All Publications

  • The effects of indoor air pollution from solid fuel use on cognitive function among middle-aged and older population in China. The Science of the total environment Luo, Y., Zhong, Y., Pang, L., Zhao, Y., Liang, R., Zheng, X. 2021; 754: 142460


    Growing evidence has linked outdoor air pollution exposure with higher risk of cognitive impairments. However, the role of indoor air pollution in cognitive decline is not well elaborated. By using nationally representative longitudinal data, this study aimed to explore the effects of indoor air pollution from solid fuel use on cognitive function among middle-aged and older individuals in China.Data were obtained from 2011 to 2015 waves of CHARLS (China Health and Retirement Longitudinal Study). Scores from the Telephone Interview of Cognitive Status and figure drawing/word recall tests were used to measure cognitive function in 39,482 individuals. Exposure to indoor air pollution was measured as use of solid fuel for cooking. Solid fuel was defined as coal, biomass charcoal, wood, and straw; clean fuel was defined as liquefied gas, natural gas, and electricity. Linear mixed effect models were applied to examine the effect of indoor air pollution from solid fuel use on cognitive function.Participants had an average global cognitive function of 9.67 (SD = 4.13). Solid fuel users made up 49.71% of participants, but this proportion was much greater among those living in rural areas (64.22%). Compared with clean fuel users, solid fuel users had worse cognitive function. On average, solid fuel users had a 0.81 (95%CI: -0.89, -0.73) lower global cognition score, 0.63 (95%CI: -0.69, -0.57) lower mental health score, and 0.16 (95%CI: -0.22, -0.14) lower episodic memory score. These effects were stronger among participants who are female, aged 65 years old and above, have education level of primary school and below, or have cardiovascular diseases.These results provide evidence for the role of indoor air pollution in neurobehavioral disorders in China. Promotion of practices like expanded use of clean fuel and improved stoves in households may be crucial to significantly reduce indoor air pollution and protect mental health.

    View details for DOI 10.1016/j.scitotenv.2020.142460

    View details for PubMedID 33254849

  • Schizophrenia and education in Chinese metropolises: a population-based study SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY Luo, Y., He, P., Zhang, L., Pang, L., Guo, C., Liang, R., Zheng, X. 2020


    Schizophrenia is a public concern in metropolises. Increases in city size may strengthen the correlation between prevalence of schizophrenia and indices of socioeconomic status, such as education. This study used population-based data of adults to investigate the association between education and schizophrenia in Chinese metropolises and its differences between inner city areas and outer suburbs.Data was obtained from the Second China National Sample Survey on Disability in 2006, and analysis was restricted to 189,143 participants aged 18 years or older in all counties (districts) of Beijing, Shanghai, and Tianjin. Schizophrenia diagnoses were ascertained according to the International Statistical Classification of Diseases, 10th Revision. Logistic regression models were fitted to examine the association between education and schizophrenia.An inverse U-shaped pattern between education and schizophrenia was found in inner city areas of Chinese metropolises. Compared with the primary school or below group, the odds ratios of junior high school group and senior high school or above group was 2.79 (95% CI 1.96, 3.96) and 1.45(95% CI 0.99, 2.13), respectively. In outer suburbs, junior high school (OR = 0.87, 95% CI 0.63, 1.19) and senior high school or above groups (0.58, 95% CI 0.38, 0.87) were less likely to develop schizophrenia than the primary school or below group.This study showed an association between education and schizophrenia in Chinese metropolises. In inner city areas, the association was an inverse U-shaped pattern between education and schizophrenia, whereas in suburban areas, the association was a negative linear pattern. Our findings can help identify high-risk populations of schizophrenia in Chinese metropolises. Programs for prevention and early intervention of schizophrenia will need to consider the socioeconomic disparities between inner city and outer suburban areas. Public policies can help improve mental health by developing social security for migrants in inner city areas and promoting regional equality.

    View details for DOI 10.1007/s00127-020-01898-6

    View details for Web of Science ID 000550652400001

    View details for PubMedID 32691081

  • Association between urbanicity and dementia in China: a population-based study. The journals of gerontology. Series B, Psychological sciences and social sciences Luo, Y., Zhao, Y., Pang, L., Guo, C., Liang, R., Zheng, X. 2020


    OBJECTIVES: This study investigated the relationship between urbanicity and dementia, and predicted its non-linear pattern among Chinese adults aged 50 years old and above.METHODS: This study used data from the Second National Sample Survey on Disability, which was implemented from 1 April to 31 May 2006 across China. Dementia status was determined by a two-stage process: the combination of self-reports or family members' reports and an on-site medical diagnosis by experienced specialists based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision Symptom Checklist for Mental Disorders. Logistic regression models were used to examine the relationship between urbanicity and dementia, and restricted polynomial spline regression models were plotted to examine the non-linear exposure-response relationship of urbanicity and dementia.RESULTS: Logistic regression results showed that an increase of 10% in the degree of urbanization was associated with a 73% decrease in the odds of dementia after adjusting for covariates, particularly area-level socioeconomic variables. This observed association was stronger in the younger age group, and this age group difference was only present in females. Spline regression findings suggested a non-linear exposure-response relationship between urbanicity and the odds of dementia. Areas with very high levels of urbanization were associated with increased odds of dementia.CONCLUSIONS: These findings highlight the necessity to properly examinethenuanced relationship betweenurbanicityandmental health, especially for females in the younger age group. Notably, there were increased odds of dementia at very high levels of urbanicity.

    View details for DOI 10.1093/geronb/gbaa090

    View details for PubMedID 32644163

  • Low Prenatal Vitamin D Metabolite Ratio and Subsequent Postpartum Depression Risk. Journal of women's health (2002) Accortt, E. E., Arora, C., Mirocha, J., Jackman, S., Liang, R., Karumanchi, S. A., Berg, A. H., Hobel, C. J. 2020


    Background: Depression is a common complication of pregnancy and vitamin D deficiency is one biological risk factor for postpartum depression (PPD). Methods: We evaluated the ratio of 24,25(OH)2D and 25(OH)D serum concentrations referred to as the Vitamin D Metabolite Ratio (VMR), a new candidate biomarker during pregnancyand its relationship with PPD. Women were enrolled in the first trimester of pregnancy and followed through four timepoints. Results: A total of 89 women had complete depression, biomarker and demographic data and 34% were at risk for PPD (CES-D≥16). Stepwise multiple logistic regression models for PPD risk were carried out with eight predictors. Results showed that only lower VMR, OR = 1.43, 95% CI 1.10-1.86, p = 0.007, and Hispanic/Latina identification, OR = 3.83, 95% CI 1.44-10.92, p = 0.007 were significantly associated with higher PPD risk. Conclusion: Routine prenatal screening for vitamin D metabolites, particularly in Hispanic/Latina women, may identify women at risk for PPD.

    View details for DOI 10.1089/jwh.2019.8209

    View details for PubMedID 33021442

  • Use of the Bedside-Placed Angel Catheter IVC Filter for Venous Thromboembolic Disease in Critically Ill Medical Patients JOURNAL OF INTENSIVE CARE MEDICINE Matusov, Y., Weinberg, A. S., Liang, R., Meza, J., Friedman, O., Tapson, V. F. 2019
  • Extubation to high-flow nasal cannula in critically ill surgical patients. The Journal of surgical research Dhillon, N. K., Smith, E. J., Ko, A., Harada, M. Y., Polevoi, D., Liang, R., Barmparas, G., Ley, E. J. 2017; 217: 258–64


    High-flow nasal cannula (HFNC) is increasingly used to reduce reintubations in patients with respiratory failure. Benefits include providing positive end expiratory pressure, reducing anatomical dead space, and decreasing work of breathing. We sought to compare outcomes of critically ill surgical patients extubated to HFNC versus conventional therapy.A retrospective review was conducted in the surgical intensive care unit of an academic center during August 2015 to February 2016. Data including demographics, ventilator days, oxygen therapy after extubation, reintubation rates, surgical intensive care unit and hospital length of stay, and mortality were collected. Self and palliative extubations were excluded. Characteristics and outcomes, with the primary outcome being reintubation, were compared between those extubated to HFNC versus cool mist/nasal cannula (CM/NC).Of the 184 patients analyzed, 46 were extubated to HFNC and 138 to CM/NC. Mean age and days on ventilation before extubation were 57.8 years and 4.3 days, respectively. Both cohorts were similar in age, sex, and had a similar prevalence of cardiopulmonary diagnoses at admission. Although prior to extubation HFNC had lengthier ventilation requirements (7.1 versus 3.4 days, P < 0.01) and ICU stays (7.8 versus 4.1 days, P < 0.01), the rate of reintubation was similar to CM/NC (6.5% versus 13.8%, P = 0.19). Multivariable analysis demonstrated HFNC to be associated with a lower risk of reintubation (adjusted odds ratio = 0.15, P = 0.02). Mortality rates were similar.Ventilated patients at risk for recurrent respiratory failure have reduced reintubation rates when extubated to HFNC. Patients with prolonged intubation or those with high-risk comorbidities may benefit from extubation to HFNC.

    View details for DOI 10.1016/j.jss.2017.06.026

    View details for PubMedID 28711371