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Background: Brain cancer is one of the worst types of cancer worldwide. Understanding the epidemiology of CNS cancer is critical for properly allocating healthcare resources. Methods: We collected data on CNS cancer deaths in Wuhan, China, during 2010–2019. We constructed the cause-eliminated life tables to calculate life expectancy (LE), mortality, and years of life lost (YLLs) by age and sex. The BAPC model was used to forecast the future trends of age-standardized mortality rate (ASMR). Decomposition analysis was adopted to explore the contribution of population growth, population aging, and age-specific mortality to the change in total CNS cancer deaths. Results: In 2019, the ASMR of CNS cancer was 3.75, and the ASYR was 135.70 in Wuhan, China. ASMR was expected to decrease to 3.43 in 2024. The age distribution of deaths due to CNS cancer was concentrated in the middle-aged and older population, with a peak in the 65–69 age group. Caidian, Jianghan, and Qingshan had the greatest ASMRs in 2019 in Wuhan, with ASMRs of 6.32, 4.78, and 4.75, respectively. Population aging is critical to the change in total CNS cancer deaths. Conclusion: We analyzed the current status, temporal trends, and gender and age distributions of the burden of CNS cancer in Wuhan, during 2010–2019, providing a valuable reference for better lessening the CNS cancer burden.

Most studies of short-term exposure to ambient air pollution and cerebrovascular diseases focused on specific stroke-related outcomes, and results were inconsistent due to data unavailability and limited sample size. It is unclear yet how ambient air pollution contributes to the total cardiovascular mortality in central China. Daily deaths from cerebrovascular diseases were obtained from the Disease Surveillance Point System (DSPs) of Wuhan Center for Disease Control and Prevention during the period from 2013 to 2019. Air pollution data were obtained from Wuhan Ecology and Environment Institute from 10 national air quality monitoring stations, including average daily PM

The present work evaluated a mercury adsorption from its aqueous solution through chemically enhanced kapok fiber with the self-polymerization of the dopamine (DA) on the surface of the kapok fiber. The adsorption capacity of mercury ions was greatly improved with the DA coated kapok fiber (235.7 mg/g), compared with the raw kapok fiber (39.9 mg/g). The kinetic and isotherm studies were established, and the most fitting pseudo-first-order reaction and the Langmuir model indicated that the homogenous chemisorption occurred on the surface of the chemically modified kapok fiber with the equilibrium time of 80 min. According to the FTIR and XPS spectra analyses, the bidentate adsorption of mercury ions was illustrated with hydroxyl groups induced by three-dimensional (3-D) polymerization of DA. The optimum pH was at 8 for the adsorption with the dopamine-coated kapok fiber and the high adsorption efficiency was still maintained after three recycle times, extending its application to treating a number of industrial wastewater streams.

Epithelial-to-mesenchymal transition (EMT) in nasal epithelial cells is involved with tissue remodeling of nasal polyps. The present study investigated the molecular mechanisms through which miR‑155‑5p regulated EMT in chronic rhinosinusitis (CRS). Patients were divided into the following groups: CRSsNP, CRS without nasal polyposis group, CRSwNP, CRS with nasal polyposis and controls. The expression of transforming growth factor (TGF)‑β1, EMT markers, sirtuin 1 (SIRT1) and miR‑155‑5p were determined by western blotting and reverse transcription‑quantitative PCR. Cell morphology following TGF‑β1 treatment in the presence of miR‑155‑5p inhibitors or controls was observed under a microscope. Target genes and potential binding sites between miR‑155‑5p and SIRT1 were predicted by TargetScan and confirmed using dual‑luciferase reporter assay. In patients with CRS, the expression levels of E‑cadherin were downregulated and the expression levels of TGF‑β1, mesenchymal markers and miR‑155‑5p were upregulated. Additionally, these changes in expression levels were reduced or increased to a greater extent in the CRSwNP group compared with the CRSsNP group. Furthermore, TGF‑β1 expression promoted EMT in human nasal epithelial cells (HNEpCs) and upregulated miR‑155‑5p expression. These effects were reversed by miR‑155‑5p inhibitors. Additionally, SIRT1 was predicted as a target gene of miR‑155‑5p. Downregulation of miR‑155‑5p upregulated epithelial marker expression and downregulated mesenchymal marker expression by regulating SIRT1. Therefore, the downregulation of miR‑155‑5p inhibited EMT in HNEpCs by targeting SIRT1.

Acute health effects of air pollution on diabetes risk have not been fully studied in developing countries and the results remain inconsistent. This study aimed to investigate the association between short-term exposure to ambient air pollution and Type 2 diabetes mellitus (T2DM) mortality in China. Data on T2DM mortality from 2013 to 2019 were obtained from the Cause of Death Reporting System (CDRS) of Wuhan Center for Disease Control and Prevention. Air pollution data for the same period were collected from 10 national air quality monitoring stations of Wuhan Ecology and Environment Institute, including daily average PM2.5, PM10, SO2, and NO2. Meteorological data including daily average temperature and relative humidity were collected from Wuhan Meteorological Bureau. Generalized additive models (GAM) based on quasi-Poisson distribution were applied to evaluate the association between short-term exposure to air pollution and daily T2DM deaths. A total of 9837 T2DM deaths were recorded during the study period in Wuhan. We found that short-term exposure to PM2.5, PM10, SO2, and NO2 were positively associated with T2DM mortality, and gaseous pollutants appeared to have greater effects than particulate matter (PM). For the largest effect, per 10 μg/m3 increment in PM2.5 (lag 02), PM10 (lag 02), SO2 (lag 03), and NO2 (lag 02) were significantly associated with 1.099% (95% CI: 0.451, 1.747), 1.016% (95% CI: 0.517, 1.514), 3.835% (95% CI: 1.480, 6.189), and 1.587% (95% CI: 0.646, 2.528) increase of daily T2DM deaths, respectively. Stratified analysis showed that females or elderly population aged 65 and above were more susceptible to air pollution exposure. In conclusion, short-term exposure to air pollution was significantly associated with a higher risk of T2DM mortality. Further research is required to verify our findings and elucidate the underlying mechanisms.

Calcium alginate (CA) beads as a green sorbent were easily fabricated in this study using sodium alginate crosslinking with CaCl2, and the crosslinking pathway was the exchange between the sodium ion of &alpha, L-guluronic acid and Ca(II). The experimental study was conducted on Cu(II), Cd(II), Ni(II) and Zn(II) as the model heavy metals and the concentration was determined by inductively coupled plasma optical emission spectrometry (ICP-OES). The characterization and sorption behavior of the CA beads were analyzed in detail via using scanning electron microscopy (SEM), fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS). The adsorption experiments demonstrated that the CA beads exhibited a high removal efficiency for the selective adsorption of Cu(II) from the tetra metallic mixture solution and an excellent adsorption capacity of the heavy metals separately. According to the isotherm studies, the maximum uptake of Cu(II) could reach 107.53 mg/g, which was significantly higher than the other three heavy metal ions in the tetra metallic mixture solution. Additionally, after five cycles of adsorption and desorption, the uptake rate of Cu(II) on CA beads was maintained at 92%. According to the properties mentioned above, this material was assumed to be applied to reduce heavy metal pollution or recover valuable metals from waste water.

Yao Cheng,1 Yaqiong Yan,2 Jie Gong,2,* Niannian Yang,2,* Shaofa Nie1,* 1Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; 2Department of Chronic Disease Prevention and Control, Wuhan Centers for Disease Prevention and Control, Wuhan, China *These authors contributed equally to this work Purpose: Following the implementation of breast cancer (BC) control strategies for years in Central China, the outcome needs to be evaluated and further strategies based on long-term surveillance should be formulated. Therefore, we examined the trends of BC incidence and mortality during 1990–2014 and projected them to 2024 in Wuhan, Central China.Patients and methods: The incidence and mortality data of BC were extracted from the Wuhan Cancer Registry. The average annual percentage changes (AAPCs) of the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were analyzed using Joinpoint regression. The Nordpred R-package was used to project BC incidence and mortality between 2015 and 2024. The age–period–cohort analysis was applied to evaluate the age, period, and cohort effects on the trends of BC incidence and mortality.Results: Overall, the ASIR increased markedly from 20.01 to 44.26 per 100,000 (AAPC=3.3%, 95% CI: 1.7%, 5.0%) during 1990–2014, and it was projected to keep increasing in the next decade (AAPC=3.0%, 95% CI: 2.0%, 4.1%). The ASMR of BC leveled off during the study period (AAPC=0.4%, 95% CI: −0.2%, 0.9%). The BC mortality of the older group (aged 50–79 years) showed significant upward trends in both observed and projected periods. Strong age, period, and cohort effects were observed in BC incidence, and BC mortality was significantly driven by age and cohort effects.Conclusion: The ASIR in Wuhan was approaching those areas with the highest BC risk in China, and the evident increase in BC incidence suggested that prior strategies for BC control should be adopted. In particular, further strategies for reducing BC mortality in older age groups should be reinforced in Wuhan, Central China. Keywords: breast cancer, incidence, mortality, trend, rate projection

Objective The aim of this study was to investigate the associations between each functional fitness (FF) domain and cognitive impairment (CI) in Chinese community-dwelling older adults. Design A community-based, cross-sectional study was conducted. Setting Participants were selected by multistage stratified random sampling in Wuhan City, Hubei Province, Central China, during December 2015–May 2016. Participants A total of 2096 (1031 male and 1065 female) adults older than 65 years were included in our study. Exclusion criteria were age

We developed and psychometrically evaluated the Concise Scale of Individualism–Collectivism (CSIC) to support the growing need for cross-cultural research to better understand the relationship between culture and health. To construct the scale, we used the concept mapping technique. The CSIC contains 18 paired items, 9 of which are used to assess respondents' level of individualism and 9 to assess collectivism, rated using a 5-point Likert scale. We evaluated the instrument using a diverse sample (N = 249, Mage = 29.64, SD = 7.81) consisting of rural-to-urban migrants and nonmigrant rural and urban residents in the city of Wuhan, China. Cronbach's alpha coefficients were .91, .83, and .86 for the total CSIC scale, and for the collectivism and individualism subscales, respectively. A 2-factor model fit the data well, showing that both individualism and collectivism scores significantly differed according to level of education and area of residence, and significantly predicted levels of social capital, social support, resilience, and stress of respondents. We determined that the CSIC has adequate reliability and validity for use in research to quantify cultural beliefs about individualism and collectivism among Chinese adults.

Reducing tobacco use among adolescents in China represents a significant challenge for global tobacco control. Existing behavioral theories developed in the West – such as the Protection Motivation Theory (PMT) – may be useful tools to help tackle this challenge. We examined the relationships between PMT factors and self-reported cigarette smoking behavior and intention among a random sample of vocational high school students (N = 553) in Wuhan, China. Tobacco-related perceptions were assessed using the PMT Scale for Adolescent Smoking. Among the total sample, 45% had initiated cigarette smoking, and 25% smoked in the past month. Among those who never smoked, 15% indicated being likely or very likely to smoke in a year. Multiple regression modeling analysis indicated the significance of the seven PMT constructs, the four PMT perceptions and the two PMT pathways in predicting intention to smoke and actual smoking behavior. Overall, perceived rewards of smoking, especially intrinsic rewards, were consistently positively related to smoking intentions and behavior, and self-efficacy to avoid smoking was negatively related to smoking. The current study suggests the utility of PMT for further research examining adolescent smoking. PMT-based smoking prevention and clinical smoking cessation intervention programs should focus more on adolescents’ perceived rewards from smoking and perceived efficacy of not smoking to reduce their intention to and actual use of tobacco.

PurposeThe paper seeks to report data on cigarette smoking, anti‐smoking practices, physicians' receipt of anti‐smoking training, and the association between receipt of the training and anti‐smoking practice among physicians in Wuhan, China.Design/methodology/approachParticipants were selected through the stratified random sampling method. The questionnaires were completed by the sampled physicians and the response rate of the survey was 98.1 percent.FindingsAmong the total sample, 11 percent were current smokers. Significantly more male physicians than female physicians were current smokers (31.6 vs 0.9 percent, pppPractical implicationsMore effort should be devoted to training for physicians with focus on anti‐smoking practice and smoking cessation counseling in addition to assist physicians themselves to quit smoking.Originality/valueThe findings of this study update the data regarding cigarette smoking among physicians in Wuhan, China, and their practice of anti‐tobacco counseling. It indicates that it is very important to provide the training regarding anti‐smoking counseling among physicians.

PurposeThis study aims to examine whether, in the opinion of patients selected in 13 hospitals of Hubei province, China, hospitals are smoke free. Patients were also asked whether their physicians had inquired about their smoking status.Design/methodology/approachPatients were recruited through an intercept method (i.e. stopped by the interviewer while in the hospital); data were collected through interviews, with a response rate of 96.1 percent.FindingsAmong the intercepted patients, 48.3 percent reported having seen people smoking in hospitals; 22.3 percent had seen a doctor and/or nurse smoking; 23.8 percent had smelled tobacco in hospitals; 68.4 percent reported having seen “no‐smoking” signs in hospital settings; 42.6 percent reported having been asked about smoking status in their latest visit to a doctor and 23.8 percent reported receiving tobacco cessation counseling. Compared to hospitals in large cities, patients from medium/small city hospitals reported significantly higher levels of cigarette smoking among physicians, and poorer implementation of regulations for a smoking‐free hospital, and less smoking cessation counseling by physicians.Originality/valueFindings of this study point to the need for greater efforts to be made in promoting a smoke free environment in hospitals, as well as encouraging physicians to provide more smoking cessation counseling to smoking patients, particularly physicians in small and medium hospitals.

Background : Declines in incidence rates of nasopharyngeal carcinoma (NPC) were observed in Hong Kong and Taiwan but not other high-risk regions in China, while evidences from low-risk regions in China are still lacking. This study aimed to examine the time trends (1993–2007) of NPC in Wuhan (a low-risk region) and assess the birth cohort and calendar period effects on the observed temporal trends. Method : Using data from Wuhan Cancer Registry, age-standardized annual incidence rates of NPC were calculated by the direct method using the WHO World Standard Population (2000) as the reference. Trend in incidence rates of NPC during 1993–2007 was evaluated. Age–period–cohort models were also applied to assess the effects of age, calendar time and birth cohort on the observed temporal trends. Results : A total of 1685 new NPC cases (1210 males and 475 females) were diagnosed during 1993–2007 in Wuhan. The annual percentage change in incidence rates of NPC were 0.15% (95% confidence interval: −3.88% to 4.34%) for males and −1.17% (95% confidence interval: −4.85% to 2.66%) for females. No obvious cohort or period effect on the incidence rates of NPC was observed. Conclusion : The incidence rates of NPC remained stable during 1993–2007 in Wuhan, a low-risk region in China.

Fewer studies have been published on the association between daily mortality and ambient air pollution in Asia than in the United States and Europe. This study was undertaken in Wuhan, China, to investigate the acute effects of air pollution on mortality with an emphasis on particulate matter (PM*). There were three primary aims: (1) to examine the associations of daily mortality due to all natural causes and daily cause-specific mortality (cardiovascular [CVD], stroke, cardiac [CARD], respiratory [RD], cardiopulmonary [CP], and non-cardiopulmonary [non-CP] causes) with daily mean concentrations (microg/m3) of PM with an aerodynamic diameter--10 pm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), or ozone (O3); (2) to investigate the effect modification of extremely high temperature on the association between air pollution and daily mortality due to all natural causes and daily cause-specific mortality; and (3) to assess the uncertainty of effect estimates caused by the change in International Classification of Disease (ICD) coding of mortality data from Revision 9 (ICD-9) to Revision 10 (ICD-10) code. Wuhan is called an "oven city" in China because of its extremely hot summers (the average daily temperature in July is 37.2 degrees C and maximum daily temperature often exceeds 40 degrees C). Approximately 4.5 million residents live in the core city area of 201 km2, where air pollution levels are higher and ranges are wider than the levels in most cities studied in the published literature. We obtained daily mean levels of PM10, SO2, and NO2 concentrations from five fixed-site air monitoring stations operated by the Wuhan Environmental Monitoring Center (WEMC). O3 data were obtained from two stations, and 8-hour averages, from 10:00 to 18:00, were used. Daily mortality data were obtained from the Wuhan Centres for Disease Prevention and Control (WCDC) during the study period of July 1, 2000, to June 30, 2004. To achieve the first aim, we used a regression of the logarithm of daily counts of mortality due to all natural causes and cause-specific mortality on the daily mean concentrations of the four pollutants while controlling for weather, temporal factors, and other important covariates with generalized additive models (GAMs). We derived pollutant effect estimations for 0-day, 1-day, 2-day, 3-day, and 4-day lagged exposure levels, and the averages of 0-day and 1-day lags (lag 0-1 day) and of 0-day, 1-day, 2-day, and 3-day lags (lag 0-3 days) before the event of death. In addition, we used individual-level data (e.g., age and sex) to classify subgroups in stratified analyses. Furthermore, we explored the nonlinear shapes ("thresholds") of the exposure-response relations. To achieve the second aim, we tested the hypothesis that extremely high temperature modifies the associations between air pollution and daily mortality. We developed three corresponding weather indicators: "extremely hot," "extremely cold," and "normal temperatures." The estimates were obtained from the models for the main effects and for the pollutant-temperature interaction for each pollutant and each cause of mortality. To achieve the third aim, we conducted an additional analysis. We examined the concordance rates and kappa statistics between the ICD-9-coded mortality data and the ICD-10-coded mortality data for the year 2002. We also compared the magnitudes of the estimated effects resulting from the use of the two types of ICD-coded mortality data. In general, the largest pollutant effects were observed at lag 0-1 day. Therefore, for this report, we focused on the results obtained from the lag 0-1 models. We observed consistent associations between PM10 and mortality: every 10-microg/m3 increase in PM10 daily concentration at lag 0-1 day produced a statistically significant association with an increase in mortality due to all natural causes (0.43%; 95% confidence interval [CI], 0.24 to 0.62), CVD (0.57%; 95% CI, 0.31 to 0.84), stroke (0.57%; 95% CI, 0.25 to 0.88), CARD (0.49%; 95% CI, 0.04 to 0.94), RD (0.87%; 95% CI, 0.34 to 1.41), CP (0.52%; 95% CI, 0.27 to 0.77), and non-CP (0.30%; 95% CI, 0.05 to 0.54). In general, these effects were stronger in females than in males and were also stronger among the elderly (or = 65 years) than among the young. The results of sensitivity testing over the range of exposures from 24.8 to 477.8 microg/m3 also suggest the appropriateness of assuming a linear relation between daily mortality and PM10. Among the gaseous pollutants, we also observed statistically significant associations of mortality with NO, and SO2, and that the estimated effects of these two pollutants were stronger than the PM10 effects. The patterns of NO2 and SO2 associations were similar to those of PM10 in terms of sex, age, and linearity. O3 was not associated with mortality. In the analysis of the effect modification of extremely high temperature on the association between air pollution and daily mortality, only the interaction of PM10 with temperature was statistically significant. Specifically, the interaction terms were statistically significant for mortality due to all natural (P = 0.014), CVD (P = 0.007), and CP (P = 0.014) causes. Across the three temperature groups, the strongest PM10 effects occurred mainly on days with extremely high temperatures for mortality due to all natural (2.20%; 95% CI, 0.74 to 3.68), CVD (3.28%; 95% CI, 1.24 to 5.37), and CP (3.02%; 95% CI, 1.03 to 5.04) causes. The weakest effects occurred at normal temperature days, with the effects on days with low temperatures in the middle. To assess the uncertainty of the effect estimates caused by the change from ICD-9-coded mortality data to ICD-10-coded mortality data, we compared the two sets of data and found high concordance rates (99.3%) and kappa statistics close to 1.0 (0.98). All effect estimates showed very little change. All statistically significant levels of the estimated effects remained unchanged. In conclusion, the findings for the aims from the current study are consistent with those in most previous studies of air pollution and mortality. The small differences between mortality effects for deaths coded using ICD-9 and ICD-10 show that the change in coding had a minimal impact on our study. Few published papers have reported synergistic effects of extremely high temperatures and air pollution on mortality, and further studies are needed. Establishing causal links between heat, PM10, and mortality will require further toxicologic and cohort studies.

In Asia, limited studies have been published on the association between daily mortality and gaseous pollutants of nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide (SO2). Our previous studies in Wuhan, China, demonstrated long-term air pollution effects. However, no study has been conducted to determine mortality effects of air pollution in this region. This study was to determine the acute mortality effects of the gaseous pollutants in Wuhan, a city with 7.5 million permanent residents during the period from 2000 to 2004. There are approximately 4.5 million residents in Wuhan who live in the city's core area of 201 km2, where air pollution levels are highest, and pollution ranges are wider than the majority of the cities in the published literature. We used the generalized additive model to analyze pollution, mortality, and covariate data. We found consistent NO2 effects on mortality with the strongest effects on the same day. Every 10-microg/m3 increase in NO2 daily concentration on the same day was associated with an increase in nonaccidental (1.43%; 95% confidence interval [CI]: 0.87-1.99%), cardiovascular (1.65%; 95% CI: 0.87-2.45%), stroke (1.49%; 95% CI: 0.56-2.43%), cardiac (1.77%; 95% CI: 0.44-3.12%), respiratory (2.23%; 95% CI: 0.52-3.96%), and cardiopulmonary mortality (1.60%; 95% CI: 0.85-2.35%). These effects were stronger among the elderly than among the young. Formal examination of exposure-response curves suggests no-threshold linear relationships between daily mortality and NO2, where the NO2 concentrations ranged from 19.2 to 127.4 microg/m3. SO2 and O3 were not associated with daily mortality. The exposure-response relationships demonstrated heterogeneity, with some curves showing nonlinear relationships for SO2 and O3. We conclude that there is consistent evidence of acute effects of NO2 on mortality and suggest that a no-threshold linear relationship exists between NO2 and mortality.