The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

INTRODUCTION

More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance.

OBJECTIVES

To comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison.

METHODS

We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology.

RESULTS

The combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up.

CONCLUSIONS

The consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population.

KEY WORDS

Mortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.

Gas flow and accretion via spiral streamers and circumstellar disks in a young binary protostar

The majority of stars are part of gravitationally bound stellar systems, such as binaries. Observations of protobinary systems constrain the conditions that lead to stellar multiplicity and subsequent orbital evolution. We report high-angular resolution observations of the circumbinary disk around [BHB2007] 11, a young binary protostar system. The two protostars are embedded in circumstellar disks that have radii of 2 to 3 astronomical units and probably contain a few Jupiter masses. These systems are surrounded by a complex structure of filaments connecting to the larger circumbinary disk. We also observe accretion and radio jets associated with the protobinary system. The accretion is preferentially onto the lower-mass protostar, consistent with theoretical predictions.

1271Short-term effects of exposure to ambient fine particulate matter on out-of-hospital cardiac arrest: a nationwide case-crossover study in Japan

Introduction

The cardiovascular health consequences of ambient air pollution generally equal or exceed those due to pulmonary diseases and cancers. Particulate matter less than 2.5μm in aerodynamic diameter (PM2.5) has become a major focus of research on the short-term exposure to air pollution and cardiovascular disease. However, the evidence regarding the association between several air pollutants and out-of-hospital cardiac arrest (OHCA), has been inconsistent, which could be due to limited sample sizes (∼11,000). Thus, a larger study may assist in characterising possible associations.

Purpose

This study aimed to identify the associations between exposure to ambient air pollution and the incidence of OHCA in Japan.

Methods

A case-crossover design was used to determine the odds ratio (OR) of OHCA across Japan with daily exposure of PM2.5, carbon monoxide (CO), photochemical oxidants (Ox), and sulfur dioxide (SO2) on the day of the arrest or 1–3 days before it (lag 0–3). OHCA cases were identified through the All-Japan Utstein registry of the Fire and Disaster Management Agency from January 1, 2014 to December 31, 2015. All cause OHCAs were investigated by conditional logistic regression adjusted for daily temperature and relative humidity.

Results

A total of 249,372 OHCAs were included during study period. Each 10 μg/m3 increase in daily PM2.5 exposure over 4 days was associated with all cause OHCA risk (lag 0: OR 1.017, 95% confidence interval (CI) 1.010, 1.024; lag 1: OR 1.015, 95% CI 1.008, 1.022; lag 2: OR 1.018, 95% CI 1.011, 1.025; lag 3: OR 1.021, 95% CI 1.014, 1.028; lag 0–1: OR 1.022, 95% CI 1.014, 1.030). CO, Ox and SO2 also showed significant associations with OHCAs. In the multi-pollutant model, the effects of PM2.5 remained independent of CO, Ox and SO2 (Table).

Conclusion

Short-term exposure to PM2.5 was independently associated with an increased risk of OHCA.

2284Sex and age differences in short-term exposure to ambient fine particulate matter and out-of-hospital cardiac arrest: a nationwide case-crossover study in Japan

Introduction

Accumulating evidence has shown the elevated risk for cardiovascular diseases (CVD) with exposure to air pollution, such as fine particles <2.5μm in aerodynamic diameter (PM2.5). A bi-directional relationship exists between air pollution and traditional CV risk factors like obesity, diabetes, and hypertension. However, little is known about the effect of age and sex on association between ambient air pollution and out-of-hospital cardiac arrest (OHCA).

Purpose

This study aimed to identify sex and age differences in the associations between exposure to PM2.5 and OHCA in Japan.

Methods

A case-crossover design was used to determine the odds ratio (OR) of OHCA across Japan with daily PM2.5 exposure on the day of the arrest or 1–3 days before it (lag 0–3). OHCA cases were identified through the All-Japan Utstein registry of the Fire and Disaster Management Agency from January 1, 2014 to December 31, 2015. OHCAs were investigated by conditional logistic regression adjusted for daily temperature and relative humidity with stratification by sex and age.

Results

A total of 249,372 OHCAs were included during study period. Their mean age was 75 years and 57% were male. Each 10 μg/m3 increase in daily PM2.5 exposure over 4 days was associated with all cause OHCA risk for male (lag 0: OR 1.022, 95% confidence interval (CI) 1.013, 1.031; lag 1: OR 1.016, 95% CI 1.007, 1.025; lag 2: OR 1.016, 95% CI 1.007, 1.026; lag 3: OR 1.017, 95% CI 1.008, 1.027; lag 0–1: OR 1.025, 95% CI 1.015, 1.036). Increased risk in OHCA was also found with lag 1 to lag 3 PM2.5 exposure among women. Lag 0 to lag 3 PM2.5 exposures were significantly associated with OHCA among patients older than 65 years. Among 35 to 64 years, only lag 3 PM2.5 exposure was associated with an increased risk in OHCA. No significant association was observed between PM2.5 exposure and OHCA among patients less than 35 years.

Conclusions

Short-term exposure to PM2.5 is associated with an increased risk of OHCA in both sexes. Patients older than 65 years were more susceptible to PM2.5 exposure than younger age group.

[Dynamics and epidemiological characteristics of hand, foot and mouth disease in Shaanxi province, 2009-2018]

Objective: To understand the dynamics and epidemiological characteristics of hand, foot and mouth disease (HFMD) in Shaanxi province during 2009-2018 and provide evidence for prevention and control of HFMD. Methods: Information on HFMD was collected from the Chinese Disease Prevention and Control Information System in Shaanxi Province during 2009-2018 and was analyzed by descriptive, dynamic geometric series averaging and circular distribution methods. Results: The annual average incidence rate of HFMD was 140.04/100 000 in Shaanxi province during 2009-2018. The highest incidence rates were seen in age groups as 1-year olds (3 494.24/100 000), 2-year olds (2 734.79/100 000) and 3-year olds (2 608.58/100 000). The highest reported mortality rates appeared in: 1-year olds as 1.42/100 000, 2-year olds as 0.77/100 000) and 0-year olds (0.53/100 000). The incidence rate increased most rapidly in the 1-year olds and the 0-year olds groups. The top three incidence rates were reported in Xi'an (251.34/100 000), Weinan (161.21/100 000) and Xianyang (123.73/100 000) cities in Guanzhong area of Shaanxi province. In the whole province, incidence rate was on the rise, and the average increases of incidence rates were all greater than zero in these cities. The proportion of severe cases in most cities somehow declined. Results from the circular distribution method estimated that the peak incidence would appear in April 10-11 each year, and the high incidence season was from April to July. In 2018, the composition of enterviruses (EV) 71 was 26.47% (1 303/4 922). In 2014 to 2018, the proportion of Coxsackie virus A16 (Cox A16) was between 20.06%(753/3 753) and 23.08% (855/3 705). The proportions of other EVs increased from 6.09% (14/230) to 51.91% (2 555/4 922) during 2009-2018. Conclusions: The overall incidence rate of HFMD was increasing, with high risk population appeared in children under 3 year olds, in Shaanxi province during 2009-2018. However, both mortality and fatality rates were declining, with severe cases also showing a downward trend in most of the areas. Composition of pathogens was changing over time.

[Research progress of idiopathic tinnitus]

SummaryIdiopathic tinnitus is a spontancous sense of hearing under neither external acoustic or electric stimuli,and is one of the common symptoms of otorhinolaryngology. At present，the clinical stages and classification of tinnitus vary among different countries. The examination of tinnitus is also multifaceted, including audiology, imaging, psychology and other tests to find tinnitus for the purpose. There are many treatments for tinnitus, including etiological treatment, counseling, cognitive behavioral therapy, tinnitus masking therapy, tinnitus therapy, hearing aids, cochlear implants, drug therapy, repetitive transcranial magnetic stimulation, electrical stimulation and so on.The above treatment methods have not reached a consensus on the efficacy of tinnitus. In recent years, some technology innovations based on sound have produced personalized treatment schemes for different types of tinnitus,which will inevitably become a hot topic in future research.

The role of ultrasonography in the diagnosis of persistent sciatic artery

AIM

To investigate the accuracy of ultrasonography in the diagnosis of persistent sciatic artery (PSA) compared to computed tomography angiography (CTA).

MATERIALS AND METHODS

From May 2002 to Dec 2018, 61 consecutive patients seen at Shandong Medical Imaging Research Institute with a clinical suspicion of PSA were included. Ultrasonography was used to assess the abdominal and lower-limb arteries. The main sonographic criteria for a positive diagnosis were the visualisation of PSA, the enlarged internal iliac artery, and abnormality of common femoral artery and superficial femoral artery. These data were compared with CTA findings. Kappa statistics was applied to determine the level of agreement. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography as a diagnostic method were assessed.

RESULTS

Ultrasonography findings were positive in 16 of 61 patients with a clinical suspicion of PSA. The diagnosis was confirmed by CTA in 17 patients. There was one false-positive result and two false-negative results at ultrasonography. The kappa value was 0.875. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography were 88.2%, 97.7%, 93.8%, 95.6%, 95.1% and 0.859, respectively.

CONCLUSIONS

Ultrasonography could be a reliable, accurate, and non-invasive diagnostic imaging method in the diagnosis of patients with suspected PSA.

Correction to: Rehmanniae Radix Preparata suppresses bone loss and increases bone strength through interfering with canonical Wnt/β-catenin signaling pathway in OVX rats

There was a mistake in the part of OVX rats model and RRP intervention in the original publication.

Angiogenesis in residual cancer and roles of HIF-1α, VEGF, and MMP-9 in the development of residual cancer after radiofrequency ablation and surgical resection in rabbits with liver cancer

BACKGROUND

The aim of the study was to investigate the changes of blood flow signal in residual cancer after ultrasound-guided radiofrequency ablation (RFA) treatment of rabbit liver cancer over time, and to analyse the correlation between changes in blood flow signal and changes in hypoxia-inducible factor 1-alpha (HIF-1α), vascular endothelial growth factor (VEGF), and matrix metalloproteinase-9 (MMP-9) in residual cancer tissue after RFA.

MATERIALS AND METHODS

One hundred and ten rabbits were randomly selected, VX2 tumour cells were implanted subcutaneously, tumour cells were implanted in liver. Ninety rabbits were divided into three groups: Group 1 - untreated controls, Group 2 - RFA group, Group 3 - surgical resection group. Tumour size, blood flow signal, microvessel density (MVD) in liver cancer were assessed.

RESULTS

Correlation of HIF-1a, VEGF, MMP-9 mRNA and protein expressions with blood flow signal in residual cancer were observed. Liver tumour was 2.3 ± 0.32 cm, significant differences in the grade of blood flow signal were noted among different time points (days 0, 3, 7, and 14; p < 0.05). Significant differences were also observed between the surgical resection and RFA groups at the same time points (p < 0.05). The MVD in the RFA group was lower than that in the control group, but higher than that in the surgical resection group. The immunohistochemical scores for VEGF and MMP-9 in the RFA group were lower than those in the control group, but higher than those in the surgical resection group. The grade of ultrasound blood flow signal was positively correlated with the expression of two angiogenesis-related factors, VEGF and MMP-9, and the MVD in the control, RFA, and surgical resection groups.

CONCLUSIONS

There is a higher risk of tumour recurrence with RFA than with surgical resection.

[Antimicrobial resistance and molecular epidemiology of foodborne Yersinia enterocolitica in Pudong New District, Shanghai]

Objective: To investigate the antimicrobial resistance and molecular epidemiology of foodborne Yersinia (Y.) enterocolitica in Pudong New District of Shanghai. Methods: Four kinds of raw food samples were collected in retail circulation sites in Pudong from 2012 to 2016. Cold enrichment method was used to isolate Y. enterocolitica and further detection of biotype, serotype, virulent genes, antimicrobial susceptibility of the isolates and pulsed field gel electrophoresis (PFGE) were conducted. Results: A total of 3 900 raw food samples were collected during this period, including poultry product (n=590), livestock product (n=1 074), aquatic product (n=1 488), vegetable (n=748), in which 111 (2.8%) were contaminated by Y. enterocolitica. The detection rates of Y. enterocolitica in poultry product samples (5.3%, 31/590) and livestock product samples (4.5%, 48/1 074) were higher than those in aquatic product samples (1.6%, 24/1 488) and vegetable samples (1.1%, 8/748). The predominant biotype was 1A (95.5%) and predominant serotype was O∶8 (42.3%). All the strains lacked ail, ystA, yadA and virF genes, which encoded pathogenic Y. enterocolitica. Seventy six (68.5%) strains harbored ystB gene, in which 35 (31.5%) belonged to 1A/O∶8/ystB pattern. Most strains were resistant to ampicillin (74.8%) and amoxicillin/clavulanic acid (70.3%), and non-sensitive rate to Cefoxitin was over 50.0%. No third generation cephalosporin or fluoroquinolone resistant strains were detected, but 38.7% (43/111) strains were multidrug resistant (MDR). Serotype O∶8 and O∶5 strains had 44 and 18 PFGE patterns, respectively. Conclusions: The main foodborne exposure sources of Y. enterocolitica in raw food were poultry and livestock products in Pudong New District. 1A/O∶8/ystB was the predominant pattern with potential pathogenicity despite lacks of typical pathogenic virulent genes. The antimicrobial resistant rates of Y. enterocolitica were at a low level, but MDR strains still existed. Molecular types of the isolates showed highly genetic diversity.

Diagnostic Utility of Optic Nerve Measurements with MRI in Patients with Optic Nerve Atrophy

BACKGROUND AND PURPOSE

No MR imaging measurement criteria are available for the diagnosis of optic nerve atrophy. We determined a threshold optic nerve area on MR imaging that predicts a clinical diagnosis of optic nerve atrophy and assessed the relationship between optic nerve area and retinal nerve fiber layer thickness measured by optical coherence tomography, an ancillary test used to evaluate optic nerve disorders.

MATERIALS AND METHODS

We evaluated 26 patients with suspected optic nerve atrophy (8 with unilateral, 13 with bilateral and 5 with suspected but not demonstrable optic nerve atrophy) who had both orbital MR imaging and optical coherence tomography examinations. Forty-five patients without optic nerve atrophy served as controls. Coronal inversion recovery images were used to measure optic nerve area on MR imaging. Retinal nerve fiber layer thickness was determined by optical coherence tomography. Individual eyes were treated separately; however, bootstrapping was used to account for clustering when appropriate. Correlation coefficients were used to evaluate relationships; receiver operating characteristic curves, to investigate predictive accuracy.

RESULTS

There was a significant difference in optic nerve area between patients' affected eyes with optic nerve atrophy (mean, 3.09 ± 1.09 mm²), patients' unaffected eyes (mean, 5.27 ± 1.39 mm²; P = .008), and control eyes (mean, 6.27 ± 2.64 mm²; P < .001). Optic nerve area ≤ 4.0 mm² had a sensitivity of 0.85 and a specificity of 0.83 in predicting the diagnosis of optic nerve atrophy. A significant relationship was found between optic nerve area and retinal nerve fiber layer thickness (r = 0.68, P < .001).

CONCLUSIONS

MR imaging-measured optic nerve area ≤ 4.0 mm² has moderately high sensitivity and specificity for predicting optic nerve atrophy, making it a potential diagnostic tool for radiologists.

Rehmanniae Radix Preparata suppresses bone loss and increases bone strength through interfering with canonical Wnt/β-catenin signaling pathway in OVX rats

Rehmanniae Radix Preparata (RRP) improves bone quality in OVX rats through the regulation of bone homeostasis via increasing osteoblastogenesis and decreasing osteoclastogenesis, suggesting it has a potential for the development of new anti-osteoporotic drugs.

INTRODUCTION

Determine the anti-osteoporotic effect of RRP in ovariectomized (OVX) rats and identify the signaling pathway involved in this process.

METHODS

OVX rats were treated with RRP aqueous extract for 14 weeks. The serum levels of tartrate-resistant acid phosphatase (TRAP), receptor activator of nuclear factor kappa-Β ligand (RANKL), alkaline phosphatase (ALP), and osteoprotegerin (OPG) were determined by ELISA. Bone histopathological alterations were evaluated by H&E, Alizarin red S, and Safranin O staining. Bone mineral density (BMD) and bone microstructure in rat femurs and lumbar bones were determined by dual-energy X-ray absorptiometry and micro-computed tomography. Femoral bone strength was detected by a three-point bending assay. The expression of Phospho-glycogen synthase kinase 3 beta (p-GSK-3β), GSK-3β, Dickkopf-related protein 1 (DKK1), cathepsin K, OPG, RANKL, IGF-1, Runx2, β-catenin, and p-β-catenin was determined by western blot and/or immunohistochemical staining.

RESULTS

Treatment of OVX rats with RRP aqueous extract rebuilt bone homeostasis demonstrated by increasing the levels of OPG as well as decreasing the levels of TRAP, RANKL, and ALP in serum. Furthermore, RRP treatment preserved BMD and mechanical strength by increasing cortical bone thickness and epiphyseal thickness as well as improving trabecular distribution in the femurs of OVX rats. In addition, RRP downregulated the expression of DKK1, sclerostin, RANKL, cathepsin K, and the ratio of p-β-catenin to β-catenin, along with upregulating the expression of IGF-1, β-catenin, and Runx2 and the ratio of p-GSK-3β to GSK-3β in the tibias and femurs of OVX rats. Echinacoside, jionoside A1/A2, acetoside, isoacetoside, jionoside B1, and jionoside B2 were identified in the RRP aqueous extract.

CONCLUSION

RRP attenuates bone loss and improves bone quality in OVX rats partly through its regulation of the canonical Wnt/β-catenin signaling pathway, suggesting that RRP has the potential to provide a new source of anti-osteoporotic drugs.

The prognostic significance of macroscopic serosal change in subserosal invasion (stage T3) gastric cancer

BACKGROUND

For patients with gastric cancer intraoperative macroscopic serosal change is not always consistent with pathological T stage. We investigated whether macroscopic serosal change is associated with unfavourable prognosis of patients with gastric cancer.

METHODS

We reviewed 856 patients with stage T3 gastric cancer who underwent curative gastrectomy in our institution. All patients were classified as serosa negative and serosa positive according to the macroscopic serosal change during the operation. The prognostic difference between two groups was compared and clinicopathologic features were analysed.

RESULTS

The percentage of macroscopic serosal change accounted for 55.7% of all patients. Compared with normal serosal surface, the patients with macroscopic serosal change had larger tumour size, more extensive stomach involvement and more advanced stage N. The prognosis of stage T3 with macroscopic serosal change was significantly poorer than that of those with normal serosal surface, especially for those with stages T3N0 and T3N1. Multivariate analysis identified macroscopic serosal change as an independent factor associated with unfavourable prognosis of stage T3 cancer.

CONCLUSION

Although the depth of tumour invasion mainly depends on pathological evaluation after surgery, the prognostic significance of intraoperative macroscopic serosal change should not be ignored for those patients with subserosal invasion.

Fusion protein tTF-EG3287 induces occlusion of tumor vessels and impairs tumor growth in human colon caner

The problems including narrow indications, low drug loading, and difficulty in intervention severely affect the clinical efficacy of anti-tumor embolization. Here, we designed a novel tTF-EG3287 protein consisting of the truncated tissue factor (tTF) fused with the bicyclic polypeptide which was encoded by exons 7 and 8 for accurate localization in the tumor vascular endothelial cells (EG3287). This study aims to explore its anti-cancer effect. Gene sequencing was used to verify the fusion gene and SDS-PAGE gel to confirm the optimal induction time and concentration of tTF-EG3287. Nickel affinity chromatography column was used to purify the fusion protein. Confocal microscopy was used to assess the target activity of tTF-EG3287 on colon cancer cells in vitro. Thrombelastography assay was used to identify the pro-coagulant activity of tTF-EG3287. In in vivo experiments, the specific localization of tTF-EG3287 in tumor tissues and the effect of tTF-EG3287 on tumor thrombosis were further detected by in vivo imaging and HE staining, respectively. The tTF-EG3287 fusion protein was efficiently purified by nickel-affinity chromatography column. Moreover, tTF-EG3287 fusion protein showed strong coagulation a ctivity and specific binding ability to the cell surface of colon cancer. In vivo, tTF-EG3287 stably and persistently accumulated in tumor tissues, and specifically induced mixed thrombus formation in tumor vessels, and then impaired tumor growth (tumor inhibition rate=79.2%, p<0.01). Our data prove that the fusion protein tTF-EG3287 could be used as a novel and promising anti-cancer strategy and has great potential value for clinical applications.

[Value of RNA oxidation product 8-oxo-Gsn in evaluating renal function in patients with chronic kidney disease]

Objective: To investigate the relationship of DNA oxidative product 8-oxo-dGsn and RNA oxidative product 8-oxo-Gsn with chronic kidney disease (CKD). Methods: Between January 2015 and December 2016, 146 cases of CKD (30, 30, 31, 30 and 25 cases of CKD stage 1-5, respectively) were collected in the Department of Nephrology in Beijing Hospital. Among them, 70 cases were male, accounting for 47.95%. The age distribution ranged from 21 to 88 years, with an average age of (56.43±16.79) years. Their fasting blood and morning urine were collected. The levels of 8-oxo-dGsn and 8-oxo-Gsn in plasma and urine were quantified by isotope-diluted liquid chromatography mass spectrometry (MS)/MS (ID-LC-MS/MS). Results: The urine 8-oxo-Gsn/Cr in patients with CKD stage 1-5 was (3.07±1.07) μmol/mol, (3.42±1.34) μmol/mol, (3.72±1.47) μmol/mol, (3.90±1.93) μmol/mol and (3.75±2.26) μmol/mol, respectively. The urinary 8-oxo-Gsn content in CKD stage 4 patients was significantly higher than those of other 4 stages (P<0.05). The serum/urine ratio of 8-oxo-Gsn was 0.02±0.02, 0.03±0.02, 0.06±0.04, 0.10±0.05 and 0.34±0.03, respectively, and in CKD stage 4 and 5 patients, it increased significantly, especially in CKD stage 5 cases (P<0.05). Expression of 8-oxo-Gsn had a good correlation with renal function[the Spearman 's correlation coefficient: serum 8-oxo-Gsn and serum creatinine was 0.629 (P<0.001); urine/serum 8-oxo-Gsn and eGFR was 0.799 (P<0.001); serum/urine 8-oxo-Gsn and serum/urine creatinine was 0.888 (P<0.001)]. With age increasing, CKD patients showed increased RNA oxidation, and 8-oxo-Gsn increased significantly in patients over 60 years (P<0.05). After multiple linear regression analysis, 8-oxo-Gsn was only associated with serum creatinine (β=0.656, t=8.275, P<0.001). Conclusions: Our finding indicates that the RNA oxidation occurs in patients with renal disease, and its oxidation increased as the disease progressing. The significant increase in the ratio of plasma and urinary 8-oxo-Gsn is of great importance on evaluating renal function.