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Objective To describe the occurrence of general surgical complications and establish prediction models for different types of complications based on a multicenter cohort study. Methods Based on Modern Surgery and Anesthesia Safety Management System Construction and Promotion(MSCP), patients who underwent general surgery in 4 hospitals from January to June 2015 and from January to June 2016 were selected as participants, and perioperative data of patients were collected. Logistic regression was used to identify risk factors and predict complications. Results Among 19 223 patients, 830(4.32%) had complications. Among participants who had complications, 371(44.70%) had incision complications, 190(22.89%) had fistula complications, 310(37.35%) had infection complications, 161(19.40%) had failure complications, and 104(12.5%) died. There were significant differences in the risk factors of different types of complications. The risk factors of incision,infection and failure covered the whole perioperative period, while fistula complications mainly focused on the difficulty of surgery and postoperative treatment, and for death outcomes, postoperative risk factors were more severe than preoperative risk factors. The areas under the curves of prediction were between 0.80-0.93. Conclusions In general surgery, different types of complications have different risk factors. The targeted prediction model can avoid the rough simplification of complications and fuzzy influence of each factor, and can provide reference for the prevention of complications.

Background: The current guidelines for managing screen‐detected pulmonary nodules offer rule‐based recommendations for immediate diagnostic work‐up or follow‐up at intervals of 3, 6, or 12 months. Customized visit plans are lacking. Purpose: To develop individualized screening schedules using reinforcement learning (RL) and evaluate the effectiveness of RL‐based policy models. Methods: Using a nested case–control design, we retrospectively identified 308 patients with cancer who had positive screening results in at least two screening rounds in the National Lung Screening Trial. We established a control group that included cancer‐free patients with nodules, matched (1:1) according to the year of cancer diagnosis. By generating 10,164 sequence decision episodes, we trained RL‐based policy models, incorporating nodule diameter alone, combined with nodule appearance (attenuation and margin) and/or patient information (age, sex, smoking status, pack‐years, and family history). We calculated rates of misdiagnosis, missed diagnosis, and delayed diagnosis, and compared the performance of RL‐based policy models with rule‐based follow‐up protocols (National Comprehensive Cancer Network guideline; China Guideline for the Screening and Early Detection of Lung Cancer). Results: We identified significant interactions between certain variables (e.g., nodule shape and patient smoking pack‐years, beyond those considered in guideline protocols) and the selection of follow‐up testing intervals, thereby impacting the quality of the decision sequence. In validation, one RL‐based policy model achieved rates of 12.3% for misdiagnosis, 9.7% for missed diagnosis, and 11.7% for delayed diagnosis. Compared with the two rule‐based protocols, the three best‐performing RL‐based policy models consistently demonstrated optimal performance for specific patient subgroups based on disease characteristics (benign or malignant), nodule phenotypes (size, shape, and attenuation), and individual attributes. Conclusions: This study highlights the potential of using an RL‐based approach that is both clinically interpretable and performance‐robust to develop personalized lung cancer screening schedules. Our findings present opportunities for enhancing the current cancer screening system. [ABSTRACT FROM AUTHOR]

Objective To estimate the long-term effect of the changing demography in China on blood supply and demand. Methods We developed a predictive model to estimate blood supply and demand during 2017-2036 in mainland China and in 31 province-level regions. Model parameters were obtained from World Population Prospects, China statistical yearbook 2016, China's report on blood safety and records from a large tertiary hospital. Our main assumptions were stable age-specific per capita blood supply and demand over time. Findings We estimated that the change in demographic structure between 2016 (baseline year) and 2036 would result in a 16.0% decrease in blood supply (from 43.2 million units of 200 mL to 36.3 million units) and a 33.1% increase in demand (from 43.2 million units to 57.5 million units). In 2036, there would be an estimated shortage of 21.2 million units. An annual increase in supply between 0.9% and 1.8% is required to maintain a balance in blood supply and demand. This increase is not enough for every region as regional differences will increase, e.g. a blood demand/supply ratio > 1.45 by 2036 is predicted in regions with large populations older than 65 years. Sensitivity analyses showed that increasing donations by 4.0% annually by people aged 18-34 years or decreasing the overall blood discard rate from 5.0% to 2.0% would not offset but help reduce the blood shortage. Conclusion Multidimensional strategies and tailored, coordinated actions are needed to deal with growing pressures on blood services because of China's ageing population. Objectif Estimer I'effet a long terme de revolution demographique en Chine sur l'approvisionnement et la demande en produits sanguins. Methodes Nous avons elabore un modele de prevision pour estimer l'approvisionnement et la demande en produits sanguins en Chine continentale et dans 31 provinces entre 2017 et 2036. Les parametres du modele ont ete definis a partir des Perspectives de la population mondiale, de l'Annuaire statistique 2016 de la Chine, du Rapport de la Chine sur la securite transfusionnelle et des dossiers d'un important hopital de soins tertiaires. Nous sommes partis de l'hypothese que l'approvisionnement et la demande en produits sanguins par habitant et par groupe d'age etaient stables dans le temps. Resultats Nous avons estime que Revolution de la structure demographique entre 2016 (annee de reference) et 2036 entrainerait une diminution de l'approvisionnement en produits sanguins de 16,0% (de 43,2 millions d'unites de 200 mL a 36,3 millions d'unites) et une augmentation de la demande de 33,1% (de 43,2 millions d'unites a 57,5 millions d'unites). Nous estimons qu'en 2036, il manquera 21,2 millions d'unites. Une augmentation annuelle de l'approvisionnement de 0,9% a 1,8% est necessaire pour maintenir un equilibre entre l'approvisionnement et la demande en produits sanguins. Cette augmentation n'est pas suffisante pour toutes les regions, car les differences regionales vont s'accentuer. Par exemple, un rapport demande/approvisionnement en produits sanguins [greater than or equal to] 1,45 d'ici a 2036 est prevu dans les regions qui comptent un nombre eleve d'habitants ages de plus de 65 ans. Les analyses de sensibilite ont montre qu'une augmentation des dons de 4,0% chaque annee par des individus ages de 18 a 34 ans ou une diminution du taux global de rejet de produits sanguins de 5,0% a 2,0% ne permettrait pas de reduire a neant la penurie de produits sanguins, mais aiderait a la resorber. Conclusion Des strategies multidimensionnelles et des actions adaptees et concertees sont necessaires pour faire face aux pressions croissantes qui pesent sur les services de transfusion sanguine en raison du vieillissement de la population chinoise. Conclusion Se necesitan estrategias multidimensionales y acciones coordinadas y adaptadas para hacer frente a la creciente presion sobre los servicios de transfusion de sangre debido al envejecimiento de la poblacion de China. Objetivo Estimar el efecto a largo plazo de los cambios demograficos en China sobre la oferta y la demanda de sangre. Metodos Se desarrollo un modelo predictivo para estimar la oferta y la demanda de sangre durante el periodo en China continental y en 31 provincias. Los parametros del modelo se obtuvieron de World Population Prospects (Perspectivas mundiales de poblacion), China statistical yearbook 2016 (Anuario estadistico de China 2016), China's report on blood safety (Informe de China sobre seguridad de la sangre) y de registros de un gran hospital terciario. Los supuestos principales eran la estabilidad de la oferta y la demanda de sangre per capita especifica de la edad a lo largo del tiempo. Resultados Se estimo que el cambio en la estructura demografica entre 2016 (ano inicial) y 2036 resultaria en una disminucion del 16,0% en el suministro de sangre (de 43,2 millones de unidades de 200 ml a 36,3 millones de unidades) y un aumento del 33,1% en la demanda (de 43,2 millones de unidades a 57,5 millones de unidades). En 2036, habria una escasez estimada de 21,2 millones de unidades. Se requiere un aumento anual de la oferta de entre el 0,9% y el 1,8% para mantener un equilibrio entre la oferta y la demanda de sangre. Este aumento no es suficiente para todas las regiones, ya que las diferencias regionales aumentaran, por ejemplo, se pronostica una relacion entre la demanda y la oferta de sangre [mayor que o igual a] = 1,45 para el ano 2036 en regiones con grandes poblaciones mayores de 65 anos. Los analisis de sensibilidad mostraron que el aumento de las donaciones en un 4,0% anual por parte de las personas de 18 a 34 anos o la disminucion de la tasa general de descarte de sangre del 5,0% al 2,0% no compensaria sino que ayudaria a reducir la escasez de sangre., Introduction Maintaining a safe and adequate supply of blood for health services is an important responsibility of every World Health Organization Member State. (1,2) Demographic changes are a threat to [...]

Type I interferons (IFNs) are produced by almost all cell types and play a vital role in host defense against viral infection. Infection with an RNA virus activates receptors such as RIG-I, resulting in the recruitment of the adaptor protein MAVS to the RIG-I–like receptor (RLR) signalosome and the formation of prion-like functional aggregates of MAVS, which leads to IFN-β production. Here, we identified the aldehyde dehydrogenase 1B1 (ALDH1B1) as a previously uncharacterized IFN-stimulated gene (ISG) product with critical roles in the antiviral response. Knockout of ALDH1B1 increased, whereas overexpression of ALDH1B1 restricted, the replication of RNA viruses, such as vesicular stomatitis virus (VSV), Zika virus (ZIKV), dengue virus (DENV), and influenza A virus (IAV). We found that ALDH1B1 localized to mitochondria, where it interacted with the transmembrane domain of MAVS to promote MAVS aggregation. ALDH1B1 was recruited to MAVS aggregates. In addition, ALDH1B1 also enhanced the interaction between activated RIG-I and MAVS, thus increasing IFN-β production and the antiviral response. Furthermore, Aldh1b1−/− mice developed more severe symptoms than did wild-type mice upon IAV infection. Together, these data identify an aldehyde dehydrogenase in mitochondria that functionally regulates MAVS-mediated signaling and the antiviral response. Editor's summary: Detection of RNA-based viruses by the receptor RIG-I induces the aggregation of the mitochondrial protein MAVS, which in turn stimulates the production of proinflammatory cytokines critical for host defenses. Sun et al. found that this antiviral response was enhanced by ALDH1B1, a mitochondrially localized aldehyde dehydrogenase involved in ethanol metabolism. ALDH1B1, whose abundance was increased by infection with clinically relevant RNA viruses, limited viral replication. Interaction of ALDH1B1 with MAVS enhanced its aggregation and its association with RIG-I. ALDH1B1-deficient mice had higher viral titers in the lung, developed more severe lung damage, and were less likely to survive infection with influenza A. Thus, ALDH1B1 promotes antiviral signaling pathways initiated by RIG-I and MAVS. —Wei Wong [ABSTRACT FROM AUTHOR]

Little is known about the association between surface water quality and cancer incidence, especially in China. Drinking water quality has been linked to the incidence of several cancers in individual-level studies. However, few studies have attempted to examine multiple pollutants and multiple cancers at population level. This study used water monitoring and population-level cancer data from across China to examine spatial associations between water pollutants and types of cancer. We found a "dose–response" relationship between the number of pollutants present at high levels and cancer incidence. These results provide evidence of a nationwide spatial association between water quality and cancer in China. The precise relationship varies with cancers and pollutants. However, the overall consistency of the "dose–response" relationship suggests that surface water quality is an important factor in cancer incidence. Our findings highlight new issues such as the changing effects when different pollutants co-exist and an increasing number of new cancer cases partially attributable to poor water quality. Our work also points to some ways to deal with these challenges. [ABSTRACT FROM AUTHOR]

Carbon dots (CDs) have been studied for years as one of the most promising fluorescent nanomaterials. Herein, fluorescent CDs excited by visible light emitted red fluorescence with a quantum yield of 32.8% via a facile hydrothermal treatment. In addition to being applied in cell imaging, the as-prepared CDs were also utilized in the detection of ammonia and formaldehyde in aqueous solutions because of their pH-dependent properties, with a low limit of detection of 3.7 nM and 44 μM, respectively. Furthermore, we synthesized flexible and transparent fluorescence films by mixing the as-prepared CDs and PVB powder, which can be utilized to directly detect ammonia gas under visible light according to significant colour changes. Therefore, the as-prepared CDs would have more prominent and influential application in clinical diagnostics and environmental analysis. [ABSTRACT FROM AUTHOR]

Aim: To provide a historical and global picture of research concerning lung nodules, compare the contributions of major countries and explore research trends over the past 10 years. Methods: A bibliometric analysis of publications from Scopus (1970-2020) and Web of Science (2011-2020). Results: Publications about pulmonary nodules showed an enormous growth trend from 1970 to 2020. There is a high level of collaboration among the 20 most productive countries and regions, with the USA located at the center of the collaboration network. The keywords 'deep learning', 'artificial intelligence' and 'machine learning' are current hotspots. Conclusions: Abundant research has focused on pulmonary nodules. Deep learning is emerging as a promising tool for lung cancer diagnosis and management. [ABSTRACT FROM AUTHOR]

Main observation and conclusion: A novel and facile approach towards highly luminescent CuNCs@MMI (2‐mercapto‐1‐methylimidazole) has been developed within 30 s with the assistance of ionic liquids (ILs)—[Bmim]BF4. FT‐IR spectra, Zeta potential, TEM and SEM images showed that the as‐prepared CuNCs@MMI within [Bmim]BF4 could assemble into well‐ordered triangle supramolecular nanostructures via electrostatic interaction. In addition, pH‐responsion of CuNCs@MMI in photoluminescence intensity indicated the great potential for pH sensing applications. [ABSTRACT FROM AUTHOR]

Background and objectives: Haemovigilance involves surveillance of the whole chain of blood transfusion with the aim of identifying adverse events and errors and improving outcomes for patients. The Chinese Haemovigilance Network, founded in August 2017, has witnessed a rapid development in the last three years. Materials and methods: Based on the 1,022 cases in 2019, we analysed the adverse reactions (ARs) by blood component, clinical outcome severity and demography of recipients in an effort to publish the first annual Chinese haemovigilance report. Results: The AR rate associated with blood transfusion in 2019 was 0·2% in China. Allergic reactions and FNHTR were the two most common adverse symptoms, accounting for 97·7% of the reports. Two‐thirds of the TAD, AHTR and TACO and all of the HTR and DHTR resulted in hospitalization or prolongation of hospitalization. Plasma and AP were usually associated with allergic reaction (81·1%), whereas red cells more commonly cause FNHTR (68·8%) and all the AHTR, HTR, DSTR and DHTR. 84·1% of patients were aged 16 years or over, and the majority of the TAD, AHTR, TACO and HTR involved patients aged 60 and above. The ratio of serious adverse reactions (SARs) was 8·2%. Allergic reaction and FNHTR were top two (85·7%) SARs. The first case related to anti‐D immunoglobulin was detected in a DHTR report. Conclusion: This report provides the world's first overview of transfusion‐related adverse reactions in China. This report is useful for better understanding transfusion risks in China. [ABSTRACT FROM AUTHOR]

Highly ordered metal nanoclusters (NCs) have attracted much attention due to their controllability and regularity. Herein, self-assembled CuNCs with orange-red emission were prepared using m-aminothiophenol (m-AT) within 10 s. The hydrogen bonding interactions of CuNCs@m-AT were controlled precisely by adjusting the pH, and this induced the continuous self-assembly process of monodisperse, nano-spheres, nano-meshes and nano-sheets, and established the relationship between the macrostates and the microstructures of CuNCs@m-AT. For the first time, an organic anion was used to induce the emission of CuNCs@m-AT and to carry out the phase transfer of CuNCs@m-AT from the aqueous phase to the n-butanol phase. In addition, we found that m-AT was more beneficial for the synthesis of CuNCs, compared to o-AT and p-AT. This work provides an example of the structure-dependent CuNCs@m-AT on luminescent properties and showed the potential of –NH2 in the design of superstructures of nanoscale materials with unique functions and properties. [ABSTRACT FROM AUTHOR]

Background and Objectives: A health industry standard recommending restrictive transfusion is to be in effect in China in April 2019. We aim to explore its potential economic and clinical impacts among surgical patients. Materials and Methods: A decision tree model was applied to compare cost‐effectiveness of current routine transfusion in China, a restrictive (transfusion at Hb < 8 g/dl or ischaemic symptoms) and a liberal (transfusion at Hb < 10 g/dl) strategy. Parameters were estimated from empirical data of 25 227 surgical inpatients aged ≥30 years in a multicenter study and supplemented by meta‐analysis when necessary. Results are shown for cardio‐cerebral‐vascular (CCV) surgery and non‐CCV (orthopaedics, general, thoracic) surgery separately. Results: Per 10 000 patients in routine, restrictive, liberal transfusion scenarios, total spending (transfusion and length of stay related) was 7·67, 7·58 and 9·39 million CNY (1 CNY × 0.157 = 1 US dollar) for CCV surgery and 6·35, 6·70 and 8·09 million CNY for non‐CCV surgery; infectious and severe complications numbered 354, 290, and 290 (CCV) and 315, 286, and 330 (non‐CCV), respectively. Acceptability curves showed high probabilities for restrictive strategy to be cost‐effective across a wide range of willingness‐to‐pay values. Such findings were mostly consistent in sensitivity and subgroup analyses except for patients with cardiac problems. Conclusion: We showed strong rationale, succeeding previous findings only in cardiac or joint procedures, to comply with the new standard as restrictive transfusion has high potential to save blood, secure safety, and is cost‐effective for a wide spectrum of surgical patients. Experiences should be further summarized to pave the way towards individualized transfusion. [ABSTRACT FROM AUTHOR]

Aim: Uncontrolled hypertension is an independent risk factor for cardiovascular disease and is the leading cause of mortality in haemodialysis patients. The aim of this study was to examine the effectiveness of self‐management support (SMS) for blood pressure (BP) control and health behaviours. Methods: We conducted a cluster randomized controlled trial (RCT) in which 90 adult haemodialysis patients were assigned to either an SMS or common intervention (CI) group. The SMS group received an intervention consisting of self‐management education and motivational interviewing. The CI group received standard care and routine health education. The primary outcome was the BP monitored before each haemodialysis. Secondary outcomes included salt intake (measured using a balance formula), home BP monitoring (HBPM) (assessed using two self‐administered questions), and medication adherence (measured using the Medication‐taking Behavior Scale). Data were collected at baseline and at 1, 3 and 6 months post‐intervention. Results: The SMS group showed continuous reductions in systolic BP from baseline: –9.2, −8.7, and −8.4 mmHg at 1, 3 and 6 months after the intervention, respectively (P < 0.01). Compared with the CI group, the SMS group had a greater decrease in systolic BP at 1 month: –5.9 mmHg (P = 0.0388), but no significant difference was found at 3 or 6 months (P > 0.05). SMS patients showed an improvement in health behaviours relative to baseline (less salt intake, more consistent HBPM, and greater medication adherence) (P < 0.05). Conclusions: Self‐management support obtained short‐term success in improving salt restriction, regular performance of HBPM and medication adherence, which led to better BP control. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the trend of human fecundity over time in China. Methods: This retrospective study was conducted in Tongliao, China. Couples who were married during the time period between January 1, 1981 and December 31, 2003 were considered eligible for this study. A total of 27,413 individuals provided valid information via house-to-house interviews. The 12-month cumulative pregnancy rate (CPR) and annual percentage change were used as the outcome measurements. Results: There was a significant increase in the CPR over the five successive time groups. A break point in 1988 divided the entire study period into two distinct segments: 1981–1988, during which the CPR increased from 72.2% to 84.2%, and 1988–2003, during which the CPR increased from 84.2% to 87.2%. Conclusions: The findings were unlikely to be the result of biases, and could not be explained by increased medical treatment for infertility and changes in the prevalence of sexually transmitted diseases. Dramatic societal and behavioral changes due to the unique family planning policy and economic reform policies in China might have been the plausible reason for the results. [ABSTRACT FROM AUTHOR]

Objectives: To portray the stage characteristics of lung cancers detected in CT screenings, and explore whether there’s universal stage superiority over other methods for various pathological types using available data worldwide in a meta-analysis approach. Materials and Methods: EMBASE and MEDLINE were searched for studies on lung cancer CT screening in natural populations through July 2015 without language or other filters. Twenty-four studies (8 trials and 16 cohorts) involving 1875 CT-detected lung cancer patients were enrolled and assessed by QUADAS-2. Pathology-confirmed stage information was carefully extracted by two reviewers. Stage I or limited stage proportions were pooled by random effect model with Freeman-Tukey double arcsine transformation. Results: Pooled stage I cancer proportion in CT screenings was 73.2% (95% confidence interval: 68.6%, 77.5%), with a significant rising trend (Ptrend<0.05) from baseline (64.7%) to ≥5 repeat rounds (87.1%). Relative to chest radiograph and usual care, the increased stage I proportions in CT were 12.2% (P>0.05), and 46.5% (P<0.05), respectively. Pathology-specifically, adenocarcinomas (66%) and squamous cell lung cancers (17%) composed the majority of CT-detected lung cancers, and had significantly higher stage I proportions relative to chest radiograph (bronchioloalveolar adenocarcinomas, 80.9% vs 51.4%; other adenocarcinomas, 58.8% vs 38.3%; squamous cell lung cancers, 52.3% vs 38.3%; all P<0.05). However, the percentage of small cell lung cancer was lower using CT than other detection routes, and no significant difference in limited stage proportion was observed (6.8% vs 10.8%, P>0.05). Conclusion: CT screening can detect more early stage non-small cell lung cancers, but not all of them could be beneficial as there are a considerable number of indolent ones such as bronchioloalveolar adenocarcinomas. Still, current evidence is lacking regarding small cell lung cancers. [ABSTRACT FROM AUTHOR]

Background: A relationship of blood uric acid (UA) with hypertension and cardiovascular risk is under debate thus salt intake is hypothesized to contribute to such associations. Methods: In this cross-sectional study, stratified cluster random sampling elicited a sample of 1805 Kazakhs with 92.4% compliance. Hypertension and moderate-or-high total cardiovascular risk (mTCR) were defined according to guidelines. Sodium intake was assessed by urinary sodium excretion. Prevalence ratios (PRs) were used to express associations of UA with hypertension and mTCR. Results: In the highest tertile of sodium intake in women, the adjusted PRs (95% confidence intervals) of low to high quartiles compared with the lowest quartile of UA, were 1.22(0.78–1.91), 1.18(0.75–1.85), and 1.65(1.09–2.51) for hypertension and 1.19(0.74–1.90), 1.39(0.91–2.11), and 1.65(1.10–2.47) for mTCR (P for trend <0.05). However, these findings were not shown for other sodium intake levels. There were similar results in men. PRs markedly increased with a concomitant increase in UA and sodium intake and there was a significant interaction (P = 0.010) for mTCR with PRs of 1.69(1.10–2.60) for men and 3.70(2.09–6.52) for women in those with the highest compared with the lowest quartile of UA and tertile of sodium intake. Similar findings were shown for hypertension. Conclusions: This study implied that a high salt intake may enhance the associations of UA with hypertension and cardiovascular risk. [ABSTRACT FROM AUTHOR]

The authors used a cluster analysis approach to investigate which female sex workers (FSW) are preferential targets for female condom (FC) intervention programs in southern China. Cross-sectional 6-month ( N = 316) and 12-month ( N = 217) postintervention surveys of FSW were analyzed. Based on FC attitudes and beliefs, initially suggesting FC use to a partner, practicing insertion, total times ever used, and willingness to use in the future, cluster analysis apportioned women into two clusters, with 50.6% and 58.1% of participants in the likely future FC users group at 6 months and 12 months, respectively. Likely future FC users tended to be from boarding houses, older, currently or previously married, experienced with childbirth, with current multiple sex partners, longer history of sex work, and more unprotected sexual encounters. Focusing FC programs on sectors of the community with more FSW who are likely to use FC may be more costeffective for enhancing FC acceptability and usage. [ABSTRACT FROM AUTHOR]

Changes in sexual attitudes and behaviors and resurgence of the sex industry in China have increased concerns about HIV/AIDS and sexually transmitted infections (STI) epidemics. Little attention has been paid to the significant and growing sex industry in rural China. Promotion of barrier protection in this context is most effective to prevent STIs and pregnancy. The female condom (FC) is a barrier method that gives women more autonomy in its application, and has other advantages, but has been little promoted and tested in high risk contexts in China. The China/US Women's Health Project was designed to promote FC use in addition to male condoms (MC) through outreach intervention conducted in sex work establishments in rural and small urban towns in southern China, using the original prototype FC1. The study used quantitative and qualitative methods to document the pre-intervention context, intervention delivery process, and post-intervention outcomes of FC use. In this paper we compare post-intervention FC users and non-users in the first study sites, two rural towns in a single county in Hainan Province. Examination of cross-sectional six-month and 12-month surveys indicated that, despite relatively high MC use, about one-third of the women in sex work establishments in these rural towns had adopted FC at each post-intervention survey. Compared with non-users, FC users were more likely to be freelance women in boarding houses, more sexually experienced, married with children, more sexually active in the prior month, and more exposed to the intervention. The rural context hampered intervention implementation, particularly the significant limits in health and human resources available to manage prevention of HIV/STIs among women in the sex industry. These challenges highlight the need to better understand the context of the rural sex industry and capacity of local resources for better prevention efforts and the benefits that new prevention technologies like FC can offer. [ABSTRACT FROM AUTHOR]

Background/purpose: We assessed the effect of smoking on death from chronic obstructive pulmonary disease (COPD) in China by employing a large population-based, case-spouse control study design using data from a nationwide survey of mortality.Methods: During 1989-1991, a nationwide retrospective survey of mortality was conducted in China. For approximately 1,000,000 adults dying from all causes during 1986-1988, their surviving spouses or other informants provided detailed information about their own as well as the deceased person's smoking history. For this study, 183,393 individuals who died of COPD at age > or = 40 years were taken as cases, while 272,984 sex-matched surviving spouses of subjects who died from any cause were taken as controls.Results: COPD death rates for smokers were more than twice as high as those of non-smokers, with a dose-response risk pattern, despite the fact that COPD death rates varied widely by region and age. Tobacco accounted for 41.4% of COPD deaths in men, but only 13.5% of those in women, who had a lower rate of smoking.Conclusion: A case-spouse control study, as an alternative design, is valid and feasible in utilizing information from population-based, retrospective mortality survey data for an analytical epidemiological study of disease etiology. [ABSTRACT FROM AUTHOR]

Purpose: To examine age-related effects of smoking on lung cancer mortality in a large population-based case-control study that was incorporated into a nationwide retrospective survey of mortality in China. Methods: Two data sets were pooled for this analysis: national mortality survey data and data from a nationwide case-control comparison. These pooled data were used to calculate age-specific lung cancer death rates by smoking status and expected years of lost life expectancy for each smoking-associated death. Results: There was a significant excess of deaths (54% of urban deaths, 51% of rural deaths) at 35 to 69 years of age among male smokers and the average loss of life expectancy per smoking-associated death at these ages was 18.3 years. For women ages 35 to 69 years of age, 29% and 11% excess lung cancer mortality was observed in urban and rural smokers, respectively, with an average loss of life expectancy per smoking-associated death of 21.3 years. Conclusions: Tobacco smoking was associated with a large number of deaths from lung cancer. Utilizing information from a population-based retrospective mortality survey for conducting an analytic epidemiological study of main determinants of disease is feasible and can generate important results. [Copyright &y& Elsevier]

To date, SARS‐CoV‐2 has caused millions of deaths, but the choice of treatment is limited. We previously established a platform for identifying Food and Drug Administration (FDA)‐approved repurposed drugs for avian influenza A virus infections that could be used for coronavirus disease 2019 (COVID‐19) treatment. In this study, we analyzed blood samples from two cohorts of 63 COVID‐19 patients, including 19 patients with severe disease. Among the 39 FDA‐approved drugs we identified for COVID‐19 therapy in both cohorts, 23 drugs were confirmed by literature mining data, including 14 drugs already under COVID‐19 clinical trials and 9 drugs reported for COVID‐19 treatments, suggesting the remaining 16 FDA‐approved drugs may be candidates for COVID‐19 therapy. Additionally, we previously reported that herbal small RNAs (sRNAs) could be effective components in traditional Chinese medicine (TCM) for treating COVID‐19. Based on the abundance of sRNAs, we screened the 245 TCMs in the Bencao (herbal) sRNA Atlas that we had previously established, and we found that the top 12 TCMs for COVID‐19 treatment was consistent across both cohorts. We validated the efficiency of the top 30 sRNAs from each of the top 3 TCMs for COVID‐19 treatment in poly(I:C)‐stimulated human non‐small cell lung cancer cells (A549 cells). In conclusion, our study recommends potential COVID‐19 remedies using FDA‐approved repurposed drugs and herbal sRNAs from TCMs. [ABSTRACT FROM AUTHOR]

Surgery is still far from being completely safe and reliable. Surgical safety has, therefore, been the focus of considerable attention over the last few decades, and there are a growing number of national drives to improve it. There are also a number of large surgical complication reporting systems and system-based interventions, both of which have made remarkable progress in the past two decades. These systems, however, have either mainly focused on reporting complications and played a limited role in guiding practice or have provided nonselective interventions to all patients, perhaps imposing unnecessary burdens on frontline medical staff. We have, therefore, developed an evidence-based stratified surgical safety information system based on a multicenter surgical safety improvement program. This study discusses some critical issues in the process of developing this information system, including (1) decisions about data gathering, (2) establishing and sharing knowledge, (3) developing functions for the system, (4) system implementation, and (5) evaluation and continuous improvement. Using examples drawn from the surgical safety improvement program, we have shown how this type of system can be fitted into day-to-day clinical practice and how it can guide medical practice by incorporating inherent patient-related risk and providing tailored interventions for patients with different levels of risk. We concluded that multidisciplinary collaboration, involving experts in health care (including senior staff in surgery, nursing, and anesthesia), data science, health care management, and health information technology, can help build an evidence-based stratified surgical patient safety improvement system. This can provide an information-intensified surgical safety learning platform and, therefore, benefit surgical patients by delivering tailored interventions and an integrated workflow. [ABSTRACT FROM AUTHOR]