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A growing number of biological studies suggest that exogenous sulfur dioxide (SO2) at a certain concentration may promote human resistance to Mycobacterium tuberculosis. However, the results of most relevant studies are inconsistent, and few studies have explored the relationship between SO2 exposure and tuberculosis risk at provincial level. In addition, occupational exposure has long been considered to have a certain impact on the human body, so for the first time, we discussed the differences between different occupations in the study on the relationship between air pollutant exposure and tuberculosis risk, and evaluated the impact of occupational exposure. This study aimed to explore the association between short-term SO2 exposure and the risk of outpatient visits to tuberculosis in Anhui province and 16 prefecture-level cities from 2015 to 2020. We used several models for multi-stage analysis, including distributed lag nonlinear model (DLNM), Poisson generalized linear regression model, and random-effects model. The association was assessed using the 28-day cumulative lag effect RR and 95%CI for each 10-unit increase in SO2 concentration. We divided all patients into the following six occupations: Worker, Farmer, Retired people, Children and Students, Cadre and Office clerk, and Service staff (catering, business, etc.). Sex, age, and season were analyzed by subgroup. Finally, the robustness of the multi-pollutant model was tested. At provincial level, the overall effect value of SO2 was RR=0.8191 (95%CI: 07702~0.8712); after grouping all patients by occupation, the association found only among Farmers (RR = 0.7150, 95%CI: 0.6699–0.7632, lag 0–28 days) and Workers (RR = 0.8566, 95%CI: 0.7930–0.9930, lag 0–4 days) was still statistically significant. Estimates for individual cities and using random-effects models to estimate average associations showed that SO2 exposure was associated with a reduced risk of outpatient TB visits in 14 municipalities, which remained significant when aggregated (RR = 0.9030, 95%CI: 0.8730–0.9340). Analysis of patients grouped by occupation in each municipality showed that statistical significance was again observed only in the Farmer (RR = 0.8880, 95%CI: 0.8610–0.9160) and Worker (RR = 0.8250, 95%CI: 0.7290–0.9340) groups. Stratified analysis of age, sex, and season showed that the effect of SO2 exposure was greater for middle-aged people (18–64 years old) and males, and less for seasonal changes. In summary, we found that exposure to SO2 reduces the risk of outpatient visits to tuberculosis, with farmers and workers more susceptible to SO2. Gender and age had a greater impact on the risk of TB outpatient visits than seasonal variations. [ABSTRACT FROM AUTHOR]

There is growing evidence that air pollution plays a role in TB, and most studies have been conducted in the core countries with inconsistent results. Few studies have comprehensively included the six common air pollutants, so they cannot consider whether various pollutants interact with each other. Our objectives were to investigate the association between short-term exposure to six common air pollutants and the risk of tuberculosis outpatient visits in Fuyang, China, 2015–2020. We combined the two models to explore the effects of exposure to six air pollutants on the risk of tuberculosis outpatient visits, including the Poisson generalized linear regression model and distributed lag non-linear model (DLNM). We performed stratified analyses for the season, type of cases, gender, and age. We used the lag-specific relative risks and cumulative relative risk obtained by increasing pollutant concentration by per 10 units to evaluate the connection between six air pollutants and TB; PM2.5 (RR = 1.0018, 95% CI: 1.0004–1.0032, delay of 12 days) and SO2 (RR = 1.0169, 95% CI: 1.0007–1.0333, lag 0–16 days) were 0.9549 (95% CI: 0.9389–0.9712, lag 0 day) and 0.8212 (95% CI: 0.7351–0.9173, 0–20-day lag). Stratified analyses showed that seasonal differences had a greater impact on TB, males were more likely to develop TB than females, older people were more likely to develop TB than younger people, and air pollution had a great impact on new cases. Exposure to O3, CO, PM10, PM2.5, and NO2 increases the risk of TB outpatient visits, except SO2 which reduces the risk. The incidence of TB has seasonal fluctuations. It is necessary for the government to establish a sound environmental monitoring and early warning system to strengthen the monitoring and emission management of pollutants in the atmosphere. Management, prevention, and treatment measures should be developed for high-risk groups (males and older people), reducing the risk of TB by reducing their specific behaviors and changing their lifestyle. We need to pay more attention to the impact of seasonal effects on TB to protect TB patients and avoid a shortage of medical resources, and it is necessary for the government to develop some seasonal preventive measures in the future. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) causes about 10 million new cases and 1.5 million deaths every year, as the World Health Organization's Global Tuberculosis Report shows. We aimed to investigate the association between short-term exposure to particulate pollutants and the risk of tuberculosis outpatient visits in 16 cities of Anhui Province, China, during the period 2015–2020, and to provide more evidence for the relationship between tuberculosis and air pollution. In this study, we analyzed the data using a variety of models, including Poisson's generalized linear regression model, distributed lag non-linear model (DLNM) and random effects model. We assessed the relationship between particulate matter exposure and tuberculosis using a 28-day cumulative lag effect for every 10 unit increases in pollutant concentration and 95% CI. We performed stratified analyses for gender and age. Age stratification included <18 years old group, 19–64 years old group and >64 years old group and gender stratification included male group and female group, and then we performed a sensitivity analysis to test the stability of the results. The overall effect values of PM2.5 and PM10 were RR = 1.031 (95%CI: 1.019–1.043) and RR = 1.023 (95%CI: 1.016–1.030), respectively. Estimation for individual cities showed that the strongest association between PM2.5 and the risk of TB outpatient visits was observed in Tongling, with an RR of 1.136 (95%CI: 1.0261–1.2583), also the PM10 in Suzhou, with an RR of 1.0629 (95%CI: 1.0421–1.0842). Stratified analysis showed that particulate matter exposure had a more significant impact on males and the elderly, and that there was little association between particulate matter exposure and TB risk in children and adolescents. Exposure to PM2.5 and PM10 increases the risk of TB outpatient visits. Males and the elderly are vulnerable groups, and different prevention and control strategies should be developed for different groups to reduce the burden of TB. • China's first province-wide study on the TB outpatient visits and particulate pollutants. • Exposure to particulate pollutants increases the risk of tuberculosis outpatient visits. • Exposure to particulate pollutants has a greater impact on male and the elderly. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that gestational diabetes mellitus (GDM) alters the growth trajectory of a fetus and increases the risk of abnormal birth weight. In spite of this, there is still a significant debate regarding the mode and optimal timing of diagnosing this condition. Our aim was to determine fetal growth velocity and birth biometry in pregnant women with GDM at varying risk levels., Methods: We conducted a cohort study involving 1023 pregnant women at a maternity hospital in Ma'anshan, China. All women completed an oral glucose tolerance test at 24-28 weeks' gestation. We measured fetal head circumference (HC), femoral length (FL), abdominal circumference (AC), biparietal diameter (BPD), and estimate fetal weight (EFW) by ultrasound at 17, 24, 31, and 35 weeks' gestation, respectively., Results: Overall, 5115 ultrasound scans were performed. Among both low-risk and medium-high-risk pregnant women at 17-24 weeks' gestation, GDM exposure was associated with an increase in fetal growth velocity. Neonates born to women with GDM at medium-high risk had significantly larger birth weights than those born to women without GDM, while this was not observed in women at low risk., Conclusion: In medium-high-risk pregnant women, exposure to GDM has a greater effect on the fetus, leading to abnormal fetal growth velocity that lasts beyond week 24. It is evident from our results that the effects of GDM on fetal growth differ between medium-high-risk pregnant women and low-risk pregnant women, and therefore a different screening program based on the risk factor for GDM is warranted., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Anti-PD-1 therapy and chemotherapy is a recommended first-line treatment for recurrent or metastatic nasopharyngeal carcinoma, but the role of PD-1 blockade remains unknown in patients with locoregionally advanced nasopharyngeal carcinoma. We assessed the addition of sintilimab, a PD-1 inhibitor, to standard chemoradiotherapy in this patient population., Methods: This multicentre, open-label, parallel-group, randomised, controlled, phase 3 trial was conducted at nine hospitals in China. Adults aged 18-65 years with newly diagnosed high-risk non-metastatic stage III-IVa locoregionally advanced nasopharyngeal carcinoma (excluding T3-4N0 and T3N1) were eligible. Patients were randomly assigned (1:1) using blocks of four to receive gemcitabine and cisplatin induction chemotherapy followed by concurrent cisplatin radiotherapy (standard therapy group) or standard therapy with 200 mg sintilimab intravenously once every 3 weeks for 12 cycles (comprising three induction, three concurrent, and six adjuvant cycles to radiotherapy; sintilimab group). The primary endpoint was event-free survival from randomisation to disease recurrence (locoregional or distant) or death from any cause in the intention-to-treat population. Secondary endpoints included adverse events. This trial is registered with ClinicalTrials.gov (NCT03700476) and is now completed; follow-up is ongoing., Findings: Between Dec 21, 2018, and March 31, 2020, 425 patients were enrolled and randomly assigned to the sintilimab (n=210) or standard therapy groups (n=215). At median follow-up of 41·9 months (IQR 38·0-44·8; 389 alive at primary data cutoff [Feb 28, 2023] and 366 [94%] had at least 36 months of follow-up), event-free survival was higher in the sintilimab group compared with the standard therapy group (36-month rates 86% [95% CI 81-90] vs 76% [70-81]; stratified hazard ratio 0·59 [0·38-0·92]; p=0·019). Grade 3-4 adverse events occurred in 155 (74%) in the sintilimab group versus 140 (65%) in the standard therapy group, with the most common being stomatitis (68 [33%] vs 64 [30%]), leukopenia (54 [26%] vs 48 [22%]), and neutropenia (50 [24%] vs 46 [21%]). Two (1%) patients died in the sintilimab group (both considered to be immune-related) and one (<1%) in the standard therapy group. Grade 3-4 immune-related adverse events occurred in 20 (10%) patients in the sintilimab group., Interpretation: Addition of sintilimab to chemoradiotherapy improved event-free survival, albeit with higher but manageable adverse events. Longer follow-up is necessary to determine whether this regimen can be considered as the standard of care for patients with high-risk locoregionally advanced nasopharyngeal carcinoma., Funding: National Natural Science Foundation of China, Key-Area Research and Development Program of Guangdong Province, Natural Science Foundation of Guangdong Province, Overseas Expertise Introduction Project for Discipline Innovation, Guangzhou Municipal Health Commission, and Cancer Innovative Research Program of Sun Yat-sen University Cancer Center., Translation: For the Chinese translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

We aimed to characterize the association between air pollutants exposure and periodontal diseases outpatient visits and to explore the interactions between ambient air pollutants and meteorological factors. The outpatient visits data of several large stomatological and general hospitals in Hefei during 2015-2020 were collected to explore the relationship between daily air pollutants exposure and periodontal diseases by combining Poisson's generalized linear model (GLMs) and distributed lag nonlinear model (DLNMs). Subgroup analysis was performed to identify the vulnerability of different populations to air pollutants exposure. The interaction between air pollutants and meteorological factors was verified in both multiplicative and additive interaction models. An interquartile range (IQR) increased in nitrogen dioxide (NO 2 ) concentration was associated with the greatest lag-specific relative risk (RR) of gingivitis at lag 3 days (RR = 1.087, 95% CI 1.008-1.173). Fine particulate matter (PM 2.5 ) exposure also increased the risk of periodontitis at the day of exposure (RR = 1.049, 95% CI 1.004-1.096). Elderly patients with gingivitis and periodontitis were both vulnerable to PM 2.5 exposure. The interaction analyses showed that exposure to high levels of NO 2 at low temperatures was related to an increased risk of gingivitis, while exposure to high levels of NO 2 and PM 2.5 may also increase the risk of gingivitis and periodontitis in the high-humidity environment, respectively. This study supported that NO 2 and PM 2.5 exposure increased the risk of gingivitis and periodontitis outpatient visits, respectively. Besides, the adverse effects of air pollutants exposure on periodontal diseases may vary depending on ambient temperature and humidity., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: As a communicable disease and major public health issue, many studies have quantified the associations between tuberculosis (TB) and meteorological factors with inconsistent results. The purpose of this multicenter study was to characterize the associations between ambient temperature, humidity and the risk of TB hospitalizations and to investigate potential heterogeneity., Method: Data on daily hospitalizations for TB, meteorological factors and ambient air pollutants for 16 cities in Anhui Province were collected from 2015 to 2020. A distributed lag nonlinear model (DLNM) was performed to obtain the estimates of meteorological-TB relationships by cities. Then, we used the multivariate meta-regression model to pool the city-specific estimates with air pollution, demographic indicators, medical resource and latitude as potential modifiers to explore the sources of heterogeneity. Finally, we divided the whole province into three regions to validate the meteorological-TB relationships by regions., Results: The overall pooled temperature-TB association presented an approximate S-shaped curve, with relative risk (RR) peaking at 5 °C (RR = 1.536, 95% CI: 1.303-1.811) compared to the reference temperature (27 °C). Lag-response curve suggested that low temperature exposure increased the risk of TB hospitalizations at lag 0 and 1 day (lag0 day: RR = 1.136, 95% CI: 1.048-1.231, lag1 day: RR = 1.052, 95% CI: 1.023-1.082). However, the overall exposure-response curve between relative humidity and TB showed almost horizontal line with reference relative humidity to 78%. The residual heterogeneity ranged from 27.1% to 36.9%, with air pollution, latitude and medical resource explained the largest proportion., Conclusion: We found that low temperature exposure is associated with an acute increased risk of TB hospitalizations in Anhui Province. The association between temperature and TB admission varies depending on air pollution, latitude, and medical resources. Since the effect of short-term exposure to humidity is not significant, further studies are supposed to focus on the long-term effect of humidity., 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 © 2022. Published by Elsevier B.V.)

A growing number of biological studies suggest that exogenous sulfur dioxide (SO 2 ) at a certain concentration may promote human resistance to Mycobacterium tuberculosis. However, the results of most relevant studies are inconsistent, and few studies have explored the relationship between SO 2 exposure and tuberculosis risk at provincial level. In addition, occupational exposure has long been considered to have a certain impact on the human body, so for the first time, we discussed the differences between different occupations in the study on the relationship between air pollutant exposure and tuberculosis risk, and evaluated the impact of occupational exposure. This study aimed to explore the association between short-term SO 2 exposure and the risk of outpatient visits to tuberculosis in Anhui province and 16 prefecture-level cities from 2015 to 2020. We used several models for multi-stage analysis, including distributed lag nonlinear model (DLNM), Poisson generalized linear regression model, and random-effects model. The association was assessed using the 28-day cumulative lag effect RR and 95%CI for each 10-unit increase in SO 2 concentration. We divided all patients into the following six occupations: Worker, Farmer, Retired people, Children and Students, Cadre and Office clerk, and Service staff (catering, business, etc.). Sex, age, and season were analyzed by subgroup. Finally, the robustness of the multi-pollutant model was tested. At provincial level, the overall effect value of SO 2 was RR=0.8191 (95%CI: 07702~0.8712); after grouping all patients by occupation, the association found only among Farmers (RR = 0.7150, 95%CI: 0.6699-0.7632, lag 0-28 days) and Workers (RR = 0.8566, 95%CI: 0.7930-0.9930, lag 0-4 days) was still statistically significant. Estimates for individual cities and using random-effects models to estimate average associations showed that SO 2 exposure was associated with a reduced risk of outpatient TB visits in 14 municipalities, which remained significant when aggregated (RR = 0.9030, 95%CI: 0.8730-0.9340). Analysis of patients grouped by occupation in each municipality showed that statistical significance was again observed only in the Farmer (RR = 0.8880, 95%CI: 0.8610-0.9160) and Worker (RR = 0.8250, 95%CI: 0.7290-0.9340) groups. Stratified analysis of age, sex, and season showed that the effect of SO 2 exposure was greater for middle-aged people (18-64 years old) and males, and less for seasonal changes. In summary, we found that exposure to SO 2 reduces the risk of outpatient visits to tuberculosis, with farmers and workers more susceptible to SO 2 . Gender and age had a greater impact on the risk of TB outpatient visits than seasonal variations., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)