Comparison of Secular Trends in Road Injury Mortality in China and the United States: An Age-Period-Cohort Analysis

This study aimed to identify and compare the mortality trends for road injuries in China and the United States, and evaluate the contributions of age, period, and cohort effects to the trends from 1990 to 2014. Using the 2016 Global Burden of Disease Study database, the mortality trends were analyzed by joinpoint regression and age-period-cohort modeling. Overall, the mortality for road injuries was higher in China than in the United States. The mortality in China increased from 1992 to 2002 (annual percent change [APC] was 1.9%), and then decreased from 2002 to 2015 (APC2002⁻2009 was 1.5%; APC2009⁻2015 was 3.5%). For the United States, the mortality decreased from 1990 to 2010 (APC1990⁻1997 was 1.8%; APC1997⁻2005 was 0.7%; APC2005⁻2010 was 4.2%). Age-period-cohort modeling revealed significant period and cohort effects. Compared with the period 2002⁻2004, the period risk ratios (RRs) in 2010⁻2014 period declined by 14.62% for China and 18.86% for the United States. Compared with the 1955⁻1959 birth cohort, the cohort RRs for China and the United States in the 2010⁻2014 cohort reduced by 47.60% and 75.94%, respectively. Period and cohort effects could not be ignored for reducing road injury mortalities

Stroke Mortality Attributable to Ambient Particulate Matter Pollution from 1990 to 2015 in China: An Age-Period-Cohort and Spatial Autocorrelation Analysis

In this study, we analyzed the temporal and spatial variations of stroke mortality attributable to ambient particulate matter pollution (stroke mortality-PM2.5) in China from 1990 to 2015. Data were collected from the Global Burden of Disease (GBD) 2015 study and analyzed by an age-period-cohort model (APC) with an intrinsic estimator (IE) algorithm, as well as spatial autocorrelation based on the Geographic Information System. Based on APC analysis with the IE method, stroke mortality-PM2.5 increased exponentially with age, its relative risk reaching 42.85 (95% CI: 28.79, 63.43) in the 75–79 age group. The period effects showed a reversed V-shape and its highest relative risk was 1.22 (95% CI: 1.15, 1.27) in 2005. The cohort effects decreased monotonically from 1915–1919 to 1990–1994. The change rate fluctuated from 1920–1924 to 1990–1994, including three accelerating and three decelerating decreases. There was a positive spatial autocorrelation in stroke mortality-PM2.5 from 1990 to 2015. Hot-spots moved from the northeastern areas to the middle and southwestern areas, whereas cold-spots lay mostly in coastal provinces. Besides the aging process in recent years, stroke mortality-PM2.5 had significantly declined from 2005 to 2015 due to socio-economic and healthcare development. Stroke mortality-PM2.5 varied substantially among different regions, and cost-effective prevention and control should be implemented more in the middle and southwestern areas of China

Burden of Ischaemic heart disease and attributable risk factors in China from 1990 to 2015: findings from the global burden of disease 2015 study

Abstract Background Ischaemic heart disease (IHD) is a major barrier to sustainable human development, but its health burden and geographic distribution among provinces of China remain unclear. This study aimed to estimate IHD burden in provinces of China, and attributable to risk factors from 1990 to 2015. Methods Data were collected from the Global Burden of Disease 2015 Study, which evaluated IHD burden and attributable risk factors using deaths and disability-adjusted life years (DALYs). Statistical models including cause of death ensemble modelling, Bayesian meta-regression analysis, and comparative risk assessment approaches were applied to reduce bias and produce comprehensive results of IHD deaths, DALYs and attributable risks. The 95% uncertainty intervals (UIs) were calculated and reported for mortality and DALYs. Results The age-standardised death rate per 100,000 people increased by 13.3% from 101.3 (95%UI: 95.3–107.5) to 114.8 (95%UI: 109.8–120.1) from 1990 to 2015 in China, whereas the age-standardised DALY rate declined 3.9% to 1760.2 per 100,000 people (95%UI: 1671.6–1864.3). In 2015, the age-standardised death rate per 100,000 people was the highest in Heilongjiang (187.4, 95%UI: 161.6–217.5) and the lowest in Shanghai (44.2, 95%UI: 37.0–53.1), and the age-standardised DALY rate per 100,000 people was the highest in Xinjiang (3040.8, 95%UI: 2488.8–3735.4) and the lowest in Shanghai (524.4, 95%UI: 434.7–638.4). Geographically, the age-standardised death and DALY rates for southern provinces were lower than northern provinces, especially in southeastern coastal provinces. 95.3% of the IHD burden in China was attributable to environmental, behavioural and metabolic risk factors. The five leading IHD risks in 2015 were high systolic blood pressure, high total cholesterol, diet high in sodium, diet low in whole grains, and smoking. Conclusions Population growth and ageing has led to a steady increase in the IHD burden. Regional disparities in IHD burden were observed in provinces of China. The distribution characteristics of IHD burden provide guidance for decision makers to formulate targeted preventive policies and interventions

Diagnostic Performance of Fas Ligand mRNA Expression for Acute Rejection after Kidney Transplantation: A Systematic Review and Meta-Analysis

<div><p>Background</p><p>The value of Fas ligand (FASL) as a diagnostic immune marker for acute renal rejection is controversial; this meta-analysis aimed to clarify the role of FASL in acute renal rejection.</p><p>Methods</p><p>The relevant literature was included by systematic searching the MEDLINE, EMBASE, and Cochrane Library databases. Accuracy data for acute rejection (AR) and potential confounding variables (the year of publication, area, sample source, quantitative techniques, housekeeping genes, fluorescence staining, sample collection time post-renal transplantation, and clinical classification of AR) were extracted after carefully reviewing the studies. Data were analyzed by Meta-DiSc 1.4, RevMan 5.0, and the Midas module in Stata 11.0 software.</p><p>Results</p><p>Twelve relevant studies involving 496 subjects were included. The overall pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio, together with the 95% CI were 0.64 (0.57–0.70), 0.90 (0.85–0.93), 5.66 (3.51–9.11), 0.30 (0.16–0.54), and 30.63 (14.67–63.92), respectively. The area under the summary receiver operating characteristic curve (AUC) was 0.9389. Fagan’s nomogram showed that the probability of AR episodes in the kidney transplant recipient increased from 15% to 69% when FASL was positive, and was reduced to 4% when FASL was negative. No threshold effect, sensitivity analyses, meta-regression, and subgroup analyses based on the potential variables had a significant statistical change for heterogeneity.</p><p>Conclusions</p><p>Current evidence suggests the diagnostic potential for FASL mRNA detection as a reliable immune marker for AR in renal allograft recipients. Further large, multicenter, prospective studies are needed to validate the power of this test marker in the non-invasive diagnosis of AR after renal transplantation.</p></div

Basic information extracted from the eligible studies.

<p>Basic information extracted from the eligible studies.</p

Deeks’ funnel plot for the assessment of potential bias in FasL analysis.

<p>Deeks’ funnel plot for the assessment of potential bias in FasL analysis.</p

Diagnostic accuracy of FasL for AR after kidney transplantation.

<p>Diagnostic accuracy of FasL for AR after kidney transplantation.</p