Browsing by Author "Ji, John S"
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Item Open Access Association between Blood Lead and Walking Speed in the National Health and Nutrition Examination Survey (NHANES 1999–2002)(Environmental Health Perspectives, 2013-04-19) Ji, John S; Elbaz, Alexis; Weisskopf, Marc GItem Open Access Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancer registries.(The Lancet. Global health, 2018-05) Zeng, Hongmei; Chen, Wanqing; Zheng, Rongshou; Zhang, Siwei; Ji, John S; Zou, Xiaonong; Xia, Changfa; Sun, Kexin; Yang, Zhixun; Li, He; Wang, Ning; Han, Renqiang; Liu, Shuzheng; Li, Huizhang; Mu, Huijuan; He, Yutong; Xu, Yanjun; Fu, Zhentao; Zhou, Yan; Jiang, Jie; Yang, Yanlei; Chen, Jianguo; Wei, Kuangrong; Fan, Dongmei; Wang, Jian; Fu, Fangxian; Zhao, Deli; Song, Guohui; Chen, Jianshun; Jiang, Chunxiao; Zhou, Xin; Gu, Xiaoping; Jin, Feng; Li, Qilong; Li, Yanhua; Wu, Tonghao; Yan, Chunhua; Dong, Jianmei; Hua, Zhaolai; Baade, Peter; Bray, Freddie; Jemal, Ahmedin; Yu, Xue Qin; He, JieFrom 2003 to 2005, standardised 5-year cancer survival in China was much lower than in developed countries and varied substantially by geographical area. Monitoring population-level cancer survival is crucial to the understanding of the overall effectiveness of cancer care. We therefore aimed to investigate survival statistics for people with cancer in China between 2003 and 2015.We used population-based data from 17 cancer registries in China. Data for the study population was submitted by the end of July 31, 2016, with follow-up data on vital status obtained on Dec 31, 2015. We used anonymised, individual cancer registration records of patients (aged 0-99 years) diagnosed with primary, invasive cancers from 2003 to 2013. Patients eligible for inclusion had data for demographic characteristics, date of diagnosis, anatomical site, morphology, behaviour code, vital status, and last date of contact. We analysed 5-year relative survival by sex, age, and geographical area, for all cancers combined and 26 different cancer types, between 2003 and 2015. We stratified survival estimates by calendar period (2003-05, 2006-08, 2009-11, and 2012-15).There were 678 842 records of patients with invasive cancer who were diagnosed between 2003 and 2013. Of these records, 659 732 (97·2%) were eligible for inclusion in the final analyses. From 2003-05 to 2012-15, age-standardised 5-year relative survival increased substantially for all cancers combined, for both male and female patients, from 30·9% (95% CI 30·6-31·2) to 40·5% (40·3-40·7). Age-standardised 5-year relative survival also increased for most cancer types, including cancers of the uterus (average change per calendar period 5·5% [95% CI 2·5-8·5]), thyroid (5·4% [3·2-7·6]), cervix (4·5% [2·9-6·2]), and bone (3·2% [2·1-4·4]). In 2012-15, age-standardised 5-year survival for all patients with cancer was higher in urban areas (46·7%, 95% CI 46·5-47·0) than in rural areas (33·6%, 33·3-33·9), except for patients with oesophageal or cervical cancer; but improvements in survival were greater for patients residing in rural areas than in urban areas. Relative survival decreased with increasing age. The increasing trends in survival were consistent with the upward trends of medical expenditure of the country during the period studied.There was a marked overall increase in cancer survival from 2003 to 2015 in the population covered by these cancer registries in China, possibly reflecting advances in the quality of cancer care in these areas. The survival gap between urban and rural areas narrowed over time, although geographical differences in cancer survival remained. Insight into these trends will help prioritise areas that need increased cancer care.National Key R&D Program of China, PUMC Youth Fund and the Fundamental Research Funds for the Central Universities, and Major State Basic Innovation Program of the Chinese Academy of Medical Sciences.Item Open Access Co-effects of Transportation Means and Air Quality on Neurological, Pulmonary, and Cardiovascular Function(2021-04-15) Ong, Gui Xian; Zhang, Yang; Wang, HuapingThe guidelines on outdoor activities in the presence of air pollution vary. We aim to find out the effects of walking and air pollution among young adults. We conducted a randomized, 3-session cross-over trial, with 28 healthy Duke Kunshan University (DKU) students. Between October 2020 and February 2021 on days with varying air quality levels, students walked or took the bus from DKU to Scholars Hotel in Kunshan, China. Indicators of neurological function (reaction speed, visual memory, verbal memory, and numerical memory), pulmonary function (PEF, FEV1 , FVC, and FEV1 / FVC), and cardiovascular function (systolic pressure, diastolic pressure, and heart rate) were tested before and after the interventions. The paired t-test findings revealed that walking was beneficial for pulmonary function, with an average PEF increase of 40.29 ± 84.87 L/min (p<0.05). On the other hand, air pollution decreased diastolic pressure by an average of -3.85 ± 5.30 mmHg (p<0.05) and numerical memory by an average of -2.27 ± 2.37 points (p<0.01). The regressions results showed that air pollution was associated with statistically significant decreases in cognitive and pulmonary function. An increase in PM 2.5 (1 µg/m3 ) was associated with decreased numerical memory (-2.32 points; p<0.05) and a unit increase in AQI was correlated with decreased FEV 1 (-6.71 L; p<0.05). On the co-effects of walking and air pollution, our evidence was inconclusive. Walking outdoors during air polluted days may negatively affect pulmonary functions and neurological functions, while its effect on cardiovascular functions is not clear. Being cautious, individuals may refrain from exercising in air polluted environments to avoid potential negative health impacts. Nonetheless, we are unable to make strong inferences towards such behavioral recommendations due to the limited effect size.Item Open Access Factors Influencing Hospitalization Rates and Inpatient Cost of Patients with Tuberculosis in Jiangsu Province, China: An Uncontrolled before and after Study.(International journal of environmental research and public health, 2019-08) Hu, Dan; Long, Qian; Chen, Jiaying; Wang, Xuanxuan; Huang, Fei; Ji, John SOBJECTIVE:The China Center for Disease Control and Prevention (CDC) introduced an innovative financing model of tuberculosis (TB) care and control with the aim of standardizing TB treatment and reducing the financial burden associated with patients with TB. This is a study of the pilot implementation of new financing mechanism in Zhenjiang, between 2014-2015. We compared TB hospitalization rates and inpatient service costs before and after implementation to examine the factors associated with hospital admissions. Our goal is to provide evidence-based recommendations for improving TB service provision and cost control. METHODS:We reviewed new policy documents on TB financing. We conducted a patient survey to investigate the utilization of inpatient services, and patients' out-of-pocket payment for inpatient care. We extracted total medical expenditures of inpatient services from inpatient records of TB designated hospitals. FINDINGS:63.6% (n = 159) of the surveyed patients with TB were admitted for treatment in 2015, which was higher than that in 2013 (54.8%, n = 144). The number of hospital admission was slightly lower in 2015 (1.16 per patient) than in 2013 (1.26 per patient), while the length of hospital stay was longer in 2015 (24 days) than in 2013 (16 days). In 2015, patients from families with low incomes were more likely to be admitted than those from higher income groups (OR = 3.06, 95% CI: 1.12-8.33). The average inpatient service cost in 2015 (3345 USD) was 1.7 times the cost in 2013 (1952 USD). It was found that 96.2% of patients with TB who were from low-income households spent more than 20% of their household income on inpatient care in 2013, versus 100% in 2015. CONCLUSION:The TB hospital admission rate and total inpatient service cost increased over the study period. The majority of patients with TB, particularly poor patient who used inpatient care, continue to suffer from heavy financial burden.Item Open Access Lead Exposure and Tremor among Older Men: The VA Normative Aging Study(Environmental Health Perspectives, 2015-01-23) Ji, John S; Power, Melinda C; Sparrow, David; Spiro, Avron; Hu, Howard; Louis, Elan D; Weisskopf, Marc GItem Open Access Mapping 123 million neonatal, infant and child deaths between 2000 and 2017.(Nature, 2019-10-16) Burstein, Roy; Henry, Nathaniel J; Collison, Michael L; Marczak, Laurie B; Sligar, Amber; Watson, Stefanie; Marquez, Neal; Abbasalizad-Farhangi, Mahdieh; Abbasi, Masoumeh; Abd-Allah, Foad; Abdoli, Amir; Abdollahi, Mohammad; Abdollahpour, Ibrahim; Abdulkader, Rizwan Suliankatchi; Abrigo, Michael RM; Acharya, Dilaram; Adebayo, Oladimeji M; Adekanmbi, Victor; Adham, Davoud; Afshari, Mahdi; Aghaali, Mohammad; Ahmadi, Keivan; Ahmadi, Mehdi; Ahmadpour, Ehsan; Ahmed, Rushdia; Akal, Chalachew Genet; Akinyemi, Joshua O; Alahdab, Fares; Alam, Noore; Alamene, Genet Melak; Alene, Kefyalew Addis; Alijanzadeh, Mehran; Alinia, Cyrus; Alipour, Vahid; Aljunid, Syed Mohamed; Almalki, Mohammed J; Al-Mekhlafi, Hesham M; Altirkawi, Khalid; Alvis-Guzman, Nelson; Amegah, Adeladza Kofi; Amini, Saeed; Amit, Arianna Maever Loreche; Anbari, Zohreh; Androudi, Sofia; Anjomshoa, Mina; Ansari, Fereshteh; Antonio, Carl Abelardo T; Arabloo, Jalal; Arefi, Zohreh; Aremu, Olatunde; Armoon, Bahram; Arora, Amit; Artaman, Al; Asadi, Anvar; Asadi-Aliabadi, Mehran; Ashraf-Ganjouei, Amir; Assadi, Reza; Ataeinia, Bahar; Atre, Sachin R; Quintanilla, Beatriz Paulina Ayala; Ayanore, Martin Amogre; Azari, Samad; Babaee, Ebrahim; Babazadeh, Arefeh; Badawi, Alaa; Bagheri, Soghra; Bagherzadeh, Mojtaba; Baheiraei, Nafiseh; Balouchi, Abbas; Barac, Aleksandra; Bassat, Quique; Baune, Bernhard T; Bayati, Mohsen; Bedi, Neeraj; Beghi, Ettore; Behzadifar, Masoud; Behzadifar, Meysam; Belay, Yared Belete; Bell, Brent; Bell, Michelle L; Berbada, Dessalegn Ajema; Bernstein, Robert S; Bhattacharjee, Natalia V; Bhattarai, Suraj; Bhutta, Zulfiqar A; Bijani, Ali; Bohlouli, Somayeh; Breitborde, Nicholas JK; Britton, Gabrielle; Browne, Annie J; Nagaraja, Sharath Burugina; Busse, Reinhard; Butt, Zahid A; Car, Josip; Cárdenas, Rosario; Castañeda-Orjuela, Carlos A; Cerin, Ester; Chanie, Wagaye Fentahun; Chatterjee, Pranab; Chu, Dinh-Toi; Cooper, Cyrus; Costa, Vera M; Dalal, Koustuv; Dandona, Lalit; Dandona, Rakhi; Daoud, Farah; Daryani, Ahmad; Das Gupta, Rajat; Davis, Ian; Davis Weaver, Nicole; Davitoiu, Dragos Virgil; De Neve, Jan-Walter; Demeke, Feleke Mekonnen; Demoz, Gebre Teklemariam; Deribe, Kebede; Desai, Rupak; Deshpande, Aniruddha; Desyibelew, Hanna Demelash; Dey, Sagnik; Dharmaratne, Samath Dhamminda; Dhimal, Meghnath; Diaz, Daniel; Doshmangir, Leila; Duraes, Andre R; Dwyer-Lindgren, Laura; Earl, Lucas; Ebrahimi, Roya; Ebrahimpour, Soheil; Effiong, Andem; Eftekhari, Aziz; Ehsani-Chimeh, Elham; El Sayed, Iman; El Sayed Zaki, Maysaa; El Tantawi, Maha; El-Khatib, Ziad; Emamian, Mohammad Hassan; Enany, Shymaa; Eskandarieh, Sharareh; Eyawo, Oghenowede; Ezalarab, Maha; Faramarzi, Mahbobeh; Fareed, Mohammad; Faridnia, Roghiyeh; Faro, Andre; Fazaeli, Ali Akbar; Fazlzadeh, Mehdi; Fentahun, Netsanet; Fereshtehnejad, Seyed-Mohammad; Fernandes, João C; Filip, Irina; Fischer, Florian; Foigt, Nataliya A; Foroutan, Masoud; Francis, Joel Msafiri; Fukumoto, Takeshi; Fullman, Nancy; Gallus, Silvano; Gebre, Destallem Gebremedhin; Gebrehiwot, Tsegaye Tewelde; Gebremeskel, Gebreamlak Gebremedhn; Gessner, Bradford D; Geta, Birhanu; Gething, Peter W; Ghadimi, Reza; Ghadiri, Keyghobad; Ghajarzadeh, Mahsa; Ghashghaee, Ahmad; Gill, Paramjit Singh; Gill, Tiffany K; Golding, Nick; Gomes, Nelson GM; Gona, Philimon N; Gopalani, Sameer Vali; Gorini, Giuseppe; Goulart, Bárbara Niegia Garcia; Graetz, Nicholas; Greaves, Felix; Green, Manfred S; Guo, Yuming; Haj-Mirzaian, Arvin; Haj-Mirzaian, Arya; Hall, Brian James; Hamidi, Samer; Haririan, Hamidreza; Haro, Josep Maria; Hasankhani, Milad; Hasanpoor, Edris; Hasanzadeh, Amir; Hassankhani, Hadi; Hassen, Hamid Yimam; Hegazy, Mohamed I; Hendrie, Delia; Heydarpour, Fatemeh; Hird, Thomas R; Hoang, Chi Linh; Hollerich, Gillian; Rad, Enayatollah Homaie; Hoseini-Ghahfarokhi, Mojtaba; Hossain, Naznin; Hosseini, Mostafa; Hosseinzadeh, Mehdi; Hostiuc, Mihaela; Hostiuc, Sorin; Househ, Mowafa; Hsairi, Mohamed; Ilesanmi, Olayinka Stephen; Imani-Nasab, Mohammad Hasan; Iqbal, Usman; Irvani, Seyed Sina Naghibi; Islam, Nazrul; Islam, Sheikh Mohammed Shariful; Jürisson, Mikk; Balalami, Nader Jafari; Jalali, Amir; Javidnia, Javad; Jayatilleke, Achala Upendra; Jenabi, Ensiyeh; Ji, John S; Jobanputra, Yash B; Johnson, Kimberly; Jonas, Jost B; Shushtari, Zahra Jorjoran; Jozwiak, Jacek Jerzy; Kabir, Ali; Kahsay, Amaha; Kalani, Hamed; Kalhor, Rohollah; Karami, Manoochehr; Karki, Surendra; Kasaeian, Amir; Kassebaum, Nicholas J; Keiyoro, Peter Njenga; Kemp, Grant Rodgers; Khabiri, Roghayeh; Khader, Yousef Saleh; Khafaie, Morteza Abdullatif; Khan, Ejaz Ahmad; Khan, Junaid; Khan, Muhammad Shahzeb; Khang, Young-Ho; Khatab, Khaled; Khater, Amir; Khater, Mona M; Khatony, Alireza; Khazaei, Mohammad; Khazaei, Salman; Khazaei-Pool, Maryam; Khubchandani, Jagdish; Kianipour, Neda; Kim, Yun Jin; Kimokoti, Ruth W; Kinyoki, Damaris K; Kisa, Adnan; Kisa, Sezer; Kolola, Tufa; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Kraemer, Moritz UG; Krishan, Kewal; Krohn, Kris J; Kugbey, Nuworza; Kumar, G Anil; Kumar, Manasi; Kumar, Pushpendra; Kuupiel, Desmond; Lacey, Ben; Lad, Sheetal D; Lami, Faris Hasan; Larsson, Anders O; Lee, Paul H; Leili, Mostafa; Levine, Aubrey J; Li, Shanshan; Lim, Lee-Ling; Listl, Stefan; Longbottom, Joshua; Lopez, Jaifred Christian F; Lorkowski, Stefan; Magdeldin, Sameh; Abd El Razek, Hassan Magdy; Abd El Razek, Muhammed Magdy; Majeed, Azeem; Maleki, Afshin; Malekzadeh, Reza; Malta, Deborah Carvalho; Mamun, Abdullah A; Manafi, Navid; Manda, Ana-Laura; Mansourian, Morteza; Martins-Melo, Francisco Rogerlândio; Masaka, Anthony; Massenburg, Benjamin Ballard; Maulik, Pallab K; Mayala, Benjamin K; Mazidi, Mohsen; McKee, Martin; Mehrotra, Ravi; Mehta, Kala M; Meles, Gebrekiros Gebremichael; Mendoza, Walter; Menezes, Ritesh G; Meretoja, Atte; Meretoja, Tuomo J; Mestrovic, Tomislav; Miller, Ted R; Miller-Petrie, Molly K; Mills, Edward J; Milne, George J; Mini, GK; Mir, Seyed Mostafa; Mirjalali, Hamed; Mirrakhimov, Erkin M; Mohamadi, Efat; Mohammad, Dara K; Mohammad, Dara K; Darwesh, Aso Mohammad; Mezerji, Naser Mohammad Gholi; Mohammed, Ammas Siraj; Mohammed, Shafiu; Mokdad, Ali H; Molokhia, Mariam; Monasta, Lorenzo; Moodley, Yoshan; Moosazadeh, Mahmood; Moradi, Ghobad; Moradi, Masoud; Moradi, Yousef; Moradi-Lakeh, Maziar; Moradinazar, Mehdi; Moraga, Paula; Morawska, Lidia; Mosapour, Abbas; Mousavi, Seyyed Meysam; Mueller, Ulrich Otto; Muluneh, Atalay Goshu; Mustafa, Ghulam; Nabavizadeh, Behnam; Naderi, Mehdi; Nagarajan, Ahamarshan Jayaraman; Nahvijou, Azin; Najafi, Farid; Nangia, Vinay; Ndwandwe, Duduzile Edith; Neamati, Nahid; Negoi, Ionut; Negoi, Ruxandra Irina; Ngunjiri, Josephine W; Thi Nguyen, Huong Lan; Nguyen, Long Hoang; Nguyen, Son Hoang; Nielsen, Katie R; Ningrum, Dina Nur Anggraini; Nirayo, Yirga Legesse; Nixon, Molly R; Nnaji, Chukwudi A; Nojomi, Marzieh; Noroozi, Mehdi; Nosratnejad, Shirin; Noubiap, Jean Jacques; Motlagh, Soraya Nouraei; Ofori-Asenso, Richard; Ogbo, Felix Akpojene; Oladimeji, Kelechi E; Olagunju, Andrew T; Olfatifar, Meysam; Olum, Solomon; Olusanya, Bolajoko Olubukunola; Oluwasanu, Mojisola Morenike; Onwujekwe, Obinna E; Oren, Eyal; Ortega-Altamirano, Doris DV; Ortiz, Alberto; Osarenotor, Osayomwanbo; Osei, Frank B; Osgood-Zimmerman, Aaron E; Otstavnov, Stanislav S; Owolabi, Mayowa Ojo; P A, Mahesh; Pagheh, Abdol Sattar; Pakhale, Smita; Panda-Jonas, Songhomitra; Pandey, Animika; Park, Eun-Kee; Parsian, Hadi; Pashaei, Tahereh; Patel, Sangram Kishor; Pepito, Veincent Christian Filipino; Pereira, Alexandre; Perkins, Samantha; Pickering, Brandon V; Pilgrim, Thomas; Pirestani, Majid; Piroozi, Bakhtiar; Pirsaheb, Meghdad; Plana-Ripoll, Oleguer; Pourjafar, Hadi; Puri, Parul; Qorbani, Mostafa; Quintana, Hedley; Rabiee, Mohammad; Rabiee, Navid; Radfar, Amir; Rafiei, Alireza; Rahim, Fakher; Rahimi, Zohreh; Rahimi-Movaghar, Vafa; Rahimzadeh, Shadi; Rajati, Fatemeh; Raju, Sree Bhushan; Ramezankhani, Azra; Ranabhat, Chhabi Lal; Rasella, Davide; Rashedi, Vahid; Rawal, Lal; Reiner, Robert C; Renzaho, Andre MN; Rezaei, Satar; Rezapour, Aziz; Riahi, Seyed Mohammad; Ribeiro, Ana Isabel; Roever, Leonardo; Roro, Elias Merdassa; Roser, Max; Roshandel, Gholamreza; Roshani, Daem; Rostami, Ali; Rubagotti, Enrico; Rubino, Salvatore; Sabour, Siamak; Sadat, Nafis; Sadeghi, Ehsan; Saeedi, Reza; Safari, Yahya; Safari-Faramani, Roya; Safdarian, Mahdi; Sahebkar, Amirhossein; Salahshoor, Mohammad Reza; Salam, Nasir; Salamati, Payman; Salehi, Farkhonde; Zahabi, Saleh Salehi; Salimi, Yahya; Salimzadeh, Hamideh; Salomon, Joshua A; Sambala, Evanson Zondani; Samy, Abdallah M; Santric Milicevic, Milena M; Jose, Bruno Piassi Sao; Saraswathy, Sivan Yegnanarayana Iyer; Sarmiento-Suárez, Rodrigo; Sartorius, Benn; Sathian, Brijesh; Saxena, Sonia; Sbarra, Alyssa N; Schaeffer, Lauren E; Schwebel, David C; Sepanlou, Sadaf G; Seyedmousavi, Seyedmojtaba; Shaahmadi, Faramarz; Shaikh, Masood Ali; Shams-Beyranvand, Mehran; Shamshirian, Amir; Shamsizadeh, Morteza; Sharafi, Kiomars; Sharif, Mehdi; Sharif-Alhoseini, Mahdi; Sharifi, Hamid; Sharma, Jayendra; Sharma, Rajesh; Sheikh, Aziz; Shields, Chloe; Shigematsu, Mika; Shiri, Rahman; Shiue, Ivy; Shuval, Kerem; Siddiqi, Tariq J; Silva, João Pedro; Singh, Jasvinder A; Sinha, Dhirendra Narain; Sisay, Malede Mequanent; Sisay, Solomon; Sliwa, Karen; Smith, David L; Somayaji, Ranjani; Soofi, Moslem; Soriano, Joan B; Sreeramareddy, Chandrashekhar T; Sudaryanto, Agus; Sufiyan, Mu'awiyyah Babale; Sykes, Bryan L; Sylaja, PN; Tabarés-Seisdedos, Rafael; Tabb, Karen M; Tabuchi, Takahiro; Taveira, Nuno; Temsah, Mohamad-Hani; Terkawi, Abdullah Sulieman; Tessema, Zemenu Tadesse; Thankappan, Kavumpurathu Raman; Thirunavukkarasu, Sathish; To, Quyen G; Tovani-Palone, Marcos Roberto; Tran, Bach Xuan; Tran, Khanh Bao; Ullah, Irfan; Usman, Muhammad Shariq; Uthman, Olalekan A; Vahedian-Azimi, Amir; Valdez, Pascual R; van Boven, Job FM; Vasankari, Tommi Juhani; Vasseghian, Yasser; Veisani, Yousef; Venketasubramanian, Narayanaswamy; Violante, Francesco S; Vladimirov, Sergey Konstantinovitch; Vlassov, Vasily; Vos, Theo; Vu, Giang Thu; Vujcic, Isidora S; Waheed, Yasir; Wakefield, Jon; Wang, Haidong; Wang, Yafeng; Wang, Yuan-Pang; Ward, Joseph L; Weintraub, Robert G; Weldegwergs, Kidu Gidey; Weldesamuel, Girmay Teklay; Westerman, Ronny; Wiysonge, Charles Shey; Wondafrash, Dawit Zewdu; Woyczynski, Lauren; Wu, Ai-Min; Xu, Gelin; Yadegar, Abbas; Yamada, Tomohide; Yazdi-Feyzabadi, Vahid; Yilgwan, Christopher Sabo; Yip, Paul; Yonemoto, Naohiro; Lebni, Javad Yoosefi; Younis, Mustafa Z; Yousefifard, Mahmoud; Yousof, Hebat-Allah Salah A; Yu, Chuanhua; Yusefzadeh, Hasan; Zabeh, Erfan; Moghadam, Telma Zahirian; Bin Zaman, Sojib; Zamani, Mohammad; Zandian, Hamed; Zangeneh, Alireza; Zerfu, Taddese Alemu; Zhang, Yunquan; Ziapour, Arash; Zodpey, Sanjay; Murray, Christopher JL; Hay, Simon ISince 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.Item Open Access Occupational Determinants of Cumulative Lead Exposure(Journal of Occupational and Environmental Medicine, 2014-04) Ji, John S; Schwartz, Joel; Sparrow, David; Hu, Howard; Weisskopf, Marc GItem Open Access The Effects of Residential Greenness and Air Pollution on Oxidative Stress Levels in Urban and Peri-urban Residents of Beijing(2021) Qi, WenhaoBackground and Aims Exposure to air pollution has been associated with increased risks of cardiopulmonary diseases, cancer, and mortality. Simultaneously, greenspace has also documented to be protective of mortality. Oxidative stress may be an intermediate biomarker in these processes. There has been little investigation on the effects of residential greenness and air pollution on oxidative stress. There are two aims of this study: 1) To explore the association of personal and ambient air pollution exposure with urinary oxidative stress levels; 2) To investigate the association of quantified-contemporary greenness with urinary oxidative stress levels and the interaction between greenness and air pollution exposure in affecting oxidative stress levels, respectively.
Methods In an existing panel study named AIRLESS (Effects of AIR pollution on cardiopuLmonary disEaSe in urban and peri-urban reSidents in Beijing), 123 residents living in an urban district (Haidian district) and 128 residents in a peri-urban district (Pinggu) of Beijing participated in the study. All participants were non-smokers, ≥ 49 years of age, and included 110 men and 140 women. Personal and ambient exposures to air pollutants were assessed for each participant during winter 2016 and summer 2017, respectively. Each participant was instructed to carry a validated personal air monitor (PAM) to measure particulate matters (PM1, PM2.5, and PM10), nitrogen dioxide, carbon monoxide, and ozone concentrations at a high spatiotemporal resolution seven consecutive days in each sampling season. We calculated contemporaneous green space coverage level by the average daily satellite-derived Normalized Difference Vegetation Index (NDVI) in the zone with 500m*500m grids by Google Earth Engine (GEE) using the Moderate-resolution Imaging Spectroradiometer (MODIS) dataset from NASA (National Aeronautics and Space Administration). We used the coordinates of the ambient air pollution monitoring stations and monitoring dates to match the NDVI data. Multiple oxidative stress biomarkers were measured, including urinary free malondialdehyde (MDA), urinary total MDA, and urinary 8-hydroxydeoxyguanosine (8-OHdG). All biomarkers were normalized by urinary creatinine in statistical analyses. Due to the right skewness, all biomarkers data were ln-transformed in the aim-specific analyses. (1) The association of personal and ambient air pollution exposure with the percent change of urinary oxidative stress biomarkers was estimated using linear mixed-effects models and the distributed lag linear model was used to investigate daily air pollutants’ hysteresis effects on the percent change of urinary oxidative stress biomarkers. (2) The association between tertiary NDVI with urinary oxidative stress biomarkers was estimated using linear mixed-effects regression and subgroup analysis was used to test the robustness of the association between quantified NDVI with the mean percent change of oxidative stress biomarkers using the linear mixed-effects model in different groups. (3) To explore the interaction between greenness and air pollution in affecting oxidative stress by each of these exposure variables, stratified analyses were conducted to examine whether air pollution exposure modifies the effect of greenness and whether greenness modifies the effect of air pollution. Tertiles of NDVI, personal PM2.5 exposure, and personal ozone exposure were used in these analyses.
Results We found positive associations of CO and ozone personal exposure, respectively, with percent change of the three oxidative stress biomarkers. The association tended to be significant only in the ozone model with the percent change of 8-OHdG [8.69% 95%CI: (2.98,14.39), p-value=0.004]. However, in the models of ambient air pollution, some non-significantly negative associations were observed. Consistent positive associations of ambient lag 1- and 2- day CO exposure with the percent change in levels of each of the three oxidative stress biomarkers were weakly persisted. However, the positive associations remained significant between CO exposure and total MDA (p value=0.033) only in lag2-day. In the analyses of greenness as the exposure variable, we observed that individuals who lived in greener areas tended to have lower levels of oxidative stress. Participants in the highest NDVI tertile (0.36-0.83) had significantly lower free and total MDA levels, mean and (95%CI) by -20.21% (-37.84%, -1.30%) and -17.77% (-32.89%, -2.16%), respectively, compared to the lowest NDVI tertile (0.11-0.25) (p-value =0.028). In the urban area, we found significant negative associations of NDVI with free MDA (p-=0.003), total MDA (p =0.005), and 8-OHdG (p=0.022), but not in the peri-urban area. In the modification (interaction) analyses, we observed negative estimates of quantified NDVI associated with each of the three biomarkers in the low personal ozone exposure group (Ozone≤18.7 ppb). We also observed negative estimates of quantified NDVI associated with free and total MDA in the low PM2.5 exposure group (PM2.5≤32μg/m3). In addition, we observed significant effects of personal ozone exposure on 8-OHdG [17.77 95%CI: (8.04, 27.56), p value=0.010]; personal CO exposure on free MDA [12.48 95%CI: (3.15, 21.85), p value=0.012 and total MDA [9.06 95%CI: (1.28, 16.64), p value=0.021] only in participants falling in the lowest NDVI tertile; and the positive associations were no longer significant in participants with higher tertiary NDVI.
Conclusion The protective effects of greenness on oxidative stress, especially in urban residents, elucidates the importance of green space in the urban built environment. Additionally, the adverse effects of air pollution exposure on oxidative stress indicates the noteworthiness of personal protection against air pollution exposure in urban residents.
Item Open Access The Tsinghua-Lancet Commission on Healthy Cities in China: unlocking the power of cities for a healthy China.(Lancet (London, England), 2018-04-17) Yang, Jun; Siri, José G; Remais, Justin V; Cheng, Qu; Zhang, Han; Chan, Karen KY; Sun, Zhe; Zhao, Yuanyuan; Cong, Na; Li, Xueyan; Zhang, Wei; Bai, Yuqi; Bi, Jun; Cai, Wenjia; Chan, Emily YY; Chen, Wanqing; Fan, Weicheng; Fu, Hua; He, Jianqing; Huang, Hong; Ji, John S; Jia, Peng; Jiang, Xiaopeng; Kwan, Mei-Po; Li, Tianhong; Li, Xiguang; Liang, Song; Liang, Xiaofeng; Liang, Lu; Liu, Qiyong; Lu, Yongmei; Luo, Yong; Ma, Xiulian; Schwartländer, Bernhard; Shen, Zhiyong; Shi, Peijun; Su, Jing; Wu, Tinghai; Yang, Changhong; Yin, Yongyuan; Zhang, Qiang; Zhang, Yinping; Zhang, Yong; Xu, Bing; Gong, PengItem Open Access Time for health to enter China's climate action framework(The Lancet Public Health, 2019-09-01) Ji, John S