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Vertical expansion makes the structure and pattern of the city more complicated. Traditional two-dimensional landscape pattern cannot completely reflect the ecological structure and functional characteristics of urban landscape. In this study, we used the three-dimensional landscape pattern metrics to quantify the regional three-dimensional landscape pattern, and used boosted regression tree (BRT) machine learning algorithms to comprehensively analyze the interaction between social-environmental factors and urban landscape patterns in the central part of Shanghai. Results showed that high building ratio, mean architecture height, and architecture height standard deviation had higher values in the surrounding area of the inner ring. The number of buildings and landscape shape index were higher in the outer ring than those in other area. Building coverage ratio, floor area ratio and Shannon's diversity index had higher values in the central part, with the metrics of Puxi being generally higher than those of Pudong. Population density and normalized vegetation index (NDVI) interacted most significantly with the three-dimensional landscape pattern, with GDP as the least influential factor. Within a certain range, the three-dimensional landscape pattern metrics increased with larger population density in the social factors, and decreased with lower rate of NDVI and water surface ratio in the environmental factors. Our results demonstrated that the BRT method was effective in quantifying the interaction between landscape pattern and social-environmental factors. Our results help improve the understanding of the relationship between ecological environment and human well-being in the central part of Shanghai and provide a scientific basis for the urban three-dimensional expansion planning.

The global, regional, and national burden of cancer among adolescents and young adults in 204 countries and territories, 1990-2019: a population-based study.

BACKGROUND: Accurate appraisal of burden of adolescents and young adults (AYAs) cancers is crucial to informing resource allocation and policy making. We report on the latest estimates of burden of AYA cancers in 204 countries and territories between 1990 and 2019 in association with socio-demographic index (SDI). PATIENTS AND METHODS: Estimates from the Global Burden of Disease study 2019 were used to analyse incidence, mortality, and disability-adjusted life years (DALYs) due to AYA cancers at global, regional, and national levels by sex. Association between AYA cancer burden and SDI were investigated. Burdens of AYA cancers were contextualized in comparison with childhood and older adult cancers. All estimates are reported as counts and age-standardized rates per 100,000 person-years. RESULTS: In 2019, there were 1.2 million incident cases, 0.4 million deaths, and 23.5 million DALYs due to AYA cancers globally. The highest age-standardized incidence rate occurred in Western Europe (75.3 [Females] and 67.4 [Males] per 100,000 person-years). Age-standardized death (23.2 [Females] and 13.9 [Males] per 100,000 person-years) and DALY (1328.3 [Females] and 1059.2 [Males] per 100,000 person-years) rates were highest in Oceania. Increasing SDI was associated with a higher age-standardized incidence rate. An inverted U-shaped association was identified between SDI and death and DALY rates. AYA cancers collectively is the second leading cause of non-communicable diseases-related deaths globally in 2019. DALYs of AYA cancers ranked the second globally and the first in low and low-middle SDI locations when compared with that of childhood and older adult cancers. CONCLUSION: The global burden of AYA cancers is substantial and disproportionally affect populations in limited-resource settings. Capacity building for AYA cancers is essential in promoting equity and population health worldwide.

Global, regional, and national burden of severe periodontitis, 1990-2019: An analysis of the Global Burden of Disease Study 2019.

AIM: Up-to-date epidemiological studies on the global burden of severe periodontitis is scarce. This study aimed to present the latest estimates for prevalence of severe periodontitis from 1990 to 2019, by region, age, and level of socio-demographic development. MATERIALS AND METHODS: Estimates from the Global Burden of Disease study 2019 were used to investigate burden and trends of prevalence of severe periodontitis and its association with socio-demographic development at global, regional, and national level. Decomposition analysis was performed to explore the contribution of demographic and epidemiological factors to the evolving burden of severe periodontitis. RESULTS: In 2019, there were 1.1 billion (95% uncertainty interval: 0.8-1.4 billion) prevalent cases of severe periodontitis globally. From 1990 to 2019, age-standardized prevalence rate of severe periodontitis increased by 8.44% (6.62%-10.59%) worldwide. Prevalence of severe periodontitis is higher among less developed countries/regions. Global population growth accounted for 67.9% of the increase in the number of prevalent cases of severe periodontitis from 1990 to 2019. CONCLUSIONS: The global burden of severe periodontitis has been substantial and increasing over the past three decades. Upstream policy changes are urgently needed to address the global public health challenge of severe periodontitis.

Differential Psychological Factors Associated With Unnecessary Dental Avoidance and Attendance Behavior During the Early COVID-19 Epidemic.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 is challenging the dental community to an unprecedented degree. Knowledge of the increased risk of infection in dental settings has been disseminated to the public and guidelines have been formulated to assist dental attendance decision-making. However, dental attendance behaviors incompatible with treatment need is not uncommon in clinical settings. Important gaps remain in the knowledge about how psychological factors are affecting dental attendance behaviors during the COVID-19 epidemic. In this cross-sectional study, a questionnaire survey was performed during February and March 2020. A total of 342 and 294 dental patients who attended and avoided dental visits, respectively, were included. The participants were classified into four groups based on dental attendance behavior and emergent/urgent dental treatment need. Bivariate analysis was performed to investigate factors associated with dental attendance. Multivariable logistic regression based on principal component scores was performed to identify major psychological constructs associated with unnecessary dental avoidance and attendance. Among all the factors explored, inability to wear masks during dental treatment (P < 0.001; effect size: 0.32) was most closely associated with the overall pattern of dental attendance among participants. Multivariable regression suggested that unnecessary dental avoidance was associated with perceived risk of infection in general and in dental settings (odds ratio [95% CI]: 0.62 [0.53, 0.72]; p < 0.001), perceived impact of COVID-19 and dental problems on general health (0.79 [0.65, 0.97]; 0.021), and personal traits such as trust and anxiety (0.77 [0.61, 0.98]; 0.038). Unnecessary dental attendance was associated with optimism toward the epidemic (1.68 [1.42, 2.01]; <0.001) and trust (1.39 [1.13, 1.74]; 0.002). Multidisciplinary efforts involving dental and medical professionals as well as psychologists are warranted to promote more widespread adoption, among the general public, of dental attendance behaviors compatible with dental treatment need during the COVID-19 epidemic.

The relationship between maternal vitamin D deficiency and glycolipid metabolism and adverse pregnancy outcome.

OBJECTIVE: Maternal vitamin D deficiency is associated with glucose and lipid metabolism in the mother and offspring. Meanwhile, it can also lead to adverse pregnancy outcomes. The aim of this case-control study was to document maternal, umbilical arterial glucose and lipid metabolic levels and correlations in pregnancies with or without vitamin D deficiency, while also investigating adverse pregnancy outcomes. DESIGN/PARTICIPANTS/MEASUREMENTS: A total of 425 pregnant women who received antenatal care and delivered at Wenzhou People's Hospital were enrolled. According to their serum 25-hydroxyvitamin D [25(OH)D] level, the pregnant women were divided into the vitamin D deficiency group [25(OH)D < 20 ng/mL, 185 participants] and the control group [25(OH)D ≥ 20 ng/mL, 240 participants]. Maternal blood samples were collected at 24-28 weeks of gestation and delivery for 75-g oral glucose tolerance test (OGTT), and measurements of glucose and lipid metabolite levels and 25(OH)D levels. Umbilical arterial samples were collected during delivery (33.57-41.43 gestational weeks). RESULTS: Compared with control participants, vitamin D deficiency women had significantly higher concentrations of fasting blood-glucose (P < .01), 1-h OGTT plasma glucose (P < .01), 2-h OGTT plasma glucose (P < .01), insulin (P < .01), HOMA-IR (P < .01), LDL (P < .01) and triglycerides (P = .02) and lower concentrations of HOMA-S (P < .01). Compared with the control group, vitamin D deficiency women had higher concentrations of triglycerides (P < .01) and lower concentrations of HDL-C (P < .01) and HOMA-ß (P = .01) in infant umbilical arterial blood. Pearson's correlation analysis demonstrated that the maternal 25(OH)D level was negatively correlated with maternal plasma glucose, insulin, LDL-C, cholesterol, triglyceride and HOMA-IR (r = -.38, -.27, -.2, -.11, -.11, -.33 and .11; P < .01, <.01, <.01, <.05, <.05 and <.01, respectively), while there was a positive correlation between maternal serum 25(OH)D and HOMA-S (r = .11, P < .05). The triglyceride level in the umbilical artery was negatively correlated with maternal serum 25(OH)D concentration (r = -.286, P < .01), while the HDL-C and HOMA-ß in umbilical artery were positively related (r = .154, .103, P < .01). Compared with the control group, the incidences of pre-eclampsia [4.8% (9/185) vs 1.25% (3/240), P = .03], gestational diabetes mellitus [19.45% (36/185) vs 12.08% (29/240), P = .04] and premature rupture of membranes [15.68% (29/185) vs 5.42% (13/240), P < .01] were higher in the vitamin D deficiency group. CONCLUSION: Vitamin D deficiency during pregnancy is associated with maternal glucose and lipid metabolism and pregnancy outcomes. Therefore, it is worth recommending to maintain vitamin D status at an optimal level in pregnant women to prevent metabolic disorders and pregnancy complications.

Efficacy and safety of chimeric antigen receptor-T cells in the treatment of B cell lymphoma: a systematic review and meta-analysis.

BACKGROUND: Conventional treatment has limited efficacy in relapsed/refractory B-cell lymphoma. Since chimeric antigen receptor T-cell (CAR-T) technology has shown high safety and results in high remission rates, we investigated its efficacy and safety in B-cell lymphoma treatment and analyzed potential affecting factors to provide evidence for therapeutic strategies and applications. METHODS: We searched databases including PubMed, Embase, and Cochrane up to July 2019. Meta-analysis 1 was conducted to study the efficacy of CAR-T cell for treating B-cell lymphoma, measuring the response rate and complete remission rate as outcomes. Sub-group analysis was performed for age, pathological type, target antigen, co-stimulatory molecule, and conditioning chemotherapy. Meta-analysis 2 was undertaken on the safety of the treatment with the incidence rate of toxicity (cytokine-releasing syndrome [CRS], neurotoxicity) as an outcome. RESULTS: Seventeen studies were included in the systematic review and meta-analysis. It was found that CAR-T cells had good therapeutic effects in the following cases: B-cell lymphoma (patients ≥65 years old); diffuse large B-cell lymphoma pathological type; patients with treatment target antigen other than CD19; patients treated with co-stimulatory molecules other than CD28, including 4-1BB+CD28 or 4-1BB; and patients treated with cyclophosphamide/fludarabine pre-treatment protocol conditioning chemotherapy. Although the CRS and neurotoxicity incidences were high, most were reversible with minimal risk of death. CONCLUSION: CAR-T cell treatment is safe for clinical application; however, toxicity effects should be monitored.

Paeonol and danshensu combination attenuates apoptosis in myocardial infarcted rats by inhibiting oxidative stress: Roles of Nrf2/HO-1 and PI3K/Akt pathway.

Paeonol and danshensu is the representative active ingredient of traditional Chinese medicinal herbs Cortex Moutan and Radix Salviae Milthiorrhizae, respectively. Paeonol and danshensu combination (PDSS) has putative cardioprotective effects in treating ischemic heart disease (IHD). However, the evidence for the protective effect is scarce and the pharmacological mechanisms of the combination remain unclear. The present study was designed to investigate the protective effect of PDSS on isoproterenol (ISO)-induced myocardial infarction in rats and to elucidate the potential mechanism. Assays of creatine kinase-MB, cardiac troponin I and T and histopathological analysis revealed PDSS significantly prevented myocardial injury induced by ISO. The ISO-induced profound elevation of oxidative stress was also suppressed by PDSS. TUNEL and caspase-3 activity assay showed that PDSS significantly inhibited apoptosis in myocardia. In exploring the underlying mechanisms of PDSS, we found PDSS enhanced the nuclear translocation of Nrf2 in myocardial injured rats. Furthermore, PDSS increased phosphorylated PI3K and Akt, which may in turn activate antioxidative and antiapoptotic signaling events in rat. These present findings demonstrated that PDSS exerts significant cardioprotective effects against ISO-induced myocardial infarction in rats. The protective effect is, at least partly, via activation of Nrf2/HO-1 signaling and involvement of the PI3K/Akt cell survival signaling pathway.

Using Monte Carlo simulation to assess variability and uncertainty of tobacco consumption in a city by sewage epidemiology.

OBJECTIVE: To use Monte Carlo simulation to assess the uncertainty and variability of tobacco consumption through wastewater analysis in a city. METHODS: A total of 11 wastewater treatment plants (WWTPs) (serving 2.2 million people; approximately 83% of urban population in Dalian) were selected and sampled. By detection and quantification of principal metabolites of nicotine, cotinine (COT) and trans-3'-hydroxycotinine (OH-COT), in raw wastewater, back calculation of tobacco use in the population of WWTPs can be realised. RESULTS: COT and OH-COT were detected in the entire set of samples with an average concentration of 2.33 ± 0.30 and 2.76 ± 0.91 µg/L, respectively. The mass load of absorbed NIC during the sampling period ranged from 0.25 to 4.22 mg/day/capita with an average of 1.92 mg/day/capita. Using these data, we estimated that smokers in the sampling area consumed an average of 14.6 cigarettes per day for active smoker. Uncertainty and variability analysis by Monte Carlo simulation were used to refine this estimate: the procedure concluded that smokers in Dalian smoked between 10 and 27 cigarettes per day. This estimate showed good agreement with estimates from epidemiological research. CONCLUSIONS: Sewage-based epidemiology may be a useful additional tool for the large-scale monitoring of patterns of tobacco use. Probabilistic methods can be used to strengthen the reliability of estimated use generated from wastewater analysis.

[Linking optical properties of dissolved organic matter with NDMA formation potential in the Huangpu River].

Surface water samples from the Huangpu River were filtered to measure the UV absorption and fluorescence spectrum. Dissolved organic carbon (DOC), N-nitrosodimethylamine (NDMA), and its formation potential (NDMA-FP) were also analyzed to explore relationships between the properties of dissolved organic matter (DOM) and the formation potential of disinfection byproducts-NDMA in the Huangpu River. The study found that: NDMA-FP concentration increased with the increasing of DOC concentration (r = 0.487, P < 0.01), but it had negative relationships with SUVA254 and HIX (r = -0.605, P < 0.01; r = -0.396, P < 0.01). NDMA-FP concentration had positive relationships with the fluorescence intensity of protein-like substances such as low-molecular-weight (LMW) tyrosine-like and tryptophan-like substances (r = 0.421, P < 0.01; r = 0.426, P < 0.01), but had a negative relationship with humic-like substance (r = -0.422, P < 0.01). Therefore, NDMA formation potential increases with the increasing DOM content in the Huangpu River, which is significantly related with the protein-like substances, but decreases with the increasing aromaticity and humification of DOM.

[Compositions and residual properties of petroleum hydrocarbon in contaminated soil of the oilfields].

The aims of this study were to determine the compositions and residual properties of petroleum hydrocarbon in soil, as well as to identify the source and weathering degree of the pollution. A total of 5 producing wells in Gudao and Hekou oil producing region of Shengli oilfields were analyzed. More than 50 individual target compounds including straight-and branched-chain alkanes( n-alkanes, pristine and phytane) and polycyclic aromatic hydrocarbons (PAHs) in soil samples and crude oil were determined by gas chromatography-mass spectrometry (GC-MS). The percentages of chain alkanes and PAHs in total solvent extractable matters(TSEM) of soil samples were both much lower than those in the crude oil samples. The compositions of petroleum hydrocarbon in soil samples differed from those in crude oil, which indicated the n-alkanes with carbon numbers <12 were much easier to lose in contrast to the n-alkanes with high carbon numbers. With n-octadecane/phytane as index for the weathering rate of oil contaminated soils, the relationship between the index and petroleum hydrocarbon compounds was analyzed using principal component analysis (PCA). The results showed that the n-alkanes with carbon numbers > 33 and the PAHs with rings between 3 and 5 were much harder to degrade. PCA of 4 indexes for source identification revealed more than 50% of the soil samples were polluted by crude oil, which needs more attention during remediation.