The Lancet Regional Health: Western Pacific最新文献

{"title":"Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adults","authors":"Paul J. Collings ,&nbsp;Mengyao Wang ,&nbsp;Harrison Hin Sheung Ho ,&nbsp;Shiu Lun Au Yeung ,&nbsp;Parco M. Siu ,&nbsp;Benjamin J. Cowling ,&nbsp;Stephen J. Sharp ,&nbsp;Søren Brage ,&nbsp;Nicholas J. Wareham ,&nbsp;Huaidong Du ,&nbsp;Derrick A. Bennett ,&nbsp;Youngwon Kim ,&nbsp;China Kadoorie Biobank (CKB) Study Collaborative Group","doi":"10.1016/j.lanwpc.2025.101524","DOIUrl":"10.1016/j.lanwpc.2025.101524","url":null,"abstract":"<div><h3>Background</h3><div>In Chinese adults, there is a considerable burden of sedentary behaviour. This study aimed to estimate the implications of reallocating sedentary leisure-time to non-sedentary behaviours for incident cardiometabolic diseases.</div></div><div><h3>Methods</h3><div>A prospective cohort study of 462,370 Chinese adults (mean age 51 years; 59% female) who were free from diabetes and cardiovascular diseases at baseline. Isotemporal substitution Cox regression models were used to estimate the associations of reallocating self-reported sedentary leisure-time to the same amount of sleep, housework, Taichi, or conventional exercise (e.g., walking, jogging, ball games, swimming) with the risk of incident diabetes, stroke, and myocardial infarction (MI). The results are reported as adjusted hazard ratios and 95% confidence intervals per 30 min/day time exchanges. Potential impact fractions were calculated to estimate the proportional reductions in incident disease cases associated with time substitutions, assuming causality.</div></div><div><h3>Findings</h3><div>During &gt;5.25 million person-years of follow-up, 19,738 incident diabetes, 51,460 stroke, and 6767 MI cases were accrued. Lower disease risks were found for replacement of sedentary leisure-time by sleep (diabetes: 0.97 [0.95–0.99], stroke: 0.98 [0.97–0.99], MI: 0.97 [0.94–0.99]; in participants who slept &lt;7 h/day), housework (diabetes: 0.97 [0.97–0.98], stroke: 0.99 [0.98–0.99], MI: 0.97 [0.95–0.98]), Taichi (diabetes: 0.97 [0.95–0.99], stroke: 0.98 [0.97–0.99], MI: 0.95 [0.92–0.98]), or conventional exercise (diabetes: 0.97 [0.95–0.99], stroke: 0.97 [0.95–0.98], MI: 0.92 [0.88–0.96]). Potential impact fractions ranged from an estimated 3.5% (95% confidence interval: 3.1–3.9%) fewer cases of incident stroke when replacing sedentary leisure-time with housework, to an estimated 9.6% (5.9–13.3%) fewer cases of incident MI when reallocating sedentary leisure-time to conventional exercise.</div></div><div><h3>Interpretation</h3><div>Replacing sedentary leisure-time with behaviours such as housework, Taichi, sleep (in short sleepers) and conventional exercise is associated with lower risks of common cardiometabolic diseases in Chinese adults. Prevention strategies should be developed to promote movement behaviours and optimal levels of sleep at the expense of sedentary leisure-time.</div></div><div><h3>Funding</h3><div>This analysis was supported by a <span>Health and Medical Research Fund</span> (HMRF) Research Fellowship (grant no: <span><span>06200087</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101524"},"PeriodicalIF":7.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent lymphatic filariasis transmission seven years after validation of elimination as a public health problem: a cross-sectional study in Tonga","authors":"Harriet L.S. Lawford ,&nbsp;‘Ofa Tukia ,&nbsp;Joseph Takai ,&nbsp;Sarah Sheridan ,&nbsp;Selina Ward ,&nbsp;Holly Jian ,&nbsp;Beatris Mario Martin ,&nbsp;Reynold ‘Ofanoa ,&nbsp;Colleen L. Lau","doi":"10.1016/j.lanwpc.2025.101513","DOIUrl":"10.1016/j.lanwpc.2025.101513","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization (WHO) has validated 21 countries as having eliminated lymphatic filariasis (LF) as a public health problem. Post-validation surveillance (PVS) is required in countries where LF has been eliminated. Tonga eliminated LF in 2017, but no PVS strategy has been established. We aimed to identify any persistent LF transmission in Tonga in 2024 and provide evidence to support a PVS strategy.</div></div><div><h3>Methods</h3><div>A four-pronged, targeted, cross-sectional study was conducted in the Tongan districts of Tongatapu, Ha’apai, and Ongo Niuas in May–July 2024 in communities, primary schools, high schools, and an outpatient clinic. Participants were tested for LF antigen (Ag) and microfilariae (Mf). The outcome measure for persistent LF transmission was Ag-positivity.</div></div><div><h3>Findings</h3><div>Between 9 May and 19 July 2024, 1787 participants were recruited from 12 communities, 11 primary schools, five high schools, and one outpatient clinic. Overall, 39 participants (2·2%) were Ag-positive and five (0·3%) were Mf-positive. The highest Ag prevalence was in communities (4·0%; 95% confidence interval [95%CI]: 2·9–5·6), where all Mf-positives (n = 5) were identified. Ag-positivity was associated with male sex (adjusted odds ratio [aOR]:4·86; 95%CI: 2·25–10·46), older age (&gt;50 years vs 5–10 years [aOR:7·51; 95%CI: 2·13–26·47]), and residing in Ha’apai (aOR:15·08; 95%CI: 5·41–42·05) and Ongo Niuas (aOR:10·85; 95%CI: 3·91–30·08).</div></div><div><h3>Interpretation</h3><div>We found persistent LF transmission in Tonga seven years post-validation. Community surveillance yielded the highest Ag and Mf prevalence. Efficiency of PVS could be improved by integrating surveillance activities into the existing health system and conducting community-based surveys, particularly among older males and in high prevalence areas.</div></div><div><h3>Funding</h3><div><span>Task Force for Global Health</span>, <span>Bill &amp; Melinda Gates Foundation</span>, and the <span>United States Agency for International Development</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101513"},"PeriodicalIF":7.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care provided to women during and after a pregnancy complicated by hyperglycaemia: the impacts of a multi-component health systems intervention","authors":"Diana MacKay ,&nbsp;Jacqueline A. Boyle ,&nbsp;Sandra Campbell ,&nbsp;Natasha Freeman ,&nbsp;Anna McLean ,&nbsp;Denella Hampton ,&nbsp;Cherie Whitbread ,&nbsp;Paula Van Dokkum ,&nbsp;Kirby Murtha ,&nbsp;Christine Connors ,&nbsp;Elizabeth Moore ,&nbsp;Ashim Sinha ,&nbsp;Yvonne Cadet-James ,&nbsp;Sharni Cardona ,&nbsp;Jeremy Oats ,&nbsp;H David McIntyre ,&nbsp;Anthony J. Hanley ,&nbsp;Alex Brown ,&nbsp;Jonathan E. Shaw ,&nbsp;Renae Kirkham ,&nbsp;Louise Maple-Brown","doi":"10.1016/j.lanwpc.2025.101514","DOIUrl":"10.1016/j.lanwpc.2025.101514","url":null,"abstract":"<div><h3>Background</h3><div>Aboriginal and Torres Strait Islander women experience a disproportionate burden of hyperglycaemia in pregnancy. A multi-component health systems intervention aiming to improve antenatal and postpartum care was implemented across Australia’s Northern Territory (NT) and Far North Queensland (FNQ) between 2016 and 2019. Components included clinician education, improving recall systems, enhancing policies and guidelines, and embedding Diabetes in Pregnancy (DIP) Clinical Registers in systems of care. This program was evaluated to determine impacts on clinical practice and maternal health.</div></div><div><h3>Methods</h3><div>Data for women with hyperglycaemia in pregnancy from primary care clinical records and the DIP Clinical Registers were analysed to assess changes in: antenatal and postpartum diabetes testing; HbA1c/glucose levels; medication use; weight checks performed, weight and body mass index; and postpartum contraception, smoking and breastfeeding.</div></div><div><h3>Findings</h3><div>Clinical practice in the NT improved, including increased uptake of the recommended first trimester 75 g oral glucose tolerance test among women with hyperglycaemia risk factors (Aboriginal and Torres Strait Islander women 11.7% to 26.5%, p &lt; 0.001; non-Indigenous women 6.2% to 19.3%, p &lt; 0.001). In the NT, postpartum diabetes monitoring (56% to 68%, p = 0.039) and contraceptive use (41% to 60%, p = 0.001) increased among Aboriginal and Torres Strait Islander women. In FNQ, postpartum glucose monitoring increased among women with T2D (26% to 68% Aboriginal and Torres Strait Islander, p = 0.002; 50% to 100% non-Indigenous, p = 0.008), although there were no improvements in antenatal care indicators.</div></div><div><h3>Interpretation</h3><div>Aspects of care for women with hyperglycaemia in pregnancy improved in the NT and FNQ following a multi-component health systems intervention.</div></div><div><h3>Funding</h3><div>This study is funded by the <span>Australian National Health and Medical Research Council</span> (NHMRC) <span>Global Alliance for Chronic Diseases</span> Grant <span><span>1092968</span></span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"57 ","pages":"Article 101514"},"PeriodicalIF":7.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incretin-based drugs and the risk of gallbladder or biliary tract diseases among patients with type 2 diabetes across categories of body mass index: a nationwide cohort study","authors":"Hwa Yeon Ko ,&nbsp;Sungho Bea ,&nbsp;Dongwon Yoon ,&nbsp;Bin Hong ,&nbsp;Jae Hyun Bae ,&nbsp;Young Min Cho ,&nbsp;Ju-Young Shin","doi":"10.1016/j.lanwpc.2024.101242","DOIUrl":"10.1016/j.lanwpc.2024.101242","url":null,"abstract":"<div><h3>Background</h3><div>Despite emerging evidence of gallbladder or biliary tract diseases (GBD) risk regarding incretin-based drugs, population-specific safety profile considering obesity is lacking. We aimed to assess whether stratification by body mass index (BMI) modifies the measures of association between incretin-based drugs and the risk of GBD.</div></div><div><h3>Methods</h3><div>We conducted an active-comparator, new-user cohort study using a nationwide claims data (2013–2022) of Korea. We included type 2 diabetes (T2D) patients stratified by Asian BMI categories: Normal, 18.5 to &lt;23 kg/m²; Overweight, 23 to &lt;25 kg/m²; Obese, ≥25 kg/m². The primary outcome was a composite of GBD, including cholelithiasis, cholecystitis, obstruction of the gallbladder or bile duct, cholangitis, and cholecystectomy. We used 1:1 propensity score (PS) matching and estimated hazard ratios (HR) with 95% confidence intervals (CI) using Cox models.</div></div><div><h3>Findings</h3><div>New users of DPP4i and SGLT2i were 1:1 PS matched (n = 251,420 pairs; 186,697 obese, 39,974 overweight, and 24,749 normal weight pairs). The overall HR for the risk of GBD with DPP4i vs. SGLT2i was 1.21 (95% CI 1.14–1.28), with no effect modification by BMI (p-value: 0.83). For the second cohort, new users of GLP1RA and SGLT2i were 1:1 PS matched (n = 45,443 pairs; 28,011 obese, 8948 overweight, and 8484 normal weight pairs). The overall HR for the risk of GBD with GLP1RA vs. SGLT2i was 1.27 (1.07–1.50), with no effect modification by BMI (p-value: 0.73).</div></div><div><h3>Interpretation</h3><div>The increased risks of GBD were presented in both cohorts with no evidence of effect heterogeneity by BMI.</div></div><div><h3>Funding</h3><div><span>Ministry of Food and Drug Safety</span>, Health Fellowship Foundation.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101242"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of population-based screening for chronic kidney disease among the general population and adults with diabetes in China: a modelling study","authors":"Fengyu Wen ,&nbsp;Jinwei Wang ,&nbsp;Chao Yang ,&nbsp;Fulin Wang ,&nbsp;Yan Li ,&nbsp;Luxia Zhang ,&nbsp;José A. Pagán","doi":"10.1016/j.lanwpc.2025.101493","DOIUrl":"10.1016/j.lanwpc.2025.101493","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Despite the majority of patients with chronic kidney disease (CKD) live in low- and middle-income countries, most evidence on screening strategies is derived from high-income countries, where the contexts differ significantly. This study aims to assess the cost-effectiveness of population-based CKD screening strategies in both the general population and adults with diabetes in China.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A validated microsimulation model of CKD was developed to evaluate the costs and health consequences of population-based CKD screening strategies from a societal perspective. A cohort of the population aged 45 years in China was simulated over their lifetime. Model parameters were estimated based on the existing literature and various data sources in China. Main outcomes included the averted number of cases with cardiovascular disease (CVD) and kidney failure with replacement therapy (KFRT) under the population-based screening strategy compared with usual care, and the incremental cost-effectiveness ratios (ICERs). CKD screening with different frequencies and for different age groups in both the general population and adults with diabetes were considered. One-way sensitivity analyses were performed to assess the robustness of the results.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The ICER of annual screening starting at 45 years of age was $10,588 per quality-adjusted life year (QALY) for the general population and $9184 per QALY for adults with diabetes. Other screening strategies were also cost-effective compared to usual care, with ICERs less than three times the per-capita gross domestic product of China ($35,501). The most prominent absolute decrease in lifetime incidence of KFRT and CVD were also observed with the annual screening strategy in both the general population and in adults with diabetes. Specifically, the decreases were 1.88 and 8.55 per 1000 individuals for KFRT, and 35.07 and 19.92 per 1000 individuals for CVD, respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;CKD screening in both the general population and adults with diabetes is cost-effective and could avert substantial numbers of KFRT and CVD cases in China.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;This study was supported by grants from &lt;span&gt;National Natural Science Foundation of China&lt;/span&gt; (&lt;span&gt;&lt;span&gt;72125009&lt;/span&gt;&lt;/span&gt;), &lt;span&gt;National Key Research and Development Program of China&lt;/span&gt; (&lt;span&gt;&lt;span&gt;2022YFF1203001&lt;/span&gt;&lt;/span&gt;), &lt;span&gt;National High Level Hospital Clinical Research Funding&lt;/span&gt; (State Key Laboratory of Vascular Homeostasis and Remodeling, &lt;span&gt;Peking University&lt;/span&gt;, &lt;span&gt;&lt;span&gt;24QZ007&lt;/span&gt;&lt;/span&gt;), &lt;span&gt;Peking University&lt;/span&gt; Medicine Sailing Program for Young Scholars’ Scientific &amp; Technological Innovation (&lt;span&gt;&lt;span&gt;BMU2023YFJHMX014&lt;/span&gt;&lt;/span&gt;), Young Elite Scientists Sponsorship Program by &lt;span&gt;CAST&lt;/span&gt; (&lt;span&gt;&lt;span&gt;2022QNRC001&lt;/span&gt;&lt;/span&gt;), and &lt;span&gt;CAMS Innovation Fun","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101493"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming barriers to primary care research in Japan: a call to action","authors":"Thomas Rouyard ,&nbsp;Emilie Yoda ,&nbsp;Ryota Nakamura ,&nbsp;Michiko Moriyama ,&nbsp;Masako Ii ,&nbsp;Maham Stanyon ,&nbsp;Mei Endo ,&nbsp;Koki Nakamura ,&nbsp;Satoshi Kanke ,&nbsp;Ryuki Kassai","doi":"10.1016/j.lanwpc.2025.101523","DOIUrl":"10.1016/j.lanwpc.2025.101523","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101523"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the technical feasibility of serological testing and treatment for Plasmodium vivax in mobile at-risk of malaria Cambodian populations","authors":"Costanza Tacoli ,&nbsp;Sopheany Thin ,&nbsp;Malen Ea ,&nbsp;Nimol Khim ,&nbsp;Agnes Orban ,&nbsp;Dysoley Lek ,&nbsp;Rhea J. Longley ,&nbsp;Michael White ,&nbsp;Leanne J. Robinson ,&nbsp;Benoit Witkowski ,&nbsp;Ivo Mueller ,&nbsp;Jean Popovici","doi":"10.1016/j.lanwpc.2025.101518","DOIUrl":"10.1016/j.lanwpc.2025.101518","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Cambodia is targeting malaria elimination by 2025, aligning with the WHO's Mekong Malaria Elimination program. While elimination of &lt;em&gt;Plasmodium falciparum&lt;/em&gt; is nearly achieved, &lt;em&gt;Plasmodium vivax&lt;/em&gt; elimination presents challenges inherent to this species due to the occurrence of dormant parasite stages, known as hypnozoites. A new approach has been proposed to serologically identify individuals likely carrying hypnozoites that should receive appropriate antimalarial treatment: &lt;em&gt;P. vivax&lt;/em&gt; serological testing and treatment (PvSeroTAT). This study aims to determine the technical feasibility of a PvSeroTAT approach in malaria endemic communities with highly mobile populations in Eastern Cambodia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;From October 24th 2021 to February 26th 2023, two successive rounds of PvSeroTAT were conducted in adult and adolescent males in three villages of Mondolkiri, Eastern Cambodia. At each round, capillary blood samples were collected from consenting participants to be used for &lt;em&gt;P. vivax&lt;/em&gt; serology and G6PD activity determination. Seropositive participants, who were G6PD normal, were then recontacted to be provided an anti-hypnozoite primaquine regimen following Cambodian treatment guidelines (0.25 mg/kg for 14 days). Cross-sectional surveys to evaluate &lt;em&gt;P. vivax&lt;/em&gt; prevalence were conducted before, during and after the PvSeroTAT interventions in the same three villages and in three additional neighboring control villages where interventions were not implemented.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Participation was high, with 96% (456/477) of eligible individuals enrolled in at least one round of PvSeroTAT. However, only 63% of participants enrolled in the first PvSeroTAT round agreed to participate in the second round. In the first and second round of PvSeroTAT, 31% (101/327) and 30% (98/334) of enrolled participants, respectively, were seropositive and among those, 82% (163/199) were eligible for primaquine treatment. All 163 seropositive eligible individuals could be recontacted and offered a primaquine treatment, this occurred within 10 days for 96% of individuals (157/163). &lt;em&gt;P. vivax&lt;/em&gt; prevalence decreased in all villages, including the control ones, after the first round of PvSeroTAT from 7.7% to 2.7% overall.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The participation rates and overall technical feasibility of PvSeroTAT in highly mobile individuals living within communities in malaria endemic areas of Cambodia were very promising. PvSeroTAT with a lab-based assay is feasible in Cambodia even if it is logistically more challenging than using point-of-care assays. Further studies to understand community perspectives about test and treat approaches in the absence of clinical symptoms will be important for the development of tailored community education and awareness material to improve participation in multiple rounds of test and treat interventions.&lt;/di","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101518"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impulse oscillometry-derived equation for prediction of abnormal FEV1/FVC ratio for COPD screening in Chinese population: a multicenter cross-sectional study","authors":"Meishan Liu ,&nbsp;Xin Yao ,&nbsp;Yiwei Shi ,&nbsp;Huiguo Liu ,&nbsp;Liang Chen ,&nbsp;Yong Lu ,&nbsp;Chunmei Zhang ,&nbsp;Xinran Zhang ,&nbsp;Lirong Liang ,&nbsp;Xiaohong Chang ,&nbsp;Li An ,&nbsp;Kian Fan Chung ,&nbsp;Janwillem W.H. Kocks ,&nbsp;Kewu Huang","doi":"10.1016/j.lanwpc.2025.101501","DOIUrl":"10.1016/j.lanwpc.2025.101501","url":null,"abstract":"<div><h3>Background</h3><div>The diagnosis of chronic obstructive pulmonary disease (COPD) is based on spirometry that requires a forced expiratory manoeuvre, which is laborious and difficult for mass screening. Impulse oscillometry (IOS) is easier than spirometry and performed with tidal breathing. We sought to develop an equation for predicting forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) and screening COPD using IOS parameters.</div></div><div><h3>Methods</h3><div>Data from patients who simultaneously underwent spirometry and IOS were obtained from databases at five tertiary hospitals in China. Multivariable linear regression analysis was used to develop a predictive model for pre-bronchodilator (BD) FEV₁/FVC. Model performance was analyzed against spirometric criteria of airflow obstruction (AO, defined as pre-BD FEV₁/FVC &lt; 0.7) and COPD (post-BD FEV₁/FVC &lt; 0.7).</div></div><div><h3>Findings</h3><div>Using 15,113 patients and externally validated with 9586 patients, the model estimated FEV₁/FVC ratio could identified AO and spirometry-defined COPD in internal (AUC = 0.822 and 0.849, respectively) and external (AUC = 0.790 and 0.828, respectively) validation. A clinical algorithm was constructed to classify patients into three different groups: estimated FEV₁/FVC &lt; 0.7: likely COPD; estimated FEV₁/FVC ≥ 0.7 and ≤0.73: suspicious for COPD; estimated FEV₁/FVC &gt; 0.73: unlikely COPD. The sensitivity and specificity for detecting spirometry-defined COPD were 88.0% and 77.0%, respectively, while the negative predictive value ranged from 93.7% to 98.6% and positive predictive value ranged from 26.5% to 62.1% across different COPD prevalence groups in the Chinese population.</div></div><div><h3>Interpretation</h3><div>This equation could be useful to screen for COPD particularly in community and primary care settings.</div></div><div><h3>Funding</h3><div>The Financial Budgeting Project of <span>Beijing Institute of Respiratory Medicine</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101501"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in smoking prevalence among 14–15-year-old adolescents before and after the emergence of vaping in New Zealand; an interrupted time series analysis of repeated cross-sectional data, 1999–2023","authors":"Sam Egger ,&nbsp;Michael David ,&nbsp;Judith McCool ,&nbsp;Lucy Hardie ,&nbsp;Marianne F. Weber ,&nbsp;Qingwei Luo ,&nbsp;Becky Freeman","doi":"10.1016/j.lanwpc.2025.101522","DOIUrl":"10.1016/j.lanwpc.2025.101522","url":null,"abstract":"<div><h3>Background</h3><div>New Zealand experienced a prolonged period of minimal regulation on e-cigarettes until the passing of the 2020 Smokefree Environments and Regulated Products (Vaping) Amendment Act.</div></div><div><h3>Methods</h3><div>Interrupted time series analyses of the Action for Smokefree 2025 (ASH) Year 10 Snapshot Survey data from 1999 to 2023 to compare changes in smoking trends among 14–15-year-old students (n = 690,470) before and after the advent of vaping in New Zealand (around 2010).</div></div><div><h3>Findings</h3><div>The prevalence of daily-vaping increased from 1.1% in 2015 (the first year the question was asked) to 1.8% in 2018 before rising to 10.0% in 2023, a nine-fold increase over eight years. From 1999 to 2023, considerable declines in ever-, regular-, and daily-smoking prevalence were observed. However, the rates of decline in ever- and regular-smoking slowed significantly from 2010 onwards (p &lt; 0.001 for both), coinciding with the advent and rapid growth of vaping among New Zealand adolescents. In contrast, the rate of decline in daily-smoking did not significantly change from 2010 onwards (p = 0.066). These findings were robust to sensitivity analyses, including the use of different time series interruption points (change-years) and controlling for inflation-adjusted cigarette prices.</div></div><div><h3>Interpretation</h3><div>Our findings starkly contrast with those from a previous analysis of ASH data, which suggested that e-cigarettes appear to be displacing smoking among New Zealand youth. Instead, our findings suggest that among 14–15-year-olds, the rapid rise of vaping may have slowed the rates of decline in ever- and regular-smoking, while having little or no impact on the rate of decline in daily smoking. Our findings underscore the importance of effective policy approaches to curb both adolescent vaping and smoking.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101522"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-cancer risks among female breast cancer survivors: a matched cohort study in Japan","authors":"Chitose Kawamura ,&nbsp;Krishnan Bhaskaran ,&nbsp;Takaaki Konishi ,&nbsp;Yasuaki Sagara ,&nbsp;Hiroko Bando ,&nbsp;Tomohiro Shinozaki ,&nbsp;Shuko Nojiri ,&nbsp;Motohiko Adomi ,&nbsp;Angel Y.S. Wong ,&nbsp;Nanako Tamiya ,&nbsp;Masao Iwagami","doi":"10.1016/j.lanwpc.2025.101519","DOIUrl":"10.1016/j.lanwpc.2025.101519","url":null,"abstract":"<div><h3>Background</h3><div>The number of breast cancer (BC) survivors has increased worldwide, but the landscape of their non-cancer disease risks remains unclear, especially among Asian women.</div></div><div><h3>Methods</h3><div>In the JMDC claims database, which covers company employees and their family members in Japan, women aged 18–74 years with and without an incident BC were matched in a 1:4 ratio for age and entry timing to the database between January 2005 and December 2019. The risks for six cardiovascular diseases (myocardial infarction, heart failure, atrial fibrillation/flutter, ischaemic stroke, intracranial haemorrhage, and pulmonary embolism) and six non-cardiovascular diseases (major osteoporotic fractures, other fractures, gastrointestinal bleeding, urinary tract infection, infectious pneumonia, and anxiety/depression) were compared between the groups.</div></div><div><h3>Findings</h3><div>Comparing 24,017 BC survivors and 96,068 matched women (mean age, 50.5 years, standard deviation, 8.7 years), the incidence rates of heart failure, atrial fibrillation/flutter, and all non-cardiovascular diseases were higher in the BC survivor group. The highest adjusted hazard ratio (HR) was noted for heart failure (3.99 [95% confidence interval 2.58–6.16]), followed by gastrointestinal bleeding (3.55 [3.10–4.06]), and anxiety/depression (3.06 [2.86–3.28]). The HRs in the first year were larger than those for 1–10 years for most outcomes, whereas the HRs for fracture outcomes were larger for 1–10 years.</div></div><div><h3>Interpretation</h3><div>BC survivors in Japan showed an increased risk of many non-cancer diseases compared to women without BC. Most risks increased more steeply during the first year following diagnosis, whereas the risk of fractures increased later.</div></div><div><h3>Funding</h3><div>Competitive research funding from <span>Pfizer Health Research Foundation</span> in Japan.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"56 ","pages":"Article 101519"},"PeriodicalIF":7.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}