Relative Risk Values Research Articles

Influence of exogenous risk-inducing factors on the incidence of intestinal infections in the population of the territory of intensive tourism

Introduction. The development of tourism in regions with an insufficient level of social infrastructure and a low self-cleaning capacity of the environment poses a danger due to the gain in infectious diseases. The level of water in Lake Baikal may determine the potential for dilution of chemical and microbiological contaminants in the coastal zone.
 Materials and methods. The incidence of acute intestinal infections (AII) was studied in the area located on the south-eastern shore of the lake. Baikal (2016–2022). There were assessed risk-inducing factors including climate, water level of the lake, number of tourists, water quality. The values of relative risk, etiological share, economic damage were calculated. 
 Results. The incidence was 630.8 (455.9–781.9) in 0–14 years children, 16.0 (4.8–48.5) cases per 100 thousand population in people over 15 years old. The relative risk in children in the year of low water content of the lake. Baikal RR=1.498 (CI 1.067–2.102). The total level of economic damage caused by additional cases of rotavirus infection in children amounted to 4,528.960 of rubles with high water content, and 5,625.740 of rubles with low water content. 
 Limitations of the study relate to the inability to accurately estimate the number of tourists visiting the region; the inflation rate is not taken into account when calculating the economic damage. 
 Conclusion. The AII incidence in the children’s population of the coastal region is characterized by an increase in the years of water content in Lake Baikal, which differs from the optimal level, with changes in risk-inducing factors.

Effects of Ambient O3 on Respiratory Mortality, Especially the Combined Effects of PM2.5 and O3.

In China, the increasing concentration of ozone (O3) has emerged as a significant air pollution issue, leading to adverse effects on public health, particularly the respiratory system. Despite the progress made in managing air pollution in China, it is crucial to address the problem of environmental O3 pollution at present. The connection between O3 exposure and respiratory mortality in Shenyang, China, from 2014 to 2018 was analyzed by a time-series generalized additive regression model (GAM) with quasi-Poisson regression. Additionally, the potential combined effects of fine particulate matter (PM2.5) and O3 were investigated using the synergy index (SI). Our findings indicate that each 10 μg/m3 increase in O3 at lag 2 days was associated with a maximum relative risk (RR) of 1.0150 (95% CI: 1.0098-1.0202) for respiratory mortality in the total population. For individuals aged ≥55 years, unmarried individuals, those engaged in indoor occupations, and those with low educational attainment, each 10 μg/m3 increase in O3 at lag 07 days was linked to RR values of 1.0301 (95% CI: 1.0187-1.0417), 1.0437 (95% CI: 1.0266-1.0610), 1.0317 (95% CI: 1.0186-1.0450), and 1.0346 (95% CI: 1.0222-1.0471), respectively. Importantly, we discovered a synergistic effect of PM2.5 and O3, resulting in an SI of 2.372 on the occurrence of respiratory mortality. This study confirmed a positive association between O3 exposure and respiratory mortality. Furthermore, it highlighted the interaction between O3 and PM2.5 in exacerbating respiratory deaths.

Short-term effects of air pollution on hospitalization of children with acute upper respiratory infections: A time series analysis in Lanzhou, China.

Short-term air pollution exposure is correlated with childhood acute upper respiratory infections (AURI) hospitalizations. We surveyed the relationship between AURI hospitalizations and air pollutant concentrations in children aged 0-14 years from 1 January 2014 to 31 December 2019 in Lanzhou City. We collected both data on air pollutant concentrations and children's AURI hospitalizations during the study period. Distributional lagged nonlinear models were adopted to assess the short-term effects of air pollutants on children's AURI hospitalizations. We also performed subgroup analysis and sensitivity analysis. A total of 15,881 children were hospitalized for AURI during the study period. The results showed that for each 10 µg/m3 increase in PM2.5 , SO2 , and NO2 concentrations at lag0-6, the relative risk (RR) values for children hospitalized for AURI were RR = 1.0247 (95% CI: 1.0092,1.0405), RR = 1.0928 (95% CI: 1.0562, 1.1308), and RR = 1.0715 (95% CI: 1.0495, 1.0940), respectively. PM10 was significantly associated with AURI hospitalization in children only at lag0, RR = 1.0028 (95% CI: 1.0000, 1.0056). Short-term exposures to PM2.5 , PM10 , SO2 , and NO2 all increase the risk of AURI hospitalization in children variously.

Molecular identification of Eimeria spp. and Eimeria bovis in water buffaloes, Iraq

Eimeria is a protozoan parasite of many wild and domestic animals including buffaloes resulting in a widespread disease known as coccidiosis that may impact production, well fare and health status. This study was designed to identify the prevalence of Eimeria spp. and E. bovis in buffaloes using conventional molecular technique. An overall 281 buffaloes of different sexes and ages of many rural areas in Wasit province were subjected during November (2022) to February (2023) to direct collect of fecal samples from the rectum. After molecular examination of all fecal samples by polymerase chain reaction (PCR), the results showed that 25.98 and 35.62% buffaloes were positive to Eimeria spp. and E. bovis, respectively. Furthermore, significant prevalence of Eimeria spp. being higher in  1 year than older ones and Al-Kut than other study region, but not between females and males; while, E. bovis was more prevalent in  1 year, Al-Kut and Al-Hay, and females. Additionally, values of odds ratio and relative risk were elevated significantly in  1 year female buffaloes of Al-Kut region. From our point of view, this represents the first molecular study identifies E. bovis in buffaloes from Iraq. In conclusion, molecular based-PCR revealed a high efficacy in identification of E. bovis, and can be used in epidemiological investigations of coccidiosis in entire country. However, we suggest that the DNA sequence variation in ITS1 region of different Eimeria species should be conducted to view genetic mutations as well as genetic association with other worldwide strains. Also, extensive investigation is necessary to bridge the knowledge gap and providing for diagnosis this parasite in buffaloes as well as in other field animals. Keywords: Coccidiosis, PCR, Bubalus bubalis, calf, wasit province. Iraq

Relative risk of the COVID-19 pandemic and regional inflation convergence in Indonesia

This study investigates the relationship between the risk of a COVID-19 pandemic and the regional inflation convergence in Indonesia. It is important to examine the regional inflation convergences to evaluate the inflation rate and the impact of macroeconomic policy on inflation convergence, as the COVID-19 recession differs from the previous inflation recession. To calculate the impact of the relative risk of the COVID-19 pandemic on regional inflation convergence in Indonesia, the dynamic econometric spatial panel data model is used to calculate relative risk without spatial or SIRs. On the contrary, for calculating the risk relative to spatial elements, the CAR Leroux or BSCL Bayesian Spatial Model is used. Using BSCL, the calculation of the relative risk value for the COVID-19 pandemic concludes that Sumatera Island, Java Island, Kalimantan Island, Sulawesi Island, Maluku Island, and Papua Island have high risks, while Bali Island and Nusa Tenggara Island have low risks. In both static and dynamic models, the influence of currency circulation on inflation convergence is positive, and the relative risk of a COVID-19 pandemic on inflation convergence is negative. Studies show that the COVID-19 pandemic is a deterrent to inflation convergence, while the circulation of money drives inflation convergence.

Differential effects of size-specific particulate matter on lower respiratory infections in children: A time-series analysis in Lanzhou, China

This study aimed to assess the differential effects of size-specific PM (PM2.5, PM10–2.5, and PM10) on daily outpatients for Lower Respiratory Infection (LRI), Pneumonia, and Bronchitis among children in Lanzhou, China. A distributed lag nonlinear model (DLNM) was employed to evaluate the non-linear and delayed effects. The models were fitted with different lag structures, including single lag days from the current to the previous seven days (lag0 to lag7) and moving average concentrations over seven lag days (lag0–1 to lag0–7). We found that different PM fractions were significantly associated with hospital visits for LRI, pneumonia, and bronchitis, and cumulative effects increased with the increasing number of lag days investigated. Relative risk (RR) of LRI outpatient visits among children per 10 µg/m3 increase in PM2.5, PM10–2.5, and PM10 were 1.070 (95% CI: 1.059, 1.081), 1.010 (95% CI: 1.006, 1.015), and 1.013 (95% CI: 1.010, 1.016), respectively. For every 10 μg/m3 increase in PM2.5, PM10–2.5, and PM10, the RR values for pneumonia were 1.081, 1.013, and 1.019, and those for bronchitis were 1.069, 1.009, and 1.012, respectively. Boys and children aged 0–3 years were more sensitive to PM exposure. We also found significantly higher effects of PM in cold seasons than that in warm seasons. Our results suggested that short-term exposure to size-specific PM, PM2.5 in particular, might be an important trigger of outpatient visits for overall and cause-specific LRI.

Clustering of systemic lupus erythematosus mortality in southwestern Spain.

To analyse time trends in systemic lupus erythematosus (SLE) mortality and explore possible provincial clustering of SLE mortality in Spain (2001-2020). We conducted an ecological study using deaths registered in SLE at the Spanish National Institute of Statistics between 2001 and 2020. Jointpoint regression models have been used to evaluate temporal trends. To analyse the spatial pattern of SLE mortality in men and women in Spain, crude rates, age-standardised mortality rates (ASMRs), smooth relative risk (RR) and posterior probabilities (PP) for RR greater than one for the period 2001-2020 were calculated. The Global Moran I index was used to assess the existence of global spatial autocorrelation. Local indicators of spatial association (LISA) and Kulldorff's spatial scan statistic were used to identify clusters. Over the 20 years analyzed in this study, the SLE average ASMR for the period was 2.7 for women and 0.7 for men, with a sex ratio (female/male) of 3.8. In men, no province showed a RR>1. Conversely, in women, eight provinces showed values of RR> 1 with a PP greater than 0.8 (Seville, Cadiz, Huelva and Murcia in the south, Barcelona, Zaragoza, Huesca and Leon in the north). In men, neither of the two methods detected a clustering of provinces. However, in women, both methods identified a cluster of provinces located in the southwest of the country (Huelva, Cádiz, Seville and Malaga) as a cluster with significant excess mortality. In the second cluster (centred on the province of Huelva) obtained with the Kulldorff method, two more provinces were added (Badajoz and Cordoba, also located in the southwest). We detected a cluster of provinces with an excess risk of female SLE mortality in the southwest of Spain.

Prognostic value of quantitative flow ratio in patients with coronary heart disease after percutaneous coronary intervention therapy: a meta-analysis.

Coronary atherosclerotic heart disease is one of the most serious health and life-threatening diseases. There is no doubt that despite the increasing number of assessment methods used clinically, the prognosis assessment is still not ideal, and newer assessment methods are needed. To investigate the predictive value of quantitative flow ratio (QFR) for adverse events (vessel-oriented composite endpoint events/target lesion failure) in patients after percutaneous coronary intervention (PCI). Eight studies involving 4,173 patients (5,688 vascular lesions) were included. These are studies on the relationship between QFR values and prognosis of adverse cardiac events after PCI. This meta-analysis was performed after quality assessment and data extraction of clinical trials data that met the inclusion criteria. Each of the eight studies described the cut-off values for the best predictive ability of post-PCI QFR and the hazard ratio (HR) between QFR values and adverse events, respectively. The pooled HR of these studies was 4.72 (95% CI: 3.29-6.75). Concurrently, lower post-PCI QFR values were associated with the occurrence of individual clinical events (cardiac death/myocardial infarction/target vessel revascularization), with relative risk values of 6.51 (95% CI: 4.96-8.53), 4.83 (95% CI: 3.08-7.57), and 4.21 (95% CI: 2.66-6.68), respectively. QFR may have great potential in the assessment of prognosis. It is necessary to measure QFR value after PCI. A lower QFR value after PCI was an important predictor for experiencing adverse events.

Short-term ambient air pollution risk for ischemic stroke hospitalization and related economic burden: A multi-city time-series study in southwest China

Short-term exposure to air pollution is associated with hospitalization for ischemic stroke (IS); however, evidence of the impact of the exposure on IS in highly polluted developing regions is limited. This study aimed to assess the relationships between air pollutants and IS hospitalization, as well as economic burden attributable to the hospitalization in Sichuan, China. Records from 160,555 IS hospitalizations were collected from medical institutions in nine cities in Sichuan from 2017 to 2019, along with simultaneous meteorological and air pollution data. Generalized additive model (GAM) was used to analyze the relationship between air pollutants and IS hospitalizations. The economic burden due to air pollutants exposure were further assessed using a cost-of-illness (COI) method. All p values were corrected for multiple comparisons. The single pollutant model showed that the effects of each interquartile range (IQR) increase in PM2.5, PM10, O3, and CO, on IS hospitalization peaked on lag 07, with relative risk values of 1.057(95% CI: 1.030–1.085), 1.060(95% CI:1.032–1.090), 1.110(95% CI:1.043–1.181), and 1.096 (95% CI:1.060–1.132), respectively. Stratified analysis shows that older people are more susceptible to the impact of air pollutants, and compared to the warm season, IS hospitalization in the cold season is more susceptible to exposure to O3 and CO. It has been determined that during the study period, the number of IS hospitalizations attributable to PM2.5 pollution was 5,157 and to PM10 pollution was 3,650, with an economic cost of CNY 67, 966, 100 and 48, 107, 900, respectively. In this study, we found that short-term exposure to PM2.5, PM10, O3, and CO can lead to increased hospitalizations for stroke and a quantifiably greater economic burden.

Benchmark dose modeling for epidemiological dose-response assessment using prospective cohort studies.

Benchmark dose (BMD) methodology has been employed as a default dose-response modeling approach to determine the toxicity value of chemicals to support regulatory chemical risk assessment. Especially, a relatively standardized BMD analysis framework has been established for modeling toxicological data regarding the formats of input data, dose-response models, definitions of benchmark response, and model uncertainty consideration. However, the BMD approach has not been well developed for epidemiological data mainly because of the diverse designs of epidemiological studies and various formats of data reported in the literature. Although most of the epidemiological BMD analyses were developed to solve a particular question, the methods proposed in two recent studies are able to handle cohort and case-control studies using summary data with consideration of adjustments for confounders. Therefore, the purpose of the present study is to investigate and compare the "effective count"-based BMD modeling approach and adjusted relative risk (RR)-based BMD analysis approach to identify an appropriate BMD modeling framework that can be generalized for analyzing published data of prospective cohort studies for BMD analysis. The two methods were applied to the same set of studies that investigated the association between bladder and lung cancer and inorganic arsenic exposure for BMD estimation. The results suggest that estimated BMDs and BMDLs are relatively consistent; however, with the consideration of established common practice in BMD analysis, modeling adjusted RR values as continuous data for BMD estimation is a more generalizable approach harmonized with the BMD approach using toxicological data.

Association of sugar-sweetened beverages with the risk of colorectal cancer: a systematic review and meta-analysis.

The association between sugar-sweetened beverages intake and colorectal cancer (CRC) remains controversial. A metaanalysis was performed to clarify the correlation between sugar-sweetened beverages and CRC risk/mortality. A systematic literature search was conducted in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Sinomed (CBM), Wanfang Data Knowledge Service Platform, and China Science and Technology Journal VIP database. Articles were restricted to be available in any language until March 31, 2022. The highest exposed categories were used to calculate the pooled relative risks (RR) values. Pooled relative risks (RR) and 95% confidence intervals (CI) were used to estimate the association of sugar-sweetened beverages with CRC risk and mortality. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I2 statistic. A total of 17 studies (6 case-control and 11 cohort) involving 557,391 subjects were included in this meta-analysis. The pooled RRs for CRC incidence and mortality among people taking sugar-sweetened beverages were 1.17 (95% CI: 1.07-1.28) and 1.13 (95% CI: 0.99-1.29), respectively. In subgroup analysis, a correlation was found in the distal colon with a pooled RR of 1.41 (95% CI: 1.10-1.80). There was no correlation in the proximal colon with a pooled RR of 1.58 (95% CI: 0.79-3.17). We found statistically significant associations between CRC incidence and sugar-sweetened beverages intake in North America and Oceania, with pooled RRs of 1.16 (95% CI: 1.00-1.33) and 1.32 (95% CI: 1.13-1.55), respectively. In sensitivity analysis, after excluding each study and calculating heterogeneity and effect sizes, there was still a correlation between sugar-sweetened beverages intake and CRC risk. This meta-analysis suggests that sugar-sweetened beverages intake may increase CRC risk, independent of CRC mortality. Whether CRC risk increases with increased sugar-sweetened beverage intake needs further investigation in the future. This meta-analysis aimed to indicate the relationship between sugar-sweetened beverages intake and the risk and mortality of colorectal cancer. A total of 17 studies involving 557,391 subjects were included. The results showed that sugar-sweetened beverages may increase the risk of colorectal cancer but may not be associated with colorectal cancer mortality.

Brief intervention to enhance cessation of smokeless tobacco use in newly diagnosed patients with head and neck cancers: A randomized controlled trial in patient-relative dyads.

Tobacco use is a major causative factor for head and neck cancers (HNC). Continued use of tobacco even after cancer diagnosis is common and is associated with all-cause and cancer-specific mortality, cancer recurrence and poor treatment response. Evidence suggests that behavioral interventions, help achieve greater smoking cessation rates in HNC patients. However, intervention studies focussed on HNC patients using smokeless tobacco, which is more common than smoking in India, are sparse. We conducted a parallel arm randomized controlled trial (RCT) on dyads of patients with recently diagnosed HNC and a close relative. The experimental arm received a brief tobacco cessation intervention (BTCI) and the control arm received treatment as usual (TAU); 27 and 25 dyads in each arm completed the trial. Overall for the dyads using SLT, the relative risk of continuing to use SLT was 3.23 times higher (odds ratio = 7.01) if BTCI was not undertaken at one-month follow-up and 4.43 times higher (odds ratio = 8.65) at 3-months follow-up. For patients only, the relative risk of continuing to use SLT at one-month and 3-months follow-ups was 4.99 and 12.04 times higher, respectively, if BTCI was not undertaken. For relatives only, the corresponding relative risk values were 2.14 and 2.2. We conclude that BTCI delivered to patient-relative dyads, compared to TAU, is effective in enhancing the discontinuation rates of the use of SLT in newly diagnosed patients with HNC. This form of intervention is significantly effective for discontinuing SLT use in the relatives too.

Effect of short-term exposure to ambient air pollutants on non-accidental mortality in emergency department visits: a time-series study.

Exposure to air pollution has been linked to an increased risk of premature mortality. However, the acute effects of air pollution on the risk of non-accidental mortality have not been extensively researched in developing countries, and the findings thus far have been inconsistent. Therefore, this study aimed to examine the association between short-term exposure to six pollutants (PM2.5, PM10, SO2, NO2, O3, and CO) and non-accidental mortality in Beijing, China. Daily data on non-accidental deaths were gathered from 1 January 2017 to 31 December 2018. Air pollution data for the same period were collected from 35 fixed-site air quality monitoring stations in Beijing. Generalized additive models (GAM) based on Poisson regression were used to investigate the association between non-accidental mortality in emergency department visits and the daily average levels of air pollutants. There were 8,676 non-accidental deaths recorded during 2017-2018. After sensitivity analysis, short-term exposure to air pollutants, particularly gaseous pollutants, was linked to non-accidental mortality. Specifically, for every 10 μg/m3 increase (5 μg/m3 in SO2, 0.5 mg/m3 in CO) of SO2 (lag 04), NO2 (lag 04), O3 (lag 05), and CO (lag 04), the relative risk (RR) values were 1.054 (95% CI: 1.009, 1.100), 1.038 (95% CI: 1.013, 1.063), 1.032 (95% CI: 1.011, 1.054), and 1.034 (95% CI: 1.004, 1.066), respectively. In terms of causes of death, short-term exposure to NO2, SO2, and O3 increased the risk of circulatory mortality. Further stratified analysis revealed that the stronger associations were presented in females for O3 while in males for CO. People aged 65 and over were strongly associated with ambient air pollution. Our study showed that ambient air pollutants were associated with non-accidental mortality. Our findings suggested that efforts to control gaseous pollution should be stepped up, and vulnerable groups should be the focus of health protection education.

Urban-rural difference in the lagged effects of PM2.5 and PM10 on COPD mortality in Chongqing, China

BackgroundIt is true that Chronic obstructive pulmonary disease (COPD) will increase social burden, especially in developing countries. Urban-rural differences in the lagged effects of PM2.5 and PM10 on COPD mortality remain unclear, in Chongqing, China.MethodsIn this study, a distributed lag non-linear model (DLNMs) was established to describe the urban-rural differences in the lagged effects of PM2.5, PM10 and COPD mortality in Chongqing, using 312,917 deaths between 2015 and 2020.ResultsAccording to the DLNMs results, COPD mortality in Chongqing increases with increasing PM2.5 and PM10 concentrations, and the relative risk (RR) of the overall 7-day cumulative effect is higher in rural areas than in urban areas. High values of RR in urban areas occurred at the beginning of exposure (Lag 0 ~ Lag 1). High values of RR in rural areas occur mainly during Lag 1 to Lag 2 and Lag 6 to Lag 7.ConclusionExposure to PM2.5 and PM10 is associated with an increased risk of COPD mortality in Chongqing, China. COPD mortality in urban areas has a high risk of increase in the initial phase of PM2.5 and PM10 exposure. There is a stronger lagging effect at high concentrations of PM2.5 and PM10 exposure in rural areas, which may further exacerbate inequalities in levels of health and urbanization.

Mineral and Bone Metabolism Markers and Mortality in Diabetic Patients on Haemodialysis.

Diabetic patients on haemodialysis have a higher risk of mortality than non-diabetic patients. The aim of this COSMOS analysis was to assess whether bone and mineral laboratory values (calcium, phosphorus, and PTH) contribute to such risk. COSMOS is a multicentre, open-cohort, 3-year prospective study, which includes 6797 patients from 227 randomly selected dialysis centres from 20 European countries. The association between mortality and calcium, phosphate or PTH was assessed using Cox proportional hazard regression models using both penalized splines smoothing and categorization according to KDIGO guidelines. The effect modification of the association between the relative risk of mortality and serum calcium, phosphate or PTH by diabetes was assessed. There was a statistically significant effect modification of the association between the relative risk of mortality and serum PTH by diabetes (p = 0.011). The slope of the curve of the association between increasing values of PTH and relative risk of mortality was steeper for diabetic compared with non-diabetic patients, mainly for high levels of PTH. In addition, high serum PTH (> 9 times the normal values) was significantly associated with a higher relative risk of mortality in diabetic patients but not in non-diabetic patients (1.53[95%CI:1.07-2.19] and 1.17[95%CI:0.91-1.52]). No significant effect modification of the association between the relative risk of mortality and serum calcium or phosphate by diabetes was found (p = 0.2 and p = 0.059, respectively). The results show a different association of PTH with the relative risk of mortality in diabetic and non-diabetic patients. These findings could have relevant implications for the diagnosis and treatment of CKD-MBD.

Cytokine profile in the patients with combined cardio- and ophtalmopathies

Combined cardiological and ophthalmological pathology has a high prevalence in older age groups of the population and common pathogenetic mechanisms, among which, of course, is a violation of the cytokine profile. However, the cytokine profile of the blood was practically not analyzed in elderly patients with combined ischemic heart disease with glaucoma. The aim of the study was to study the cytokine profile in patients with combined cardio- and ophthalmopathology. The study was performed at the S.N. Fedorov National Medical Research Center “MNTK Eye Microsurgery”, in two groups: patients with combined coronary heart disease with glaucoma (n = 58 people), and patients with coronary heart disease (n = 49 people), who in both cases have the same age of 60-74 years. The diagnosis of glaucoma was carried out in accordance with the criteria of the “National Glaucoma Guidelines”. Electrocardiographic, echocardiographic, radiographic, and enzyme studies were performed to diagnose coronary heart disease. The determination of cytokines in blood plasma was carried out on the device “Becton Dickinson FACS Canto 2 (USA)” using a special set of CBA (BD Biosciences, USA). Among the patients of the compared groups of the same age, significant differences in most cytokines were revealed, namely, a predominant increase in patients with combined cardio- and ophthalmopathology relative to the group with coronary heart disease. The content of IL-5, IL-12, IFNγ, TNFα in the blood plasma of patients with coronary heart disease combined with glaucoma increased with a significant difference compared to patients with coronary heart disease. However, the highest increase among the cytokines under consideration is characteristic of IL-6 and IL-17, which amounted to 23.8±1.1 pg/mL and 20.2±1.7 pg/mL in patients with combined cardio- and ophthalmopathology versus 6.3±0.3 pg/mL and 7.9±0.5 pg/mL, respectively, in patients with coronary heart disease. At the same time, the level of IL-4 and IL-10 decreased significantly to 2.2±0.2 pg/mL and 6.4±0.4 pg/mL versus 4.8±0.3 pg/mL and 11.9±0.6 pg/mL. The use of logistic regression made it possible to determine the relative risk values of the studied blood cytokines and to develop uncorrected and adjusted models, according to which the closest association with the risk of developing combined coronary heart disease with glaucoma was established for IL-6 and IL-17, with the relative risk values in the uncorrected model of 2.87 and 2.71, respectively (p < 0.001). However, in the adjusted model, the association of IL-6 with combined coronary heart disease with glaucoma increased to 2.92 (CI 2.80-3.27, p = 0.004), and IL-17 decreased to 2.64 (CI 2.51-2.85, p = 0.003). There was also a significant association of IL-4, IL-5, IL-12, IFNγ and TNFα with combined coronary heart disease with glaucoma. The study demonstrated new associations of systemic cytokines with the risk of developing combined coronary heart disease associated with glaucoma.

High-risk spatial clusters for Zika, dengue, and chikungunya in Rio de Janeiro, Brazil.

To analyze the spatial distribution and identify high-risk spatial clusters of Zika, dengue, and chikungunya (ZDC), in the city of Rio de Janeiro, Brazil, and their socioeconomic status. An ecological study based on data from a seroprevalence survey. Using a rapid diagnostic test to detect the arboviruses, 2,114 individuals were tested in 2018. The spatial distribution was analyzed using kernel estimation. To detect high-risk spatial clusters of arboviruses, we used multivariate scan statistics. The Social Development Index (SDI) was considered in the analysis of socioeconomic status. Among the 2,114 individuals, 1,714 (81.1%) were positive for at least one arbovirus investigated. The kernel estimation showed positive individuals for at least one arbovirus in all regions of the city, with hot spots in the North, coincident with regions with very low or low SDI. The scan statistic detected three significant (p<0.05) high-risk spatial clusters for Zika, dengue, and chikungunya viruses. These clusters correspond to 35.7% (n=613) of all positive individuals of the sample. The most likely cluster was in the North (cluster 1) and overlapped regions with very low and low SDI. Clusters 2 and 3 were in the West and overlapping regions with low and very low SDI, respectively. The highest values of relative risks were in cluster 1 for CHIKV (1.97), in cluster 2 for ZIKV (1.58), and in cluster 3 for CHIKV (1.44). Regarding outcomes in the clusters, the Flavivirus had the highest frequency in clusters 1, 2, and 3 (42.83%, 54.46%, and 52.08%, respectively). We found an over-risk for arboviruses in areas with the worst socioeconomic conditions in Rio de Janeiro. Moreover, the highest concentration of people negative for arboviruses occurred in areas considered to have better living conditions.

Long-term exposure and health risk assessment from air pollution: impact of regional scale mobility

BackgroundThe negative effect of air pollution on human health is widely reported in recent literature. It typically involves urbanized areas where the population is concentrated and where most primary air pollutants are produced. A comprehensive health risk assessment is therefore of strategic importance for health authorities.MethodsIn this study we propose a methodology to perform an indirect and retrospective health risk assessment of all-cause mortality associated with long-term exposure to particulate matter less than 2.5 microns (PM2.5), nitrogen dioxide (NO2) and ozone (O3) in a typical Monday to Friday working week. A combination of satellite-based settlement data, model-based air pollution data, land use, demographics and regional scale mobility, allowed to examine the effect of population mobility and pollutants daily variations on the health risk. A Health Risk Increase (HRI) metric was derived on the basis of three components: hazard, exposure and vulnerability, utilizing the relative risk values from the World Health Organization. An additional metric, the Health Burden (HB) was formulated, which accounts for the total number of people exposed to a certain risk level.ResultsThe effect of regional mobility patterns on the HRI metric was assessed, resulting in an increased HRI associated with all three stressors when considering a dynamic population compared to a static one. The effect of diurnal variation of pollutants was only observed for NO2 and O3. For both, the HRI metric resulted in significantly higher values during night. Concerning the HB parameter, we identified the commuting flows of the population as the main driver in the resulting metric.ConclusionsThis indirect exposure assessment methodology provides tools to support policy makers and health authorities in planning intervention and mitigation measures. The study was carried out in Lombardy, Italy, one of the most polluted regions in Europe, but the incorporation of satellite data makes our approach valuable for studying global health.

Association between weather and hip fracture in adults: a nationwide study in China 198 cities.

Hip fractures represent a significant public health issue due to high incidence in aging society. Evidence of the short-term effects of weather on the risk of hip fracture is limited and inconsistent. We aimed to examine the associations between weather conditions and daily hospital admissions for hip fracture in adults in China. A national time-series analysis between 2014 and 2017 was conducted. Data on daily hospital admissions for hip fracture were obtained from the database of Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI). Weather conditions were acquired from the China Meteorological Data Sharing Service Center. Based on a time-stratified case-crossover design, conditional Poisson regression was used to estimate the impact on relative risk (RR) of weather conditions on hospital admissions for hip fracture. During the study period, a total of 137,504 hospital admissions for hip fractures were identified. All analyzed weather conditions showed consistent significant associations at lag 0 day for each 10 mm increase in precipitation, 10 m/s in wind speed, and 10°C in temperature, with the RR value being 1.079 (95% CI, 1.074-1.083) for precipitation, 1.404 (95% CI, 1.346-1.465) for wind speed, and 1.558 (95% CI, 1.546-1.570) for temperature. Women were more vulnerable to be affected by precipitation and temperature. In conclusion, increased risk for hip fractures in adults is associated with weather conditions. The improved understanding of the relationship between weather conditions and hip fractures hospital admission can be useful for resource allocation and provider preparedness.

Mortality and morbidity assessment attributed to short- and long-term exposure to fine particles in ambient air of Agadir city, Morocco: The AirQ model approach.

It is well established that respiratory mortality and morbidity are associated with high concentrations of fine particles such as PM2.5. The aim of this study was to evaluate the long- and short-term impacts of PM2.5 on the population of Agadir, Morocco, using AirQ 2.1.1 software. The mean PM2.5 values were obtained from data collected at three sites. Baseline incidence data were obtained from the literature, and relative risk (RR) values were referenced from the World Health Organization. This study quantified long-term total mortality (LT-TM), lung cancer mortality (LT-LC), morbidity from acute lower respiratory tract infections (LT-ALRI), and morbidity from chronic obstructive pulmonary disease (LT-COPD), as well as short-term total mortality (ST-TM). The attributable proportions (AP) of LT-TM and LT-LC were estimated to 14.19% and 18.42%, respectively. Their excess deaths were estimated to 279 and 11 persons, respectively, and their RRs to 1.16 (95% CI: 1.10-1.22) and 1.23 (95% CI: 1.12-1.37), respectively. Furthermore, the AP of LT-ALRI and LT-COPD were estimated to 14.36% and 15.68%, respectively, their excess deaths to 33 and 4, and their RRs to 1.17 (95% CI: 1.11-1.31) and 1.19 (95% CI: 1.00-1.02), respectively. In comparison, the AP of ST-TM was estimated to 1.27%, with a 25-person excess death rate. This study was conducted to inform decision-making and to promote local policies on ambient air quality.