Optimum Parameters in Ultrasound Coherent Plane Wave Compounding for High LPWV Estimation: Validation on Phantom and Feasibility in 10 Subjects.

OBJECTIVES: The aim of this study is to determine the optimum and fine values of the number and transmission angles of tilted plane waves for coherent plane-wave compounding (CPWC)-based high local pulse wave velocity (LPWV) estimation. METHODS: A Verasonics system incorporating a linear array probe L14-5/38 with 128 elements and a pulsatile pump, CompuFlow1000, were used to acquire radio frequency data of 3, 5, 7, and 9 tilted plane wave sequences with angle intervals from 0° to 12° with a coarse interval increment step of 1°, and the angle intervals from 0° to 2° with a fine interval increment step of 0.25° from a carotid vessel phantom with the LPWV of 13.42 ± 0.90 m/s. The mean value, standard deviation, and coefficients of variation (CV) of the estimated LPWVs were calculated to quantitatively assess the performance of different configurations for CPWC-based LPWV estimation. Ten healthy human subjects of two age groups were recruited to assess the in vivo feasibility of the optimum parameter values. RESULTS: The CPWC technique with three plane waves (PRF of 12 kHz corresponding to a frame rate of 4000 Hz) with an interval of 0.75° had LPWVs of 13.52 ± 0.08 m/s with the lowest CV of 1.84% on the phantom, and 5.49 ± 1.46 m/s with the lowest CV of 12.35% on 10 subjects. CONCLUSIONS: The optimum parameters determined in this study show the best repeatability of the LPWV measurements with a vessel phantom and 10 healthy subjects, which support further studies on larger datasets for potential applications.

Tissue accumulation of microplastics and potential health risks in human.

Microplastics have become ubiquitous throughout the environment. Humans constantly ingest and inhale microplastics, increasing concerns about the health risks of microplastic exposure. However, limited data impedes a full understanding of the internal exposure to microplastics. Herein, to evaluate microplastic exposure via the respiratory and digestive systems, we used laser direct infrared spectroscopy to identify microplastics >20 µm in size in different human tissues. Consequently, 20-100 µm microplastics were concentrated in all tissues, with polyvinyl chloride (PVC) being the dominant polymer. The highest abundance of microplastics was detected in lung tissue with an average of 14.19 ± 14.57 particles/g, followed by that in the small intestine, large intestine, and tonsil (9.45 ± 13.13, 7.91 ± 7.00, and 6.03 ± 7.37 particles/g, respectively). The abundance of microplastics was also significantly greater in females than in males (p < 0.05). Despite significant diversity, our estimation showed that the lungs accumulated the highest amounts of microplastic. Moreover, PVC particles may cause potential health risks because of their high polymer hazard index and maximal risk level. This study provides evidence regarding the occurrence of microplastics in humans and empirical data to support assessments of the health risks posed by microplastics.

Unveiling the traits of dry and wet pre-magnetized zero-valent iron-activated peroxymonosulfate: Degradation of oxytetracycline.

It has been previously reported that pre-magnetization could enhance the efficacy of zero-valent iron (ZVI) in removing contaminants. However, little is known about the effects and persistence of different magnetization methods on pre-magnetized ZVI (Pre-ZVI) when used in advanced oxidation processes (AOPs). Gaining a comprehensive understanding of the durability of various pre-magnetization methods in enhancing the removal efficiency of different pollutants will significantly impact the widespread utilization of Pre-ZVI in practical engineering. Herein, we investigated the efficiency of dry and wet Pre-ZVI-activated peroxymonosulfate (PMS) in eliminating oxytetracycline (OTC) and evaluated the durability of Pre-ZVI. Additionally, we examined several factors that influence the degradation process's efficiency. Our results found that the reaction constant k values corresponding to the dry Pre-ZVI/PMS system at the pH values of 3, 7, and 9 varied from approximately 0.0384, 0.0331, and 0.0349 (day 1) to roughly 0.0297, 0.0278, and 0.0314 (day 30), respectively. Meanwhile, the wet Pre-ZVI/PMS system exhibited k values ranging from approximately 0.0392, 0.0349, and 0.0374 (day 1) to roughly 0.0380, 0.0291, and 0.0322 (day 30), respectively. Moreover, we proposed four OTC degradation pathways using LC-MS/MS and density functional theory calculations. The toxicity of the degradation products was assessed using the ecological structure activity relationship and the toxicity estimation software tool. Overall, this study provides insights into the application of Pre-ZVI/PMS that can be selectively used to eliminate tetracycline antibiotics from water.

Association Analysis of Gene Sequencing by NeoSeq Combined with Tandem Mass Spectrum and Four Neonatal Diseases.

BACKGROUND: NeoSeq is a new method of gene sequencing for newborn screening. The goal is to explore the relationship between gene sequencing by NeoSeq combined with tandem mass spectrum (TMS) and four neonatal diseases. METHODS: A total of 1,989 newborns from August 2010 to December 2021 were enrolled. The case number of congenital hypothyroidism, phenylketonuria, adrenocortical hyperplasia, and glucose-6-phosphate dehydrogenase deficiency was counted, and the results of gene sequencing by NeoSeq and TMS were analyzed. RESULTS: The proportion of male newborns was higher than that of female newborns (51.68% vs. 48.32%). The detection rate of glucose-6-phosphate dehydrogenase deficiency was higher than that of the other three diseases (0.60% vs. 0.05%, 0.05%, 0.15%). A total of 121 newborns were recalled from 1989 newborns by traditional screening technique, and TMS detected phenylketonuria, citrullinemia, glutaric acidemia type I, and 3-methylcro-tonyl-CoA carboxylase deficiency in 1 newborn each. Gene sequencing by NeoSeq of newborns with positive TMS results confirmed the presence of susceptibility genes, and 17 of 1,868 newborns with normal biochemical tests had pathogenic genes. CONCLUSIONS: The incidence of glucose-6-phosphate dehydrogenase deficiency is relatively higher in four neonatal diseases, and the detection rate of gene sequencing by NeoSeq combined with TMS is high.

Quantitative determination of bromochloroacetamide in mice urine by gas chromatography combined with salting-out assisted dispersive liquid-liquid microextraction.

Bromochloroacetamide (BCAcAm) is the main haloacetamide (HAcAm) detected in drinking water in different regions and exhibits strong cytotoxicity and genotoxicity. However, there is no appropriate method for detecting BCAcAm in urine or other biological samples, and thus, the internal exposure level in the population cannot be accurately assessed. In this study, a gas chromatography-electron capture detector (GC-ECD) was combined with salting-out assisted dispersive liquid-liquid microextraction (SA-DLLME) to develop a rapid and robust method for BCAcAm detection in urine of mice continuously exposed to BCAcAm. The factors influencing the pre-treatment procedure, including the type and volume of extraction and disperser solvents, extraction and standing time, and the amount of salt, were evaluated systematically. Under the optimised conditions, the analyte achieved good linearity in the spiked concentration range of 1.00-400.00 µg L-1, and the correlation coefficient was higher than 0.999. The limit of detection (LOD) and the limit of quantification (LOQ) were 0.17 µg L-1 and 0.50 µg L-1, respectively. The recoveries ranged from 84.20% to 92.17%. The detection of BCAcAm at three different calibration levels using this method afforded an intra-day precision of 1.95-4.29%, while the inter-day precision range was 5.54-9.82% (n = 6). This method has been successfully applied to monitor the concentration of BCAcAm in mouse urine in toxicity experiments and can provide technical support for assessing human internal exposure levels and health risks in later studies.

Occurrence and multi-pathway health risk assessment of trihalomethanes in drinking water of Wuxi, China.

Chlorination is widely used to disinfect drinking water to keep humans safe from microorganisms. During chlorination, chlorine and its compounds react with contaminants to form disinfection by-products (DBPs). Toxicological and epidemiological studies have demonstrated that trihalomethanes (THMs) are the most widely investigated DBPs in drinking water, and their exposure has been associated with some adverse health effects. However, studies about risk characteristics in this field are limited. We estimated the health risks of THMs exposure in drinking water through multi-pathways, and systematically analyzed the factors influencing health risks of THMs in Wuxi, China. A total of 488 drinking water samples were collected and analyzed for THMs from four water treatment utilities from 2008 to 2016 in Wuxi. And water exposure parameters were obtained from 602 participants by structured questionnaires. The median concentration of THMs ranged from 6.71 µg/L to 9.18 µg/L. The cumulative cancer risk of THMs exposure through multi-pathways was 1.26 × 10-4, and CHBr2Cl made the largest contribution to the total cancer risk (48.25%). The non-cancer risk of THMs exposure was 2.02 × 10-1. Health risks of the exposure to THMs in drinking water in summer were significantly higher than that in winter (P = 0.0003 for cancer risk, and P = 5.95 × 10-7 for non-cancer risk). In our study, the average individual disability-adjusted life years (DALYs) lost was 1.27 × 10-4 per person-year (ppy). This study attempted to use DALYs for risk assessment of THMs, which will provide useful information for risk comparison and prioritization of hazards in drinking water. This suggested that potential higher risk might exist, and possible measures could be considered to decrease the health risks.

Urinary trihalomethane concentrations and liver function indicators: a cross-sectional study in China.

While it is known that exposure to disinfection by-products (DBPs), including trihalomethanes (THMs), impairs liver function, few epidemiological studies have explored this association. Here, we determined the concentrations of four urinary trihalomethanes (chloroform [TCM], and three Br-THMs, bromodichloromethane [BDCM], dibromochloromethane [DBCM], and bromoform [TBM]), and nine serum liver function indicators in 182 adults ≥ 18 years of age, examined at a medical examination center in Wuxi, China, in 2020 and 2021. Generalized linear model analysis revealed positive associations between urinary DBCM and alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), total protein (TP), and albumin (ALB). Urinary Br-THMs and total THMs (TTHMs) were positively associated with ALT, AST, TBIL, indirect bilirubin (IBIL), TP, and ALB (all P < 0.05). Urinary THMs were not associated with alkaline phosphatase (ALP) or glutamine transaminase (GGT) (all P > 0.05). Generalized additive model-based penalized regression splines were used to confirm these associations. In conclusion, THM exposure was associated with altered serum biomarkers of liver function.

Identification of microplastics in human placenta using laser direct infrared spectroscopy.

Microplastics are ubiquitous in the environment, including in food and drinking water. Consequently, there is growing concern about the human health risks associated with microplastic exposure through diet. However, the occurrence of microplastics in the human body, particularly in mothers and fetuses, is incompletely understood because of the limited amount of data on their presence in the body and the human placenta. This study evaluated the presence and characteristics of microplastics in 17 placentas using laser direct infrared (LD-IR) spectroscopy. Microplastics were detected in all placenta samples, with an average abundance of 2.70 ± 2.65 particles/g and a range of 0.28 to 9.55 particles/g. Among these microplastics, 11 polymer types were identified. The microplastics were mainly composed of polyvinyl chloride (PVC, 43.27 %), polypropylene (PP, 14.55 %), and polybutylene succinate (PBS, 10.90 %). The sizes of these microplastics ranged from 20.34 to 307.29 µm, and most (80.29 %) were smaller than 100 µm. Most of the smaller microplastics were fragments, but fibers dominated the larger microplastics (200-307.29 µm). Interestingly, the majority of PVC and PP were smaller than 200 µm. This study provides a clearer understanding of the shape, size, and nature of microplastics in the human placenta. Importantly, these data also provide crucial information for performing risk assessments of the exposure of fetuses to microplastics in the future.

Remote sensing estimation of the flood storage capacity of basin-scale lakes and reservoirs at high spatial and temporal resolutions.

The flood storage of lakes and reservoirs plays an important role in flood regulation and control in floodplains. However, the flood storage capacity of lakes and reservoirs is ineffectively quantified at the basin scale due to the limited access to in-situ data and poor quality of optical satellite images in flooding seasons. To address this, taking a typical floodplain basin (the Poyang Lake basin) in the Yangtze as a study case, radar satellite data combined with measured bathymetry and digital elevation model data were utilized to reconstruct the time series of the water inundation area and water storage change of all lakes and reservoirs larger than 1 km2 during the once-in-a-generation flood event that occurred in 2020 (termed as the 2020 flood event hereafter). Results show that the flood storage capacity of Poyang Lake can reach the maximum at 12.18 Gt, and that for other lakes and reservoirs within the basin is approximately 2.95 Gt. It indicates a total flood-storage capacity of 15.13 Gt for the basin-scale lakes and reservoirs, approximately accounting for 45.02% of the terrestrial water storage change of the basin. The storage capacity of Poyang Lake was approximately four times larger than the entirety of other lakes and reservoirs in the basin despite that its maximum water inundation area is in the proportion of 2.58 times other water bodies. This finding indicates that the Poyang Lake provided the dominant contribution to flood storage among all the lakes and reservoirs in the basin. This study introduced a remote sensing approach to quantify the flood storage capacity of basin-scale lakes and reservoirs at high spatial and temporal resolutions during the flood event, which could fill the insufficiently-quantified knowledge about dynamics of lakes and reservoirs in areas lacking full-covered in-situ data records. This study also helps to offer a quantitative basis to improve flood forecasting and control for the public authority, stakeholders, and decision-makers.

Cumulative health risk assessment of disinfection by-products in drinking water by different disinfection methods in typical regions of China.

Disinfection was essential to keep human healthy from microorganisms in drinking water. Meanwhile, disinfection by-products (DBPs) have been proved to be associated with some adverse health effects. The DBP levels were different in drinking water disinfected by different methods and may cause diverse health risks. However, studies in this field and systematic analysis about risk characteristics are limited. We estimated the health risks of DBPs exposure in drinking water through multi-pathways, and systematically analyzed the characteristics of different disinfection methods and influence factors of health risk of DBPs in China. Drinking water samples were collected and analyzed for DBPs from some representative water treatment plants in several typical regions in China. We adopted the additive method to estimate the health risks of DBPs exposure in drinking water through multi-pathways, and used descriptive and hierarchical analysis to understand their characteristics and influence factors. The concentrations of the six DBPs in drinking water ranged from 1.6 µg/L to 13.3 µg/L. The cumulative cancer risk of DBPs exposure through multi-pathways was 8.63 × 10-5. The total HI of DBPs exposure was 1.70 × 10-1. The health risks of DBPs in drinking water disinfected by chlorine dioxide and sodium hypochlorite were lower than by other disinfection methods. The health risk of DBPs in drinking water was dominated by risk through oral and inhalation route. The health risks in wet season were higher than that in dry season. There is no significant difference in health risk for males and females, but children experienced higher health risks than adults. Our study suggested the situation of that a large population experienced the high cancer risk of DBPs in drinking water in typical regions of China. It was suggested that potential higher risk should be concerned, and possible measures could be considered to decrease the health risks.

Assessment of Temperature-Hand, Foot, and Mouth Disease Association and Its Variability across Urban and Rural Populations in Wuxi, China: A Distributed Lag Nonlinear Analysis.

Hand, foot, and mouth disease (HFMD) has brought millions of attacks and a substantial burden in the Asia-Pacific region. Previous studies assessed disease risks around the world, which demonstrated great heterogeneity, and few determined the modification effect of social factors on temperature-disease relationship. We conducted a time-series study to evaluate the temperature-associated HFMD morbidity risk using daily data (from 2011 to 2017) and to identify potential modifiers relating to urban-rural status and aggregation mode of children. By applying a distributed lag nonlinear model (DLNM) and controlling for time-varying factors and other meteorological factors, we found that the relationship between daily mean temperature and the cumulative risk of HFMD was an approximately M-shaped curve. The effects of higher temperature appeared to be greater and more persistent than those of lower temperature. With the reference of -6°C, the cumulative relative risk (RR) values of high temperature (95 percentile) and low temperature (5 percentile) were 3.74 (95% CI: 2.50-5.61) and 1.72 (95% CI: 1.24-2.37) at lag 4-7, respectively. Temperature-associated HFMD morbidity risks were more pronounced among rural children and those attending kindergartens or schools at specific lags and temperatures. Relative risk values for temperature-disease association was highest among the 3- to 6-year group, whereas no gender difference was observed. Studying effect estimates and their modifications using the DLNM on a daily scale helps to identify susceptible groups and guide policy-making and resource allocation according to specific local conditions.

Determination of 10 Haloacetamides in drinking water by gas chromatography with automated solid phase extraction.

Drinking water disinfection may result in the formation of different classes of toxic disinfection by-products (DBPs). Haloacetamides (HAcAms) are an emerging class of nitrogenous DBPs (N-DBPs), which are generally more prevalent at lower concentrations in disinfected water than carbonaceous DBPs. Herein a fast, convenient, and effective method of analyzing 10 HAcAms in drinking water samples was demonstrated. This method was developed using gas chromatography /electron capture detection (GC/ECD) supplemented with automated solid phase extraction (auto-SPE). The variables for automated SPE procedures were further optimized, including the selection of SPE sorbents, types and volumes of extraction solvents, SPE washing solvents and wash times. Under optimized conditions, the instrumental linearity range was 0.5-150 µg L-1 with correlation coefficients>0.9975. The limits of detection and quantification of this method were 0.002-0.003 µg L-1 and 0.005-0.010 µg L-1, respectively. The recovery values ranged from 72.4% to 108.5%, and the relative standard deviations ranged from 3.3% to 9.1%. Therefore, the auto-SPE-GC-ECD method showed acceptable linearity and repeatability and was subsequently validated and applied to analyze 10 HAcAms in drinking water.

Developmental toxicity of disinfection by-product monohaloacetamides in embryo-larval stage of zebrafish.

As an emerging class of nitrogenous disinfection by-products (N-DBPs), haloacetamides (HAcAms) have been widely detected in drinking water. Limited toxicity studies have shown an inconsistent toxicity of monoHAcAms, including CAcAm, BAcAm and IAcAm. In this study, the developmental toxicity of monoHAcAms was evaluated in embryo-larval stage of zebrafish. Embryos were exposed to one concentration of 2.50, 5.00, 10.0, 20.0, 40.0 and 80.0 mg/L monoHAcAms from 4 h post-fertilization (hpf) to 120 hpf. Multiple endpoints, including hatching rate, morphological abnormalities, mortality as well as locomotor behavior were assessed at specified stages (24, 48, 72, 96 and 120 hpf). Results showed that 80 mg/L CAcAm and 40 mg/L BAcAm significantly decreased the hatching rate, IAcAm decreased the hatching rate and delayed the hatching process in a concentration-dependent manner with an EC50 of 16.37 mg/L at 72 hpf. The frequency and severity order of morphological abnormalities increased with the raised exposure concentrations and prolonged exposure time, and the corresponding EC50 at 96 hpf were 21.10, 9.77 and 16.60 mg/L for CAcAm, BAcAm and IAcAm, respectively. MonoHAcAms exposure resulted in a time- and dose-dependent response in mortality and the calculated LC50 at 72 hpf were 38.44, 17.74 and 28.82 mg/L for CAcAm, BAcAm and IAcAm, respectively. Based on EC50 for morphological abnormalities and LC50, a toxicity rank order of BAcAm > IAcAm > CAcAm was observed. Different degrees of hyperactivity and hypoactivity were observed from locomotor behavior analysis in larvae from ≤10.0 mg/L monoHAcAms exposure groups. The light-dark periodic change was disappeared in larvae of 10.0 mg/L BAcAm exposure group. In summary, our study showed that monoHAcAms were developmentally toxic to zebrafish even at very low concentrations and BAcAm exerted higher toxicity than IAcAm and CAcAm. These results will further our understanding of the toxicity of HAcAms and its potential toxicological impact on human and ecological environment.

Different cytotoxicity of disinfection by-product haloacetamides on two exposure pathway-related cell lines: Human gastric epithelial cell line GES-1 and immortalized human keratinocyte cell line HaCaT.

Humans are exposed to disinfection by-products (DBPs) mainly through drinking water ingestion and dermal contact. As an emerging class of nitrogenous DBPs (N-DBPs), haloacetamides (HAcAms) have been found to have significantly higher cytotoxicity than regulated DBPs. In this study, we investigated the cytotoxicity of HAcAms on two exposure pathway-related cell lines: human gastric epithelial GES-1 cells and immortalized keratinocytes HaCaT. Our results showed that the ranking order of cytotoxicity of 13 HAcAms was different between HaCaT and GES-1 cells. In addition, the 50% inhibitive concentration in HaCaT was 1.01-3.29 times that in GES-1. Further comparison among GES-1, HaCaT and CHO cell lines confirmed that different cell lines exhibited different sensitivity to the same compound. Importantly, HAcAms showed 5.83-7.13 × 104 times higher toxicity than the well-clarified DBP chloroform, clearly demonstrating the increased toxicity of HAcAms. Finally, using a novel high-content screening (HCS) analysis, we found that 39.29% of chlorinated HAcAms, 42.86% of brominated HAcAms and 16.07% of iodinated HAcAms significantly affected at least one of the cell-health parameters, such as nuclear size, membrane permeability, mitochondrial membrane potential, or cytochrome c release, in GES-1 or HaCaT cells. Thus, brominated HAcAms appear to have stronger effects under the sublethal exposure dose, possibly causing cytotoxicity via apoptosis. Together, our study provides new insights to the toxicity of HAcAms and a comprehensive toxicology dataset for health risk assessment.

Involvement of the delayed rectifier outward potassium channel Kv2.1 in methamphetamine-induced neuronal apoptosis via the p38 mitogen-activated protein kinase signaling pathway.

Methamphetamine (Meth) is an illicit psychostimulant with high abuse potential and severe neurotoxicity. Recent studies have shown that dysfunctions in learning and memory induced by Meth may partially reveal the mechanisms of neuronal channelopathies. Kv2.1, the primary delayed rectifying potassium channel in neurons, is responsible for mediating apoptotic current surge. However, whether Kv2.1 is involved in Meth-mediated neural injury remains unknown. In the present study, the treatment of primary cultured hippocampal neurons with Meth indicated that Meth induced a time- and dose-dependent augmentation of Kv2.1 protein expression, accompanied by elevated cleaved-caspase 3 and declined bcl-2/bax ratio. The blockage of Kv2.1 with the inhibitor GxTx-1E or the knockdown of the channel noticeably abrogated the pro-apoptotic effects mediated by Meth, demonstrating the specific roles of Kv2.1 in Meth-mediated neural damage. Additionally, the p38 mitogen-activated protein kinase (MAPK) signaling was demonstrated to be involved in Meth-mediated Kv2.1 upregulation and in the subsequent pro-apoptotic effects, as treatment with a p38 MAPK inhibitor significantly attenuated Meth-mediated Kv2.1 upregulation and cell apoptosis. Of note, PRE-084, a sigma-1 receptor agonist, obviously attenuated Meth-induced upregulation of Kv2.1 expression, neural apoptosis and p38 MAPK activation. Taken together, these results reveal a novel mechanism involved in Meth-induced neural death with implications for therapeutic interventions for Meth users.

Involvement of Insulin Signaling Disturbances in Bisphenol A-Induced Alzheimer's Disease-like Neurotoxicity.

Bisphenol A (BPA), a member of the environmental endocrine disruptors (EDCs), has recently received increased attention because of its effects on brain insulin resistance. Available data have indicated that brain insulin resistance may contribute to neurodegenerative diseases. However, the associated mechanisms that underlie BPA-induced brain-related outcomes remain largely unknown. In the present study, we identified significant insulin signaling disturbances in the SH-SY5Y cell line that were mediated by BPA, including the inhibition of physiological p-IR Tyr1355 tyrosine, p-IRS1 tyrosine 896, p-AKT serine 473 and p-GSK3α/ß serine 21/9 phosphorylation, as well as the enhancement of IRS1 Ser307 phosphorylation; these effects were clearly attenuated by insulin and rosiglitazone. Intriguingly, Alzheimer's disease (AD)-associated pathological proteins, such as BACE-1, APP, ß-CTF, α-CTF, Aß 1-42 and phosphorylated tau proteins (S199, S396, T205, S214 and S404), were substantially increased after BPA exposure, and these effects were abrogated by insulin and rosiglitazone treatment; these findings underscore the specific roles of insulin signaling in BPA-mediated AD-like neurotoxicity. Thus, an understanding of the regulation of insulin signaling may provide novel insights into potential therapeutic targets for BPA-mediated AD-like neurotoxicity.

The burden of ambient air pollution on years of life lost in Wuxi, China, 2012-2015: A time-series study using a distributed lag non-linear model.

Ambient air pollution ranks high among the risk factors that increase the global burden of disease. Previous studies focused on assessing mortality risk and were sparsely performed in populous developing countries with deteriorating environments. We conducted a time-series study to evaluate the air pollution-associated years of life lost (YLL) and mortality risk and to identify potential modifiers relating to the season and demographic characteristics. Using linear (for YLL) and Poisson (for mortality) regression models and controlling for time-varying factors, we found that an interquartile range (IQR) increase in a three-day average cumulative (lag 0-2 day) concentrations of PM2.5, PM10, NO2 and SO2 corresponded to increases in YLL of 12.09 (95% confidence interval [CI]: 2.98-21.20), 13.69 (95% CI: 3.32-24.07), 26.95 (95% CI: 13.99-39.91) and 24.39 (95% CI: 8.62-40.15) years, respectively, and to percent increases in mortality of 1.34% (95% CI: 0.67-2.01%), 1.56% (95% CI: 0.80-2.33%), 3.36% (95% CI: 2.39-4.33%) and 2.39% (95% CI: 1.24-3.55%), respectively. Among the specific causes of death, cardiovascular and respiratory diseases were positively associated with gaseous pollutants (NO2 and SO2), and diabetes was positively correlated with NO2 (in terms of the mortality risk). The effects of air pollutants were more pronounced in the cool season than in the warm season. The elderly (>65 years) and females were more vulnerable to air pollution. Studying effect estimates and their modifications by using YLL to detect premature death should support implementing health risk assessments, identifying susceptible groups and guiding policy-making and resource allocation according to specific local conditions.

[Trends and forecast of hepatocellular carcinoma in Nantong, China: mortality rates from 1999 to 2011].

OBJECTIVE: To investigate the mortality rates of hepatocellular carcinoma (HCC) in Nantong,China from 1999 to 2011, in order to uncover dynamic trends and provide reasoned advice on intervention strategies to decrease HCC incidence and mortality in Nantong in the future. METHODS: Versions 10 and 9 of the WHO International Classification of Diseases (ICD-10 and ICD-9) were used to determine the number of HCC deaths in Nantong,China for the study's range of years. Thex2 test was applied to compare the HCC mortality rates according to sex and age. The Grey system GM(1,1) model was used to predict the next-5-year HCC mortality for Nantong. RESULTS: Analysis of the standardized mortality in Nantong showed a slight decreasing trend from 1999 to 2011 (x2=57 545.98, P less than 0.001),with males showing a steeper decrease than females. The total mortality of HCC during these years was 53.41 per 100,000 people,with mortality among males being significantly higher than that among females (80.81 per 100,000 people vs. 26.94 per 100,000 people; x2=13 625.42, P less than 0.001). In general, HCC mortality increased with increase in age (general trend:x2=57 545.98, P less than 0.001; male trend: x2=39 878.8, P less than 0.001; female trend: x2=20 105.3, P less than 0.001). However,HCC mortality increased significantly in women after the age of 40 and in men after the age of 35. The GM(1,1) equation was: Yt=-1265.28e(-0.0375t)+1315.5, which predicted that the HCC mortality will decrease to 25.56 per 100,000 people in 2016. CONCLUSION: Although HCC mortality generally decreased from 1999 to 2011, the rate remained high. Public health intervention strategies may be more effective if they focus on males over the age of 35 and females over the age of 40.