Population impact of fine particulate matter on tuberculosis risk in China: a causal inference

BACKGROUND

Previous studies have suggested the potential association between air pollution and tuberculosis incidence, but this association remains inconclusive and evidence to assess causality is particularly lacking. We aimed to draw causal inference between fine particulate matter less than 2.5 μm in diameter (PM2.5) and tuberculosis in China.

METHODS

Granger causality (GC) inference was performed within vector autoregressive models at levels and/or first-differences using annual national aggregated data during 1982-2019, annual provincial aggregated data during 1982-2019 and monthly provincial aggregated data during 2004-2018. Convergent cross-mapping (CCM) approach was used to determine the backbone nonlinear causal association based on the monthly provincial aggregated data during 2004-2018. Moreover, distributed lag nonlinear model (DLNM) was applied to quantify the causal effects.

RESULTS

GC tests identified PM2.5 driving tuberculosis dynamics at national and provincial levels in Granger sense. Empirical dynamic modeling provided the CCM causal intensity of PM2.5 effect on tuberculosis at provincial level and demonstrated that PM2.5 had a positive effect on tuberculosis incidence. Then, DLNM estimation demonstrated that the PM2.5 exposure driven tuberculosis risk was concentration- and time-dependent in a nonlinear manner. This result still held in the multi-pollutant model.

CONCLUSIONS

Causal inference showed that PM2.5 exposure driving tuberculosis, which showing a concentration gradient change. Air pollutant control may have potential public health benefit of decreasing tuberculosis burden.

Association between long-term exposure to ambient air pollutants and the risk of tuberculosis: A time-series study in Nantong, China

Background

Increasing evidence has shown that the risk of tuberculosis (TB) might be related to the exposure to air pollutants; however, the findings are inconsistent and studies on long-term air pollutant exposure and TB risk are scarce. This study aime to assess the relationship between monthly exposure to air pollution and TB risk in Nantong, China.

Methods

We collected the time series data on the number of TB cases, as well as environmental and socioeconomic covariates from January 2005 to December 2020. The impact of air pollutant exposure on TB risk was evaluated using the distributed lag nonlinear model (DLNM). Stratified analyses were conducted to examine the effect modifications of sex and age on the association between air pollutants and TB risk. Sensitivity analyses were applied to test the stability of the model.

Results

There were a total of 54,096 cases of TB in Nantong during the study period. In the single-pollutant model, for each 10 μg/m³ increase in concentration, the pooled relative risks (RRs) of TB reached the maximum to 1.10 (95% confidence interval (CI): 1.04-1.16, lag 10 months) for particulate matter with aerodynamic diameter less than 2.5 μm (PM_2.5), 1.05 (95% CI: 1.01-1.10, lag 9 months) for particulate matter with aerodynamic diameter less than 10 μm (PM₁₀), and 1.11 (95%CI: 1.04-1.19, lag 10 months) for nitrogen dioxide (NO₂). Ozone (O₃) did not show significant effect on TB risk. Effect modifications of sex and age on the association between air pollutants and TB risk were not observed. The multi-pollutant model results showed no significant variation compared with the single-pollutant model.

Conclusions

Our study suggests that air pollutants pose a substantial threat to the TB risk. Reducing air pollution might be crucial for TB prevention and control.

Propagation rules of shock waves in confined space under different initial pressure environments

In this paper, an initial pressure adjustable explosion vessel was developed, and the effect of negative pressure, positive pressure (0.2–1.8 atm) different initial ambient pressure on the explosive shock wave generated by the explosion of explosives was studied. The relationships between the specific impulse, shock wave velocity, the amount of explosive gas products and the ambient pressure were analyzed for different initial pressure environments. It was found that: the overpressure of the blast shock wave decreases with the initial ambient pressure of the explosion, and there exists a negative pressure environment with a dramatic pressure decrease near 0.6 atm, defined as the super-sensitive negative pressure P_cr. The propagation velocity of an explosive wave increases with a decrease in the ambient pressure, and the propagation velocity at a pressure of 1.8 atm is four times less than the velocity at a pressure of 0.2 atm. The production of explosive gas products did not change. The greater the initial pressure of the environment where the explosive is located, the smaller the ratio of the gas generated by the explosion to the initial force gas in the explosion vessel is, and the greater the impact on the propagation of shock waves is. The maximum attenuation of the first specific impulse i₁ is 72.97% and the maximum attenuation of the second specific impulse i₂ is 72.39%. The experiments provide reference data for high-altitude military confrontation, high-altitude weapons and ammunition development, and deep-earth protection engineering.

[Status of HVPG clinical application in China in 2021]

Objective: The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China. Methods: This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems. Results: According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%). Conclusion: Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

[The role Epstein-Barr virus played in the outcome of skin diseases]

Since the discovery of Epstein-Barr (EB) virus from the cultured cells in Burkitt lymphoma tissue in African children in 1964, we have gradually taken in its oncogenicity and the link between this virus and multiple mucocutaneous diseases. This review exhibits the process of EB virus infection and summarizes the clinical manifestations and varied prognosis of EB virus-associated skin diseases. The cases of common skin diseases including psoriasis, dermatomyositis, pemphigus, pemphigoid, parapsoriasis, atopic dermatitis, urticaria, systemic lupus erythematosus, scleroderma, panniculitis,erythema multiforme and vasculitis coinciding with EB virus infection were collected for the analysis of their EB virus-associated complications, treatments and outcomes.

A green and facile synthesis for rGO/Ag nanocomposites using one-step chemical co-reduction route at ambient temperature and combined first principles theoretical analyze

Recently, graphene decorated with various inorganic nanoparticles, such as Pt, Au, Ag, TiO₂ and Fe₃O₄, among which Ag nanocomposites are good candidates for electronics, optics, electrochemistry and catalysis. However, preparation techniques for Ag nanoparticles/carbon matrix hybrids require tedious multi-step processes often involving toxic reducing agents/high temperatures which is not viable for scalable production. Here, a facile, one step and eco-friendly chemical co-reduction route was utilized to synthesis of a new nanocomposites by Ag nanoparticle anchored on reduced graphene oxide (rGO) at ambient temperature and combined first principles theoretical analyze their interfacial adsorption behavior, is reported. In this way, graphene oxide (GO) and Ag⁺ simultaneously reduced by thiourea dioxide (TD) without using any additional reduced reactants. Results indicated that GO was successfully reduced to rGO and well-dispersed Ag nanoparticles with sizes of 6-7 nm, anchored on the surface of rGO sheets. Reduction mechanism was attributed to the synergistic effect of its hydrolysis products in aqueous media. The experiment and theoretical calculation results obtained demonstrate this method to be applicable to the synthesis of other metals on rGO sheets in order to improve wettability and interfacial bonding between rGO and metal and may possibly find various forthcoming medicinal, industrial and technological applications.

Observation of Weakened V-V Dimers in the Monoclinic Metallic Phase of Strained VO_{2}

Emergent order at mesoscopic length scales in condensed matter can provide fundamental insight into the underlying competing interactions and their relationship with the order parameter. Using spectromicroscopy, we show that mesoscopic stripe order near the metal-insulator transition (MIT) of strained VO_{2} represents periodic modulations in both crystal symmetry and V-V dimerization. Above the MIT, we unexpectedly find the long-range order of V-V dimer strength and crystal symmetry become dissociated beyond ≈200  nm, whereas the conductivity transition proceeds homogeneously in a narrow temperature range.

In vitro corrosion behavior and biocompatibility of nanostructured Ti6Al4V

Ti6Al4V (TC4) alloy has long been used as a bone interfacing implant material in dentistry and orthopedics due to its excellent biocompatibility and mechanical properties. The performance of TC4 can be further tailored by altering its grain structures. In this study, by means of sliding friction treatment (SFT), a nano-grained (NG) surface layer with an average grain size of ≤100 nm on the topmost surface was successfully generated on coarse-grained (CG) TC4 alloy sheet. It was shown that the NG surface possessed notably enhanced corrosion resistance in physiological solution compared to the CG surface, due to the formation of thicker and denser passive film facilitated by surface nanocrystallization. Additionally, the NG surface with stronger hydrophilicity favorably altered the absorption of anchoring proteins such as fibronectin (Fn) and vitronectin (Vn) that can mediate subsequent osteoblast functions. The in vitro results indicated that the NG surface exhibited remarkable enhancement in osteoblast adherence, spreading and proliferation, and obviously accelerated the osteoblast differentiation as compared to CG surface. Moreover, the NG surface also demonstrated good hemocompatibility. These findings suggest that SFT can endure bio-metals with advanced multifunctional properties for biomedical applications.

Direct observation of decoupled structural and electronic transitions and an ambient pressure monocliniclike metallic phase of VO2

We report the simultaneous measurement of the structural and electronic components of the metal-insulator transition (MIT) of VO2 using electron and photoelectron spectroscopies and microscopies. We show that these evolve over different temperature scales, and are separated by an unusual monocliniclike metallic phase. Our results provide conclusive evidence that the new monocliniclike metallic phase, recently identified in high-pressure and nonequilibrium measurements, is accessible in the thermodynamic transition at ambient pressure, and we discuss the implications of these observations on the nature of the MIT in VO2.

Resonant soft-X-ray emission as a bulk probe of correlated electron behavior in metallic SrxCa1-xVO3

The evolution of electron correlation in SrxCa1-xVO3 has been studied using a combination of bulk-sensitive resonant soft x-ray emission spectroscopy, surface-sensitive photoemission spectroscopy, and ab initio band structure calculations. We show that the effect of electron correlation is enhanced at the surface. Strong incoherent Hubbard subbands are found to lie ∼20% closer in energy to the coherent quasiparticle features in surface-sensitive photoemission spectroscopy measurements compared with those from bulk-sensitive resonant soft x-ray emission spectroscopy, and a ∼10% narrowing of the overall bandwidth at the surface is also observed.

Developmental changes of plasma insulin, glucagon, insulin-like growth factors, thyroid hormones, and glucose concentrations in chick embryos and hatched chicks

Developmental hormonal changes in Cobb 500 chick embryos and hatched chicks were determined by measuring plasma insulin, glucagon, insulin-like growth factor (IGF)-I, IGF-II, triiodothyronine, thyroxine, and glucose concentrations at different ages of embryogenesis and posthatch development. Plasma samples were obtained daily from 10 d of embryogenesis (10E) through 13 d posthatch and also at 17 and 21 d posthatch. A significant increase in plasma insulin was observed with increasing age from 10E to hatch. Plasma glucagon levels remained low until 17E, and then significantly increased approximately 3-fold at hatch, which corresponded with increasing plasma glucose levels during late embryo development. The plasma insulin to glucagon molar ratio of incubation from 14E to 17E ranged from 2 to 4, and was significantly higher than at any other time during incubation. These results indicate that insulin may be an important promoter of chick embryonic growth by the anabolic drive to promote protein deposition. Insulin and glucagon increased after hatch, which may be due to increased feed consumption and increased utilization of carbohydrates as the key energy source, compared with nutrients obtained through lipolysis and proteolysis in the embryos. Plasma triiodothyronine increased 4-fold from 18E to 20E, and thyroxine increased 3-fold from 16E to 19E. Insulin-like growth factor-I and IGF-II peaked at 14E. Insulin-like growth factor-I steadily increased above embryonic levels during the 3 wk of the posthatch period, whereas IGF-II levels steadily declined. These results suggest that IGF-II may be a more important functionary for chick embryonic development than IGF-I, and that IGF-I may be more important than IGF-II after hatch. The profile of metabolic hormones in the present study may help support an understanding of significant changes that occur in embryonic development and posthatch growth in chicks.

Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review

There have been few recent studies demonstrating a definitive association between the transmission of airborne infections and the ventilation of buildings. The severe acute respiratory syndrome (SARS) epidemic in 2003 and current concerns about the risk of an avian influenza (H5N1) pandemic, have made a review of this area timely. We searched the major literature databases between 1960 and 2005, and then screened titles and abstracts, and finally selected 40 original studies based on a set of criteria. We established a review panel comprising medical and engineering experts in the fields of microbiology, medicine, epidemiology, indoor air quality, building ventilation, etc. Most panel members had experience with research into the 2003 SARS epidemic. The panel systematically assessed 40 original studies through both individual assessment and a 2-day face-to-face consensus meeting. Ten of 40 studies reviewed were considered to be conclusive with regard to the association between building ventilation and the transmission of airborne infection. There is strong and sufficient evidence to demonstrate the association between ventilation, air movements in buildings and the transmission/spread of infectious diseases such as measles, tuberculosis, chickenpox, influenza, smallpox and SARS. There is insufficient data to specify and quantify the minimum ventilation requirements in hospitals, schools, offices, homes and isolation rooms in relation to spread of infectious diseases via the airborne route. PRACTICAL IMPLICATION: The strong and sufficient evidence of the association between ventilation, the control of airflow direction in buildings, and the transmission and spread of infectious diseases supports the use of negatively pressurized isolation rooms for patients with these diseases in hospitals, in addition to the use of other engineering control methods. However, the lack of sufficient data on the specification and quantification of the minimum ventilation requirements in hospitals, schools and offices in relation to the spread of airborne infectious diseases, suggest the existence of a knowledge gap. Our study reveals a strong need for a multidisciplinary study in investigating disease outbreaks, and the impact of indoor air environments on the spread of airborne infectious diseases.

[Experimental safety study using rats and mice irradiated with the complex field cure instrument]

The complex field cure instrument is a new medical instrument. The complex field is composed of several sorts of physical quantum fields. Mice and rats are continuously irradiated by the complex field for 20 days to 90 days. The result shows that WBC, Hb and PLT value of the animals irradiated with the instrument are more than the control group, and their biochemical index is normal. The internal organs of the experimental animals show no toxicity. The visceval coefficient (liver, spleen) of the experimental animals is more than the control group. The marrow micronucleas test is negative. The chromosome test show no distortion. All of the results have proved that the instrument produces no toxicity side effect. Application of the instrument is safe and reliable and it may increase immune function of the body.

An industry-wide pulmonary study of men and women manufacturing refractory ceramic fibers

An industry-wide pulmonary morbidity study was undertaken to evaluate the respiratory health of employees manufacturing refractory ceramic fibers at five US sites between 1987 and 1989. Refractory ceramic fibers are man-made vitreous fibers used for high temperature insulation. Of the 753 eligible current employees, 742 provided occupational histories and also completed the American Thoracic Society respiratory symptom questionnaire; 736 also performed pulmonary function tests. Exposure to refractory ceramic fibers was characterized by classifying workers as production or nonproduction employees and calculating the duration of time spent in production employment. The risk of working in the production of refractory ceramic fibers and having one or more respiratory symptoms was estimated by adjusted odds ratios and found to be 2.9 (95 percent confidence interval 1.4-6.2) for men and 2.4 (95 percent confidence interval 1.1-5.3) for women. The effect of exposure to refractory ceramic fibers on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), the ratio of the two (FEV1/FVC), and forced expiratory flow (liters/second) between 25 percent and 75 percent of the FVC curve (FEF(25-75)) was evaluated by multiple regression analysis using transformed values adjusted for height, by dividing by the square of each individual's height. For men, there was a significant decline in FVC for current and past smokers of 165.4 ml (p < 0.01) and 155.5 ml (p = 0.04), respectively, per 10 years of work in the production of refractory ceramic fibers. For FEV1, the decline was significant (p < 0.01) only for current smokers at 134.9 ml. For women, the decline was greater and significant for FVC among nonsmokers, who showed a decrease of 350.3 ml (p = 0.05) per 10 years of employment in the production of refractory ceramic fibers. These findings indicate that there may be important sex differences in response to occupational and/or environmental exposure.

[Clinical application of the forced inspiratory volume-time curve. A preliminary study]

The forced inspiratory volume-time curve in 25 health subjects with normal ventilation function and 25 patients with COPD were determined, and MMIF, FIV were calculated from the curves. The PImax was measured in the same 50 subjects by modified Blac method sequentially. A close relationship between MMIF, FIV and PImax was found. This result indicated that MMIF and FIV could be indeed for evaluation of strength of respiratory, muscles. Additional observations of MMIF, FIV and PImax in 50 patients with COPD before and after inotropic drugs, aminophylline and CNB, further proved the validity of MMIF and FIV.