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This study is the first report on atmospheric microplastics (MPs) observed in five outdoor environments, including an urban forest, a business center, commercial areas, and a public transportation hub in Seoul, South Korea. Air samples were collected using an active air pump sampler for 24 h in each area only on days without rainfall. All observed microplastics are secondary microplastics, in the form of irregularly-shaped fragments or fibers produced through various degradation processes, rather than being primarily produced like microbeads. The abundance of atmospheric MPs varied depending on the environment (i.e., region, height, and time) from 0.33 to 1.21 MP m-3, with the average number of MPs being 0.72 MP m-3 (standard deviation ± 0.39). MPs in the urban forest was observed to be 27% lower in abundance than that in the urban center which is ∼3 km away. The central business district was observed to have a 25% higher abundance during weekdays than on weekends. Our results show the ubiquity of MPs in various areas from high-rise buildings to forests tens of kilometers away from their direct sources, and a positive correlation between the abundance of MP and human activity. Morphologically, the fragment type (87.4%) predominated over the fiber type (12.6%), and chemically, polypropylene (PP) and polyethylene terephthalate (PET) components accounted for 65% of the total MP. PP polymers were found in all observation sites and contributed to 59% of the total MP fragments. The observed fibrous MPs were mainly composed of PET (72.7%) and PP (18.2%) polymers. Compared to other large cities (Shanghai, Beijing, Paris), Seoul is exposed to low levels of atmospheric MPs and high proportions of PP polymers. This study is limited to atmospheric MPs observed in summer and further investigation of MPs is needed to comprehensively understand the distribution and cycle of MPs based on long-term monitoring of atmospheric MPs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Whether there is an association between serum uric acid (SUA) level and risk of mortality in the general population remains unclear. Based on the China National Survey of Chronic Kidney Disease linked to mortality data, a population-based cohort study was performed to investigate the association between SUA level and all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality in China., Methods: The survival status of participants in the cross-sectional survey was identified from January 1, 2006 to December 31, 2017. Only 33,268 individuals with complete SUA data among the 47,204 participants were included in the analysis. We determined the rates of all-cause mortality, CVD mortality, and cancer mortality. We used Cox proportional hazards regression models to evaluate the effect of the SUA level on mortality., Results: During a total of 297,538.4 person-years of follow-up, 1282 deaths occurred. In the Cox proportional hazards regression model, the rate of all-cause mortality, CVD mortality, and cancer mortality had a U-shaped association with SUA levels only in men, whereas no significant associations were detected in women. For all-cause mortality in men, the multivariable-adjusted hazard ratios (HRs) in the first, second, and fourth quartiles compared with the third quartile were 1.31 (95% confidence interval [CI] 1.04-1.67), 1.17 (95% CI 0.92-1.47), and 1.55 (95% CI 1.24-1.93), respectively. For CVD mortality, the corresponding HRs were 1.47 (95% CI 1.00-2.18), 1.17 (95% CI 0.79-1.75), and 1.67 (95% CI 1.16-2.43), respectively. For the cancer mortality rate, only a marginally significant association was detected in the fourth quartile compared with the third quartile with an HR of 1.43 (95% CI 0.99-2.08)., Conclusions: The association between SUA and mortality differed by sex. We demonstrated a U-shaped association with SUA levels for all-cause and CVD mortalities among men in China., (Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Objective: Antineutrophil cytoplasmic antibody (ANCA) directed to proteinase 3 (PR3) used to be considered the serologic marker for granulomatosis with polyangiitis (GPA). However, patients with myeloperoxidase (MPO)-ANCA positive GPA have been increasingly reported. The aim of this study was to analyze the clinical and pathological characteristics and outcome of Chinese patients with MPO-ANCA positive GPA., Methods: The clinical and renal histology data, renal outcomes, response to treatment, relapse and mortality were compared between patients with MPO-ANCA positive GPA and MPO-ANCA positive microscopic polyangiitis (MPA) as well as proteinase 3 (PR3)-ANCA positive GPA., Results: 455 patients with ANCA-associated vasculitis (AAV) were recruited in this study. 276/455 patients were classified as MPO-ANCA positive MPA, 4/455 patients were classified as PR3-ANCA positive MPA, 124/455 were MPO-ANCA positive GPA and 51/455 were PR3-ANCA positive GPA. Compared with MPO-ANCA positive MPA patients, MPO-ANCA positive GPA patients had significantly higher level of BVAS and milder renal lesion at diagnosis. The probability of developing ESRD was significantly higher in patients with MPO-ANCA positive MPA than MPO-ANCA positive GPA. MPO-ANCA positive GPA patients were likely to have relapse than MPO-ANCA positive MPA patients. Compared with PR3-ANCA positive GPA patients, MPO-ANCA positive GPA patients had significantly higher proportion of female, less constitutional symptoms and milder renal lesion at diagnosis., Conclusions: Patients with MPO-ANCA positive GPA should be regarded as a unique subset of AAV. This subset of AAV patients had relatively milder renal injury. Although ANCA specificities play an important role in differentiating AAV, taking the disease type together to classify AAV may be more rational., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: Patients with antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) have high mortality despite the introduction of immunosuppressive therapy. We investigated factors associated with mortality of patients with AAV in a single Chinese cohort., Methods: A total of 398 consecutive patients with AAV diagnosed in our center were recruited. Clinical and laboratory data were collected retrospectively. The predictive values of variables associated with mortality were analyzed., Results: During followup of a median duration 25.5 months (range 1-196 mo), 135 out of 398 patients (33.9%) died, with 83 deaths within the first 12 months after diagnosis. Independent predictors of all-cause mortality were age (p < 0.001), secondary infection (p < 0.001), pulmonary involvement of AAV (p = 0.012), and initial renal function (p = 0.001). Secondary infection was the leading cause of death (53/153, 39.3%) during the first year after diagnosis, while cardiovascular event was the leading cause of death (15/53, 28.8%) after 12 months from diagnosis. Independent predictors of secondary infection were age (p = 0.002), initial renal function (p = 0.041), lymphocyte counts in the peripheral blood (p = 0.03), and underlying pulmonary involvement of AAV (p = 0.001)., Conclusion: Secondary infection is the overall leading cause and independent predictor of death in patients diagnosed with AAV. Cardiovascular event is a major cause of death during the late followup. Prudent monitoring should be given to patients of advancing age with renal dysfunction to reduce adverse events, especially infectious complications.

Background and Objectives: The HLA system plays a central role in the distinction between self antigens and non-self antigens. This study aimed to investigate the association between HLA genes and the outcomes of patients with ANCA-associated vasculitis (AAV)., Design, Setting, Participants, & Measurements: This study recruited 152 consecutive Chinese patients with AAV. The predictive value of the HLA alleles for renal outcome, response to treatment, and all-cause mortality were analyzed., Results: The proportion of patients with treatment failure was significantly higher in DRB1*0405-positive patients than in DRB1*0405-negative patients (41.7% versus 12.9%; P=0.008; corrected P=0.02). After adjusting for the other potential predictors, DRB1*0405 was still an independent predictor for the poor response to treatment (hazard ratio [HR], 5.91; 95% confidence interval [95% CI], 1.23-28.52; P=0.03). Renal survival was significantly worse in patients with DRB1*0405 than those without DRB1*0405 (P<0.001; corrected P<0.001). After adjusting for the other potential predictors, DRB1*0405 was still an independent predictor for ESRD (HR, 5.50; 95% CI, 2.18-13.88; P<0.001). The probability of all-cause mortality in patients with DPB1*0402 was significantly higher than those without DPB1*0402 (P=0.02; corrected P=0.04). After adjusting for the other potential predictors, DPB1*0402 was still an independent predictor for all-cause mortality (HR, 2.52; 95% CI, 1.21-5.28; P=0.01)., Conclusions: In AAV patients, DRB1*0405 might be an independent risk factor for the poor response to treatment and the deterioration of renal function, whereas DPB1*0402 might be an independent risk factor for all-cause mortality.