The effect of PFAS exposure on glucolipid metabolism in children and adolescents: a meta-analysis

BackgroundPrevious studies showed that per- and polyfluoroalkyl substances (PFAS), which are widely found in the environment, can disrupt endocrine homeostasis when they enter the human body. This meta-analysis aimed to evaluate current human epidemiological evidence on the relationship between PFAS exposure and glucolipid metabolism in childhood and adolescence.MethodsWe searched PubMed, Web of Science, Embase, and Cochrane Library databases, and identified population-based epidemiological studies related to PFAS and glucolipid metabolism indexes that were published before 30 December 2022. The heterogeneity of the included literature was assessed using the I-square (I2) test and statistics Q. Random-effects and fixed-effects models were used to combine the effect size. Subgroup analysis based on age and sex of the study participants was performed. A sensitivity analysis was used to evaluate the robustness and reliability of the combined results. Egger’s and Begg’s tests were used to analyze publication bias.ResultsA total of 12 studies were included in this analysis. There was a positive association between PFAS and TC (β = 1.110, 95% CI: 0.601, 1.610) and LDL (β = 1.900, 95% CI: 1.030, 2.770), and a negative association between PFAS and HOMA-IR in children and adolescents (β = −0.130, 95% CI: −0. 200, −0.059). PFOS was significant positive associated with TC (β = 8.22, 95% CI: 3.93, 12.51), LDL (β = (12.04, 95% CI: 5.08, 18.99), and HOMA-IR (β = −0.165, 95% CI: −0.292, −0.038). Subgroup analysis showed that exposure to PFAS in the adolescent group was positively associated with TC and LDL levels, and the relationship was stronger in females.ConclusionPFAS exposure is associated with glucolipid metabolism in children and adolescents. Among them, PFOS may play an important role. Recognition of environmental PFAS exposure is critical for stabilizing the glycolipid metabolism relationship during the growth and development of children and adolescents

Patient characteristics associated with treatment initiation among paediatric patients with Attention-Deficit/Hyperactivity Disorder symptoms in a naturalistic setting in Central Europe and East Asia.

BACKGROUND: Cultural views of Attention-Deficit/Hyperactivity Disorder (ADHD), differing healthcare systems and funding mechanisms, and the availability of mental health services can greatly influence the perceptions, diagnosis, and treatment of ADHD. There is, however, lack of information about treatment practice and the treatment decision-making process for ADHD, particularly in non-Western countries. Our study compared characteristics of paediatric patients newly diagnosed with ADHD symptoms who did and who did not initiate treatment, and also examined whether any differences varied by region in Central Europe and East Asia. METHODS: Data were taken from a 1-year prospective, observational study that included 1,068 paediatric patients newly diagnosed with ADHD symptoms. Clinical severity was measured using the Clinical Global Impression-ADHD-Severity (CGI-ADHD-S) scale and the Child Symptom Inventory-4 (CSI-4) checklist. Logistic regression was used to explore patient characteristics associated with treatment initiation (pharmacotherapy and/or psychotherapy) at baseline for each region. RESULTS: A total of 74.3% of patients initiated treatment at baseline (78.3% in Central Europe and 69.9% in East Asia). Of these, 48.8% started with both pharmacotherapy and psychotherapy in Central Europe, and only 17.1% did so in East Asia. The level of clinical severity was highest in the combination treatment group in Central Europe, but was highest in the psychotherapy only group in East Asia. In East Asia, treatment initiation was associated with being older, being male, and having a higher CGI-ADHD-S score. In Central Europe, treatment initiation was associated with parental psychological distress, having a higher CSI-4 score, and not being involved in bullying. CONCLUSIONS: Although factors associated with treatment initiation differed to some extent between Central Europe and East Asia, clinical severity appeared to be one of the most important determinants of treatment initiation in both regions. However, the choice between pharmacotherapy and psychotherapy, either alone or in combination, varied substantially across the regions

Patient characteristics associated with treatment initiation among paediatric patients with Attention-Deficit/Hyperactivity Disorder symptoms in a naturalistic setting in Central Europe and East Asia

BACKGROUND: Cultural views of Attention-Deficit/Hyperactivity Disorder (ADHD), differing healthcare systems and funding mechanisms, and the availability of mental health services can greatly influence the perceptions, diagnosis, and treatment of ADHD. There is, however, lack of information about treatment practice and the treatment decision-making process for ADHD, particularly in non-Western countries. Our study compared characteristics of paediatric patients newly diagnosed with ADHD symptoms who did and who did not initiate treatment, and also examined whether any differences varied by region in Central Europe and East Asia. METHODS: Data were taken from a 1-year prospective, observational study that included 1,068 paediatric patients newly diagnosed with ADHD symptoms. Clinical severity was measured using the Clinical Global Impression-ADHD-Severity (CGI-ADHD-S) scale and the Child Symptom Inventory-4 (CSI-4) checklist. Logistic regression was used to explore patient characteristics associated with treatment initiation (pharmacotherapy and/or psychotherapy) at baseline for each region. RESULTS: A total of 74.3% of patients initiated treatment at baseline (78.3% in Central Europe and 69.9% in East Asia). Of these, 48.8% started with both pharmacotherapy and psychotherapy in Central Europe, and only 17.1% did so in East Asia. The level of clinical severity was highest in the combination treatment group in Central Europe, but was highest in the psychotherapy only group in East Asia. In East Asia, treatment initiation was associated with being older, being male, and having a higher CGI-ADHD-S score. In Central Europe, treatment initiation was associated with parental psychological distress, having a higher CSI-4 score, and not being involved in bullying. CONCLUSIONS: Although factors associated with treatment initiation differed to some extent between Central Europe and East Asia, clinical severity appeared to be one of the most important determinants of treatment initiation in both regions. However, the choice between pharmacotherapy and psychotherapy, either alone or in combination, varied substantially across the regions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-014-0304-x) contains supplementary material, which is available to authorized users

Predictors and consequences of adherence to the treatment of pediatric patients with attention-deficit/hyperactivity disorder in Central Europe and East Asia.

PURPOSE: To assess baseline predictors and consequences of medication non-adherence in the treatment of pediatric patients with attention-deficit/hyperactivity disorder (ADHD) from Central Europe and East Asia. PATIENTS AND METHODS: Data for this post-hoc analysis were taken from a 1-year prospective, observational study that included a total of 1,068 newly-diagnosed pediatric patients with ADHD symptoms from Central Europe and East Asia. Medication adherence during the week prior to each visit was assessed by treating physicians using a 5-point Likert scale, and then dichotomized into either adherent or non-adherent. Clinical severity was measured by the Clinical Global Impressions-ADHD-Severity (CGI-ADHD) scale and the Child Symptom Inventory-4 (CSI-4) Checklist. Health-Related Quality of Life (HRQoL) was measured using the Child Health and Illness Profile-Child Edition (CHIP-CE). Regression analyses were used to assess baseline predictors of overall adherence during follow-up, and the impact of time-varying adherence on subsequent outcomes: response (defined as a decrease of at least 1 point in CGI), changes in CGI-ADHD, CSI-4, and the five dimensions of CHIP-CE. RESULTS: Of the 860 patients analyzed, 64.5% (71.6% in Central Europe and 55.5% in East Asia) were rated as adherent and 35.5% as non-adherent during follow-up. Being from East Asia was found to be a strong predictor of non-adherence. In East Asia, a family history of ADHD and parental emotional distress were associated with non-adherence, while having no other children living at home was associated with non-adherence in Central Europe as well as in the overall sample. Non-adherence was associated with poorer response and less improvement on CGI-ADHD and CSI-4, but not on CHIP-CE. CONCLUSION: Non-adherence to medication is common in the treatment of ADHD, particularly in East Asia. Non-adherence was associated with poorer response and less improvement in clinical severity. A limitation of this study is that medication adherence was assessed by the treating clinician using a single item question

Internal mechanism of asymmetric deformation and failure characteristics of the roof for longwall mining of a steeply dipping coal seam

Stability control of the roof is the key to safe and efficient mining of the longwall working face for a steeply dipping coal seam. In this study, a comprehensive analysis was performed on the roof destruction, migration, and filling characteristics of a steeply dipping longwall working face in an actual coalmine. Elastic foundation theory was used to construct a roof mechanics model; the effect of the coal seam inclination angle on the asymmetric deformation and failure of the roof under the constraint of an unbalanced gangue filling was considered. According to the model, increasing the coal seam angle, thickness of the immediate roof, and length of the working face as well as decreasing the thickness of the coal seam can increase the length of the contact area formed by the caving gangue in the lower area of the slope. Changes to the length of the contact area affect the forces and boundary conditions of the main roof. Increasing the coal seam angle reduces the deformation of the main roof, and the position of peak deflection migrates from the middle of the working face to the upper middle. Meanwhile, the position of the peak rotation angle migrates from the lower area of the working face to the upper area. The peak bending moment decreases continuously, and its position migrates from the headgate T-junction to the tailgate T-junction and then the middle of the working face. Field test results verified the rationality of the mechanics model. These findings reveal the effect of the inclination coal seam angle on roof deformation and failure and provide theoretical guidance for engineering practice

Identification and quantification of titanium nanoparticles in surface water: A case study in Lake Taihu, China

The accurate detection and quanti cation of nanoparticles (NPs) in aquatic environments are essential for toxicological and ecological risk assessment. Herein, we used single particle inductively coupled mass spectroscopy (SP-ICP-MS) to quantify titanium nanoparticles (Ti-NPs) in the extraction fractions of surface waters, and transmission electron microscopy coupled with an energy dispersive X-ray spectrometer (TEM-EDS) to specifically identify the nanoparticles. By using gold-NPs as reference standard, this approach achieved a Ti-NPs size detection limit in water of 25 nm with a particle number concentration limit of 10(2) particles/ml. We measured Ti-NPs concentrations in surface waters from Lake Taihu, China. The results revealed that the particles concentration was 2.78 x 10(5) particles/ml with the mean size of 67 nm in October 2016, and the particles concentration of 2.28 x 10(5) particles/ml with the mean size of 65 nm in April 2018, respectively. Based on TEM-EDS observation, various shapes of Ti-NPs were further identified, including regular cubes, long rods and flaky. We further measured the total organic carbon (TOC), and found that there was a positive correlation between Ti-NPs and TOC. This method enabled accurate detection and quantification of Ti-NPs concentration in environmental surface waters, which could be hugely useful for environmental risk assessment in aquatic systems.</p

DataSheet_1_The effect of PFAS exposure on glucolipid metabolism in children and adolescents: a meta-analysis.docx

BackgroundPrevious studies showed that per- and polyfluoroalkyl substances (PFAS), which are widely found in the environment, can disrupt endocrine homeostasis when they enter the human body. This meta-analysis aimed to evaluate current human epidemiological evidence on the relationship between PFAS exposure and glucolipid metabolism in childhood and adolescence.MethodsWe searched PubMed, Web of Science, Embase, and Cochrane Library databases, and identified population-based epidemiological studies related to PFAS and glucolipid metabolism indexes that were published before 30 December 2022. The heterogeneity of the included literature was assessed using the I-square (I2) test and statistics Q. Random-effects and fixed-effects models were used to combine the effect size. Subgroup analysis based on age and sex of the study participants was performed. A sensitivity analysis was used to evaluate the robustness and reliability of the combined results. Egger’s and Begg’s tests were used to analyze publication bias.ResultsA total of 12 studies were included in this analysis. There was a positive association between PFAS and TC (β = 1.110, 95% CI: 0.601, 1.610) and LDL (β = 1.900, 95% CI: 1.030, 2.770), and a negative association between PFAS and HOMA-IR in children and adolescents (β = −0.130, 95% CI: −0. 200, −0.059). PFOS was significant positive associated with TC (β = 8.22, 95% CI: 3.93, 12.51), LDL (β = (12.04, 95% CI: 5.08, 18.99), and HOMA-IR (β = −0.165, 95% CI: −0.292, −0.038). Subgroup analysis showed that exposure to PFAS in the adolescent group was positively associated with TC and LDL levels, and the relationship was stronger in females.ConclusionPFAS exposure is associated with glucolipid metabolism in children and adolescents. Among them, PFOS may play an important role. Recognition of environmental PFAS exposure is critical for stabilizing the glycolipid metabolism relationship during the growth and development of children and adolescents.</p