Benchmark Dose Estimation for Cadmium-Induced Renal Effects Based on a Large Sample Population from Five Chinese Provinces

A survey involving 6103 participants from five Chinese provinces was conducted to evaluate the threshold value of urinary cadmium （UCd） for renal dysfunction as benchmark dose low （BMDL）. The urinary N-acetyl-13-D-glucosaminidase （UNAG） was chosen as an effect biomarker. The UCd BMDLs for UNAG ranged from 2.18μg/g creatinine （cr） to 4.26μg/g cr in the populations of different provinces. The selection of the sample population and area affect the evaluation of the BMDL. The reference level of UCd for renal effects was further evaluated based on the data of all 6103 subjects. With benchmark responses （BMR） of 10%/5%, the overall UCd BMDLs for males in the total population were 3.73/2.08 μg/g cr. The BMD was slightly lower in females, thereby indicating that females may be relatively more sensitive to Cd exposure than are males.

Gestational age-specific neonatal mortality in Hong Kong:a population-based retrospective study

Background The neonatal period is the most vulnerable period during childhood,with the risk of death being the highest even in developed countries/regions.Hong Kong’s neonatal mortality(1‰)is among the world’s lowest and has remained similar for 15 years.This study aimed to explore neonatal deaths in Hong Kong in detail and determine whether neonatal mortality is reducible at such a low level.Methods Live births in public hospitals in Hong Kong during 01 Jan 2006–31 Dec 2017 were included.Relevant data were extracted from the electronic medical records.Gestational age-specific mortality was calculated,and the trends were analyzed using the Cochran–Armitage trend test.Causes of death were summarized,and risk factors were identified in multivariate logistic regression analysis.Results In 490,034 live births,755 cases(1.54‰)died during the neonatal period,and 293(0.6‰)died during the post-neonatal period.The neonatal mortality remained similar overall(P=0.17)and among infants born at 24–29 weeks’gestation(P=0.4),while it decreased in those born at 23(P=0.04),30–36(P<0.001)and≥37(P<0.001)weeks’gestation.Neonates born at<27 weeks’gestation accounted for a significantly increased proportion among cases who died(27.6%to 51.9%),with hemorrhagic conditions(24%)being the leading cause of death.Congenital anomalies were the leading cause of death in neonates born≥27 weeks’gestation(52%),but its cause-specific mortality decreased(P=0.002,0.6‰to 0.41‰),with most of the decrease attributed to trisomy 13/18 and multiple anomalies.Conclusion Reduction of neonatal mortality in developed regions may heavily rely on improved quality of perinatal and neonatal care among extremely preterm infants.

Identification of individuals with non-alcoholic fatty liver disease by the diagnostic criteria for the metabolic syndrome

AIM:To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease(NAFLD).METHODS:Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography.This study involved 11 714 apparently healthy Japanese men and women,18 to 83 years of age.NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d,known liver disease,or current use of medication.The revised criteria of the National Cholesterol Education Program Adult Treatment PanelⅢ were used to characterize the metabolic syndrome.RESULTS:NAFLD was detected in 32.2%(95%CI:31.0%-33.5%)of men(n=1874 of 5811)and in 8.7%(95%CI:8.0%-9.5%)of women(n=514 of 5903).Among obese people,the prevalence of NAFLD was as high as 67.3%(95%CI:64.8%-69.7%)in men and 45.8%(95%CI:41.7%-50.0%)in women.Although NAFLD was thought of as being the liver phenotype of metabolic syndrome,the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women.66.8%of men and 70.4%of women with NAFLD were not diagnosed with the metabolic syndrome.48.2%of men with NAFLD and 49.8%of women with NAFLD weren't overweight[body mass index(BMI)≥25 kg/m2].In the same way,68.6%of men with NAFLD and 37.9%of women with NAFLD weren't satisfied with abdominal classification(≥90 cm for men and≥80 cm for women).Next,authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome.The sensitivity of the definition"at least 1 criterion"was as good as 84.8%in men and 86.6%in women.Separating subjects by BMI,the sensitivity was higher in obese men and women than in non-obese men and women(92.3%vs 76.8%in men,96.1%vs 77.0%in women,respectively).CONCLUSION:Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome.

Variables associated with olfactory disorders in adults: A U.S.population-based analysis

Objective:Olfactory dysfunction is known to have significant social,psychological,and safety implications.Despite increasingly recognized prevalence,potential risk factors for olfactory loss have been arbitrarily documented and knowledge is limited in scale.The aim of this study is to identify potential demographic and exposure variables correlating with olfactory dysfunction.Methods:Cross-sectional analysis of the 2011-2012 and 2013-2014 editions of the National Health Examination and Nutrition Survey was performed.The utilized survey reports from a nationally representative sample of about 5000 persons each year located in counties across the United States.There is an interview and physical examination component which includes demographic,socioeconomic,dietary,and health-related questions as well as medical,dental,physiologic measurements,and laboratory tests.3594 adult respondents from 2011 to 2012 and 3708 respondents from 2013 to 2014 were identified from the above population-based database.The frequency of self-reported disorders as well as performance on odor identification testing was determined in relation to demographic factors,occupational or environmental exposures,and urinary levels of environmental and industrial compounds.Results:In both subjective and objective analysis,smell disorders were significantly more common with increasing age.While the non-Hispanic Black and non-Hispanic Asian populations were less likely to report subjective olfactory loss,they,along with Hispanics,performed more poorly on odor identification than Caucasians.Those with limited education had a decreased prevalence of hyposmia.Women outperformed men on smell testing.Those reporting exposure to vapors were more likely to experience olfactory dysfunction,and urinary levels of manganese,2-Thioxothiazolidine-4-carboxylic acid,and 2-Aminothiazoline-4-carboxylic acid were lower among respondents with subjective smell disturbance.In odor detection,elevated serum levels of lead and urinary levels of 2,4 dichlorophenol were associated with anosmia and hyposmia,respectively.Conclusions:This study provides current,population-based data identifying demographic and exposure elements related to smell disturbances in U.S.adults.Age,race,gender,education,exposure to vapors,urinary levels of manganese,2-Thioxothiazolidine-4-carboxylic acid,2-Aminothiazoline-4-carboxylic acid,2,4 dichlorophenol,and serum lead levels were all implicated in smell disturbance.Care should be taken in interpretation due to lack of consistency between subjective and objective measures of olfaction as well as limitations related to population-based data.Prospective trials are indicated to further elucidate these relationships.

Impact of a colorectal cancer screening program implantation on delays and prognosis of non-screening detected colorectal cancer

BACKGROUND The implementation of a colorectal cancer(CRC)screening programme may increase the awareness of Primary Care Physicians,reduce the diagnostic delay in CRC detected outside the scope of the screening programme and thus improve prognosis.AIM To determine the effect of implementation of a CRC screening programme on diagnostic delays and prognosis of CRC detected outside the scope of a screening programme.METHODS We performed a retrospective intervention study with a pre-post design.We identified 322 patients with incident and confirmed CRC in the pre-implantation cohort(June 2014–May 2015)and 285 in the post-implantation cohort(June 2017-May 2018)in the Cancer Registry detected outside the scope of a CRC screening programme.In each patient we calculated the different healthcare diagnostics delays:global,primary and secondary healthcare,referral and colonoscopyrelated delays.In addition,we collected the initial healthcare that evaluated the patient,the home location(urban/rural),and the CRC stage at diagnosis.We determined the two-year survival and we performed a multivariate proportional hazard regression analysis to determine the variables associated with survival.RESULTS We did not detect any differences in the patient or CRC baseline-related variables.A total of 20.1%of patients was detected with metastatic disease.There was a significant increase in direct referral to colonoscopy from primary healthcare(25.5%,35.8%;P=0.04)in the post-implantation cohort.Diagnostic delay was reduced by 24 d(106.64±148.84 days,82.84±109.31 d;P=0.02)due to the reduction in secondary healthcare delay(46.01±111.65 d;29.20±60.83 d;P=0.02).However,we did not find any differences in CRC stage at diagnosis or in two-year survival(70.3%;P=0.9).Variables independently associated with twoyear risk of death were age(Hazard Ratio-HR:1.06,95%CI:1.04-1.07),CRC stage(II HR:2.17,95%CI:1.07-4.40;III HR:3.07,95%CI:1.56-6.08;IV HR:19.22,95%CI:9.86-37.44;unknown HR:9.24,95%CI:4.27-19.99),initial healthcare consultation(secondary HR:2.93,95%CI:1.01-8.55;emergency department HR:2.06,95%CI:0.67-6.34),hospitalization during the diagnostic process(HR:1.67,95%CI:1.17-2.38)and urban residence(HR:1.44,95%CI:1.06-1.98).CONCLUSION Although implementation of a CRC screening programme can reduce diagnostic delays for CRC detected in symptomatic patients,this has no effect on CRC stage or survival.

CNVbase:Batch identification of novel and rare copy number variations based on multi-ethnic population data

Human genetic variants have long been known to play an important role in both Mendelian disorders and common diseases. Notably, pathogenic variants are not limited to single-nucleotide variants. It has become apparent that human diseases can also be caused by copy number variations （CNVs）, especially patient- specific novel CNVs （lafrate et al., 2004; Sebat et al., 2004; Redon et al., 2006; LuDski, 2007; Zhan~ et al.. 2009： Wu et al.. 2015）.

THE ESTIMATION OF THE PREVALENCE OF HEAR-ING-IMPAIRMENT FOR THE NOISE-EXPOSED POPULATION IN CHINA BASED ON ISO/DIS 1999.2

Based on the noise survey in China ,the formula (H=H+N-HN/120 ) of ISO/DIS 1999.2 (' Acoustics - Determination of Occupational noise exposure and estimation of noise induced hearing impairment ' , 1985) was applied to the calculation of the hearing threshold level associated with age and noise (HTLAN) of the noise - impaired people . According to the Gausscian distribution , when the noise - exposure level LEX8h was 85 ,90 ,95, 100 dB and the hearing threshold frequency is from 0.5k to 6kHz , the HTLAN of noise - exposed people withdifferent duration of exposure and its relation values to the hearing threshold frequency associated with age (HTLA) were obtained . The ISO /DIS 1999.2 has been proved to be applicable in China .

Challenges and opportunities:from big data to knowledge in AI 2.0

In this paper, we review recent emerging theoretical and technological advances of artificial intelligence （AI） in the big data settings. We conclude that integrating data-driven machine learning with human knowledge （common priors or implicit intuitions） can effectively lead to explainable, robust, and general AI, as follows： from shallow computation to deep neural reasoning; from merely data-driven model to data-driven with structured logic rules models; from task-oriented （domain-specific） intelligence （adherence to explicit instructions） to artificial general intelligence in a general context （the capability to learn from experience）. Motivated by such endeavors, the next generation of AI, namely AI 2.0, is positioned to reinvent computing itself, to transform big data into structured knowledge, and to enable better decision-making for our society.