for relative humidity [ER for 1 % increase on lag day 4 was ?1.21 % (95 % CI: ?1.63 % to ?0.79 %)] and rainfall [ER for 1 mm increase on lag day 1 was ?2.20 % (95 % CI: ?3.56 % to ?0.82 %)]. Meteorological factors might be important predictor of HFRS epidemics in Jiaonan County.     

Effects and interaction of meteorological factors on hemorrhagic fever with renal syndrome incidence in Huludao City,northeastern China, 2007–2018

BackgroundHemorrhagic fever with renal syndrome (HFRS), a rodent-borne disease, is a severe public health threat. Previous studies have discovered the influence of meteorological factors on HFRS incidence, while few studies have concentrated on the stratified analysis of delayed effects and interaction effects of meteorological factors on HFRS.ObjectiveHuludao City is a representative area in north China that suffers from HFRS with primary transmission by Rattus norvegicus. This study aimed to evaluate the climate factors of lag, interaction, and stratified effects of meteorological factors on HFRS incidence in Huludao City.MethodsOur researchers collected meteorological data and epidemiological data of HFRS cases in Huludao City during 2007–2018. First, a distributed lag nonlinear model (DLNM) for a maximum lag of 16 weeks was developed to assess the respective lag effect of temperature, precipitation, and humidity on HFRS incidence. We then constructed a generalized additive model (GAM) to explore the interaction effect between temperature and the other two meteorological factors on HFRS incidence and the stratified effect of meteorological factors.ResultsDuring the study period, 2751 cases of HFRS were reported in Huludao City. The incidence of HFRS showed a seasonal trend and peak times from February to May. Using the median WAT, median WTP, and median WARH as the reference, the results of DLNM showed that extremely high temperature (97.5^th percentile of WAT) had significant associations with HFRS at lag week 15 (RR = 1.68, 95% CI: 1.04–2.74) and lag week 16 (RR = 2.80, 95% CI: 1.31–5.95). Under the extremely low temperature (2.5^th percentile of WAT), the RRs of HFRS infection were significant at lag week 5 (RR = 1.28, 95% CI: 1.01–1.67) and lag 6 weeks (RR = 1.24, 95% CI: 1.01–1.57). The RRs of relative humidity were statistically significant at lag week 10 (RR = 1.19, 95% CI: 1.00–1.43) and lag week 11 (RR = 1.24, 95% CI: 1.02–1.50) under extremely high relative humidity (97.5^th percentile of WARH); however, no statistically significance was observed under extremely low relative humidity (2.5^th percentile of WARH). The RRs were significantly high when WAT was -10 degrees Celsius (RR = 1.34, 95% CI: 1.02–1.76), -9 degrees Celsius (1.37, 95% CI: 1.04–1.79), and -8 degrees Celsius (RR = 1.34, 95% CI: 1.03–1.75) at lag week 5 and more than 23 degrees Celsius after 15 weeks. Interaction and stratified analyses showed that the risk of HFRS infection reached its highest when both temperature and precipitation were at a high level.ConclusionsOur study indicates that meteorological factors, including temperature and humidity, have delayed effects on the occurrence of HFRS in the study area, and the effect of temperature can be modified by humidity and precipitation. Public health professionals should pay more attention to HFRS control when the weather conditions of high temperature with more substantial precipitation and 15 weeks after the temperature is higher than 23 degrees Celsius.     

Short-Term Effect of El Ni?o-Southern Oscillation on Pediatric Hand,Foot and Mouth Disease in Shenzhen,China

Hand, foot and mouth disease (HFMD) was an emerging viral infectious disease in recent years in Shenzhen. The underlying risk factors have not yet been systematically examined. This study analyzed the short-term effect of El Niño-Southern Oscillation on pediatric HFMD in Shenzhen, China. Daily count of HFMD among children aged below 15 years old, Southern Oscillation Index (SOI), and weather variables were collected to construct the time series. A distributed lag non-linear model was applied to investigate the effect of daily SOI on pediatric HFMD occurrence during 2008–2010. We observed an acute effect of SOI variation on HFMD occurrence. The extremely high SOI (SOI = 45, with 0 as reference) was associated with increased HFMD, with the relative risk (RR) being 1.66 (95% Confidence Interval [CI]: 1.34–2.04). Further analyses of the association between HFMD and daily mean temperature and relative humidity supported the correlation between pediatric HFMD and SOI. Meteorological factors might be important predictors of pediatric HFMD occurrence in Shenzhen.     

The effect of solar-geomagnetic activity during and after admission on survival in patients with acute coronary syndromes

A number of studies have established the effects of solar-geomagnetic activity on the human cardio-vascular system. It is plausible that the heliophysical conditions existing during and after hospital admission may affect survival in patients with acute coronary syndromes (ACS). We analyzed data from 1,413 ACS patients who were admitted to the Hospital of Kaunas University of Medicine, Lithuania, and who survived for more than 4 days. We evaluated the associations between active-stormy geomagnetic activity (GMA), solar proton events (SPE), and solar flares (SF) that occurred 0–3 days before and after admission, and 2-year survival, based on Cox’s proportional-hazards model, controlling for clinical data. After adjustment for clinical variables, active-stormy GMA on the 2nd day after admission was associated with an increased (by 1.58 times) hazard ratio (HR) of cardiovascular death (HR?=?1.58, 95 % CI 1.07–2.32). For women, geomagnetic storm (GS) 2 days after SPE occurred 1 day after admission increased the HR by 3.91 times (HR?=?3.91, 95 % CI 1.31–11.7); active-stormy GMA during the 2nd–3rd day after admission increased the HR by over 2.5 times (HR?=?2.66, 95 % CI 1.40–5.03). In patients aged over 70 years, GS occurring 1 day before or 2 days after admission, increased the HR by 2.5 times, compared to quiet days; GS in conjunction with SF on the previous day, nearly tripled the HR (HR?=?3.08, 95 % CI 1.32–7.20). These findings suggest that the heliophysical conditions before or after the admission affect the hazard ratio of lethal outcome; adjusting for clinical variables, these effects were stronger for women and older patients.     

Ischemic Stroke Hospital Admission Associated with Ambient Temperature in Jinan,China

Background

This study estimated the effects of ambient temperature and relative humidity on hospital admissions for ischemic stroke during 1990–2009 in Jinan, China.

Methods

To account for possible delayed effects and harvesting effect, we examined the impact of meteorological factors up to 30 days before each admission using a distributed lag non-linear model; we controlled for season, long-term trend, day of week and public holidays in the analysis. Stratified analyses were also done for summer and winter.

Results

A total of 1,908 ischemic stroke hospital admissions were observed between 1990 and 2009. We found a strong non-linear acute effect of daily temperatures on ischemic stroke hospital admission. With the mean temperature 15°C as the reference, the relative risk (RR) was 1.43 (95% confidence interval (CI): 1.10–1.85) for 0°C daily temperature on the same day, and 0.43 (95% CI: 0.31–0.59) for 30°C daily temperature on the same day, respectively. The effect of ambient temperature was similar in summer and winter. No significant association was observed between relative humidity and ischemic stroke hospitalization.

Conclusions

Low temperature might be a risk factor for ischemic stroke, and high temperature might be protective factor of ischemic stroke occurrence in Jinan, China.     

The impact of the 2008 cold spell on mortality in Shanghai, China

No prior studies in China have investigated the health impact of cold spell. In Shanghai, we defined the cold spell as a period of at least seven consecutive days with daily temperature below the third percentile during the study period (2001–2009). Between January 2001 and December 2009, we identified a cold spell between January 27 and February 3, 2008 in Shanghai. We investigated the impact of cold spell on mortality of the residents living in the nine urban districts of Shanghai. We calculated the excess deaths and rate ratios (RRs) during the cold spell and compared these data with a winter reference period (January 6–9, and February 28 to March 2). The number of excess deaths during the cold spell period was 153 in our study population. The cold spell caused a short-term increase in total mortality of 13 % (95 % CI: 7–19 %). The impact was statistically significant for cardiovascular mortality (RR?=?1.21, 95 % CI: 1.12–1.31), but not for respiratory mortality (RR?=?1.14, 95 % CI: 0.98–1.32). For total mortality, gender did not make a statistically significant difference for the cold spell impact. Cold spell had a significant impact on mortality in elderly people (over 65 years), but not in other age groups. Conclusively, our analysis showed that the 2008 cold spell had a substantial effect on mortality in Shanghai. Public health programs should be tailored to prevent cold-spell-related health problems in the city.     

CHANGES IN WORKING TIME ARRANGEMENTS OVER TIME AS A CONSEQUENCE OF WORK-FAMILY CONFLICT

Existing longitudinal studies on the relationship between working time arrangements (WTA) and work-family conflict have mainly focused on the normal causal relationship, that is, the impact of WTA on work-family conflict over time. So far, however, the reversed relationship, that is, the effect of work-family conflict on adjustments in WTA over time, has hardly been studied. Because work-family conflict is highly prevalent in the working population, further insight in this reverse relationship is invaluable to gain insight into secondary selection processes. The aim of this study is to investigate whether work-family conflict is prospectively related to adjustments in work schedules, working hours, and overtime work, and to explore sex differences and different time lags in this relation. Data of the prospective Maastricht Cohort Study were used. To study the effect of work-family conflict on a change from shift- to day work over 32 months of follow-up, male three-shift (n?=?727), five-shift (n?=?932), and irregular-shift (n?=?451) workers were selected. To study effects of work-family conflict on reduction of working hours over 12 and 24 months of follow-up, respectively, only day workers (males and females) were selected, capturing 5809 full-time workers (≥36?h/wk) and 1387 part-time workers (<36?h/wk) at baseline. To examine effects of work-family conflict on refraining from overtime work over 12 months of follow-up, only day workers reporting frequent overtime work at baseline were selected (3145 full-time and 492 part-time workers). Cox regression analyses were performed with adjustments for age, educational level, and presence of a long-term illness. Work-family conflict was associated with a significantly increased risk of changing from shift- to day work over 32 months of follow-up in three-shift workers (relative risk [RR]?=?1.77, 95% confidence interval [CI] 1.19–2.63) but not in five-shift workers (RR?=?1.32, 95% CI 0.78–2.24) and irregular-shift workers (RR?=?0.81, 95% CI 0.50–1.31). Within day workers, work-family conflict among full-time workers was associated with a significantly increased risk of reducing working hours during 1 yr of follow-up in women (RR?=?2.80, 95% CI 1.42–5.54) but not men (RR?=?1.34, 95% CI 0.81–2.22). In part-time workers, work-family conflict was associated with a significantly increased risk of reducing working hours during 1 yr of follow-up both in women (RR?=?1.99, 95% CI 1.04–3.82) and men (RR?=?4.03, 95% CI 1.28–12.68). Whereas the effects of work-family conflict on a reduction of working hours somewhat decreased among female full-time workers after 2 yr of follow-up (RR?=?2.13, 95% CI 1.24–3.66), among male full-time workers the effects increased and reached statistical significance (RR?=?1.53, 95% CI 1.05–2.21). Work-family conflict was not significantly associated with refraining from overtime work over 1 yr of follow-up. This study shows that work-family conflict has important consequences in terms of adjustments in work schedules and working hours over time, with considerable sex differences. The study thereby clearly illustrates secondary selection processes both in shift- and day workers, with significant implications for labor force participation, emphasizing the need for prevention of work-family conflict (Author correspondence: Nicole.Jansen@epid.unimaas.nl).     

Parasite load and risk factors for poor outcome among children with visceral leishmaniasis. A cohort study in Belo Horizonte,Brazil, 2010-2011

Clinical and laboratory risk factors for death from visceral leishmaniasis (VL) are relatively known, but quantitative real-time polymerase chain reaction (qPCR) might assess the role of parasite load in determining clinical outcome. The aim of this study was to identify risk factors, including parasite load in peripheral blood, for VL poor outcome among children. This prospective cohort study evaluated children aged ≤ 12 years old with VL diagnosis at three times: pre-treatment (T0), during treatment (T1) and post-treatment (T2). Forty-eight patients were included and 16 (33.3%) met the criteria for poor outcome. Age ≤ 12 months [relative risk (RR) 3.51; 95% confidence interval (CI) 1.89-6.52], tachydyspnoea (RR 3.46; 95% CI 2.19-5.47), bacterial infection (RR 3.08; 95% CI 1.27-7.48), liver enlargement (RR 3.00; 95% CI 1.44-6.23) and low serum albumin (RR 7.00; 95% CI 1.80-27.24) were identified as risk factors. qPCR was positive in all patients at T0 and the parasite DNA was undetectable in 76.1% of them at T1 and in 90.7% at T2. There was no statistical association between parasite load at T0 and poor outcome.     

Weather Variability, Sunspots, and the Blooms of Cyanobacteria

The roles of weather variability and sunspots in the occurrence of cyanobacteria blooms, were investigated using cyanobacteria cell data collected from the Fred Haigh Dam, Queensland, Australia. Time series generalized linear model and classification and regression tree (CART) model were used in the analysis. Data on notified cell numbers of cyanobacteria and weather variables over the periods 2001 and 2005 were provided by the Australian Department of Natural Resources and Water, and Australian Bureau of Meteorology, respectively. The results indicate that monthly minimum temperature (relative risk [RR]: 1.13, 95% confidence interval [CI]: 1.02–1.25) and rainfall (RR: 1.11; 95% CI: 1.03–1.20) had a positive association, but relative humidity (RR: 0.94; 95% CI: 0.91–0.98) and wind speed (RR: 0.90; 95% CI: 0.82–0.98) were negatively associated with the cyanobacterial numbers, after adjustment for seasonality and auto-correlation. The CART model showed that the cyanobacteria numbers were best described by an interaction between minimum temperature, relative humidity, and sunspot numbers. When minimum temperature exceeded 18°C and relative humidity was under 66%, the number of cyanobacterial cells rose by 2.15-fold. We conclude that weather variability and sunspot activity may affect cyanobacteria blooms in dams.     

The association of extreme temperatures and the incidence of tuberculosis in Japan

Seasonal variation in the incidence of tuberculosis (TB) has been widely assumed. However, few studies have investigated the association between extreme temperatures and the incidence of TB. We collected data on cases of TB and mean temperature in Fukuoka, Japan for 2008–2012 and used time-series analyses to assess the possible relationship of extreme temperatures with TB incident cases, adjusting for seasonal and interannual variation. Our analysis revealed that the occurrence of extreme heat temperature events resulted in a significant increase in the number of TB cases (relative risk (RR) 1.20, 95 % confidence interval (CI) 1.01–1.43). We also found that the occurrence of extreme cold temperature events resulted in a significant increase in the number of TB cases (RR 1.23, 95 % CI 1.05–1.45). Sex and age did not modify the effect of either heat or cold extremes. Our study provides quantitative evidence that the number of TB cases increased significantly with extreme heat and cold temperatures. The results may help public health officials predict extreme temperature-related TB incidence and prepare for the implementation of preventive public health interventions.     

Large Daily Stock Variation Is Associated with Cardiovascular Mortality in Two Cities of Guangdong,China

Objective

The current study aimed to examine the effects of daily change of the Shenzhen Stock Exchange Index on cardiovascular mortality in Guangzhou and Taishan, China.

Methods

Daily mortality and stock performance data during 2006–2010 were collected to construct the time series for the two cities. A distributed lag non-linear model was utilized to examine the effect of daily stock index changes on cardiovascular mortality after controlling for potential confounding factors.

Results

We observed a delayed non-linear effect of the stock index change on cardiovascular mortality: both rising and declining of the stock index were associated with increased cardiovascular deaths. In Guangzhou, the 15–25 lag days cumulative relative risk of an 800 index drop was 2.08 (95% CI: 1.38–3.14), and 2.38 (95% CI: 1.31–4.31) for an 800 stock index increase on the cardiovascular mortality, respectively. In Taishan, the cumulative relative risk over 15–25 days lag was 1.65 (95% CI: 1.13–2.42) for an 800 index drop and 2.08 (95% CI: 1.26–3.42) for an 800 index rising, respectively.

Conclusions

Large ups and downs in daily stock index might be important predictor of cardiovascular mortality.     

The relationship between long-term sunlight radiation and cognitive decline in the REGARDS cohort study

Sunlight may be related to cognitive function through vitamin D metabolism or circadian rhythm regulation. The analysis presented here sought to test whether ground and satellite measures of solar radiation are associated with cognitive decline. The study used a 15-year residential history merged with satellite and ground monitor data to determine sunlight (solar radiation) and air temperature exposure for a cohort of 19,896 cognitively intact black and white participants aged 45+ from the 48 contiguous United States. Exposures of 15, 10, 5, 2, and 1-year were used to predict cognitive status at the most recent assessment in logistic regression models; 1-year insolation and maximum temperatures were chosen as exposure measures. Solar radiation interacted with temperature, age, and gender in its relationships with incident cognitive impairment. After adjustment for covariates, the odds ratio (OR) of cognitive decline for solar radiation exposure below the median vs above the median in the 3rd tertile of maximum temperatures was 1.88 (95 % CI: 1.24, 2.85), that in the 2nd tertile was 1.33 (95 % CI: 1.09, 1.62), and that in the 1st tertile was 1.22 (95 % CI: 0.92, 1.60). We also found that participants under 60 years old had an OR?=?1.63 (95 % CI: 1.20, 2.22), those 60–80 years old had an OR?=?1.18 (95 % CI: 1.02, 1.36), and those over 80 years old had an OR?=?1.05 (0.80, 1.37). Lastly, we found that males had an OR?=?1.43 (95 % CI: 1.22, 1.69), and females had an OR?=?1.02 (0.87, 1.20). We found that lower levels of solar radiation were associated with increased odds of incident cognitive impairment.     

Alzheimer’s Disease is an Important Risk Factor of Fractures: a Meta-analysis of Cohort Studies

The risk of fracture in individuals with Alzheimer’s disease had not been fully quantified. A systematic review and meta-analysis of cohort studies was performed to estimate the impact of Alzheimer’s disease on risk of fractures. Pubmed and Embase were searched for eligible cohort studies assessing the association between Alzheimer’s disease and risk of fractures. The overall relative risks (RRs) with 95% CIs were calculated using a random-effects model to evaluate the association. Six cohort studies with a total of 137,986 participants were included into the meta-analysis. Meta-analysis of a total of six studies showed that Alzheimer’s disease was significantly associated with two-fold increased risk of fractures (RR?=?2.18, 95 % CI 1.64–2.90, P?<?0.001; I ²?=?91.4 %). Meta-regression analysis showed that type of fractures was a source of heterogeneity (P?=?0.003). Meta-analysis of five studies on hip fracture showed that Alzheimer’s disease was significantly associated with 2.5-fold increased risk of hip fracture (RR?=?2.52, 95 % CI 2.26–2.81, P?<?0.001; I ²?=?25.2 %). There was no risk of publication bias observed in the funnel plot. There is strong evidence that Alzheimer’s disease is a risk factor of hip fracture.     

Excess mortality and morbidity during the July 2006 heat wave in Porto, Portugal

The purpose of this study was to understand the effects of the July 2006 heat wave through the use of the heat index, in mortality (all causes) and morbidity (all causes, respiratory and circulatory diseases) in general, and in people over 74 years and by gender, in Porto. In this paper, the Poisson generalized additive regression model was used to estimate the impact of apparent temperature (heat index) and daily mortality and morbidity during the July 2006 heat wave. Daily mortality, morbidity and heat index were correlated with lags of apparent temperature up to 7 days using Pearson correlation. For a 1°C increase in mean apparent temperature we observed a 2.7 % (95 % CI: 1.7–3.6 %) increase in mortality (all cause), a 1.7 % (95 % CI: 0.6–2.9 %) increase in respiratory morbidity, a 2.2 % (95 % CI: 0.4–4.1 %) increase in respiratory morbidity in women, a 5.4 % (95%CI: 1.1–6.6 %) increase in chronic obstructive pulmonary morbidity, and a 7.5 % (95 % CI: 1.3–14.1 %) increase in chronic obstructive pulmonary morbidity in women, for the entire population. For people?≥?75 years, our results showed a 3.3 % increase (95 % CI: 1.7–5.0 %) in respiratory morbidity, a 2.7 % (95 % CI: 0.4–5.1 %) increase in respiratory morbidity in men, a 3.9 % (95 %CI: 1.6–6.3 %) increase in respiratory morbidity in women, a 7.0 % (95 % CI: 1.1–13.2 %) in chronic obstructive pulmonary disease, and a 9.0 % (95 % CI: 0.3–18.5 %) in chronic obstructive pulmonary disease in women. The use of heat index in a Mediterranean tempered climate enabled the identification of the effects of the July 2006 heat wave in mortality due to all causes and in respiratory morbidity of the general population, as well as in respiratory morbidity of individuals with more than 74 years of age.     

Permanent night workers´ sleep and psychosocial factors in hospital work. A comparison to day and shift work

ABSTRACT

We aimed to study whether permanent night workers sleep and psychosocial factors differ from day workers and shift workers. The participants (n = 9 312, 92% females, average age 45 years, most commonly nurses and departmental secretaries) were day workers (DW, n = 2 672), shift workers (SW, n = 6 486) and permanent night workers (PNW, n = 154). The Finnish Public Sector survey responses from six hospital districts from 2012 were combined to payroll data from 91 days preceding the survey. The data were analyzed using Pearson χ²-test, one-way ANOVA and multinomial logistic regression analysis. The PNWs reported slightly longer average sleep length than the SWs or the DWs (7:27 vs. 7:13 and 7:10 h, p < 0.001). The PNWs reported least often difficulties in maintaining sleep (p < 0.001) compared to the SWs and the DWs. The PNWs reported most often difficulties to fall asleep and fatigue during free-time (p-values <0.001). The DWs and PNWs experienced less often work-life conflict than the SWs (25 and 26 vs. 38%, p < 0.001). The PNWs were more often satisfied with autonomy at work and appreciation and fair treatment by colleagues than the DWs or the SWs (p < 0.001). The SWs and PNWs reported remarkably higher occurrence of verbal (p < 0.001, OR 3.71, 95% CI 3.23–4.27 and OR 7.67, 95% CI 5.35–10.99, respectively) and physical workplace violence (p < 0.001, OR 9.24, 95% CI 7.17–11.90 and OR 28.34, 95% CI 16.64–43.06, respectively) compared to DWs. Conclusively, PNWs reported contradictory differences in sleep quality compared to DWs and SWs. PNWs are more often satisfied with their colleagues and autonomy at work than DWs or SWs but face workplace violence remarkably more often.     

Short versus long duration of dual antiplatelet therapy following drug-eluting stents: a meta-analysis of randomised trials

Background

Dual antiplatelet therapy (DAPT) remains the cornerstone therapy in the prevention of ischaemic events following drug-eluting stent (DES) implantation. Mandatory duration of DAPT after DES however, is a matter of debate. We aimed to evaluate safety and efficacy of short-term (up to 6 months) versus long-term (12 months) DAPT after DES implantation.

Methods

We searched PubMed, EMBASE, Cochrane databases, and international meetings for randomised clinical trials (RCTs) comparing short with long DAPT. We performed a systematic review and meta-analysis of major trials with primary outcomes: all-cause death, myocardial infarction, definite or probable stent thrombosis, stroke, and major bleeding event.

Results

Nine RCTs with a total number of 19,099 patients were pooled in the present meta-analysis. When compared with long DAPT, short DAPT was associated with a significant reduction in major bleeding events (0.62% vs. 1.10%, risk ratio (RR) 0.58, 95% confidence interval (CI) 0.39 to 0.86, p?<?0.007, I²?=?21%), whereas all-cause death (1.65% vs. 1.84%, RR 0.90, 95% CI 0.73 to 1.11, p?=?0.34, I2?=?0%), myocardial infarction (1.91% vs. 1.68%, RR 1.14, 95% CI 0.92 to 1.40, p?=?0.23, I2?=?0%), definite or probable stent thrombosis (0.62% vs. 0.47%, RR 1.25, 95% CI 0.84 to 1.86, p?=?0.27, I2?=?0%), and stroke (0.60% vs. 0.67%, RR 0.91, 95% CI 0.63 to 1.31, p?=?0.61, I2?=?0%) were similar.

Conclusions

Short DAPT following DES implantation results in a significant reduction of major bleeding events with no apparent increase in all-cause death, myocardial infarction, stent thrombosis, or stroke. Future dedicated trials should investigate the optimal strategies for patient-tailored DAPT in various subgroups.

     

Spatial patterns and effects of air pollution and meteorological factors on hospitalization for chronic lung diseases in Beijing,China

Chronic obstructive pulmonary disease(COPD), lung cancer(LC) and tuberculosis(TB) are common chronic lung diseases that generate a large disease burden and significant health care resource use in China. The aim of this study was to quantify spatial patterns and effects of air pollution and meteorological factors on hospitalization of COPD, LC and TB in Beijing. Daily counts of hospitalization for 2010 were obtained from the Beijing Urban Employees Basic Medical Insurance(UEBMI) system.Bayesian hierarchical Poisson regression models were applied to identify spatial patterns of hospitalization for COPD, LC and TB at the district level and explore associations with inhalable particulate matter(aerodynamic diameter 10 μm, PM_(10)), sulfur dioxide(SO_2), nitrogen dioxide(NO_2), mean temperature and relative humidity. There were 18,882, 14,295 and 2,940 counts of hospitalizations for COPD, LC and TB respectively, in Beijing in 2010. Clusters of high relative risk were in different locations for the three diseases. The effect of relative humidity on COPD hospitalization was most significant with a relative risk(RR) of 1.070(95%CI: 1.054, 1.086) per one percent increase. For lung cancer hospitalization, exposure to ambient SO_2 was associated with a RR of 1.034(95%CI: 1.011, 1.058) per μg m~(–3) increase. For tuberculosis, the effect of mean temperature was significant with a RR of 1.107(95%CI: 1.038, 1.180) per °C increase. Risk factors and spatial patterns were different for hospitalization of non-infectious and infectious chronic lung disease in Beijing. Even over a short time period(one year), associations were apparent with air pollution and meteorological factors.     

The expression profile and clinic significance of the SIX family in non-small cell lung cancer

Background

The SIX family homeobox genes have been demonstrated to be involved in the tumor initiation and progression, but their clinicopathological features and prognostic values in non-small cell lung cancer (NSCLC) have not been well defined. We analyzed relevant datasets and performed a systemic review and a meta-analysis to assess the profile of SIX family members in NSCLC and evaluate their importance as biomarkers for diagnosis and prediction of NSCLC.

Methods

This meta-analysis included 17 studies with 2358 patients. Hazard ratio (HR) and 95 % confidence interval (CI) were calculated to represent the prognosis of NSCLC with expression of the SIX family genes. Heterogeneity of the ORs and HRs was assessed and quantified using the Cochrane Q and I ² test. Begg’s rank correlation method and Egger’s weighted regression method were used to screen for potential publication bias. Bar graphs of representative datasets were plotted to show the correlation between the SIX expression and clinicopathological features of NSCLC. Kaplan-Meier survival curves were used to validate our prognostic analysis by pooled HR.

Results

The systematic meta-analysis unveiled that the higher expressions of SIX1-5 were associated with the greater possibility of the tumorigenesis. SIX4 and SIX6 were linked to the lymph node metastasis (LNM). SIX2, SIX3, and SIX4 were correlated with higher TNM stages. Furthermore, the elevated expressions of SIX2, SIX4, and SIX6 predicted poor overall survival (OS) in NSCLC (SIX2: HR?=?1.14, 95 % CI, 1.00–1.31; SIX4: HR?=?1.39, 95 % CI, 1.16–1.66; SIX6: HR?=?1.18, 95 % CI, 1.00–1.38) and poor relapse-free survival (RFS) in lung adenocarcinoma (ADC) (SIX2: HR?=?1.42, 95 % CI, 1.14–1.77; SIX4: HR?=?1.52, 95 % CI, 1.09–2.11; SIX6: HR?=?1.25, 95 % CI, 1.01–1.56).

Conclusions

Our report demonstrated that the SIX family members play distinct roles in the tumorigenesis of NSCLC and can be potential biomarkers in predicting prognosis of NSCLC patients.

     

Association Between Circulating Copeptin Level and Mortality Risk in Patients with Intracerebral Hemorrhage: a Systemic Review and Meta-Analysis

Copeptin has been identified as a biomarker of disease severity and is associated with mortality risk in several common diseases. This study sought to determine the association between circulating copeptin level and mortality risk in patients with intracerebral hemorrhage. PubMed, Web of Science, and Wanfang Medicine Database were searched for studies assessing the association between circulating copeptin level and mortality risk in patients with intracerebral hemorrhage. The pooled hazard ratio (HR) of mortality was calculated and presented with 95 % confidence interval (95 % CI). Data from 1332 intracerebral hemorrhage patients were derived from 9 studies. Meta-analysis showed that intracerebral hemorrhage patients with poor prognosis had much higher copeptin levels than those survivors (standardized mean difference?=?1.68, 95 % CI 1.26–2.11, P?<?0.00001). Meta-analysis of 8 studies with HRs showed that high circulating copeptin level was associated with higher risk of mortality in patients with intracerebral hemorrhage (HR?=?2.42, 95 % CI 1.60–3.65, P?<?0.0001). Meta-analysis of 6 studies with adjusted HRs showed that high circulating copeptin level was independently associated with higher risk of mortality in patients with intracerebral hemorrhage (HR?=?1.67, 95 % CI 1.26–2.22, P?=?0.0003). Our study suggests that there is an obvious association between circulating copeptin level and mortality in patients with intracerebral hemorrhage. High circulating copeptin level is independently associated with higher risk of mortality in patients with intracerebral hemorrhage.