Association between Ambient Air Pollution and Outpatient Visits for Acute Bronchitis in a Chinese City

Objective To investigate the short-term association between outdoor air pollution and outpatient visits for acute bronchitis,which is a rare subject of research in the mainland of China.Methods A time-series analysis was conducted to examine the association of outdoor air pollutants with hospital outpatient visits in Shanghai by using two-year daily data(2010-2011).Results Outdoor air pollution was found to be associated with an increased risk of outpatient visits for acute bronchitis in Shanghai.The effect estimates of air pollutants varied with the lag structures of the concentrations of the pollutants.For lag06,a 10 μg/m3 increase in the concentrations of PM10,SO2,and NO2 corresponded to 0.94%(95% CI:0.83%,1.05%),11.12%(95% CI:10.76%,11.48%),and 4.84%(95% CI:4.49%,5.18%) increases in hospital visits for acute bronchitis,respectively.These associations appeared to be stronger in females(P0.05).Between-age differences were significant for SO2(P0.05),and between-season differences were also significant for SO2(P0.05).Conclusion Our analyses have provided the first evidence that the current air pollution level in China has an effect on acute bronchitis and that the rationale for further limiting air pollution levels in Shanghai should be strengthened.     

Intraindividual analysis of instantaneous heart rate variability

We examined the use and potential of quantifying instantaneous heart rate variability (HRV) using a joint time-frequency and time-domain methods. These new techniques are promising, because they provide tools to quantify nonstationary, beat-by-beat changes in HRV components, and are therefore flexible with respect to the design of experimental protocols. A smoothed pseudo-Wigner-Ville distribution (SPWVD) and a time-domain index using polynomial filtering produced fairly coherent estimates of band-specific HRV amplitudes, whereas SPWVD yielded additional information on the frequency characteristics of HRV. Instantaneous HRV appeared to have a complex and a frequency-specific relationship to cardiac activity and electrodermal activity, It is concluded that the time-frequency analysis of HRV is a very promising method for mapping transient changes in the frequency and amplitude characteristics of cardiac dynamics.     

Death trends based on autopsy data compared to the beginning of the coronavirus pandemic in Brazil

The novel Coronavirus disease (COVID-19) is responsible for thousands of deaths worldwide, especially in Brazil, currently one of the leading countries in number of infections and deaths. The beginning of the COVID-19 epidemic in Brazil is uncertain due to the low number of tests done in the country. The excess number of deaths can suggest the beginning of the pandemic in this context. In this article, we used an autoregressive integrated moving average (ARIMA) model to investigate possible excesses in the number of deaths processed by the São Paulo Autopsy Service according to different causes of deaths: all-cause, cardiovascular, and pulmonary causes. We calculated the expected number of deaths using data from 2019 to 2020 (n=17,011), and investigated different seasonal patterns using harmonic dynamic regression with Fourier terms with residuals modeled by an ARIMA method. We did not find any abnormalities in the predicted number of deaths and the real values in the first months of 2020. We found an increase in the number of deaths only by March 20, 2020, right after the first COVID-19 confirmed case in the city of São Paulo, which occurred on March 16, 2020.     

确诊病例时序传播图及活动轨迹表在新型冠状病毒肺炎疫情分析中的作用

目的 探讨时序传播图和病例活动轨迹表在描述某地区新型冠状病毒肺炎传播模式方面的优势,为政府相关部门进行疫情防控提供依据。方法 将某地区某时段确诊病例按照其发病时间、年龄、性别、密切接触人数及相互关系,绘制时序传播图和发病前14 d的活动轨迹表。结果 截至2020年2月10日,该地区报告的63例新型冠状病毒肺炎病例中,确诊57例（含死亡1例）,无症状感染者6例;输入性病例57例（占总报告病例数的90.48%）,聚集性疫情报告病例36例（占总报告病例数的57.14%）,病例间互为亲友关系或同乘乘客,病例代际已传播至第4代。结论 确诊病例时序传播图和活动轨迹表提示,该地区新型冠状病毒肺炎疫情以输入性病例为主,聚集性传播成为当地疫情发展的主要构成。确诊病例时序传播图和活动轨迹表简单明了,可一图看懂当地传播模式,值得在重大传染病防控工作中推广。     

2016—2020年江西省南昌市大气污染物与儿童呼吸疾病门诊病例数的时间序列关联研究

目的 探讨江西省南昌市6种常规监测大气污染物对儿童呼吸疾病的影响。方法 选取2016－2020年江西省南昌市大气污染物、气象数据和江西省儿童医院呼吸系统日门诊量,采用时间序列Poisson分布的广义相加模型（GAM）,定量分析大气污染物与儿童呼吸系统疾病门诊病例数的相关性。 结果 研究期间大气污染物SO2、NO2、O3-8h、CO、PM2.5、PM10的日均浓度分别为11.35 μg/m3、32.80 μg/m3、 91.80 μg/m3、0.89 mg/m3、37.42 μg/m3、68.22 μg/m3。PM2.5、PM10、SO2、CO、NO2的浓度升高对儿童呼吸系统疾病日门诊量的增加存在统计学意义,均在当日（lag0）和累积滞后第7 d（lag07）效应最强,其中SO2在累积滞后（lag07）的浓度值对儿童呼吸系统疾病门诊病例数的超额危险度（ER = 9.47%,95%CI:6.78%～12.22%）最大。双污染物模型中,调整其他5种污染物后,O3-8h对儿童呼吸系统疾病门诊量的增加无统计学意义;将O3-8h引入双污染物模型后,均一定程度的增加了其他污染物的效应,SO2在O3-8h的影响下,对儿童呼吸系统疾病门诊数影响效应值最大;PM2.5、PM10、O3-8h引入双污染模型后,SO2和NO2的效应值均扩大。 结论 2016－2020年大气污染物对南昌市儿童呼吸系统疾病有统计学影响,污染物浓度的升高导致儿童呼吸系统门诊量就诊人数增加,其中SO2对门诊量影响最大。     

Association of meteorological factors and atmospheric particulate matter with the incidence of pneumonia: an ecological study

ObjectivesInconsistent results have been found between pneumonia and meteorological factors. We aimed to identify principal meteorological factors associated with pneumonia, and to estimate the effect size and lag time.MethodsThis was nationwide population-based study used a healthcare claims database merged with a weather database in eight metropolitan cities in Korea. We applied a stepwise approach using the Granger causality test and generalized additive model to elucidate the association between weekly pneumonia incidence (WPI) and meteorological factors/air pollutants (MFAP). Impulse response function was used to examine the time lag.ResultsIn total, 2 011 424 cases of pneumonia were identified from 2007 to 2017. Among MFAP, diurnal temperature range (DTR), humidity and particulate matter ≤2.5 μm in diameter (PM_2.5) showed statistically significant associations with WPI (p < 0.001 for all 3 MFAPs). The association of DTR and WPI showed an inverted U pattern for bacterial and unspecified pneumonia, whereas for viral pneumonia, WPI increased gradually in a more linear manner with DTR and no substantial decline. Humidity showed a consistent pattern in all three pneumonia categories. WPI steeply increased up to 10 to 20 μg/m³ of PM_2.5 but did not show a further increase in higher concentrations. On the basis of the result, we examined the effect of MFAP in different lag times up to 3 weeks.ConclusionsDTR, humidity and PM_2.5 were identified as MFAP most closely associated with WPI. With the model, we were able to visualize the effect–time association of MFAP and WPI.     

武汉市江岸区大气污染与脑卒中死亡关系的时间序列分析

目的：分析2003—2010年武汉市江岸区大气污染物的短期暴露对人群脑卒中死亡的影响。方法收集武汉市江岸区CDC自2003年1月1日至2010年12月31日的脑卒中死亡监测资料和同期环境监测中心大气污染物数据,应用基于广义相加模型的时间序列分析方法,定量评价大气污染中可吸入颗粒物（PM10）、SO2和NO2与人群脑卒中死亡的关系。结果2003—2010年PM10、SO2和NO2日均浓度分别为(115.0±60.0)、(50.2±33.7)和(57.6±25.3)μg/m3,脑卒中总死亡人数为9204例,其中女性4495例,≥65岁人群占7628例。PM10、SO2和NO2滞后1 d的浓度每升高10μg/m3,人群脑卒中死亡率分别增加0.67%(95%CI：0.25%~1.10%)、0.87%(95%CI：0.13%~1.63%)和2.07%(95%CI：1.08%~3.07%)。在调整了其他污染物后的多污染物模型中,仅NO2与脑卒中死亡仍存在统计学关联（β=2.07,95%CI：1.08~3.07,P<0.001）。其中,调整了PM10、SO2、PM10+SO2后,NO2浓度每升高10μg/m3,在滞后1 d的情况下,人群脑卒中死亡率分别增加1.77%(95%CI：0.54%~3.01%)、2.27%(95%CI：0.98%~3.57%)和2.00%(95%CI：0.59%~3.43%)。对不同性别、年龄组人群的分层分析发现,大气污染对女性和≥65岁人群脑卒中死亡的影响较大[滞后1 d时,PM10、SO2、NO2对女性脑卒中死亡率增加的β（95%CI）值分别为0.97%（0.37%~1.57%）、1.73%（0.69%~2.78%）、2.98%（1.59%~4.39%）,对年龄≥65岁老人的死亡率增加的β（95%CI）值分别为0.94%（0.47%~1.42%）、1.06%（0.23%~1.90%）、2.50%（1.40%~3.62%）]。结论大气污染物的短期暴露与人群脑卒中死亡有关,且不同性别和年龄组人群的敏感性可能存在一定差异。     

中国道路交通伤害的时间序列分析

目的 建立我国道路交通伤害的预测模型，以期从宏观上掌握我国道路交通伤害的发生和变化趋势，为控制我国道路交通伤害提供参考依据。方法 收集我国1951-2003年的道路交通伤害资料．进行时间序列分析，建立自回归-求和-移动平均模型（ARIMA模型）。结果 建立了我国道路交通伤害事故数、万车死亡率和10万人死亡率各自的ARIMA模型方程，显示预测值与实际值接近。结论 时间序列模型在道路交通伤害预测中具有较好的应用价值。