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Evaluation of Changes in Social Isolation and Loneliness with Incident Cardiovascular Events and Mortality. 评估社交孤立和孤独感的变化与心血管事件和死亡率的关系。
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI: 10.1007/s44197-024-00243-3
Yilin Chen, Huachen Xue, Yu Nie, Yujing Zhou, Sizhi Ai, Yaping Liu, Jihui Zhang, Yannis Yan Liang

Background: It remains unknown how the patterns of change of social isolation and loneliness are associated with the onset of cardiovascular disease (CVD) and mortality. We aimed to investigate the longitudinal association of changes in social isolation and loneliness with incident CVD, all-cause mortality, CVD mortality and subsequent cardiac function.

Methods: This prospective cohort study included 18,258 participants aged 38-73 years who participated in visit 0 (2006-2010) and visit 1 (2012-2013) using UK Biobank (mean age 57.1, standard deviation [SD] 7.4; 48.7% males). Social isolation or loneliness was categorized into four patterns: never, transient, incident, and persistent. Incident CVD, all-cause and CVD mortality were ascertained through linkage data. Cardiac function was assessed by cardiovascular magnetic resonance imaging in a subsample (N = 5188; visit 2, since 2014).

Results: Over a median follow-up of 8.3 (interquartile range [IQR] 8.1-8.6) years, compared with never social isolation, persistent social isolation was associated with the higher risk of incident CVD (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.03-1.33), all-cause (1.42, 1.12-1.81) and CVD (1.53, 1.05-2.23) mortality. Likewise, persistent loneliness was strongly associated with the greater risk of incident CVD (1.13, 1.00-1.27), all-cause (1.28, 1.02-1.61) and CVD mortality (1.52, 1.06-2.18).

Conclusions: Persistent social isolation and loneliness posed a substantially higher risk for incident CVD, all-cause and CVD mortality, and cardiac dysfunction than other patterns. Persistent social isolation and loneliness, along with an increasing cumulative score, are associated with lower cardiac function.

背景:社会隔离和孤独感的变化规律与心血管疾病(CVD)的发病和死亡率有何关联,目前仍是未知数。我们的目的是调查社会隔离和孤独感的变化与心血管疾病发病、全因死亡率、心血管疾病死亡率和后续心脏功能的纵向联系:这项前瞻性队列研究纳入了 18258 名年龄在 38-73 岁之间的参与者,他们通过英国生物数据库参与了第 0 次访问(2006-2010 年)和第 1 次访问(2012-2013 年)(平均年龄 57.1 岁,标准差 [SD] 7.4;48.7% 为男性)。社会隔离或孤独分为四种模式:从不、短暂、偶发和持续。通过关联数据确定了心血管疾病发病率、全因死亡率和心血管疾病死亡率。通过心血管磁共振成像对一个子样本(N = 5188;访问 2,自 2014 年起)的心脏功能进行了评估:在中位随访 8.3 年(四分位距[IQR] 8.1-8.6)期间,与从未有过社会隔离的人相比,持续的社会隔离与较高的心血管疾病发病风险(危险比 [HR] 1.17,95% 置信区间 [CI] 1.03-1.33)、全因(1.42,1.12-1.81)和心血管疾病(1.53,1.05-2.23)死亡率相关。同样,持续的孤独感也与心血管疾病(1.13,1.00-1.27)、全因(1.28,1.02-1.61)和心血管疾病(1.52,1.06-2.18)死亡风险的增加密切相关:与其他模式相比,持续的社会隔离和孤独对心血管疾病、全因和心血管疾病死亡率以及心脏功能障碍的发生具有更高的风险。持续的社会隔离和孤独感以及累积分数的增加与心功能减退有关。
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引用次数: 0
Age-specific Multimorbidity Patterns and Burden on All-Cause Mortality and Public Direct Medical Expenditure: A Retrospective Cohort Study. 特定年龄多病模式及其对全因死亡率和公共直接医疗支出的负担:一项回顾性队列研究。
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-06-13 DOI: 10.1007/s44197-024-00256-y
Sabrina Nan Hong, Francisco Tsz Tsun Lai, Boyuan Wang, Edmond Pui Hang Choi, Ian Chi Kei Wong, Cindy Lo Kuen Lam, Eric Yuk Fai Wan

Objective: To evaluate age-specific multimorbidity patterns and morbidity burden on mortality and healthcare expenditure across age groups.

Patients and methods: Retrospective observational study between January 1, 2009 to December 31, 2017 using electronic health records in Hong Kong: Individuals were stratified by age (< 50, 50-64, 65-79, ≥ 80), and sub-classified by number of morbidities (0, 1, 2, 3, ≥ 4) out of 21 common chronic conditions. Clustering analyses were conducted to identify specific patterns of multimorbidity. Association between the number as well as combinations of morbidities and all-cause mortality and public expenditure was examined.

Results: 4,562,832 individuals with a median follow-up of 7 years were included. Mental disorders were the top morbidities among young individuals, while cardiovascular diseases were prevalent in the elderly. An increased number of morbidities was associated with a greater relative risk for mortality and medical expenditure, and this relationship was stronger among younger patients. Compared to individuals in the same age group without morbidity, the hazard ratios (HR; 95% CI) of all-cause mortality in patients aged < 50 and ≥ 80 with two comorbidities 3.81 (3.60-4.03) and 1.38 (1.36-1.40), respectively, which increased to 14.22 (9.87-20.47) and 2.20 (2.13-2.26), respectively, as the number of morbidities increased to ≥ 4. The stroke-hypertension cluster was shown to be associated with the highest HR of mortality 2.48 (2.43-2.53) among all identified clusters arising from the clustering analysis.

Conclusion: Given the stronger association between multimorbidity and all-cause mortality and greater opportunity costs in younger populations, prevention and management of early-onset multimorbidity are warranted. (248 words).

目的评估不同年龄组的多病模式和发病率对死亡率和医疗支出的影响:2009年1月1日至2017年12月31日期间使用香港电子健康记录进行的回顾性观察研究:根据年龄对个体进行分层(结果:4,562,832人,中位随访7年):共纳入 4 562 832 人,中位随访时间为 7 年。精神障碍是年轻人的主要发病原因,而心血管疾病则是老年人的主要发病原因。发病率越高,死亡率和医疗支出的相对风险就越大,这种关系在年轻患者中更为明显。与同年龄组中没有发病的人相比,老年患者全因死亡率的危险比(HR;95% CI)要高得多:鉴于多病症与全因死亡率之间的关系更为密切,而且年轻群体的机会成本更高,因此有必要对早期多病症进行预防和管理。(248个字)。
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引用次数: 0
Internet-based Surveillance Systems and Infectious Diseases Prediction: An Updated Review of the Last 10 Years and Lessons from the COVID-19 Pandemic. 基于互联网的监控系统和传染病预测:过去 10 年的最新回顾和 COVID-19 大流行的教训。
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-08-14 DOI: 10.1007/s44197-024-00272-y
Hannah McClymont, Stephen B Lambert, Ian Barr, Sotiris Vardoulakis, Hilary Bambrick, Wenbiao Hu

The last decade has seen major advances and growth in internet-based surveillance for infectious diseases through advanced computational capacity, growing adoption of smart devices, increased availability of Artificial Intelligence (AI), alongside environmental pressures including climate and land use change contributing to increased threat and spread of pandemics and emerging infectious diseases. With the increasing burden of infectious diseases and the COVID-19 pandemic, the need for developing novel technologies and integrating internet-based data approaches to improving infectious disease surveillance is greater than ever. In this systematic review, we searched the scientific literature for research on internet-based or digital surveillance for influenza, dengue fever and COVID-19 from 2013 to 2023. We have provided an overview of recent internet-based surveillance research for emerging infectious diseases (EID), describing changes in the digital landscape, with recommendations for future research directed at public health policymakers, healthcare providers, and government health departments to enhance traditional surveillance for detecting, monitoring, reporting, and responding to influenza, dengue, and COVID-19.

在过去十年中,通过先进的计算能力、智能设备的日益普及、人工智能(AI)的日益普及,以及包括气候和土地使用变化在内的环境压力,基于互联网的传染病监测取得了重大进展和增长,加剧了流行病和新发传染病的威胁和传播。随着传染病负担的加重和 COVID-19 的流行,现在比以往任何时候都更需要开发新技术和整合基于互联网的数据方法来改善传染病监测。在本系统性综述中,我们检索了 2013 年至 2023 年有关流感、登革热和 COVID-19 基于互联网或数字监测的科学文献。我们概述了最近针对新发传染病(EID)开展的基于互联网的监测研究,描述了数字环境的变化,并针对公共卫生决策者、医疗保健提供者和政府卫生部门提出了未来研究的建议,以加强传统监测对流感、登革热和 COVID-19 的检测、监测、报告和响应。
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引用次数: 0
Prevalence and Predictive Factors of Panic Disorder among Adults in Saudi Arabia: A Cross-Sectional Study. 沙特阿拉伯成年人恐慌症的患病率和预测因素:一项横断面研究。
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-02-19 DOI: 10.1007/s44197-024-00208-6
Ahmed Aljadani, Khalid Alshammari, Mossa Alshammari, Sulaiman Alshammari, Ahmed Alhuwaydi, Mohamed AbouZed, Islam Shabaan, Nasr Elzahab, Abdullah Altuhayni, Naif Alghasab

Panic disorder (PD) is a severe anxiety disorder characterized by recurrent and unexpected panic attacks that cause intense distress. Despite the high prevalence of panic disorder and its significant impact on life, limited research has been conducted on its prevalence and their associated factors in Saudi Arabia. This study seeks to contribute to the understanding of PD among adults in Saudi Arabia by examining its prevalence and associated factors, using an online survey method. A validated questionnaire-based cross-sectional study was conducted targeting 1276 Saudi adults. Data were collected electronically via Google Forms from the eligible participants. The questionnaire comprised three sections: sociodemographic information, medical history, and a validated diagnostic tool for PD. The prevalence of PD among Saudi adults was 13.1%. Most individuals with PD experienced their first panic attack before the age of 18. Only 38.3% individuals with PD sought medical attention, and approximately one-third of those who sought help did not receive a diagnosis. Multiple logistic regression analysis revealed that significant risk factors for PD included being female; having chronic health problems, a comorbid psychiatric disorder, a high body mass index; and experiencing suicidal ideation (P < 0.05). The highest risk was associated with chronic diseases (adjusted odds ratio = 3.1, 95% confidence interval: 2.1-4.6). This study demonstrates that PD is a prevalent and debilitating mental health condition among Saudi Arabian adults. Non-mental health physicians should be aware of PD, as many cases remain undiagnosed.

惊恐障碍(PD)是一种严重的焦虑症,其特征是反复发作的意外惊恐发作会造成强烈的痛苦。尽管恐慌症的发病率很高,对生活的影响也很大,但沙特阿拉伯对其发病率及其相关因素的研究却很有限。本研究采用在线调查的方法,通过研究恐慌症在沙特阿拉伯成年人中的患病率及其相关因素,旨在加深人们对恐慌症的了解。本研究针对 1276 名沙特成年人开展了一项基于有效问卷的横断面研究。通过谷歌表格以电子方式向符合条件的参与者收集数据。问卷包括三个部分:社会人口学信息、病史和经验证的帕金森病诊断工具。沙特成年人的 "怯懦症 "患病率为 13.1%。大多数患有帕金森氏症的人在 18 岁之前经历过首次恐慌症发作。只有 38.3% 的帕金森氏症患者寻求过医疗帮助,而在寻求帮助的患者中,约有三分之一没有得到诊断。多元逻辑回归分析表明,罹患帕金森氏症的重要风险因素包括女性、慢性健康问题、合并精神疾病、体重指数高以及有自杀倾向(P<0.05)。
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引用次数: 0
Statistical Analysis of Factors Associated with Diarrhea in Yemeni Children under Five: Insights from the 2022-2023 Multiple Indicator Cluster Survey. 也门五岁以下儿童腹泻相关因素的统计分析:2022-2023 年多指标类集调查的启示》。
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-06-10 DOI: 10.1007/s44197-024-00253-1
Ali Satty, Mohyaldein Salih, Faroug A Abdalla, Ashraf F A Mahmoud, Elzain A E Gumma, Gamal Saad Mohamed Khamis, Ahmed M A Adam, Abaker A Hassaballa, Omer M A Hamed, Zakariya M S Mohammed

Diarrheal disease remains a significant cause of preventable morbidity and mortality in the pediatric population, particularly among children below five years of age. Although the occurrence of diarrheal episodes is on the decline, its impact continues to escalate at a concerning rate among children under the age of five, especially in developing countries. The objective of this paper is to investigate the factors associated with diarrhea in Yemeni children younger than five years, drawing on data from the latest edition of the Multiple Indicator Cluster Survey (MICS) Yemen conducted in 2022-2023. To identify factors associated with the prevalence of childhood diarrhea, bivariate analysis and multivariable logistic regression were utilized. The findings of this study suggest that age group 6-23, unimproved sanitation, and low-income households are associated with high risk of diarrhea in children under five years of age in Yemen. The study contributes additional evidence regarding factors that should be prioritized in public health strategies geared towards reducing diarrheal prevalence among Yemeni children.

腹泻疾病仍然是儿科人群中可预防的发病率和死亡率的一个重要原因,尤其是在五岁以下儿童中。虽然腹泻发病率正在下降,但其对五岁以下儿童的影响仍在以令人担忧的速度上升,尤其是在发展中国家。本文旨在利用 2022-2023 年进行的最新一期也门多指标类集调查(MICS)的数据,研究与也门五岁以下儿童腹泻相关的因素。为了确定与儿童腹泻患病率相关的因素,研究人员采用了双变量分析和多变量逻辑回归。研究结果表明,6-23 岁年龄组、未改善的卫生条件和低收入家庭与也门 5 岁以下儿童腹泻的高风险有关。这项研究为减少也门儿童腹泻发病率的公共卫生战略应优先考虑的因素提供了更多证据。
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引用次数: 0
Correction: Statistical Analysis of Factors Associated with Diarrhea in Yemeni Children under Five: Insights from the 2022-2023 Multiple Indicator Cluster Survey. 更正:也门五岁以下儿童腹泻相关因素的统计分析:2022-2023 年多指标类集调查的启示》。
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 DOI: 10.1007/s44197-024-00268-8
Ali Satty, Mohyaldein Salih, Faroug A Abdalla, Ashraf F A Mahmoud, Elzain A E Gumma, Gamal Saad Mohamed Khamis, Ahmed M A Adam, Abaker A Hassaballa, Omer M A Hamed, Zakariya M S Mohammed
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引用次数: 0
International Newborn Screening: Where Are We in Saudi Arabia? 国际新生儿筛查:沙特阿拉伯的情况如何?
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-06-26 DOI: 10.1007/s44197-024-00263-z
Noara Alhusseini, Yara Almuhanna, Lama Alabduljabbar, Soaad Alamri, Maryam Altayeb, Ghadi Askar, Noor Alsaadoun, Khadijah Ateq, Mariam M AlEissa

Newborn screening (NBS) programs are believed to play an important role in the decrease of infant mortality rates in many countries. This is achieved through offering early detection and treatment of many genetic as well as metabolic disorders prior to the onset of symptoms. Our paper examines NBS across seven diverse nations: Saudi Arabia, the United States, Japan, Singapore, Canada, Australia, and the United Kingdom. This paper discusses the diseases screened for by each country, latest additions, as well as future recommendations, when applicable. Employing a comparative approach, we conducted a comprehensive review of the most recent published literature on NBS programs in each country and subsequently examined their latest implemented NBS guidelines as outlined on their respective official government health sector websites. We then reviewed the economic feasibility of each of these programs and factors that affect implementation and overall benefit. While all six countries employ well-developed programs, variations are observed. Those variations are mainly attributed to disparities in access, resource scarcity, financial availability, as well as ethical and cultural considerations. From a local perspective, we recommend conducting further population-based studies to assess the epidemiological data in relation to the disease burden on the country's economy. Moreover, we recommend updating national and international guidelines to contain a more comprehensive approach on policies, operation, and sustainability to deliver a service through the lens of value-based healthcare.

在许多国家,新生儿筛查(NBS)项目被认为在降低婴儿死亡率方面发挥了重要作用。这是通过在症状出现之前对许多遗传性和代谢性疾病进行早期检测和治疗来实现的。我们的论文研究了七个不同国家的新生儿监测系统:沙特阿拉伯、美国、日本、新加坡、加拿大、澳大利亚和英国。本文讨论了每个国家筛查的疾病、最新增加的疾病以及未来的建议(如适用)。我们采用比较的方法,对各国最新发表的有关新生儿筛查项目的文献进行了全面回顾,并随后检查了各国最新实施的新生儿筛查指南,这些指南在其各自的政府卫生部门官方网站上都有概述。然后,我们审查了每个计划的经济可行性以及影响实施和整体效益的因素。虽然这六个国家都采用了完善的计划,但也存在差异。这些差异主要归因于医疗服务的可及性、资源的稀缺性、资金的可用性以及道德和文化方面的考虑。从当地的角度来看,我们建议进一步开展以人口为基础的研究,以评估与疾病对国家经济造成的负担相关的流行病学数据。此外,我们还建议更新国家和国际指南,使其包含更全面的政策、运作和可持续性方法,以便通过基于价值的医疗保健视角提供服务。
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引用次数: 0
Climate Change Projections for Stroke Incidence in Taiwan: Impact of 2 °C and 4 °C Global Warming Level. 气候变化对台湾中风发病率的预测:2 °C和4 °C全球变暖水平的影响。
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-09-02 DOI: 10.1007/s44197-024-00289-3
Wei-Te Wu, Miku Kono, Chuan-Pin Lee, Yu-Yin Chang, Yao-Hsu Yang, Ching-Chun Lin, Tzu-Ming Liu, Hsin-Chi Li, Yung-Ming Chen, Pau-Chung Chen

Objectives: This study aimed to establish the exposure-lag-response effect between daily maximum temperature and stroke-related emergency department visits and to project heat-induced stroke impacts under global warming levels (GWL) of 2 °C and 4 °C.

Methods: Stroke-related emergency department visits in Taiwan from 2001 to 2020 were identified using the National Health Insurance Research Database (NHIRD). The study population consisted of 1,100,074 initial stroke cases matched with 2,200,148 non-stroke controls. We employed Distributed Lag Nonlinear Models (DLNM) in a case-crossover study to investigate the association between temperature and stroke. Generalized Estimating Equations (GEE) models with a Poisson function were used to correlate high-temperature exposure with annual stroke incidence rates. Projections were made under two global warming scenarios, GWL 2.0 °C and 4.0 °C, using Coupled General Circulation Model (GCMs). Baseline data from 1995 to 2014 were transformed for spatial distribution at the township level. Geographic Information System (GIS) spatial analysis was performed using Quantum GIS 3.2.0 software.

Results: DLNM exposure-lag-response effect revealed that daily maximum temperature exceeding 34 °C significantly increased the risk of stroke-related emergency department visits, particularly for ischemic stroke. Under the 2 °C GWL scenario, the frequency of days with temperatures surpassing 34 °C is projected to rise substantially by the median year of 2042, with a further increase to 92.6 ± 18.0 days/year by 2065 under the 4 °C GWL scenario. Ischemic stroke showed the highest increase in temperature-related incidence rates, notably rising from 7.80% under the GWL 2 °C to 36.06% under the GWL 4 °C. Specifically, the annual temperature-related incidence rate for ischemic stroke is expected to increase significantly by 2065. Regions such as Taichung, Hsinchu, Yilan, and Taitung demonstrated pronounced changes in heat-related ischemic stroke incidence under the GWL 4 °C.

Conclusions: The findings emphasize the importance of addressing temperature-related stroke risks, particularly in regions projected to experience significant temperature increases. Effective mitigation strategies are crucial to reduce the impact of rising temperatures on stroke incidence and safeguard public health.

目的:本研究旨在确定日最高气温与中风相关急诊就诊之间的暴露-滞后-反应效应,并预测全球变暖水平(GWL)为 2 ℃ 和 4 ℃ 时热诱发中风的影响:方法:利用国家健康保险研究数据库(NHIRD)对 2001 年至 2020 年台湾地区与中风相关的急诊就诊情况进行了识别。研究人群包括 1,100,074 例初始中风病例和 2,200,148 例非中风对照。我们在病例交叉研究中采用了分布式滞后非线性模型(DLNM)来研究体温与中风之间的关系。采用泊松函数的广义估计方程 (GEE) 模型将高温暴露与中风年发病率联系起来。利用耦合大气环流模型(GCMs)对两种全球变暖情景(GWL 2.0 °C和4.0 °C)进行了预测。对 1995 年至 2014 年的基线数据进行了转换,以便在乡镇一级进行空间分布。使用 Quantum GIS 3.2.0 软件进行了地理信息系统(GIS)空间分析:DLNM暴露-滞后-反应效应显示,日最高气温超过34 °C会显著增加中风相关急诊就诊风险,尤其是缺血性中风。在 2 °C GWL 情景下,预计到 2042 年的中位数年,气温超过 34 °C 的天数频率将大幅上升,在 4 °C GWL 情景下,到 2065 年将进一步增加到 92.6 ± 18.0 天/年。缺血性中风与温度相关的发病率增幅最大,从全球升温潜能值 2 °C 下的 7.80% 显著上升到全球升温潜能值 4 °C 下的 36.06%。具体而言,预计到 2065 年,缺血性中风与温度相关的年发病率将显著增加。在 GWL 4 °C 下,台中、新竹、宜兰和台东等地区与高温相关的缺血性中风发病率有明显变化:研究结果强调了应对与温度相关的中风风险的重要性,尤其是在预计气温将显著升高的地区。有效的缓解策略对于降低气温升高对中风发病率的影响和保障公众健康至关重要。
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引用次数: 0
The Role of Active and Passive Smoking in Chronic Obstructive Pulmonary Disease and Systemic Inflammation: A 12-year Prospective Study in China. 主动吸烟和被动吸烟在慢性阻塞性肺病和全身炎症中的作用:中国一项为期 12 年的前瞻性研究
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-09-03 DOI: 10.1007/s44197-024-00290-w
Lu Chen, Haijuan Xiong, Qiaorui Wen, Jun Lv, Dianjianyi Sun, Pei Pei, Ling Yang, Yiping Chen, Huaidong Du, Lihui Li, Xiaoming Yang, Daniel Avery, Junshi Chen, Zhengming Chen, Liming Li, Canqing Yu

Background: There is no consensus on the cause and effect of systemic chronic inflammation (SCI) regarding chronic obstructive pulmonary disease (COPD). The impact of second-hand smoke (SHS) on COPD has reached inconsistent conclusions.

Methods: The China Kadoorie Biobank cohort was followed up from the 2004-08 baseline survey to 31 December 2018. Among the selected 445,523 participants in the final analysis, Cox and linear regressions were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of tobacco exposure with COPD risk and baseline levels of log-transformed inflammatory factors [βs (95% CIs)], respectively.

Results: Participants were followed up for a median of 12.1 years and 11,825 incident COPD events were documented. Ever-smokers were associated with a higher risk of COPD than non-smokers with non-weekly SHS exposure. A younger age to start smoking, a greater amount of daily tobacco consumption, and deeper inhalation were associated with increased risk of COPD and correlated with elevated levels of plasma high-sensitivity C-reactive protein (hs-CRP, all Ptrend < 0.001) even two years before COPD onset. Among former smokers, COPD risk declined with longer smoking cessation (Ptrend < 0.001) and those quitting smoking for over ten years presented no difference in COPD risk and hs-CRP level from non-smokers [HR (95% CI) = 1.05 (0.89, 1.25), β (95% CI) = 0.17 (- 0.09, 0.43)]. Among non-smokers, weekly SHS exposure was associated with a slightly higher COPD risk [HR (95% CI) = 1.06 (1.01, 1.12)].

Conclusions: Incremental exposure to tobacco smoke was related to elevated SCI level before COPD onset, then an increase in COPD susceptibility. Quitting smoking as early as possible is suggested as a practical approach to reducing COPD risk in smokers. Given the high prevalence of both COPD and SHS exposure, the risk associated with SHS exposure deserves attention.

背景:关于慢性阻塞性肺病(COPD)的全身慢性炎症(SCI)的原因和影响,目前尚无共识。关于二手烟(SHS)对慢性阻塞性肺病的影响,结论也不一致:对中国嘉道理生物库队列进行了从 2004-08 年基线调查至 2018 年 12 月 31 日的随访。在最终分析所选的445523名参与者中,分别进行了Cox回归和线性回归,以估计烟草暴露与慢性阻塞性肺疾病风险和对数转化炎症因子基线水平的危险比(HRs)和95%置信区间(CIs)[βs (95% CIs)]:对参与者进行了中位数为 12.1 年的随访,共记录了 11,825 例慢性阻塞性肺病事件。与非吸烟者相比,经常吸烟者患慢性阻塞性肺病的风险要高于非每周接触 SHS 的人。开始吸烟的年龄越小、每日吸烟量越大、吸入烟雾越深,患慢性阻塞性肺病的风险就越高,并且与血浆高敏C反应蛋白(hs-CRP,均为Ptrend趋势结论)水平的升高相关:烟草烟雾暴露量的增加与慢性阻塞性肺病发病前SCI水平的升高有关,然后增加了慢性阻塞性肺病的易感性。建议吸烟者尽早戒烟,这是降低慢性阻塞性肺病风险的实用方法。鉴于慢性阻塞性肺病和接触 SHS 的发病率都很高,与接触 SHS 相关的风险值得关注。
{"title":"The Role of Active and Passive Smoking in Chronic Obstructive Pulmonary Disease and Systemic Inflammation: A 12-year Prospective Study in China.","authors":"Lu Chen, Haijuan Xiong, Qiaorui Wen, Jun Lv, Dianjianyi Sun, Pei Pei, Ling Yang, Yiping Chen, Huaidong Du, Lihui Li, Xiaoming Yang, Daniel Avery, Junshi Chen, Zhengming Chen, Liming Li, Canqing Yu","doi":"10.1007/s44197-024-00290-w","DOIUrl":"10.1007/s44197-024-00290-w","url":null,"abstract":"<p><strong>Background: </strong>There is no consensus on the cause and effect of systemic chronic inflammation (SCI) regarding chronic obstructive pulmonary disease (COPD). The impact of second-hand smoke (SHS) on COPD has reached inconsistent conclusions.</p><p><strong>Methods: </strong>The China Kadoorie Biobank cohort was followed up from the 2004-08 baseline survey to 31 December 2018. Among the selected 445,523 participants in the final analysis, Cox and linear regressions were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of tobacco exposure with COPD risk and baseline levels of log-transformed inflammatory factors [βs (95% CIs)], respectively.</p><p><strong>Results: </strong>Participants were followed up for a median of 12.1 years and 11,825 incident COPD events were documented. Ever-smokers were associated with a higher risk of COPD than non-smokers with non-weekly SHS exposure. A younger age to start smoking, a greater amount of daily tobacco consumption, and deeper inhalation were associated with increased risk of COPD and correlated with elevated levels of plasma high-sensitivity C-reactive protein (hs-CRP, all P<sub>trend</sub> < 0.001) even two years before COPD onset. Among former smokers, COPD risk declined with longer smoking cessation (P<sub>trend</sub> < 0.001) and those quitting smoking for over ten years presented no difference in COPD risk and hs-CRP level from non-smokers [HR (95% CI) = 1.05 (0.89, 1.25), β (95% CI) = 0.17 (- 0.09, 0.43)]. Among non-smokers, weekly SHS exposure was associated with a slightly higher COPD risk [HR (95% CI) = 1.06 (1.01, 1.12)].</p><p><strong>Conclusions: </strong>Incremental exposure to tobacco smoke was related to elevated SCI level before COPD onset, then an increase in COPD susceptibility. Quitting smoking as early as possible is suggested as a practical approach to reducing COPD risk in smokers. Given the high prevalence of both COPD and SHS exposure, the risk associated with SHS exposure deserves attention.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Shifts in Paediatric Road Trauma Dynamics Pre- vs. Post-COVID-19 Lockdown: Insights from a Major Trauma Centre. COVID-19 封锁前后儿科道路创伤动态的变化:一个主要创伤中心的启示。
IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-09-04 DOI: 10.1007/s44197-024-00295-5
Rayan Jafnan Alharbi, Hussin Albargi, Ateeq Almuwallad, Naif Harthi, Sharfuddin Chowdhury

Background: The COVID-19 pandemic has brought unprecedented changes globally, significantly affecting public health sectors, including paediatric road trauma. This study aims to explore the changes in paediatric road trauma presentations and outcomes before and after the COVID-19 lockdown.

Methods: This retrospective study analysed paediatric trauma data from the Saudi TraumA Registry (STAR) from August 2017 to December 2022, comparing pre- and post-COVID-19 lockdown periods (August 2017-March 2020 and July 2020-December 2022, respectively). The study analysed demographic data, mechanism of injury, severity, ICU admissions, and mortality rates using multivariate logistic regression models.

Results: Out of 950 paediatric trauma cases analysed, there was an 44.2 [561/389 = 1.442] % increase in the number of cases post-lockdown. A significant shift was noted in the age group of 5-9 years, with cases increasing from post-lockdown. Head injuries were the most prevalent type of injury, with their proportion slightly increasing from 163 (20.5%) pre-lockdown to 248 (23.2%) post-lockdown. The ICU admission were consistent across both periods, while the definitive care mode of arrival post-lockdown showed a notable shift towards private or government ambulances.

Conclusion: Our study provides critical insights into the significant impact of the COVID-19 on paediatric road trauma. The observed increase in trauma cases post-pandemic, particularly among younger children and a notable rise in driver-related injuries among adolescents, underscores the profound effect of lockdown measures and subsequent societal changes on paediatric health. Efforts to reduce paediatric traffic injuries require collaboration among parents, educators, healthcare professionals, policymakers, and the community at large.

背景:COVID-19 大流行给全球带来了前所未有的变化,极大地影响了公共卫生部门,包括儿童道路创伤。本研究旨在探讨 COVID-19 封锁前后儿科道路创伤病例和结果的变化:这项回顾性研究分析了沙特创伤登记处(STAR)2017 年 8 月至 2022 年 12 月的儿科创伤数据,比较了 COVID-19 封锁前后(分别为 2017 年 8 月至 2020 年 3 月和 2020 年 7 月至 2022 年 12 月)的情况。研究使用多变量逻辑回归模型分析了人口统计学数据、受伤机制、严重程度、ICU入院率和死亡率:结果:在分析的 950 例儿科创伤病例中,封锁后病例数增加了 44.2 [561/389 = 1.442]%。5-9 岁年龄组的病例发生了明显变化,从封锁后开始增加。头部受伤是最常见的受伤类型,其比例从关闭前的 163 例(20.5%)略增至关闭后的 248 例(23.2%)。在这两个时期,入住重症监护室的情况一致,而在 "大关闭 "后,抵达医院的最终护理模式明显转向私人或政府救护车:我们的研究为了解 COVID-19 对儿科道路创伤的重大影响提供了重要依据。大流行后观察到的外伤病例增加,尤其是年龄较小的儿童,以及青少年中与驾驶员相关的伤害明显增加,这凸显了封锁措施和随后的社会变化对儿科健康的深远影响。减少儿科交通伤害的工作需要家长、教育工作者、医疗保健专业人员、政策制定者和整个社区的合作。
{"title":"Shifts in Paediatric Road Trauma Dynamics Pre- vs. Post-COVID-19 Lockdown: Insights from a Major Trauma Centre.","authors":"Rayan Jafnan Alharbi, Hussin Albargi, Ateeq Almuwallad, Naif Harthi, Sharfuddin Chowdhury","doi":"10.1007/s44197-024-00295-5","DOIUrl":"10.1007/s44197-024-00295-5","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has brought unprecedented changes globally, significantly affecting public health sectors, including paediatric road trauma. This study aims to explore the changes in paediatric road trauma presentations and outcomes before and after the COVID-19 lockdown.</p><p><strong>Methods: </strong>This retrospective study analysed paediatric trauma data from the Saudi TraumA Registry (STAR) from August 2017 to December 2022, comparing pre- and post-COVID-19 lockdown periods (August 2017-March 2020 and July 2020-December 2022, respectively). The study analysed demographic data, mechanism of injury, severity, ICU admissions, and mortality rates using multivariate logistic regression models.</p><p><strong>Results: </strong>Out of 950 paediatric trauma cases analysed, there was an 44.2 [561/389 = 1.442] % increase in the number of cases post-lockdown. A significant shift was noted in the age group of 5-9 years, with cases increasing from post-lockdown. Head injuries were the most prevalent type of injury, with their proportion slightly increasing from 163 (20.5%) pre-lockdown to 248 (23.2%) post-lockdown. The ICU admission were consistent across both periods, while the definitive care mode of arrival post-lockdown showed a notable shift towards private or government ambulances.</p><p><strong>Conclusion: </strong>Our study provides critical insights into the significant impact of the COVID-19 on paediatric road trauma. The observed increase in trauma cases post-pandemic, particularly among younger children and a notable rise in driver-related injuries among adolescents, underscores the profound effect of lockdown measures and subsequent societal changes on paediatric health. Efforts to reduce paediatric traffic injuries require collaboration among parents, educators, healthcare professionals, policymakers, and the community at large.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Epidemiology and Global Health
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