Assessment of the Possible Association of Air Pollutants PM10, O3, NO2 With an Increase in Cardiovascular,Respiratory, and Diabetes Mortality in Panama City: A 2003 to 2013 Data Analysis

In recent years, Panama has experienced a marked economic growth, and this, in turn, has been associated with rapid urban development and degradation of air quality. This study is the first evaluation done in Panama on the association between air pollution and mortality. Our objective was to assess the possible association between monthly levels of PM₁₀, O₃, and NO_2, and cardiovascular, respiratory, and diabetes mortality, as well as the seasonal variation of mortality in Panama City, Panama.The study was conducted in Panama City, using air pollution data from January 2003 to December 2013. We utilized a Poisson regression model based on generalized linear models, to evaluate the association between PM₁₀, NO₂, and O₃ exposure and mortality from diabetes, cardiovascular, and respiratory diseases. The sample size for PM₁₀, NO₂, and O₂ was 132, 132, and 108 monthly averages, respectively.We found that levels of PM₁₀, O₃, and NO₂ were associated with increases in cardiovascular, respiratory, and diabetes mortality. For PM₁₀ levels ≥ 40 μg/m³, we found an increase in cardiovascular mortality of 9.7% (CI 5.8–13.6%), and an increase of 12.6% (CI 0.2–24.2%) in respiratory mortality. For O₃ levels ≥ 20 μg/m³ we found an increase of 32.4% (IC 14.6–52.9) in respiratory mortality, after a 2-month lag period following exposure in the 65 to <74 year-old age group. For NO₂ levels ≥20 μg/m³ we found an increase in respiratory mortality of 11.2% (IC 1.9–21.3), after a 2-month lag period following exposure among those aged between 65 and <74 years.There could be an association between the air pollution in Panama City and an increase in cardiovascular, respiratory, and diabetes mortality. This study confirms the urgent need to improve the measurement frequency of air pollutants in Panama.     

介入治疗心脏复合畸形疗效及安全性研究

目的评估介入治疗心脏复合畸形的可行性,安全性及疗效。方法心脏复合畸形患者10（男6,女4）例,年龄5～53岁。其中房间隔缺损（ASD）并发肺动脉瓣狭窄（PS）2例、室间隔缺损（VSD）2例和动脉导管未闭（PDA）1例,PDA并发主动脉瓣关闭不全和PS各1例;VSD修补术后遗留ASD2例,ASD修补术后遗留PDA1例和刀刺伤致左室前侧术后遗留VSD1例。ASD或PDA并发PS者,先扩张肺动脉瓣,再行ASD或PDA封堵治疗。ASD并发VSD者,先封堵VSD,再封堵ASD。结果10例患者介入手术均1次成功。5例ASD封堵器的直径为8～38mm,2例膜部对称性VSD封堵器的直径为14mm和6mm,1例用10mm肌部VSD封堵器。2例PDA均用弹簧圈封堵。封堵PDA或VSD后造影无残余分流。封堵ASD后超声心动图示无残余分流。3例并发PS者,肺动脉瓣扩张术后即刻肺动脉跨瓣压差明显下降,由术前50、38、40mmHg分别降低为20、15和21mmHg。有1例PDA封堵弹簧圈脱落至肺动脉远端未能取出。随访1年肺功能正常,无肺不张。全部患者随访3个月～1年,无任何并发症发生。结论经导管介入治疗心脏复合畸形安全可行,近期疗效肯定。     

先天性心脏病婴幼儿外科治疗对策分析(附115例报告)

目的 探讨婴幼儿先天性心脏病外科围术期处理对策.方法我院于2008年6月至2011年12月对115例患先天性心脏病的婴幼儿实施外科手术治疗,男性73例,女性42例,年龄3个月至3岁,体重3.5～20.0 kg;其中室间隔缺损(VSD)54例,法洛四联症(TOF)14例,室间隔缺损合并房间隔缺损(VSD+ASD)10例,房间隔缺损(ASD)9例,动脉导管未闭(PDA)8例,肺动脉瓣狭窄(PS)7例,室间隔缺损合并动脉导管未闭(VSD+PDA)5例,完全型肺静脉异位引流(TAPVC)4例,右室双出口(DORV)3例,主动脉缩窄合并室间隔缺损(CoA+VSD)1例.结果全组死亡5例,死亡率为4.3%.死亡原因:低心排出量综合征1例,肺高压危象2例,呼吸道梗阻2例.结论先天性心脏病患儿在婴幼儿期外科治疗可以取得满意疗效,根据婴幼儿生理、病理特点采取个体化治疗对策是成功的关键.     

外科手术治疗先天性心脏病介入封堵术后并发症-附10例分析

目的:总结外科开胸手术方法治疗介入封堵动脉导管未闭(PDA)、房间隔缺损(ASD)和室间隔缺损(VSD)术后并发症。方法:对1995年至2010年10例PDA、ASD、VSD采用介入封堵后出现并发症而进行外科手术治疗的病例进行回顾性分析。其中严重主动脉瓣反流、三尖瓣反流各1例,Ⅲ°房室传导阻滞2例,封堵器移位5例,介入装置释放困难1例。10例患者均采用全麻体外循环下心脏直视手术,取出堵闭器、矫治心脏畸形。结果:10例患者均成功取出堵闭器,心脏畸形矫治满意,外科手术中开放升主动脉全部自动复跳,顺利脱机。10例患者中9例术后恢复良好,1例因肾功能衰竭及多脏器功能衰竭死亡。结论:PDA、ASD及VSD介入封堵治疗创伤小,术后恢复快,疗效肯定,但也存在一定的手术风险和出现严重并发症的可能。及时地行外科手术可以避免病情恶化、矫治心脏畸形,术后心功能恢复良好。     

Association of joint exposure to various ambient air pollutants during adolescence with blood pressure in young adulthood

The association of various air pollutants exposure during adolescence with blood pressure (BP) in young adulthood is uncertain. We intended to evaluate the long-term association of individual and joint air pollutants exposure during adolescence with BP in young adulthood. This cross-sectional study of incoming students was conducted in five geographically disperse universities in China during September and October 2018. Mean concentrations of particulate matter with diameters ≤2.5 μm (PM_2.5), ≤10 μm (PM₁₀), nitrogen dioxides (NO₂), carbon monoxide (CO), sulfur dioxide (SO₂), and ozone (O₃) at participants’ residential addresses during 2013–2018 were collected from the Chinese Air Quality Reanalysis dataset. Generalized linear mixed models (GLM) and quantile g-computation (QgC) models were utilized to estimate the association between individual and joint air pollutants exposure and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP). A total of 16,242 participants were included in the analysis. The GLM analyses showed that PM_2.5, PM₁₀, NO₂, CO, and SO₂ were significantly positively associated with SBP and PP, while O₃ was positively associated with DBP. The QgC analyses indicated that long-term exposure to a mixture of the six air pollutants had a significant positive joint association with SBP and PP. In conclusion, air pollutant co-exposure during adolescence may influence BP in young adulthood. The findings of this study emphasized the impacts of multiple air pollutants interactions on potential health and the need of minimizing pollution exposures in the environment.     

Roles of Ambient Temperature and PM2.5 on Childhood Acute Bronchitis and Bronchiolitis from Viral Infection

Studies have associated the human respiratory syncytial virus which causes seasonal childhood acute bronchitis and bronchiolitis (CABs) with climate change and air pollution. We investigated this association using the insurance claims data of 3,965,560 children aged ≤ 12 years from Taiwan from 2006–2016. The monthly average incident CABs increased with increasing PM_2.5 levels and exhibited an inverse association with temperature. The incidence was 1.6-fold greater in January than in July (13.7/100 versus 8.81/100), declined during winter breaks (February) and summer breaks (June–August). The highest incidence was 698 cases/day at <20 °C with PM_2.5 > 37.0 μg/m³, with an adjusted relative risk (aRR) of 1.01 (95% confidence interval [CI] = 0.97–1.04) compared to 568 cases/day at <20 °C with PM_2.5 < 15.0 μg/m³ (reference). The incidence at ≥30 °C decreased to 536 cases/day (aRR = 0.95, 95% CI = 0.85–1.06) with PM_2.5 > 37.0 μg/m³ and decreased further to 392 cases/day (aRR = 0.61, 95% CI = 0.58–0.65) when PM_2.5 was <15.0 μg/m³. In conclusion, CABs infections in children were associated with lowered ambient temperatures and elevated PM_2.5 concentrations, and the high PM_2.5 levels coincided with low temperature levels. The role of temperature should be considered in the studies of association between PM_2.5 and CABs.     

Short-Term Exposure to Ambient Air Pollution and Mortality From Myocardial Infarction

BackgroundShort-term exposure to ambient air pollution has been linked to occurrence of myocardial infarction (MI); however, only a limited number of studies investigated its association with death from MI, and the results remain inconsistent.ObjectivesThis study sought to investigate the association of short-term exposure to air pollution across a wide range of concentrations with MI mortality.MethodsA time-stratified case-crossover study was conducted to investigate 151,608 MI death cases in Hubei province (China) from 2013 to 2018. Based on each case’s home address, exposure to particulate matter with an aerodynamic diameter ≤2.5 μm (PM_2.5), particulate matter with an aerodynamic diameter ≤10 μm (PM₁₀), sulfur dioxide, nitrogen dioxide (NO₂), carbon monoxide, and ozone on each of the case and control days was assessed as the inverse distance–weighted average concentration at neighboring air quality monitoring stations. Conditional logistic regression models were implemented to quantify exposure-response associations.ResultsExposure to PM_2.5, PM₁₀, and NO₂ (mean exposure on the same day of death and 1 day prior) was significantly associated with increased odds of MI mortality. The odds associated with PM_2.5 and PM₁₀ exposures increased steeply before a breakpoint (PM_2.5, 33.3 μg/m³; PM₁₀, 57.3 μg/m³) and flattened out at higher exposure levels, while the association for NO₂ exposure was almost linear. Each 10-μg/m³ increase in exposure to PM_2.5 (<33.3 μg/m³), PM₁₀ (<57.3 μg/m³), and NO₂ was significantly associated with a 4.14% (95% confidence interval [CI]: 1.25% to 7.12%), 2.67% (95% CI: 0.80% to 4.57%), and 1.46% (95% CI: 0.76% to 2.17%) increase in odds of MI mortality, respectively. The association between NO₂ exposure and MI mortality was significantly stronger in older adults.ConclusionsShort-term exposure to PM_2.5, PM₁₀, and NO₂ was associated with increased risk of MI mortality.     

经导管同期治疗复合型先天性心脏病的安全性及疗效观察

目的:研究经导管同期治疗复合型先天性心脏病的可行性、方法及疗效.方法:2001-07-2007-10共30例复合型先天性心脏病患者,男11例,女19例.复合类型为:房间隔缺损(ASD)伴室间隔缺损(VSD)、动脉导管未闭(PDA)、肺动脉瓣狭窄(PS)分别为13例、7例、3例,伴二尖瓣狭窄(Lutembacher综合征)3例;VSD伴PDA 2例;PS伴PDA 2例;经导管治疗的原则:先行瓣膜球囊扩张术纠正瓣膜狭窄,其次行VSD封堵术,再次行PDA封堵术,最后行ASD封堵术.术后48 h、1个月、6个月分别行经胸超声心动图(TTE)、X线及心电图检查评价治疗效果.结果:30例复合型先天性心脏病患者均一次性介入治疗成功,术中未发生任何重要并发症.术后即刻TTE和造影示ASD、VSD、PDA所有封堵器位置良好,无残余分流.ASD和PDA伴肺动脉瓣狭窄(PS) 5例,跨肺动脉瓣平均压差由术前(56.4±15.2)mmHg(1 mmHg=0. 133 kPa)下降至术后(13.1±8 9) mmHg,差异有统计学意义(P<0.05).3例Lutembacher综合征患者,超声心动图测量二尖瓣口面积分别由二尖瓣球囊扩张术术前0.98、1.1和1.26 cm2增加到1.7、1.92和2.0 cm2,平均左房压分别由31、28和27降至9、8.5和7 mmHg.术后48 h、1个月、6个月经TTE检查示所有患者各水平分流均消失,扩大的房室内径进行性缩小,所有封堵器位置固定良好,无移位及脱落;同时X线检查,肺血明显减少,房室内径明显恢复;心电图检查无房室传导阻滞及左右束支阻滞;无其他并发症.结论:只要严格掌握适应证,术中采取适当的治疗策略,操作规范,复合型先天性心脏病同期介入治疗是可行的、安全的,可获得满意的临床效果.     

An evidence-based appraisal of global association between air pollution and risk of stroke

Background

The aim of this study was to evaluate the transient effects of air pollutants on stroke morbidity and mortality using the meta-analytic approach.

Methods

Three databases were searched for case-crossover and time series studies assessing associations between daily increases in particles with diameter < 2.5 μm (PM_2.5) and diameter < 10 μm (PM₁₀), sulfur dioxide (SO₂), carbon monoxide (CO), nitrogen dioxide (NO₂), ozone, and risks of stroke hospitalizations and mortality. Risk estimates were combined using random-effects model.

Results

A total of 34 studies were included in the meta-analysis. Stroke hospitalizations or mortality increased 1.20% (95%CI: 0.22–2.18) per 10 μg/m³ increase in PM_2.5, 0.58% (95%CI: 0.31–0.86) per 10 μg/m³ increase in PM₁₀, 1.53% (95%CI: 0.66–2.41) per 10 parts per billion (ppb) increase in SO₂, 2.96% (95%CI: 0.70–5.27) per 1 ppm increase in CO, and 2.24% (95%CI: 1.16–3.33) per 10 ppb increase in NO₂. These positive associations were the strongest on the same day of exposure, and appeared to be more apparent for ischemic stroke (for all 4 gaseous pollutants) and among Asian countries (for all 6 pollutants). In addition, an elevated risk (2.45% per 10 ppb; 95%CI: 0.35–4.60) of ischemic stroke associated with ozone was found, but not for hemorrhagic stroke.

Conclusion

Our study indicates that air pollution may transiently increase the risk of stroke hospitalizations and stroke mortality. Although with a weak association, these findings if validated may be of both clinical and public health importance given the great global burden of stroke and air pollution.     

Impact of Environmental Particulate Matter and Peritoneal Dialysis-related Infection in Patients Undergoing Peritoneal Dialysis

In patients undergoing peritoneal dialysis (PD), PD-related infection is a major cause of PD failure and hospital admission. Good air quality is required when dialysate exchange or exit site wound care is performed. To our knowledge, investigation of air pollution as a factor for PD-related infection in patients undergoing dialysis is limited. This study aimed to assess the effect of environmental particulate matter (PM) and other important risk factors on 1-year PD-related infection in patients undergoing PD.A total of 175 patients undergoing PD were recruited in this 1-year retrospective observational study. Differences in environmental PMs (PM₁₀ and PM_2.5) were analyzed with respect to the patients’ living areas. The patients undergoing PD were categorized into 2 groups according to PM_2.5 exposure: high (n = 61) and low (n = 114). Demographic, hematological, nutritional, inflammatory, biochemical, and dialysis-related data were analyzed. Multivariate binary logistic and multivariate Cox regression analyses were used to analyze 1-year PD-related infection.A total of 175 patients undergoing PD (50 men and 125 women) were enrolled. Thirty-five patients had PD-related infection within 1 year. Multivariate Cox regression analysis showed that high environmental PM_2.5 exposure (hazard ratio (HR): 2.0, 95% confidence interval [CI] [1.03–3.91]; P = .04) and female sex (HR: 2.77, 95% CI [1.07–7.19]; P = .03) were risk factors for 1-year PD-related infection.Patients undergoing PD with high environmental PM_2.5 exposure had a higher 1-year PD-related infection rate than that in those with low exposure. Therefore, air pollution may be associated with PD-related infection in such patients.     

Environmental Carbon Monoxide Level Is Associated With the Level of High-Sensitivity C-Reactive Protein in Peritoneal Dialysis Patients

Inflammation is highly prevalent among peritoneal dialysis (PD) patients. High-sensitivity C-reactive protein (hs-CRP) is the most widely used inflammatory marker in clinical medicine and is correlated with mortality in PD patients. Air pollution is associated with systemic inflammation. The aim of this cross-sectional study was to assess the role of air pollutants and other clinical variables on hs-CRP values in PD patients.We recruited a total of 175 patients who had been undergoing continuous ambulatory PD or automated PD for at least 4 months and regularly followed up. Air pollution levels were recorded by a network of 27 monitoring stations near or in the patients’ living areas throughout Taiwan. The 12-month average concentrations of particulate matter (PM) with an aerodynamic diameter of <10 and <2.5 μm (PM₁₀ and PM_2.5), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and ozone (O₃) were included.In stepwise linear regression, after adjustment for related factors, white blood cell count (β: 0.27, 95% confidence interval [CI] [0.71, 2.11]) and CO level (β: 0.17, 95% CI [2.5, 21.32]) were positively associated with hs-CRP and serum albumin levels (β: −0.25, 95% CI [−13.69, −3.96]) and normalized protein nitrogen appearance (β: −0.18, 95% CI [−17.7, −2.51]) was negatively associated with hs-CRP. However, serum indoxyl sulfate and p-cresyl sulfate levels were not significantly associated with hs-CRP (P > 0.05).In PD patients, the environmental CO level was positively correlated with hs-CRP level.     

First-pass radionuclide angiocardiography in the determination of left-to-right cardiac shunt site in children

To ascertain if the level of a left-to-right cardiac shunt can be reliably established by first-pass radionuclide angiocardiography with ^99mTc-pertechnetate, 102 children have been studied; 19 without a shunt, 26 with an atrial septal defect (ASD), 45 with a ventricular septal defect (VSD), and 12 with a patent ductus arteriosus (PDA). Time-activity curves were generated over the right atrium and ventricle, and several quantitative parameters were derived from the curves. It was concluded that in the absence of right-sided valvular incompetence, the time-activity curves show the greatest abnormality in the cardiac chambers distal to the left-to-right shunt. The right ventricular curve is typically altered in ASD but cannot be relied upon to differentiate VSD or PDA. The identification of ASD is assisted by the use of two of the parameters, the count ratio C4:C1 and time ratio T2:T1.     

Down综合征并发先天性心脏病的临床分析

目的:总结分析Down综合征(Down’s syndrome)并发的先天性心脏病畸形及血流动力学资料。方法:2008年7月~2012年10月,采用经胸二维超声心动图并彩色多普勒显像及右心导管/心血管造影检查方法,诊断36例并发先心病的Down综合征患者,本文通过36例临床资料分析,探讨Down综合征并发的先心病畸形及其血流动力学。结果:36例患者中室间隔缺损(VSD)10例,房室间隔缺损(AVSD)6例,动脉导管未闭(PDA)6例,房间隔缺损(ASD)2例,ASD+PDA 2例,ASD+VSD 1例,ASD+PDA+VSD 1例,VSD+PDA 4例,PDA+二叶主动脉瓣(BAV)1例,法洛四联症(TOF)2例,TOF+ASD 1例,18例有肺动脉高压者,其中5例为阻力型肺动脉高压。结论:①Down综合征并发的心血管畸形中,以VSD、AVSD和PDA最为常见,并常并发ASD、TOF。②在无肺动脉狭窄的患者中,约50%并发有肺动脉高压。     

Association between Birth Weight and Cardiovascular Risk Factors in Adolescents

Background

Birth weight (BW) is a medium- and long-term risk determinant of cardiovascular risk factors.

Objective

To assess the association between BW and cardiovascular risk factors in adolescents of the city of Salvador, Bahia state.

Methods

Cross-sectional study with comparison of BW groups. Sample comprising 250 adolescents classified according to the BMI as follows: high-normal (≥ 50th percentile and < 85th percentile); overweight (≥ 85th percentile and < 95th percentile); and obesity (≥ 95th percentile). The risk variables compared were as follows: waist circumference (WC); arterial blood pressure; lipid profile; glycemia; serum insulin; HOMA-IR; and metabolic syndrome. The BW was informed by parents and classified as follows: low (BW ≤ 2,500g); normal (BW > 2,500g and < 4,000g); and high (BW ≥ 4,000g).

Results

One hundred and fifty-three (61.2%) girls, age 13.74 ± 2.03 years, normal BW 80.8%, low BW 8.0%, and high BW 11.2%. The high BW group as compared with the normal BW group showed a higher frequency of obesity (42.9%, p=0.005), elevated SBP and DBP (42.9%, p=0.000 and 35.7%, p=0.007, respectively), and metabolic syndrome (46.4%, p=0.002). High BW adolescents as compared with normal BW adolescents had a prevalence ratio for high SBP 3.3 (95% CI: 1.7-6.4) and obesity 2.6 (95% CI: 1.3-5.2). The WC of high BW adolescents was 83.3 ± 10.1 (p=0.038). The lipid profile showed no statistically significant differences.

Conclusion

Our findings suggest that obesity, elevated SBP and DBP, and metabolic syndrome during adolescence might be associated with high BW.     

先天性心脏病门诊患者的分布特征

目的:调查和描述先天性心脏病（先心病）门诊患者的分布特征。方法: 从2005年1月起,由先心病内科专家门诊负责,对先心病明确诊断的初诊患者连续登记至2011年1月,共11 780例,由26种畸形组成。统计分析26种先天畸形构成比以及其中8种常见畸形（VSD、ASD、PDA、TOF、PS、AVSD、AS、TGA）在婴幼儿、儿童和成年人等阶段比例和单病种先心病中不同年龄段所占比例;4种常见先心病（VSD、ASD、PDA、AS）的3种并发症（肺动脉高压,心房颤动,感染性心内膜炎）呈现特点。结果: ①不同年龄段疾病构成比不同, VSD,TOF和TGA婴幼儿期明显高于成年人,VSD,TOF和TGA在婴幼儿和成人比例分别为53.8%和26.6%,8.6%和2.5%,5.1%和0.2%,而ASD和AS则成年人显著高于婴幼儿期,分别为41.1%和5.7%,6.8%和0.4%;②并发症呈现特点:艾森曼格综合征在VSD、ASD和PDA患者中绝大多数系成人,占97%,存活达50岁以上不足10%;心房颤动在ASD比较常见（2.4%）,其次是PDA（1.1%）,而VSD少见（0.2%）;感染性心内膜炎在AS中较常见,发生率为6.1%,VSD和PDA分别为0.52%和0.55%。 结论: 先心病在各种不同年龄阶段的构成比不同;婴幼儿期或儿童期手术可预防致残或影响生活质量的并发症。     

Organosulfur Materials with High Photo- and Photo-Oxidation Stability: 10-Anthryl Sulfoxides and Sulfones and Their Photophysical Properties Dependent on the Sulfur Oxidation State

While few studies show only symmetrical and poorly mono-SO_n (n = 0–2) substituted acenes, in this study, we present a synthesis of a new group of unsymmetrical, significantly substituted derivatives, which revealed unique photophysical properties. Both sulfides (S), sulfoxides (SO) and sulfones (SO₂) showed very high photochemical stabilities, unusual for these groups, during UV-irradiation at 254/365 nm (air O₂ and Ar), which was higher than any found in the literature. For the (S)/(SO) series (254 nm), the stabilities of 80–519 min. (air O₂ and Ar) were found. At 365 nm, stabilities of 124—812 min./(air O₂) for (S)/(SO) and higher for (SO₂) were observed. Photoluminescence lifetimes of (SO_n) of the lower anthryl symmetry remained in the following order: (SO₂) < (S) < (SO); those with full symmetry were in the following order: (S) < (SO) < (SO₂). The enhanced photostability was explained with DFT/MS/Hammett’s constants, which showed the leading role of the SO_n groups in stabilization of HOMO/LUMO frontier orbitals. The SO_n (n = 0–2) substituted acenes turned out to be tunable violet/blue/green emitters by oxidation of S atoms and the introduction of rich substitution.     

Incident dementia and long-term exposure to constituents of fine particle air pollution: A national cohort study in the United States

Growing evidence suggests that fine particulate matter (PM_2.5) likely increases the risks of dementia, yet little is known about the relative contributions of different constituents. Here, we conducted a nationwide population-based cohort study (2000 to 2017) by integrating the Medicare Chronic Conditions Warehouse database and two independently sourced datasets of high-resolution PM_2.5 major chemical composition, including black carbon (BC), organic matter (OM), nitrate (NO₃⁻), sulfate (SO₄²⁻), ammonium (NH₄⁺), and soil dust (DUST). To investigate the impact of long-term exposure to PM_2.5 constituents on incident all-cause dementia and Alzheimer’s disease (AD), hazard ratios for dementia and AD were estimated using Cox proportional hazards models, and penalized splines were used to evaluate potential nonlinear concentration–response (C-R) relationships. Results using two exposure datasets consistently indicated higher rates of incident dementia and AD for an increased exposure to PM_2.5 and its major constituents. An interquartile range increase in PM_2.5 mass was associated with a 6 to 7% increase in dementia incidence and a 9% increase in AD incidence. For different PM_2.5 constituents, associations remained significant for BC, OM, SO₄²⁻, and NH₄⁺ for both end points (even after adjustments of other constituents), among which BC and SO₄²⁻ showed the strongest associations. All constituents had largely linear C-R relationships in the low exposure range, but most tailed off at higher exposure concentrations. Our findings suggest that long-term exposure to PM_2.5 is significantly associated with higher rates of incident dementia and AD and that SO₄²⁻, BC, and OM related to traffic and fossil fuel combustion might drive the observed associations.

Globally, dementia is the seventh leading cause of death in the United States and a major cause of disability and dependency among older people, posing an urgent and significant public health challenge (1). More than 6 million Americans presently live with Alzheimer’s disease (AD) and dementia, leading to a massive economic burden; this number is projected to triple to approximately 14 million by 2060 (2). As medical treatments for the most common types of dementia remain challenging, identifying and mitigating modifiable risk factors are of paramount importance.Growing evidence indicates that exposure to air pollution, specifically fine particulate matter (PM_2.5), plays a crucial role in the pathogenesis of AD and AD-related dementias (ADRD). A recent critical review by Delgado-Saborit et al. (2021) (3) summarized the epidemiological evidence of the effects of air pollution on ADRD, and a positive association between long-term exposure to PM_2.5 mass and increased ADRD risks was consistently reported across almost all studies. Relevant publications on air pollution and ADRD have doubled since this review, with the majority of studies finding positive associations between PM_2.5 mass and either all-cause dementia or AD (4–6).To facilitate the targeting of pollution control efforts, the National Academy of Sciences and the World Health Organization have placed a high priority on determining which constituents of the PM_2.5 mass may be most hazardous (7, 8). Yang et al. (9) reviewed the literature regarding PM_2.5 constituents and both short-term and long-term health effects, focusing on all-cause mortality and cardiorespiratory morbidity, and found consistent associations with both black carbon (BC) and organic carbon (OC). However, the relative contributions of individual PM_2.5 constituents to ADRD risks remain largely unknown. Only one study to date has focused on PM_2.5 constituents and ADRD, which looked at PM_2.5 constituents and all-cause dementia in the northeastern United States (10).Elucidating the potential relationship between PM_2.5 constituents and dementia has been challenging because of the sparsity of available, speciated chemical composition measurements, and the chronic nature of neurodegeneration. To cope with these challenges, long-term, high-resolution spatiotemporal PM_2.5 constituents’ estimates are needed, which require modeling with measurement constraints from ground observations. In addition, more complete health records, such as physician visits, inpatient visits, and outpatient visits, are needed to better capture disease incidence (5).Here, we present a nationwide open cohort (i.e., dynamic cohort, meaning that members can leave or be added over time) study of the long-term PM_2.5 constituents’ exposure with incident dementia and AD among US older adults during 2000 to 2017. We used two high-resolution, multiple-species air pollution datasets and all Medicare claims across the contiguous United States to estimate the effect of PM_2.5 constituents on dementia risk.     

Association between long-term exposure of ambient air pollutants and cardiometabolic diseases: A 2012 Korean Community Health Survey

Background and aim

The associations of long-term exposure to particulate matter <10 μm in size (PM₁₀), nitrogen dioxide (NO₂), carbon monoxide (CO), sulfur dioxide (SO₂), and ozone (O₃) with cardiometabolic diseases (CMD) remain uncertain in the Korean population. Therefore, we sought to examine the associations between PM₁₀, NO₂, CO, SO₂, and O₃ and CMD using data collected from the Korean Community Health Survey.

先天性心脏病介入治疗临床效果分析

目的观察介入治疗先天性心脏病(CHD)的临床疗效,总结治疗经验。方法选取2004—2012年我院收治的行介入治疗的CHD患者76例,其中继发孔型房间隔缺损(ASD)33例、室间隔缺损(VSD)18例、ASD合并VSD 1例、动脉导管未闭(PDA)21例、肺动脉瓣狭窄(PS)3例。ASD、VSD及PDA封堵术均采用国产蘑菇伞Amplatzer法。观察患者治疗效果。结果患者均无严重并发症发生,无死亡。封堵成功73例患者(除1例ASD患者,1例VSD患者和1例PDA患者)。随访1~24个月无残余分流及严重心脏事件。结论介入治疗CHD创伤小、安全、可靠、成功率高,值得进一步推广。     

A survey of PM2.5 preventive behavioral intention and related factors among community elderly in Northern Taiwan

Population aging and air pollution are global concerns. The purpose of this study is to explore the relationship among particulate matter with a diameter of 2.5 μm or less (PM_2.5) knowledge, PM_2.5 preventive attitude, and PM_2.5 preventive behavioral intention in the elderly.A cross-sectional survey design was applied in this study, including usage intention and snowball sampling. A total of 617 elderly people aged over 65 participated, and the collected data were quantitatively analyzed.The results showed that the mean score of PM_2.5 knowledge of the elderly was 10.34 (79.53%) with the standard deviation (SD) of 3.42, the mean score of PM_2.5 preventive attitude was 4.58 (91.60%) with SD of 0.49, and the mean score of PM_2.5 preventive behavioral intention was 4.72 (94.40%) with SD of 0.40. Elderly people''s characteristics regarding PM_2.5 knowledge and PM_2.5 preventive attitude explained 22% (adjusted R² = 0.22, F = 30.44, P < .001) of the variance in PM_2.5 preventive behavioral intention.It is concluded that we found no difference in PM_2.5 knowledge, PM_2.5 preventive attitude, or PM_2.5 preventive behavioral intention among the elderly with or without chronic diseases. In our opinion, health education regarding the threat of PM_2.5 to the health of the elderly should be strengthened, to enhance their knowledge, preventive attitude, and preventive behavioral intention of PM_2.5.