Trends in myeloma incidence,mortality and survival in New Zealand (1985–2016)

BackgroundMyeloma, one of the most common haematological malignancies worldwide arises in the bone marrow. Incidence rates vary by age and ethnicity but reasons behind these trends are unknown. Treatment of myeloma has changed significantly over recent decades, resulting in longer survival and decreased mortality.MethodsFrom data supplied by the Ministry of Health, all new registrations of and deaths from myeloma between 1985 and 2016 were extracted. Trends in age-specific rates were assessed using the method of Armitage. Age-standardised rates were calculated, and trends in age-adjusted rates analysed using the Mantel-Haenszel extension chi-square test. Age-adjusted incidence and mortality rate ratios were calculated. Myeloma-specific survival was visualised using Kaplan-Meier curves and multivariable hazard ratios calculated using Cox regression.ResultsBetween 1985 and 2016, 7826 New Zealanders were registered with myeloma. Over this time the age-specific incidence of myeloma increased significantly for men, who had higher rates than women. Myeloma mortality was highest in Maori men. Men had higher mortality rates than women in all time periods. Since 1995–1999, mortality has decreased in women whereas in men it has declined since about 2000–2004. Survival has increased significantly since 1990 but Maori still have a higher risk of death than non-Maori.ConclusionThe patterns of variation in myeloma incidence, mortality and survival, as well as their trends over time may be used to assist research into the causes and management of myeloma in New Zealand.     

Pneumonia Incidence and Mortality in Mainland China: Systematic Review of Chinese and English Literature, 1985–2008

Background

Pneumonia is a leading infectious disease killer worldwide, yet the burden in China is not well understood as much of the data is published in the non-English literature.

Methodology/Principal Findings

We systematically reviewed the Chinese- and English-language literature for studies with primary data on pneumonia incidence and mortality in mainland China. Between 1985 and 2008, 37 studies met the inclusion criteria. The quality of the studies was highly variable. For children <5 years, incidence ranged from 0.06–0.27 episodes per person-year and mortality ranged from 184–1,223 deaths per 100,000 population. Overall incidence and mortality were stable or decreased over the study period and were higher in rural compared to urban areas.

Conclusions/Significance

Pneumonia continues to be a major public health challenge in young children in China, and estimates of pneumonia incidence and mortality vary widely. Reliable surveillance data and new prevention efforts may be needed to achieve and document additional declines, especially in areas with higher incidence and mortality such as rural settings.     

Association between Ambient Temperature and Acute Myocardial Infarction Hospitalisations in Gothenburg,Sweden: 1985–2010

Cardiovascular disease (CVD) is the number one cause of death globally and evidence is steadily increasing on the role of non-traditional risk factors such as meteorology and air pollution. Nevertheless, many research gaps remain, such as the association between these non-traditional risk factors and subtypes of CVD, such as acute myocardial infarction (AMI). The objective of this study was to investigate the association between daily ambient temperature and AMI hospitalisations using a case-crossover design in Gothenburg, Sweden (1985–2010). A secondary analysis was also performed for out-of-hospital ischemic heart disease (IHD) deaths. Susceptible groups by age and sex were explored. The entire year as well as the warm (April−September) and cold periods (October–March) were considered. In total 28 215 AMI hospitalisations (of 22 475 people) and 21 082 out-of-hospital IHD deaths occurred during the 26-year study period. A linear exposure-response corresponding to a 3% and 7% decrease in AMI hospitalisations was observed for an inter-quartile range (IQR) increase in the 2-day cumulative average of temperature during the entire year (11°C) and the warm period (6°C), respectively, with and without adjustment for PM₁₀, NO₂, NO_x or O₃. No heat waves occurred during the warm period. No evidence of an association in the cold period nor any association between temperature and IHD deaths in the entire year, warm or cold periods - with and without adjusting for PM₁₀, NO₂, NO_x or O₃ was found. No susceptible groups, based on age or sex, were identified either. The inverse association between temperature and AMI hospitalisations (entire year and warm period) in Gothenburg is in accordance with the majority of the few other studies that investigated this subtype of CVD.     

Prevalence and Trends in Obesity among China’s Children and Adolescents, 1985–2010

Objectives

We examined the prevalence of and trends in obesity among children and adolescents in China (1985–2010).

Methods

We used data from the 1985, 1991, 1995, 2000, 2005, and 2010 Chinese National Surveys on Students’ Constitution and Health (CNSSCH). The CNSSCH is a national survey of physical fitness and health status in Chinese students that uses multistage stratified sampling of 31 provinces and municipalities. A subject was considered obese or overweight if weight-for-height exceeded the 20% or 10% of standard weight-for-height. The standard weight-for-height was the 80th percentile for sex- and age-specific growth charts.

Results

The age-adjusted prevalence of obesity and of overweight and obesity combined was 8.1% (95% CI, 8.0–8.3%) and 19.2% (95% CI, 19.1–19.4%) among children and adolescents 7–18 years in age. Obesity was more likely to be present among children or adolescents who were male (RR, 1.93; 95% CI, 1.90–1.97), urban (RR, 1.99; 95% CI, 1.95–2.02), or 10–12 years (RR, 1.43; 95% CI, 1.40–1.46). Trend analyses of the 25-year period revealed a significant increasing trend in males (RR, 1.59; 95% CI, 1.58–1.60) and in females (RR, 1.49; 95% CI, 1.48–1.50). The rate of increase in obese or overweight prevalence was highest in boys from rural areas (9% annual increase).

Conclusions

During 1985–2010, there was a significant and continuous increase in the prevalence of obesity in children and adolescents. Obesity is epidemic in China, but may be reduced with evidence-based interventions (e.g., school intervention programs).     

Karl Beurlen (1901–1985), Nature Mysticism, and Aryan Paleontology

The relatively late acceptance of Darwinism in German biology and paleontology is frequently attributed to a lingering of Lamarckism, a persisting influence of German idealistic Naturphilosophie and Goethean romanticism. These factors are largely held responsible for the vitalism underlying theories of saltational and orthogenetic evolutionary change that characterize the writings of many German paleontologists during the first half of the 20th century. A prominent exponent of that tradition was Karl Beurlen, who is credited with having been the first German paleontologist to present a full-fledged theory of saltational evolution and orthogenetic change. A review of Beurlen’s writings reveals motives and concerns far more complex, however, and firmly rooted in contemporary v?lkisch thought and Aryan Science. Beurlen’s mature theory of evolution can indeed be understood as his own contribution to Aryan Geology and Biology, tainted as it was with National-Socialist ideology. Evolutionary biologists of the time who opposed the theories of Beurlen and like-minded authors, i.e., idealistic morphology, typology, saltational change, orthogenesis and cyclism did so on Darwinian principles, which ultimately prevailed. But at the time when the battle was fought, their adherence to the principle of natural selection was likewise ideologically tainted, namely in terms of racial theory. National-Socialist ideology was unable to forge a unity of evolutionary theory in Germany even amongst those of its proponents who endorsed this ideology.     

Short‐term fluctuations in death by cause,temperature, and income in the United States, 1930–1985

Abstract

Disclosures that this decade has had the five hottest years ever recorded globally raise concern that extreme temperatures might be associated with higher mortality. An analysis of fluctuations in annual cause‐specific deaths, seasonal temperatures, and annual income per capita in Massachusetts, Michigan, Washington, Utah, North Carolina, and Mississippi, 1930 to 1985, suggests that, on the contrary, a temperature increase throughout the year was associated with fewer deaths from all causes combined, including deaths from infectious diseases, heart diseases, cerebrovascular diseases, pneumonia, and influenza. An average temperature increase of one degree Fahrenheit was associated with a more than 2 per cent decline in deaths from pneumonia and influenza. The only category of deaths showing no significant association was death from malignant neoplasms. Compared to spring, summer, and fall temperature fluctuations, unusually cold winter temperatures had the strongest fatal effects, but only in North Carolina and Mississippi. The greatest cumulative temperature effects on mortality were found in the same two states. Controlling for annual fluctuations in income per capita did not influence the relationship between temperature and mortality. There was evidence suggesting that the level of wealth ameliorated the fatal effects of extreme temperatures. In conclusion, unusually warm weather was followed by fewer deaths; unusually cold weather, by more deaths.     

Killer Whale (Orcinus orca) Deaths in Prince William Sound,Alaska, 1985–1990

During 1985–1990, two groups of killer whales in Prince William Sound, Alaska, experienced unusually high rates of mortality, while seven others did not. Those affected were AB pod, part of the southern Alaska population of resident (fish-eating) killer whales, and the AT1 transient (marine mammal–eating) group, a very small, reproductively isolated population that last reproduced in 1984. In 1985–1986, several AB pod members were shot by fishermen defending their catch from depredation, which explains some of the deaths. Understanding the other deaths is complicated by the Exxon Valdez oil spill (March 1989) and uncertainties about the causes and times of the deaths. For AB pod, possible factors involved in the post-spill mortalities are delayed effects of bullet wounds, continued shooting, oil exposure, and consequences of being orphaned. For the AT1 group, possible factors are oil exposure, small population size, old age, and high-contaminant burdens. An analysis of possible effects of inhalation of volatile organic compounds, contact with the oil slick, and ingestion of oil with water or prey did not reveal route(s) of exposure that could explain the mortalities. The cause(s) of the killer whale deaths recorded following the oil spill remain uncertain.     

Radiotherapy facilities,equipment, and staffing in Poland: 2005–2011

Background and purpose

To evaluate the current status of radiotherapy facilities, staffing, and equipment, treatment and patients in Poland for the years 2005–2011 following implementation of the National Cancer Programme.

Methods

A survey was sent to the radiotherapy centres in Poland to collect data on available equipment, staffing, and treatments in the years 2005–2011.

Results

In 2011, 76,000 patients were treated with radiotherapy at 32 centres vs. 63,000 patients at 23 centres in 2005. Number of patients increased by 21%. In 2011, there were 453 radiation oncologists – specialists (1 in 168 patients), 325 medical physicists (1 in 215 patients), and 883 radiotherapy technicians (1 in 86 patients) vs. 320, 188, and 652, respectively, in 2005. The number of linear accelerators increased by 60%, from 70 units in 2005 to 112 in 2011. The current linac/patient ratio in Poland is 1 linac per 678 patients. Waiting times from diagnosis to the start of treatment has decreased.

Conclusion

Compared to 2005, there are more treatment facilities, more and better equipment (linacs), and more cancer care specialists. There are still large differences between the 16 Polish provinces in terms of equipment availability and ease of access to treatment. However, radiotherapy services in Poland have improved dramatically since the year 2005.     

Wetland loss dynamics in southwestern Barataria basin,Louisiana (USA), 1945–1985

We determined spatial associations of wetland loss rates in a 950-km² study area in the southwestern Barataria basin of Louisiana's Mississippi River delta plain for four intervals spanning 40 years, 1945–1985. A geographic information system was used to analyze spatial and temporal changes.Annual wetland loss rates increased over the 40 years; the rate of increase in annual rates accelerated through 1980 and then began to decelerate. The average annual rate of wetland loss for the entire study area increased from 0.2%/yr during 1945–1956, to 1.2%/yr for 1956–1969, 1.9%/yr for 1969–1980, and 2.0%/yr for 1980–1985. Wetland loss was not uniform throughout the study area. Eight sub-areas were identified as having different densities and/or causes of loss. Processes implicated in the differing loss rates include sea level rise, shoreline erosion, accelerated subsidence along natural levees, canal modification of hydrologic flows, interference of dredged material with sheet flow, and saltwater intrusion. In some areas, several processes are believed to operate together to induce wetland degradation and wetland loss.     

Cryptococcosis in China (1985–2010): Review of Cases from Chinese Database

Background

Cryptococcosis is a potential fatal disease, especially in immunocompromised patients. In China, the profile of cryptococcosis is unclear. Therefore, we summarize the epidemiology and therapy of cryptococcosis in china.

Methods

All cases reports about cryptococcosis in China were collected from CBMdisk database (China Biology and Medicine data disc) with key words of cryptococcosis, or cryptococcal infection, or cryptococcus, and case. The features of the cryptococcosis were retrospectively analyzed.

Results

There were 1,032 reports about cryptococcosis, including 8,769 cases. Among them, there were 16% patient with AIDS/HIV, and 17% ones without underlying diseases. There were 2,371 cases of CNS infection. Among them of 2,068 cases, the treatment protocols and outcome were clearly described. The percentages of patients who received intrathecal treatment of amphotericin B(AmB), AmB?+?5-FC(5-fluorocytosine), AmB?+?FCZ(fluconazole), and AmB?+?5-FU?+?FCZ in each medication group were 10, 43, 53, and 33%, respectively. The mortalities were significantly lower in the AmB, Amb?+?5-FC, AmB?+?FCZ intrathecal treatment groups compared with their non-intrathecal treatment controls (6% vs. 23%, 25% vs. 35%, 20% vs. 30%, respectively, P?P?>?0.05).

Conclusion

The Chinese cryptococcosis had its own special clinical features, such as more patients without identifiable underlying diseases. Intrathecal injection of amphotericin B was effective treatment method for cryptococcal CNS infection in China.     

Differences in Sleep,Light, and Circadian Phase in Offshore 18:00–06:00 h and 19:00–07:00 h Shift Workers

Complaints concerning sleep are high among those who work night shifts; this is in part due to the disturbed relationship between circadian phase and the timing of the sleep‐wake cycle. Shift schedule, light exposure, and age are all known to affect adaptation to the night shift. This study investigated circadian phase, sleep, and light exposure in subjects working 18:00–06:00 h and 19:00–07:00 h schedules during summer (May–August). Ten men, aged 46±10 yrs (mean±SD), worked the 19:00–07:00 h shift schedule for two or three weeks offshore (58°N). Seven men, mean age 41±12 yrs, worked the 18:00–06:00 h shift schedule for two weeks offshore (61°N). Circadian phase was assessed by calculating the peak (acrophase) of the 6‐sulphatoxymelatonin rhythm measured by radioimmunoassay of sequential urine samples collected for 72 h at the end of the night shift. Objective sleep and light exposure were assessed by actigraphy and subjective sleep diaries. Subjects working 18:00–06:00 h had a 6‐sulphatoxymelatonin acrophase of 11.7±0.77 h (mean±SEM, decimal hours), whereas it was significantly later, 14.6±0.55 h (p=0.01), for adapted subjects working 19:00–07:00 h. Two subjects did not adapt to the 19:00–07:00 h night shift (6‐sulphatoxymelatonin acrophases being 4.3±0.22 and 5.3±0.29 h). Actigraphy analysis of sleep duration showed significant differences (p=0.03), with a mean sleep duration for those working 19:00–07:00 h of 5.71±0.31 h compared to those working 18:00–06:00 h whose mean sleep duration was 6.64±0.33 h. There was a trend to higher morning light exposure (p=0.07) in the 19:00–07:00 h group. Circadian phase was later (delayed on average by 3 h) and objective sleep was shorter with the 19:00–07:00 h than the 18:00–06:00 h shift schedule. In these offshore conditions in summer, the earlier shift start and end time appears to favor daytime sleep.     

Mortality differentials in Canada, 1951–1971: French,British, and Indians

Mortality differentials reflect in part the social and economic conditions of groups in society. In this paper, the relationship between ethnic origin and mortality is investigated from the point of view of convergence and minority group status hypotheses. Multivariate methods are used to study differences among the French, the British and Native Indian (includes Metis and Eskimos) populations of Canada over three census periods from 1951 to 1971. A significant downward trend in the death rates of all three subpopulations is noted, but substantial differences persist, as the pace of mortality decline over time varies across the three ethnic groups. In the twenty-year interval between 1951 and 1971, Native Indians have experienced spectacular reductions in their overall death rates, but in comparative terms, their mortality levels still exceed those of the French (who show intermediate levels) and the British ethnic groups. The multivariate analysis provides strong support for the minority status effect, which is taken to suggest that the roots of inequalities in survival probabilities are partly a result of social and economic disparities. The convergence thesis received some support: over time the general pattern is one of declining mortality with some narrowing of the differences. An examination of four broad causes of death (neoplasms, cardiovascular, accidents-violence, and "other") suggests that Native Indians are characteristic of populations undergoing epidemiologic and demographic transitions. Their elevated risk of accidents-violence reflects social disruption in the process of modernization. Causes of death of the French and British populations are characterized by higher risks of cancer and cardiovascular diseases, typical of advanced societies.