Hui Cai

BackgroundThe birth cohort effect has been suggested to influence the rate of breast cancer incidence and the trends of associated reproductive and lifestyle factors. We conducted a cohort study to determine whether a differential pattern of associations exists between certain factors and breast cancer risk based on birth cohorts.MethodsThis was a cohort study using pooled data from 12 cohort studies. We analysed associations between reproductive (menarche age, menopause age, parity and age at first delivery) and lifestyle (smoking and alcohol consumption) factors and breast cancer risk. We obtained hazard ratios (HRs) with 95% confidence intervals (CIs) using the Cox proportional hazard regression analysis on the 1920s, 1930s, 1940s and 1950s birth cohorts.ResultsParity was found to lower the risk of breast cancer in the older but not in the younger birth cohort, whereas lifestyle factors showed …

BackgroundUnderweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories.MethodsWe used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and …

Body fatness is considered a probable risk factor for biliary tract cancer (BTC), whereas cholelithiasis is an established factor. Nevertheless, although obesity is an established risk factor for cholelithiasis, previous studies of the association of body mass index (BMI) and BTC did not take the effect of cholelithiasis fully into account. To better understand the effect of BMI on BTC, we conducted a pooled analysis using population‐based cohort studies in Asians. In total, 905 530 subjects from 21 cohort studies participating in the Asia Cohort Consortium were included. BMI was categorized into four groups: underweight (<18.5 kg/m2); normal (18.5‐22.9 kg/m2); overweight (23‐24.9 kg/m2); and obese (25+ kg/m2). The association between BMI and BTC incidence and mortality was assessed using hazard ratios (HR) and 95% confidence intervals (CIs) by Cox regression models with shared frailty. Mediation analysis …

Air balancing is a key technology for improving indoor environmental quality and reducing ventilation system energy consumption. Existing air balancing methods just considered damper angles and fan control voltages, combined as single constraint strategy to balance air. Fan power, as the direct parameter affecting system electricity consumption, has not been included in air balancing modelling. On the other hand, single constraint strategy makes current methods inflexible to maintain airflow accuracy and energy efficiency together. This paper proposes a novel air balancing energy-saving model with multiple constraint control strategy. Damper angle, fan control voltage, and fan power are combined by an improved perceptron model. It is aimed at minimizing ventilation system energy consumption, by achieving optimal airflow accuracy and energy conservation. The proposed improved perceptron under multiple …

Background Despite the various anticancer activities of tocopherols, little is known about tocopherols associated with lung cancer risk among low-income African Americans (AA) and European Americans (EA) who are disproportionately affected by the disease. Methods We conducted a nested case–control study that included 209 incident lung cancer cases and 406 matched controls within the Southern Community Cohort Study. Using biospecimens collected at cohort enrollment, plasma levels of α-, β/γ-, δ-, and total-tocopherols were measured by high-performance liquid chromatography with photodiode array detection. Conditional logistic regression was used to estimate ORs and 95% confidence intervals (CI) for lung cancer risk after adjusting for potential confounders. Stratified analyses were also conducted. Results Plasma levels of total-tocopherols …

There has been growing evidence suggesting that diabetes may be associated with increased liver cancer risk. However, studies conducted in Asian countries are limited. This project considered data of 968,738 adults pooled from 20 cohort studies of Asia Cohort Consortium to examine the association between baseline diabetes and liver cancer incidence and mortality. Cox proportional hazard model and competing risk approach was used for pooled data. Two‐stage meta‐analysis across studies was also done. There were 839,194 subjects with valid data regarding liver cancer incidence (5654 liver cancer cases [48.29/100,000 person‐years]), follow‐up time and baseline diabetes (44,781 with diabetes [5.3%]). There were 747,198 subjects with valid data regarding liver cancer mortality (5020 liver cancer deaths [44.03/100,000 person‐years]), follow‐up time and baseline diabetes (43,243 with diabetes [5.8 …

Pancreatic adenocarcinoma (PDAC) is one of the most fatal cancers and currently used biomarkers for PDAC diagnosis are not adequate for early detection. Therefore, new biomarkers for PDAC early detection are urgently needed. We conducted a large-scale study to prospectively evaluate the association of circulating miRNAs with PDAC risk. Specially, we aimed to examine whether the associations of miRNAs expression levels and changes of those levels from blood collection to cancer diagnosis (BCCD) with PDAC risk. We used pre-diagnostic plasma samples of 1307 PDAC cases from 5 cohort studies (290 from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, 395 from the Shanghai Women’s and Men’s Health Studies, 154 from the Southern Community Cohort Study, and 468 from the Multiethnic Cohort). Cancer free controls (n=1307) were selected and individually matched to index …

Background Little research has focused on the relationship between gut microbiome and chemotherapy‐induced toxicity. Methods This prospective study involves 301 patients with breast cancer who had prechemotherapy stool samples collected. Gut microbiome was sequenced by shotgun metagenomics; associations with chemotherapy‐induced toxicities during first‐line treatment by gut microbial diversity, composition, and metabolic pathways with severe (i.e., grade ≥3) hematological and gastrointestinal toxicities were evaluated via multivariable logistic regression. Results High prechemotherapy α‐diversity was associated with a significantly reduced risk of both severe hematological toxicity (odds ratio [OR] = 0.94; 95% CI, 0.89–0.99; p = .048) and neutropenia (OR = 0.94; 95% CI, 0.89–0.99; p = .016). A high abundance of phylum Synergistota, class Synergistia, and order Synergistales were significantly …

Early detection is critical for improving pancreatic cancer prognosis. Our study aims to identify circulating microRNAs (miRNAs) associated with pancreatic cancer risk. The two‐stage study used plasma samples collected ≤5 years prior to cancer diagnosis, from case–control studies nested in five prospective cohort studies. The discovery stage included 185 case–control pairs from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Replication stage samples comprised 277 pairs from Shanghai Women's Health Study/Shanghai Men's Health Study, Southern Community Cohort Study, and Multiethnic Cohort Study. Seven hundred and ninety‐eight miRNAs were measured using the NanoString nCounter Analysis System. Odds ratios (OR) and 95% confidence intervals (CI) for per 10% change in miRNAs in association with pancreatic cancer risk were derived from conditional logistic regression …

PURPOSEGut microbiota play an important role in human health, including cancer. Cancer and its treatment, in turn, may alter the gut microbiome. To understand this complex relationship, we profiled the gut microbiome of 356 Vietnamese patients with breast cancer.MATERIALS AND METHODSStool samples were collected before chemotherapy, with 162 pre- and 194 postsurgery. The gut microbiome was measured by shotgun metagenomic sequencing. Associations of gut microbial diversity, taxa abundance, and gut microbiome health index (GMHI) with sociodemographic, clinical factors, and tumor characteristics were evaluated.RESULTSPostsurgery samples were associated with significantly lower α- and β-diversities (P < .001) and showed significant differences in the abundance of 15% of 2,864 investigated taxa (false discovery rate [FDR] <0.1) compared with presurgery samples. An unhealthy gut …

IntroductionAlthough lung cancer prediction models are widely used to support risk-based screening, their performance outside Western populations remains uncertain. This study aims to evaluate the performance of 11 existing risk prediction models in multiple Asian populations and to refit prediction models for Asians.MethodsIn a pooled analysis of 186,458 Asian ever-smokers from 19 prospective cohorts, we assessed calibration (expected-to-observed ratio) and discrimination (area under the receiver operating characteristic curve [AUC]) for each model. In addition, we developed the “Shanghai models” to better refine risk models for Asians on the basis of two well-characterized population-based prospective cohorts and externally validated them in other Asian cohorts.ResultsAmong the 11 models, the Lung Cancer Death Risk Assessment Tool yielded the highest AUC (AUC [95% confidence interval (CI)] = 0 …

ObjectivesEvaluate the relationship between nurses’ perception of the long-term care (LTC) environment, specifically having visible and accessible hand hygiene stations (HHS), and nurses’ fatigue during the COVID-19 pandemic.BackgroundLTC nurses experience not only heavy workloads and fatigue but also a high risk of infection during the COVID-19 pandemic. Few studies have evaluated the relationship between safety measures such as having visible and accessible HHS and nurses’ fatigue.MethodsThe cross-sectional COVID-19 Impact on Nurses Study (COINS) was an online survey distributed to members of the American Association of Post-Acute Care Nursing through the REDCap survey platform, between June 1, 2020, and January 31, 2021. Logistic regression modeling was conducted to identify the relationship between nurses’ perception of having visible and accessible HHS and fatigue among …

PurposeEvidence from several cohorts has suggested that a higher intake of isoflavone is associated with lower risk of lung cancer in never smokers, but the association has not been investigated by histologic type of lung cancer. Adenocarcinoma is a common histologic type found in never smokers. We hypothesized that a higher intake of isoflavone is associated with a lower risk of lung adenocarcinoma among never smokers. Here, we examined the associations of isoflavone and soy food intake with lung cancer and its histologic types in never smokers.MethodsWe performed a pooled analysis using data from the Japan Public Health Center-based Prospective Study, Shanghai Women’s Health Study and Shanghai Men’s Study with 147,296 never smokers aged 40–74 years with no history of cancer. During 1,990,040 person-years of follow-up, 1247 lung cancer cases were documented. Dietary isoflavone and …

This paper proposes a self-tuning energy-saving control method based on a hierarchical control structure including three control loops. When the system runs, the initial pressure can be set arbitrarily, and then through this method, the system will do the self-adjustment, the duct perssure and airflow will be gradually reach the set value. The experiments demonstrate that the proposed air balancing method is correct and effective and has the ability to achieve control objectives. Moreover, this method can improve the energy efficiency of ventilation system and is easy to apply in practical use. It can achieve the good energy saving effect when meeting the air ventilation demand in the building.

The COVID-19 (coronavirus disease 2019) pandemic has posed greater challenges to older adults, especially those who live in congregated long-term care facilities (LTCFs) in dense urban settings. These facilities struggle with high rates of COVID-19 infections and other challenges that undermine LTCF residents’ well-being. These challenges, including social isolation and limited access to nature and community, have been exacerbated by the pressures of the pandemic. This has led to feelings of loneliness, depression, and other mental health issues among residents and a higher risk of psychological stress and infection among nurses. The pandemic has challenged the existing built environment of LTCFs. Issues regarding physical and mental health, quality of life (QoL), infection control, and pandemic resiliency have been shown to be increasingly interwoven. This chapter envisions innovative approaches …

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being 1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from...

Growing evidence suggests that gut microbiota may influence chemotherapy efficacy. However, little research has been done on the relationship between the gut microbiome and chemotherapy-induced toxicity. We conducted a prospective study among 301 chemotherapy-treated breast cancer patients who were recruited into the Vietnamese Breast Cancer Study and had a pre-chemotherapy stool sample collected. The stool collection included 134 pre- and 167 post-breast cancer surgery samples. Chemotherapy-induced toxicities during the first-line treatment were captured via medical chart reviews and patient-reported outcomes and graded using the National Cancer Institute Common Toxicity Criteria of Adverse Events classification. Gut microbiome composition was measured by shotgun metagenomic sequencing. Associations of pre-chemotherapy gut microbial diversity, taxa abundance, and microbial …

This book presents a systematic study on the air balancing technologies in heating, ventilation and air conditioning (HVAC) systems. Several modern air balancing methods, including advanced control-based air balancing, data-driven-based air balancing, and energy-saving-oriented air balancing, are introduced in this book to balance the air duct system. Furthermore, this book provides clear instructions for both HVAC designers and engineers, as well as researchers, on how to design and balance duct systems for improved performance and energy efficiency.

Introduction: Despite the importance of gut microbiota in human cardiometabolic health, the associations between circulating levels of gut microbiota-related metabolites and incident coronary heart disease (CHD) remain largely unexplored. Hypothesis: Certain circulating microbial metabolites are associated with incident CHD. Methods: This is a multi-stage and multiethnic metabolomics study. We first conducted a global, semi-quantitative assay for discovery among 900 incident CHD cases and 900 age-/sex-/race-matched controls (300 pairs of Black Americans, White Americans, and Chinese adults, respectively) selected from the Southern Community Cohort Study and Shanghai Men’s and Women’s Health Studies. We focused on 226 metabolites that were potentially related to gut microbiota and applied conditional logistic regression to estimate odds ratios (ORs) of CHD associated with a 1-SD increase of log …

Background: Exogenous sex hormone supplements had been associated with increased lung cancer mortality in a large clinical trial. No study to date has evaluated temporal trajectories of circulating sex hormones and aromatase activity and their associations with lung cancer survival. Objective: To characterize temporal changes in prediagnostic levels of circulating sex hormones and aromatase activity and to evaluate their associations with overall survival in lung cancer patients. Methods: Included in the analysis were 385 incident lung cancer patients identified in a large prospective cohort among postmenopausal women who had never used cigarette products nor exogenous sex hormone supplements. Concentrations of sex hormones were quantitated using LC-MS/MS assays in prediagnostic plasma samples. The product-substrate molar ratio of estrone to androstenedione was used as an index of …