Prediction and Mechanisms of Spontaneous Resorption in Lumbar Disc Herniation: Narrative Review.

The major symptoms of lumbar disc herniation (LDH) are low back pain, radiative lower extremity pain, and lower limb movement disorder. Patients with LDH suffer from great distress in their daily life accompanied by severe economic hardship and difficulty in self-care, with an increasing tendency in the aging population. PubMed and the Cochrane Central Register of Controlled Trials were searched for relevant studies of spontaneous resorption or regression in LDH after conservative treatment and for other potential studies, which included those from inception to June 30, 2023. The objective of this narrative review is to summarize previous literatures about spontaneous resorption in LDH and to discuss the mechanisms and influencing factors in order to assess the probability of spontaneous resorption by conservative treatment. Spontaneous resorption without surgical treatment is influenced by the types and sizes of the LDH, inflammatory responses, and therapeutic factors. If the lumbar disc herniated tissue comprises a higher percentage of cartilage or modic changes have been shown on magnetic resonance imaging (MRI), resorption in LDH is prevented. The bull's eye sign on enhanced MRI, which is a ring enhancement around a protruding disc, is a vital indicator for easy reabsorption. In addition, the type of extrusion and sequestration in LDH could forecast the higher feasibility of natural reabsorption. Moreover, the higher the proportion of protrusion on the intervertebral disc tissue within the spinal canal, the greater the likelihood of reabsorption. Therefore, which illustrates the feasibility of conservative treatments for LDH. Nonsurgical management of LDH with clinical symptoms is recommended by the authors.

The usefulness of ultrasound in identifying the underlying findings linked to pain in podagra patients.

AIM: To explore whether ultrasound (US) can be employed to identify the underlying characteristics associated with pain in patients with podagra by evaluating the relationship between ultrasound findings and clinical pain. MATERIAL AND METHODS:  Patients with podagra were recruited and grouped into a pain group (G1, 82 patients) and a non pain group (G2, 123 patients). US features were collected and compared. US data were analyzed by binary logistic regression analysis and ROC analysis. Interobserver reliability was assessed, too. RESULTS: A total of 205 patients (196 male and 9 female) were enrolled in this study. In multivariate analysis, the thickness of the synovium (OR=1.928, CI=1.074-3.463), CD (color Doppler) signal of the synovium (OR=1.458, CI=1.011-2.103), and CD signal of the tophi (OR=1.576, CI=1.142-2.177) were identified as risk factors for clinical pain. Areas under the ROC curves (AUC) were 0.713, 0.686 and 0.641 for the three indicators, respectively. The best cutoff points were 1 mm for the thickness of the synovium, grade 1 for the CD signal of the synovium and grade 2 for the CD signal of the tophi. CONCLUSIONS: Ultrasound can provide valuable information for determining underlying features associated with pain in patients with podagra.

Bismuth-doping boosting Na+ diffusion kinetics of layered oxide cathode with radially oriented {010} active lattice facet for sodium-ion batteries.

O3-type layered oxide cathodes (NaxTMO2) for sodium-ion batteries (SIBs) have attracted significant attention as one of the most promising potential candidates for practical energy storage applications. The poor Na+ diffusion kinetics is, however, one of the major obstacles to advancing large-scale practical application. Herein, we report bismuth-doped O3-NaNi0.5Mn0.5O2 (NMB) microspheres consisting of unique primary nanoplatelets with the radially oriented {010} active lattice facets. The NMB combines the advantages of the oriented and exposed electrochemical active planes for direct paths of Na+ diffusion, and the thick primary nanoplatelets for less surface parasitic reactions with the electrolyte. Consequently, the NMB cathode exhibits a long-term stability with an excellent capacity retention of 72.5% at 1C after 300 cycles and an enhanced rate capability at a 0.1C to 10C rate (1C = 240 mA g-1). Furthermore, the enhancement is elucidated by the small volume change, thin cathode-electrolyte-interphase (CEI) layer, and rapid Na+ diffusion kinetics. In particular, the radial orientation-based Bi-doping strategy is demonstrated to be effective at boosting electrochemical performance in other layered oxides (such as Bi-doped NaNi0.45Mn0.45Ti0.1O2 and NaNi1/3Fe1/3Mn1/3O2). The results provide a promising strategy of utilizing the advantages of the oriented active facets of primary platelets and secondary particles to develop high-rate layered oxide cathodes for SIBs.

Prevalence of body mass index categories among adults living alone in China: Observational study.

BACKGROUND: Adults living alone represent a growing population group in China. Understanding the prevalence of body mass index (BMI) categories and their associations with demographic and lifestyle factors among this group is essential for informing targeted interventions and public health policies. METHODS: In this population-based cross-sectional study, we used individual-level data from the 2011-2021 China General Social Survey. Main outcomes were prevalence of BMI categories adjusted for gender and age, using logistic regression and model-predicted marginal prevalence to estimate BMI categories prevalence. RESULTS: We analyzed 9,077 single-living Chinese adult participants. The primary-adjusted prevalence of BMI categories varied across different genders and age groups. Underweight was more prevalent in females (12.73%; 95% CI: 12.31% - 13.14%) than in males (7.54%; 95% CI: 7.19% - 7.88%), while overweight and obesity were higher in males. Primary-adjusted underweight prevalence was highest among the 18-24 years age group (22.09%; 95% CI: 20.17% - 24.01%) and decreased with age. Primary-adjusted overweight prevalence increased with age, peaking in the 45-54 years age group (41.94%; 95% CI: 40.96% - 42.93%). Primary-adjusted obesity prevalence exhibited a fluctuating pattern across age groups, with the highest prevalence observed in the 45-54 years age group (9.81%; 95% CI: 9.19% - 10.44%). CONCLUSION: Our findings reveal significant associations between BMI categories and demographic and lifestyle factors among adults living alone in China. These results can inform targeted interventions and public health policies aimed at promoting healthy weight management and addressing the unique health challenges faced by single-living individuals in China.

Co-expression of metabolites and sensory attributes through weighted correlation network analysis to explore flavor-contributing factors in various Pyrus spp. Cultivars.

Flavor profiles of various Pyrus spp. cultivars exhibit significant variations, yet the underlying flavor-contributing factors remain elusive. In this investigation, a comprehensive approach encompassing metabolomics analysis, volatile fingerprint analysis, and descriptive sensory analysis was employed to elucidate the flavor disparities among Nanguoli, Korla fragrant pear, and Qiuyueli cultivars and uncover potential flavor contributor. The study comprehensively characterized the categories and concentrations of nonvolatile and volatile metabolites, and 925 metabolites were identified. Flavonoids and esters dominated the highest cumulative response, respectively. Utilizing weighted correlation network analysis (WGCNA), seven highly correlated modules were identified, yielding 407 pivotal metabolites. Further correlation analysis of the differential substances provided potential flavor constituents strongly associated with various sensory attributes; taste factors had a certain association with olfactory characteristics. Our findings demonstrated the manifestation of flavor was a result of the synergistic effect of various compounds; evaluation olfactory flavor necessitated a comprehensive consideration of taste substances.

Primary Malignant Melanoma in the Parotid Gland: A Case Report and Literature Review.

Primary melanoma of the parotid gland is an extremely rare and challenging tumor with a poor prognosis, and its ultrasonic characteristics have yet to be reported. This article presents a case of a 77-year-old man with a left parotid mass that was confirmed as a melanoma following surgery. The ultrasonic features of melanoma were examined in detail, with a particular focus on their diagnostic value. Furthermore, we summarized the clinical characteristics, treatment options, and outcomes associated with primary melanoma of the parotid gland based on a thorough analysis of the available literature.

Integrating Post-Ionization Separation via Differential Mobility Spectrometry into Direct Analysis in Real Time Mass Spectrometry for Toy Safety Screening.

Direct analysis in real time (DART) enables direct desorption and ionization of analytes, bypassing the time-consuming chromatographic separation traditionally required for mass spectrometry (MS) analysis. However, DART-MS suffers from matrix interference of complex samples, resulting in compromised detection sensitivity and quantitation accuracy. In this study, DART-MS was combined with differential mobility spectrometry (DMS) to provide an additional dimension of post-ionization ion mobility separation within a millisecond time scale, compensating for the lack of separation in DART-MS analysis. As proof-of-concept, primary aromatic amines (PAAs), a class of potentially hazardous chemicals, were analyzed in various toy products, including bubble solutions, finger paints, and plush toys. In addition to commercial Dip-it glass rod and metal mesh sampling tools, a customized rapid extractive evaporation device was designed for the accelerated extraction and sensitive analysis of solid toy samples. The incorporation of DMS in DART-MS analysis enabled the rapid separation and differentiation of isomeric analytes, leading to improved accuracy and reliability. The developed protocols were optimized and validated, achieving good linearity with correlation coefficients greater than 0.99 and acceptable repeatability with relative standard deviations less than 10%. Moreover, satisfactory sensitivity was realized with limits of detection and quantitation ranges of 0.2-5 and 1-20 µg/kg (µg/L) for the 11 PAA analytes. The established methodology was applied for the analysis of real toy samples (n = 18), which confirmed its appealing potential for toy safety screening and consumer health protection.

Association of physical activity and PM2.5-attributable cardiovascular disease mortality in the United States.

Objective: The study aimed to explore the association between physical activity (PA) and PM2. 5-attributable cardiovascular disease (CVD) mortality trends across the United States (US) at the state level. Methods: We conducted a cross-sectional study using data from the Global Burden of Disease 2019 study for PM2.5-attributable CVD mortality and the Behavioral Risk Factor Surveillance System for PA prevalence. The study covered all 50 US states and the District of Columbia from 2001 to 2019. We utilized Joinpoint Regression to calculate AAPC from 2011 to 2019 and Pearson correlation coefficients to assess state-level associations between PA and PM2.5-attributable CVD mortality AAPC. Results: During 2011-2019, a total of 244,318 PM2.5-attributable CVD deaths were recorded. The age-adjusted mortality rates (AAMR) of PM2.5-attributable CVD declined substantially from 2011 to 2019 across all US states, with the most pronounced reductions observed in industrialized states such as West Virginia (51% decline), Kentucky (32%), and Ohio (22%). AAMR ratios for the US states varied substantially, ranging from 0.1 in Hawaii to 1.7 in Arkansas. The AAPC ranged from -9.4% (West Virginia) to -1.7% (New Mexico) in the majority of states, while a few states such as Alaska, Wyoming, and Washington saw slight positive AAPCs from 0.9 to 2.9%. A significant correlation was found between PA and PM2.5-attributable CVD mortality trends (r = 0.454, p = 0.001), with similar results in subgroup analyses. Conclusion: Our findings suggest a correlation between increased physical activity (PA) and increased PM2.5-attributable CVD mortality, highlighting the potential need to consider PM2.5 exposure when engaging in PA to mitigate adverse cardiovascular health impacts. However, further research is warranted to establish causality and underlying mechanisms in the relationship between PA and PM2.5-attributable CVD mortality. Potential limitations include reliance on self-reported PA data.

Trends in all causes and cause specific mortality attributable to ambient particulate matter pollution in China from 1990 to 2019: A secondary data analysis study.

BACKGROUND: Particularly fine particulate matter (PM2.5) has become a significant public health concern in China due to its harmful effects on human health. This study aimed to examine the trends in all causes and cause specific morality burden attributable to PM2.5 pollution in China. METHODS: We extracted data on all causes and cause specific mortality data attributable to PM2.5 exposure for the period 1990-2019 in China from the Global Burden of Disease 2019. The average annual percent change (AAPC) in age-standardized mortality rates (ASMR) and years of life lost (YLLs) due to PM2.5 exposure were calculated using the Joinpoint Regression Program. Using Pearson's correlation, we estimated association between burden trends, urban green space area, and higher education proportions. RESULTS: During the period 1990-1999, there were increases in mortality rates for All causes (1.6%, 95% CI: 1.5% to 1.8%), Diabetes mellitus (5.2%, 95% CI: 4.9% to 5.5%), Encephalitis (3.1%, 95% CI: 2.6% to 3.5%), Ischemic heart disease (3.3%, 95% CI: 3% to 3.6%), and Tracheal, bronchus and lung cancer (5%, 95% CI: 4.7% to 5.2%). In the period 2010-2019, Diabetes mellitus still showed an increase in mortality rates, but at a lower rate with an AAPC of 1.2% (95% CI: 1% to 1.4%). Tracheal bronchus and lung cancer showed a smaller increase in this period, with an AAPC of 0.5% (95% CI: 0.3% to 0.6%). In terms of YLLs, the trends appear to be similar. CONCLUSION: Our findings highlight increasing trends in disease burden attributable to PM2.5 in China, particularly for diabetes mellitus, tracheal, bronchus, and lung cancer.

Research advances of SERS analysis method based on silent region molecules for food safety detection.

Food safety is a critical issue that is closely related to people's health and safety. As a simple, rapid, and sensitive detection technique, surface-enhanced Raman scattering (SERS) technology has significant potential for food safety detection. Recently, researchers have shown a growing interest in utilizing silent region molecules for SERS analysis. These molecules exhibit significant Raman scattering peaks in the cellular Raman silent region between 1800 and 2800 cm-1 avoiding overlapping with the SERS spectrum of biological matrices in the range 600-1800 cm-1, which could effectively circumvent matrix effects and improve the SERS accuracy. In this review, the application of silent region molecules-based SERS analytical technique for food safety detection is introduced, detection strategies including label-free detection and labeled detection are discussed, and recent applications of SERS analysis technology based on molecules containing alkyne and nitrile groups, as well as Prussian blue (PB) in the detection of pesticides, mycotoxins, metal ions, and foodborne pathogens are highlighted. This review aims to draw the attention to the silent region molecules-based SERS analytical technique and to provide theoretical support for its further applications in food safety detection.

BMI categories across different living arrangements.

INTRODUCTION: Research on the prevalence of body mass index (BMI) categories across different living arrangements remains limited. We aimed to quantify the prevalence of BMI categories among those living alone (LA) and those not living alone (NLA). METHODS: In this population-based cross-sectional study, we used individual-level data from the 2011-2021 Behavioral Risk Factor Surveillance System. Main outcomes were prevalence of BMI categories in LA and NLA, adjusted for age, gender, and race/ethnicity, and socioeconomic status, using logistic regression and model-predicted marginal prevalence to estimate BMI categories prevalence. RESULTS: Between 2011 and 2021, we quantified BMI categories prevalence in 4,195,414 adults in the BRFSS, with 1,197,787 (28.5%) adults LA and 2,997,627 (71.5%) adults NLA. In comparison to NLA, LA consistently demonstrates lower adjusted obesity prevalence across genders and age groups, with the highest prevalence observed in the 45-64 age range, particularly within the 45-54 group (LA: 37.4%, 95% CI: 37.1-37.8%; NLA: 34.3%, 95% CI: 33.8-34.7%). Additionally, LA displays an overall lower adjusted prevalence of overweight compared to NLA, notably in the 18-34 and >64 age groups. CONCLUSIONS: Heterogeneity in BMI categories prevalence exists between LA and NLA. Future studies and public health efforts should consider this heterogeneity.

Cu/Ti co-doping boosting P2-type Fe/Mn-based layered oxide cathodes for high-performance sodium storage.

Environmentally friendly P2-type layered iron manganese oxides appear to be one of the most potential cathode materials for sodium-ion batteries (SIBs). However, their practical application is hindered by the unfavorable phase transitions, dissolution of transition metals, and poor air stability. One effective strategy by either single-cation doping or high-cost Li involved co-doping is used to alleviate the problems. Here, low-cost Cu/Ti co-doping is introduced to boost P2-Na0.7Cu0.2Fe0.2Mn0.5Ti0.1O2 as an air and electrochemical stable cathode material for SIBs. The resulting electrode delivers an initial capacity of 130 mAh g-1 at 0.1C within 2.0-4.2 V, a reversible discharge capacity of 61.0 mAh g-1 at a high rate of 5C and a capacity retention ratio exceeding 71.1% after 300 cycles. In particular, the co-doped crystal structure is well-maintained after 1 month of exposure to air, and even 3 days of soaking in water. Furthermore, the enhancement is elucidated by the effectively mitigated P2-Z and the completely suppressed P2-P'2 phase transitions, the decreased volume variation proved by in-situ X-ray diffraction (XRD), as well as the lowered transition-metal dissolution evidenced by inductively coupled plasma optical emission spectrometer (ICP-OES) and X-ray photoelectron spectroscopy (XPS). The low-lost Cu/Ti doping strategy could thus be effective for designing and preparing environmentally friendly and high-performance cathode materials for SIBs.

Pig manure-derived fulvic acid more strongly drives the fate of arsenic and antibiotic resistance genes in paddy soil.

Antibiotic resistance genes (ARGs) can threaten the clean production of rice owing to continuous selective pressure in heavy metal-antibiotic co-contaminated paddy soils. As an important soil carbon reservoir, the role of humic substances from different types of manure in the regulation of soil ARGs remains unclear. In this study, fulvic acid (FA) and humic acid (HA) were extracted from pig manure (PM), cow dung (CD), and chicken manure (CM). The influence of their characteristics and doses on the fate of ARGs was investigated in arsenic (As)-antibiotic co-contaminated paddy soils. The release of As and degradation of antibiotics were promoted in 1% PM-FA treatment, with increases of 4.8%-5.6% and 8.3%-8.8% compared with CM-FA and CD-FA treatments, respectively. The coexistence of FA/HA, Fe, As, and antibiotics in soil pore water affected the environmental behavior of ARGs, with FA showing a more positive effect. Species including Bacillus, Geobacter, Desulfitobacterium, and Christensenellaceae_R-7_group were considered potential hosts of ARGs, and their resistance to co-contamination increased after the addition of FA. Membrane transport is a potential strategy for host bacteria of ARGs to cope with As-antibiotic complex pressure. These results demonstrate the coupling mechanisms of As, antibiotics, and ARGs regulated by different humic substances in co-contaminated paddy soils, which could support the clean production of rice in agricultural practice.

Multicolor aptasensors for pesticide multiresidues detection in agricultural products using bioorthogonal surface-enhanced Raman scattering tags.

Realizing accurate pesticide multiresidue detection in a complex matrix is still a challenge for point-of-care sensing methods. Herein, we introduced background-free and multicolor aptasensors based on bioorthogonal surface-enhanced Raman scattering (SERS) tags and successfully applied them to analyze multiple pesticide residues. The excellent anti-interference and multiplex capability are due to the application of three bioorthogonal Raman reporters involving 4-ethenylbenzenamine (4-EBZM), Prussian blue (PB) and 2-amino-4-cyanopyridine (AMCP) with alkynyl and cyano groups, which demonstrated apparent Raman shift peaks at 1993 cm-1, 2160 cm-1, and 2264 cm-1 in the biologically Raman-silent region, respectively. Ultimately, a detection range of 1-50 nM for acetamiprid, atrazine and malathion was achieved with detection limits of 0.39, 0.57 and 0.16 nM, respectively. The developed aptasensors were successfully used to determine pesticide residues in real samples. These proposed multicolor aptasensors offer an effective strategy for pesticide multiresidue detection with advantages of anti-interference, high specificity and high sensitivity.

An interference-free SERS-based aptasensor for chlorpyrifos detection.

In this study, we propose an interference-free SERS-based aptasensor for trace detection of chlorpyrifos (CPF) in real samples. In the aptasensor, gold nanoparticles coated with Prussian blue (Au@PB NPs) were employed as SERS tags to provide a sole and intense Raman emission at 2160 cm-1, which could avoid overlapping with the Raman spectrum of the real samples in 600-1800 cm-1 to improve the anti-matrix effect ability of the aptasensor. Under the optimum conditions, this aptasensor displayed a linear response for CPF detection in the range of 0.1-316 ng mL-1 with a low detection limit of 0.066 ng mL-1. In addition, the prepared aptasensor shows excellent application to determine CPF in cucumber, pear and river water samples. The recovery rates were highly correlated with high-performance liquid chromatography‒mass spectrometry (HPLC‒MS/MS). This aptasensor shows interference-free, specific and sensitive detection for CPF and offers an effective strategy for other pesticide residue detection.

Exploring the Aroma Fingerprint of Various Chinese Pear Cultivars through Qualitative and Quantitative Analysis of Volatile Compounds Using HS-SPME and GC×GC-TOFMS.

To comprehensively understand the volatile compounds and assess the aroma profiles of different types of Pyrus ussuriensis Maxim. Anli, Dongmili, Huagai, Jianbali, Jingbaili, Jinxiangshui, and Nanguoli were detected via headspace solid phase microextraction (HS-SPME) coupled with two-dimensional gas chromatography/time-of-flight mass spectrometry (GC×GC-TOFMS). The aroma composition, total aroma content, proportion and number of different aroma types, and the relative quantities of each compound were analyzed and evaluated. The results showed that 174 volatile aroma compounds were detected in various cultivars, mainly including esters, alcohols, aldehydes, and alkenes: Jinxiangshui had the highest total aroma content at 2825.59 ng/g; and Nanguoli had the highest number of aroma species detected at 108. The aroma composition and content varied among pear varieties, and the pears could be divided into three groups based on principal component analysis. Twenty-four kinds of aroma scents were detected; among them, fruit and aliphatic were the main fragrance types. The proportions of aroma types also varied among different varieties, visually and quantitatively displaying changes of the whole aroma of the different varieties of pears brought by the changes in aroma composition. This study contributes to further research on volatile compound analysis, and provides useful data for the improvement of fruit sensory quality and breeding work.

TRD-YOLO: A Real-Time, High-Performance Small Traffic Sign Detection Algorithm.

Traffic sign detection is an important part of environment-aware technology and has great potential in the field of intelligent transportation. In recent years, deep learning has been widely used in the field of traffic sign detection, achieving excellent performance. Due to the complex traffic environment, recognizing and detecting traffic signs is still a challenging project. In this paper, a model with global feature extraction capabilities and a multi-branch lightweight detection head is proposed to increase the detection accuracy of small traffic signs. First, a global feature extraction module is proposed to enhance the ability of extracting features and capturing the correlation within the features through self-attention mechanism. Second, a new, lightweight parallel decoupled detection head is proposed to suppress redundant features and separate the output of the regression task from the classification task. Finally, we employ a series of data enhancements to enrich the context of the dataset and improve the robustness of the network. We conducted a large number of experiments to verify the effectiveness of the proposed algorithm. The accuracy of the proposed algorithm is 86.3%, the recall is 82.1%, the mAP@0.5 is 86.5% and the mAP@0.5:0.95 is 65.6% in TT100K dataset, while the number of frames transmitted per second is stable at 73, which meets the requirement of real-time detection.

Numerical and Experimental Study on Flame Dynamics of the Premixed Methane-Air Mixture at Different Ignition Positions in a Two-Side 45° Branch Tube.

The combustion characteristics of premixed methane-air flames in a half-open tube with a two-sided 45° branch structure at different ignition positions were investigated by experiments and large eddy simulations. The numerical results were compared with the experimental results to verify the correctness of the model. The results show that the simulation results are highly consistent with the experiment. This study provides a basic understanding of the effects of the branch tube structure and the ignition position on flame dynamics. When the flame propagates to the branch interface, it forms a symmetrical vortex structure at the branch tube with the opposite rotation direction. When the ignition position is at IP0 and IP900, the maximum overpressures obtained in the experiment are 10.1 and 10.7 kPa, respectively, and 9.2 and 10.4 kPa in the simulation, respectively. At IP0, the Karlovitz number indicating the interaction intensity between the flame surface and the turbulence during flame propagation is a maximum of 9.2 and a minimum of 0.04. The premixed flame has a folded small flame, a corrugated small flame, and a thin reaction zone.

Manure application facilitated electrokinetic remediation of antibiotic-arsenic co-contaminated paddy soil.

The co-existence of antibiotics and heavy metals in soil with manure application poses high risk to both environment and human health, and thus effective remediation methods are in urgent need. This study investigated the synergistic effects of electrokinetic remediation (EKR) on antibiotic resistance and arsenic (As) in co-contaminated paddy soils. EKR treatments in soil amended with pig manure (EKR-PD) showed better remediation efficiency compared with that without pig manure. In detail, the content of available As and the abundance of antibiotic-resistant bacteria (ARB) decreased by 25.2 %-41.4 % and 9.5 %-21.1 % after 7-d remediation, respectively, due to a relatively higher current density for EKR-PD. The role of the electric field contributed to 33.9 % of antibiotic degradation. Antibiotic resistance genes (ARGs) with ribosomal-protection and enzymatic-deactivation types were easier to remove, with the removal ratio of 37.8 %-41.6 % in EKR-PD. Brevundimonas was the most significantly different species during remediation. Bacillus and Clostridium_ sensu_stricto_1 were potential host bacteria of ARGs in the electric field. Membrane transport might be an effective strategy for microorganisms to respond to the stress of both electric field and co-contaminated environments. This study supports the potential role of EKR in the co-contamination of heavy metals and antibiotic resistance under manure application.

State-level disparities in burden of ischemic heart diseases mortality attributable to ambient fine particulate matter in the United States, 1990-2019: Observational analysis for the Global Burden of Disease (2019) study.

BACKGROUND: ambient fine particulate air pollution (PM2.5) is an important yet often overlooked risk factor for cardiovascular disease in the United States. However, epidemiologic evidence suggests that current knowledge does not comprehensively capture state-level disparities in mortality for ambient PM2.5-related ischemic heart diseases. METHODS: I performed serial cross sectional analysis with ambient PM2.5-attributable ischemic heart diseases decedents between 1990 and 2019. I used the Global Health Data Exchange to extract age adjusted mortality rates in each state, and used Joinpoint software to calculate average annual percentage change. RESULTS: the average age adjusted mortality rates (AAMR) for ischemic heart diseases attributable to ambient PM2.5 for both sex ranged from 1.5 (1.3-1.8) per 100,000 in Hawaii to 1.1 (0.9-1.3) per 100,000 in Mississippi, respectively. The rate of change in AAMR varied widely across states. Compared with the national level, the number of states with smaller decline has increased from 3 before 2002 to 10 after 2011. Oregon, Idaho, and Montana showed an upward trend in AAMR, which was independent of sex after 2011. Between 1990 and 2019, average AAMR for ischemic heart diseases attributable to ambient PM2.5 was higher for male than female in all states. But the number of states with sex disparities in the rate of change has decreased, from 13 in 1990-2002 to 5 after 2011. CONCLUSIONS: wide state-level disparities exist in burden of ischemic heart diseases attributable to ambient PM2.5. After 2011, the association between rate of AAMR decline and sex weakened across states. State-level policies and programs are needed to address the avoidable burden of ischemic heart diseases deaths attributable to ambient particulate pollution, with priority for states with a higher burden.