BACKGROUND: Because of the rapid change in economic development and lifestyle in China, and the ageing population, concerns have grown that chronic obstructive pulmonary disease (COPD) could become epidemic. An up-to-date nationwide estimation of COPD prevalence in China is needed. METHODS: We did a cross-sectional survey of a nationally representative sample of individuals from mainland China aged 40 years or older. The primary outcome was COPD, defined according to the 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) lung function criteria. FINDINGS: Between Dec 29, 2014, and Dec 31, 2015, 66 752 adults were recruited to the study population. The estimated standardised prevalence of COPD was 13·6% (95% CI 12·0-15·2). The prevalence of COPD differed significantly between men and women (19·0%, 95% CI 16·9-21·2 vs 8·1%, 6·8-9·3; p<0·0001), mainly because of a significant difference in smoking status between men and women (current smokers 58·2% vs 4·0%). The prevalence of COPD differed by geographic region, with the highest prevalence in southwest China (20·2%, 95% CI 14·7-25·8) and the lowest in central China (10·2%, 8·2-12·2). Among adults with COPD, 56·4% (95% CI 53·7-59·2) had mild disease (GOLD stage I), 36·3% (34·3-38·3) had moderate disease (GOLD stage II), 6·5% (5·5-7·4) had severe disease (GOLD stage III), and 0·9% (0·6-1·1) had very severe disease (GOLD stage IV). INTERPRETATION: In a large, nationally representative sample of adults aged 40 years or older, the estimated overall prevalence of COPD in China in 2014-15 was 13·6%, indicating that this disease has become a major public-health problem. Strategies aimed at prevention and treatment of COPD are needed urgently. FUNDING: Chinese Central Government, the Ministry of Science and Technology of The People's Republic of China, and the National Natural Science Foundation of China.
BACKGROUND: Because of the rapid change in economic development and lifestyle in China, and the ageing population, concerns have grown that chronic obstructive pulmonary disease (COPD) could become epidemic. An up-to-date nationwide estimation of COPD prevalence in China is needed. METHODS: We did a cross-sectional survey of a nationally representative sample of individuals from mainland China aged 40 years or older. The primary outcome was COPD, defined according to the 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) lung function criteria. FINDINGS: Between Dec 29, 2014, and Dec 31, 2015, 66 752 adults were recruited to the study population. The estimated standardised prevalence of COPD was 13·6% (95% CI 12·0-15·2). The prevalence of COPD differed significantly between men and women (19·0%, 95% CI 16·9-21·2 vs 8·1%, 6·8-9·3; p<0·0001), mainly because of a significant difference in smoking status between men and women (current smokers 58·2% vs 4·0%). The prevalence of COPD differed by geographic region, with the highest prevalence in southwest China (20·2%, 95% CI 14·7-25·8) and the lowest in central China (10·2%, 8·2-12·2). Among adults with COPD, 56·4% (95% CI 53·7-59·2) had mild disease (GOLD stage I), 36·3% (34·3-38·3) had moderate disease (GOLD stage II), 6·5% (5·5-7·4) had severe disease (GOLD stage III), and 0·9% (0·6-1·1) had very severe disease (GOLD stage IV). INTERPRETATION: In a large, nationally representative sample of adults aged 40 years or older, the estimated overall prevalence of COPD in China in 2014-15 was 13·6%, indicating that this disease has become a major public-health problem. Strategies aimed at prevention and treatment of COPD are needed urgently. FUNDING: Chinese Central Government, the Ministry of Science and Technology of The People's Republic of China, and the National Natural Science Foundation of China.
Background Because of the rapid change in economic development and lifestyle in China, and the ageing population, concerns have grown that chronic obstructive pulmonary disease (COPD) could become epidemic. An up-to-date nationwide estimation of COPD prevalence in China is needed. Methods We did a cross-sectional survey of a nationally representative sample of individuals from mainland China aged 40 years or older. The primary outcome was COPD, defined according to the 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) lung function criteria. Findings Between Dec 29, 2014, and Dec 31, 2015, 66 752 adults were recruited to the study population. The estimated standardised prevalence of COPD was 13.6% (95% CI 12.0-15.2). The prevalence of COPD differed significantly between men and women (19.0%, 95% CI 16.9-21.2 vs 8.1%, 6.8-9.3; p< 0.0001), mainly because of a significant difference in smoking status between men and women (current smokers 58.2% vs 4.0%). The prevalence of COPD differed by geographic region, with the highest prevalence in southwest China (20.2%, 95% CI 14.7-25.8) and the lowest in central China (10.2%, 8.2-12.2). Among adults with COPD, 56.4% (95% CI 53.7-59.2) had mild disease (GOLD stage I), 36.3% (34.3-38.3) had moderate disease (GOLD stage II), 6.5% (5.5-7.4) had severe disease (GOLD stage III), and 0.9% (0.6-1.1) had very severe disease (GOLD stage IV). Interpretation In a large, nationally representative sample of adults aged 40 years or older, the estimated overall prevalence of COPD in China in 2014-15 was 13.6%, indicating that this disease has become a major public-health problem. Strategies aimed at prevention and treatment of COPD are needed urgently.
PURPOSE: A common variant of the melatonin receptor 1B (MTNR1B) gene has been related to increased signaling of melatonin, a hormone previously associated with body fatness mainly through effects on energy metabolism. We examined whether the MTNR1B variant affects changes of body fatness and composition in response to a dietary weight loss intervention. METHODS: The MTNR1B rs10830963 variant was genotyped for 722 overweight and obese individuals, who were randomly assigned to one of four diets varying in macronutrient composition. Anthropometric and body composition measurements (DXA scan) were collected at baseline and at 6 and 24 months of follow-up. RESULTS: Statistically significant interactions were observed between the MTNR1B genotype and low-/high-fat diet on changes in weight, body mass index (BMI), waist circumference (WC) and total body fat (p interaction = 0.01, 0.02, 0.002 and 0.04, respectively), at 6 months of dietary intervention. In the low-fat diet group, increasing number of the sleep disruption-related G allele was significantly associated with a decrease in weight (p = 0.004), BMI (p = 0.005) and WC (p = 0.001). In the high-fat diet group, carrying the G allele was positively associated with changes in body fat (p = 0.03). At 2 years, the associations remained statistically significant for changes in body weight (p = 0.02), BMI (p = 0.02) and WC (p = 0.048) in the low-fat diet group, although the gene-diet interaction became less significant. CONCLUSIONS: The results suggest that carriers of the G allele of the MTNR1B rs10830963 may have a greater improvement in body adiposity and fat distribution when eating a low-fat diet.
Climate change mitigation involves reducing fossil fuel consumption and greenhouse gas emissions, which is expensive, particularly under stringent mitigation targets. The co-benefits of reducing air pollutants and improving human health are often ignored, but can play significant roles in decision-making. In this study, we quantified the co-benefits of climate change mitigation on ambient air quality and human health in both physical and monetary terms with a particular focus on Asia, where air quality will likely be degraded in the next few decades if mitigation measures are not undertaken. We used an integrated assessment framework that incorporated economic, air chemistry transport, and health assessment models. Air pollution reduction through climate change mitigation under the 2 °C goal could reduce premature deaths in Asia by 0.79 million (95% confidence interval: 0.75–1.8 million) by 2050. This co-benefit is equivalent to a life value savings of approximately 2.8 trillion United States dollars (USD) (6% of the gross domestic product [GDP]), which is decidedly more than the climate mitigation cost (840 billion USD, 2% of GDP). At the national level, India has the highest potential net benefit of 1.4 trillion USD, followed by China (330 billion USD) and Japan (68 billion USD). Furthermore, in most Asian countries, per capita GDP gain and life value savings would increase with per capita GDP increasing. We robustly confirmed this qualitative conclusion under several socioeconomic and exposure-response function assumptions.
Purpose Globally, the age-standardised prevalence of type 2 diabetes mellitus (T2DM) has nearly doubled from 1980 to 2014, rising from 4.7% to 8.5% with an estimated 422 million adults living with the chronic disease. The MULTI sTUdy Diabetes rEsearch (MULTITUDE) consortium was recently established to harmonise data from 17 independent cohort studies and clinical trials and to facilitate a better understanding of the determinants, risk factors and outcomes associated with T2DM. Participants Participants range in age from 3 to 88 years at baseline, including both individuals with and without T2DM. MULTITUDE is an individual-level pooled database of demographics, comorbidities, relevant medications, clinical laboratory values, cardiac health measures, and T2DM-associated events and outcomes across 45 US states and the District of Columbia. Findings to date Among the 135 156 ongoing participants included in the consortium, almost 25% (33 421) were diagnosed with T2DM at baseline. The average age of the participants was 54.3, while the average age of participants with diabetes was 64.2. Men (55.3%) and women (44.6%) were almost equally represented across the consortium. Non-whites accounted for 31.6% of the total participants and 40% of those diagnosed with T2DM. Fewer individuals with diabetes reported being regular smokers than their non-diabetic counterparts (40.3% vs 47.4%). Over 85% of those with diabetes were reported as either overweight or obese at baseline, compared with 60.7% of those without T2DM. We observed differences in all-cause mortality, overall and by T2DM status, between cohorts. Future plans Given the wide variation in demographics and all-cause mortality in the cohorts, MULTITUDE consortium will be a unique resource for conducting research to determine: differences in the incidence and progression of T2DM; sequence of events or biomarkers prior to T2DM diagnosis; disease progression from T2DM to disease-related outcomes, complications and premature mortality; and to assess race/ethnicity differences in the above associations.
High-efficiency particulate air (HEPA) filtration in combination with an electrostatic precipitator (ESP) can be a cost-effective approach to reducing indoor particulate exposure, but ESPs produce ozone. The health effect of combined ESP-HEPA filtration has not been examined. We conducted an intervention study in 89 volunteers. At baseline, the air-handling units of offices and residences for all subjects were comprised of coarse, ESP, and HEPA filtration. During the 5-week long intervention, the subjects were split into 2 groups, 1 with just the ESP removed and the other with both the ESP and HEPA removed. Each subject was measured for cardiopulmonary risk indicators once at baseline, twice during the intervention, and once 2 weeks after baseline conditions were restored. Measured indoor and outdoor PM2.5 and ozone concentrations, coupled with time-activity data, were used to calculate exposures. Removal of HEPA filters increased 24-hour mean PM2.5 exposure by 38 (95% CI: 31, 45) mug/m(3) . Removal of ESPs decreased 24-hour mean ozone exposure by 2.2 (2.0, 2.5) ppb. No biomarkers were significantly associated with HEPA filter removal. In contrast, ESP removal was associated with a -16.1% (-21.5%, -10.4%) change in plasma-soluble P-selectin and a -3.0% (-5.1%, -0.8%) change in systolic blood pressure, suggesting reduced cardiovascular risks.
We focus on the COM-type negative binomial distribution with three parameters, which belongs to COM-type (a, b, 0) class distributions and family of equilibrium distributions of arbitrary birth-death process. Besides, we show abundant distributional properties such as overdispersion and underdispersion, log-concavity, log-convexity (infinite divisibility), pseudo compound Poisson, stochastic ordering, and asymptotic approximation. Some characterizations including sum of equicorrelated geometrically distributed random variables, conditional distribution, limit distribution of COM-negative hypergeometric distribution, and Stein’s identity are given for theoretical properties. COM-negative binomial distribution was applied to overdispersion and ultrahigh zero-inflated data sets. With the aid of ratio regression, we employ maximum likelihood method to estimate the parameters and the goodness-of-fit are evaluated by the discrete Kolmogorov-Smirnov test.
Plume rise parameterizations calculate the rise of pollutant plumes due to effluent buoyancy and exit momentum. Some form of these parameterizations is used by most air quality models. In this paper, the performance of the commonly used Briggs plume rise algorithm was extensively evaluated, through a comparison of the algorithm's results when driven by meteorological observations with direct observations of plume heights in the Athabasca oil sands region. The observations were carried out as part of the Canada-Alberta Joint Oil Sands Monitoring Plan in August and September of 2013. Wind and temperature data used to drive the algorithm were measured in the region of emissions from various platforms, including two meteorological towers, a radio-acoustic profiler, and a research aircraft. Other meteorological variables used to drive the algorithm include friction velocity, boundary-layer height, and the Obukhov length. Stack emissions and flow parameter information reported by continuous emissions monitoring systems (CEMSs) were used to drive the plume rise algorithm. The calculated plume heights were then compared to interpolated aircraft SO2 measurements, in order to evaluate the algorithm's prediction for plume rise. We demonstrate that the Briggs algorithm, when driven by ambient observations, significantly underestimated plume rise for these sources, with more than 50 % of the predicted plume heights falling below half the observed values from this analysis. With the inclusion of the effects of effluent momentum, the choice of different forms of parameterizations, and the use of different stability classification systems, this essential finding remains unchanged. In all cases, approximately 50 % or more of the predicted plume heights fall below half the observed values. These results are in contrast to numerous plume rise measurement studies published between 1968 and 1993. We note that the observations used to drive the algorithms imply the potential presence of significant spatial heterogeneity in meteorological conditions; we examine the potential impact of this heterogeneity in our companion paper (Akingunola et al., 2018). It is suggested that further study using long-term in situ measurements with currently available technologies is warranted to investigate this discrepancy, and that wherever possible, meteorological input variables are observed in the immediate vicinity of the emitting stacks.