BACKGROUND:Disability weight (DW) quantifies the impact of disease impairments and symptoms on health statuses, and is a key parameter for estimating disease burden. In this study, we conducted an exploratory measurement of disability weights for common health states among children and adolescents in Hunan Province using a face-to-face survey methodology. This provides preliminary data to support the study of disease burden among this age group. METHODS:A household survey with face-to-face interviews was conducted to measure DWs for 148 children's health statuses. The questionnaire included 16 paired comparison (PC) questions and 3 population health equivalent (PHE) questions. Probit regression analysis was used to analyze PC responses, with probit regression results from the PC on the DW scale anchored using interval regression results from PHE responses. RESULTS:The DWs resulting from the study varied from 0.065 (95% uncertainty interval (UI): 0.047-0.087) for acute tonsillitis to 0.730 (UI: 0.709-0.750) for extremely severe intellectual developmental disorders. A comprehensive analysis shows that severe traumatic injuries, such as spinal cord injuries and amputations, as well as congenital defects like hearing loss, visual impairments, and intellectual disabilities, lead to higher DWs due to the long-lasting effects of permanent functional impairments. In contrast, minor bone fractures and transient infectious diseases result in lower DWs. The study demonstrates a high level of consistency in the comparative evaluations of various health outcomes across different sociodemographic characteristics. CONCLUSIONS:The study strengthens the empirical basis for assessing DWs in children. The PC-PHE method for assessing the DWs of children and adolescents with various health conditions within the Hunan Province population demonstrated robust logic and severity discrimination, with stable results across different population characteristics.

OBJECTIVES:The study aimed to explore the internal pathway of the association between activities of daily living and subjective well-being among Chinese older adults using a large and representative sample.BACKGROUND:There is still a lack of systematic investigation into the association between activities of daily living and subjective well-being among Chinese older adults.MATERIALS AND METHODS:The study included 10 578 participants from the Chinese Longitudinal Healthy Longevity Survey. We applied multiple linear regression analysis and Spearman correlation analysis to examine the association between activities of daily living and subjective well-being and PROCESS macro to determine the mediating effect of leisure activities on the relationship between them.RESULTS:The mean total score of subjective well-being was 30.5 ± 4.4. The prevalence of basic activities of daily living and instrumental activities of daily living limitations was 18.0% and 60.8%, respectively. Correlation analysis showed that activities of daily living score were negatively correlated with subjective well-being. Leisure activities were positively correlated with subjective well-being. The effect of instrumental activities of daily living on subjective well-being was partially mediated by leisure activities and leisure activities completely mediated the association between basic activities of daily living and subjective well-being.CONCLUSIONS:The effect of instrumental activities of daily living on subjective well-being was partially mediated by leisure activities and leisure activities completely mediated the association between basic activities of daily living and subjective well-being.

The rising rates of adolescent depression have become a critical concern, with family dynamics and interpersonal communication playing a significant role in this mental health issue. However, research on the combined effects of parental warmth and interpersonal trust on adolescent depressive symptoms remains limited. This study aimed to explore the association between parental warmth, interpersonal trust, and depressive symptoms in Chinese adolescents. The sample included 2745 adolescents aged 9 to 18 from the China Family Panel Studies (CFPS). Depressive symptoms were assessed using the CES-D8 scale, which yielded an average score of 4.34. Among participants, 11.3% exhibited symptoms consistent with depression. Multivariate linear regression revealed that both parental warmth (β = -0.296, p < 0.001) and interpersonal trust (β = -0.197, p < 0.001) significantly predicted lower depressive symptoms. Mediation analysis indicated that interpersonal trust partially mediated the relationship between parental warmth and depressive symptoms, explaining 17.68% of the total effect (β = -0.032, 95% CI = -0.060, -0.016). These associations remained significant even after controlling for demographic variables. Our findings suggest that parental warmth protects against depressive symptoms, with interpersonal trust enhancing this protective effect. Interventions focused on fostering parental warmth and enhancing interpersonal trust could improve adolescent mental health.

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Objective: This study aimed to assess the association between depression and family support among Chinese children and adolescents and to investigate whether loneliness could mediate this relationship.Methods: There were 2755 children and adolescents aged 18 and below from the China Family Panel Studies (CFPS) that participated in our study. Depression in children and adolescents was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Binary logistic regression combined with mediation analysis was used to examine the association between family support and depression and the mediating effect of loneliness on this relationship.Results: Of the 2755 children and adolescents, 848 (30.8 %) reported feeling lonely and 310 (11.3 %) reported feeling depressed. Multivariate logistic regression analysis showed that compared with children and adolescents with family support, children and adolescents without family support had a higher risk of loneliness (odds ratio (OR) = 1.668, 95 % confidence interval (CI): 1.318-2.111) and depression (odds ratio (OR) = 2.252, 95 % confidence interval (CI) 1.669-3.039). Mediation analysis revealed that loneliness played a partial mediating role in the association between family support and depression (beta = -0.109, P < 0.001), and the mediation proportion was 38.11 %.Conclusion: Family support affects depression directly and indirectly through loneliness. The results suggest that parents should provide more support to children and adolescents to reduce the risk of loneliness and underlying depression during the COVID-19 pandemic.

Background: Pediatric patients with hematologic malignancies (HM) and survivors are at high risk for numerous negative effects including decreased health-related quality of life (HRQOL). In order to understand the association between HM and QOL, we conducted this meta-analysis to systematically compare QOL between pediatric HM patients and survivors and controls.Method: The PubMed, EMBASE, Web of Science and the Cochrane Library databases were systematically searched. Data were analyzed using the random-effects model.Results: Of 6586 unique articles identified, 30 were included in this meta-analysis. Studies described 12 different HRQOL tools. Different QOL measures varied in their association with quality of life. When compared with Non -HM group, the Pediatric Quality of Life Inventory (PedsQL) has a moderate effect size (standard mean difference, SMD = 0.50, 95% CI: 0.32, 0.68; P < 0.001). When compared with health controls, it has a large effect size (SMD =-1.00, 95% CI:-1.47,-0.53; P < 0.001). In addition, Health utilities index mark (HUI), and the Pediatric Oncology Quality of Life Scale (POQOLS) have a large (SMD =-0.81, 95% CI:-1.29,-0.33; P = 0.001) and a small (SMD =-0.10, 95% CI:-0.42, 0.22; P = 0.534) effect sizes when comparing overall controls.Conclusion: Pediatric HM patients and survivors had lower QOL compared with healthy controls and higher QOL compared with Non-HM controls in most domains. Considering the negative impact of poor QOL on daily life and functional outcomes, future research should focus on proposing effective measures to improve QOL of this population.

The role of social determinants of health (SDoH) in gender differences in depression remains unclear among Chinese adults. We aimed to explore the association between SDoH and depression and investigate their role in explaining gender differences in depression. This prospective longitudinal cohort study used four wave surveys (2012, 2016, 2018, and 2020) of the China Family Panel Study (CFPS). Fourteen SDoH variables were assessed, and depression was measured using the 8-item short version of the Center for Epidemiologic Studies Depression Scale. The Cox proportional hazards regression and multiple mediation analysis were performed to estimate the effect sizes. The longitudinal sample included 18,874 participants aged 18-92 years (51.4 % males and 48.6 % females). Women had higher risk of depression than men. Unfavorable SDoH were associated with higher risk of depression. After including multiple SDoH in mediation analysis, multiple SDoH mediated 15.7 % of the total effect of gender on depression. In sum, SDoH significantly influenced depression, and specific factors explained gender differences in depression. Supporting women in education, employment, and community involvement could help reduce gender differences in depression.

This study aims to explore the independent age, period, and cohort effects on the burden of gout globally and across different Socio-demographic Index (SDI) regions. We extracted data of age-standardized incidence, prevalence, and disability-adjusted life years (DALYs) rate from the Global Burden of Disease (GBD) database as gout burden measures. In the study, Joinpoint regression analysis was conducted to explore the temporal trends from 1990 to 2019. Trend analyses were explored according to 21 world regions (including high-income North America, Australasia, Southern Latin America, East Asia, etc.) and sociodemographic indices (SDI). The age-period-cohort (APC) model was performed to estimate the age, period, and cohort effects on gout. Globally, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and DALYs increased from 1990 to 2019. The ASIR, ASPR, and DALYs for the age effect of gout in different SDI regions increased at first, and then decreased, peaking at 70–74 years. The period effect showed an upward trend, while the cohort effect continued to decrease. Surprisingly, the age, period, and cohort effect for global gout DALYs differed significantly from that in five SDI regions. Therefore, more specific interventions are urgently warranted to reduce the incidence and prevalence of gout, especially among older adults in high SDI regions.

When cooking with biomass and fossil fuels, their incomplete burning can lead to air pollution, which can trigger pernicious effects on people’s health, especially among the elderly, who are more vulnerable to toxic and harmful environmental damage. This study explored the association between different cooking fuel types and the risk of cancer and all-cause mortality among seniors constructing Cox regression models. Data were obtained by linking waves of 6, 7, and 8 of the Chinese Longitudinal Healthy Longevity Survey, which included a total of 7269 participants who were 65 years old and over. Cooking fuels were categorized as either biomass, fossil, or clean fuels. And the effects of switching cooking fuels on death risk were also investigated using Cox regression models. The results indicate that, compared with the users of clean fuels, individuals using biomass or fossil fuels were at a greater death risk for cancer [HR (95% CI): biomass, 1.13 (1.05–1.20); fossil, 1.16 (1.06–1.25)] and all causes [HR (95% CI): biomass, 1.29 (1.16–1.42); fossil, 1.32 (1.22–1.50)]. Furthermore, compared with sustained users of biomass fuels, individuals converting from biomass to clean fuels significantly reduced death risk for cancer [HR (95% CI): 0.81 (0.72–0.95)] and all causes [HR (95% CI): 0.76 (0.64–0.93)]. Similarly, all-cause death risk [HR (95% CI): 0.77 (0.62–0.93)] was noticeably reduced among these participants converting from fossil to clean fuels than persistent users of fossil fuels. Subgroup analyses revealed that males had a greater cancer and all-cause death risk when exposed to unclean fuels. These findings can inform the development of policies and the implementation of measures related to cooking fuel use to promote the health of older people and reduce the burden of disease on society.

OBJECTIVE This study aimed to assess the association between vitamin D and sleep health and to investigate whether depression could mediate this relationship. METHODS A cross-sectional analysis was performed using the 2005-2014 US National Health and Nutrition Examination Survey (NHANES) data. The logistic regression models were conducted to evaluate association of serum vitamin D concentrations with sleep health and depression. Mediation analyses were conducted to investigate the mediated effects of depression on the association of vitamin D with sleep health. RESULTS In multivariate logistic models, vitamin D was found to be negatively associated with an increased risk of poor sleep health, with an odds ratio (OR) of vitamin D deficiency versus sufficiency was 1.256 (95% CI = 1.084-1.455). Additionally, univariate logistic models showed that vitamin D was also negatively associated with depression risk (vitamin D deficiency vs. sufficiency: OR = 1.699, 95% CI = (1.373-2.103). Further mediation analyses showed that the association of vitamin D with sleep health was mediated by depression, with the mediating effects of depression accounted for 44.56% of the total effects. CONCLUSION Vitamin D affects sleep health directly and indirectly through depression. The results suggest that interventions increasing intake of vitamin D should be prioritized to promote sleep health of persons with or at risk of depression.

OBJECTIVES:Congenital birth defects are the main source of disease burden among children under 5 years old in China. This study aims to compare the trends in disease burden of different congenital birth defects among Chinese children under 5 years old from 1990 to 2019, and to provide a scientific basis for strengthening the comprehensive prevention and control of birth defects.METHODS:Based on data from the Global Burden Disease (GBD) in 2019, the incidence mortality rate, and disability-adjusted life years (DALYs) rate of congenital birth defects among Chinese children under 5 years old from 1990 to 2019 were selected as evaluation indicators. The Joinpoint regression model was used to analyze the trends in disease burden of different types with congenital birth defects over three decades. The study also compared the differences in disease burden of congenital birth defects among children under 5 years old by gender.RESULTS:Compared to 1990, the DALYs rates of congenital heart anomalies (1 931.91/100 000), digestive congenital anomalies (364.63/100 000), neural tube defects (277.20/100 000), congenital musculoskeletal and limb anomalies (133.33/100 000), and Down syndrome (128.22/100 000) in children under 5 years old in China in 2019 were decreased 70.78%, 71.61%, 86.21%, 36.84% and 73.65%, respectively. From 1990 to 2019, the mortality rates and DALYs rates of different congenital birth defects showed an overall downward trend, but the incidence of digestive congenital anomalies and Down syndrome showed an upward trend after 2005 and 2001, respectively. Except for congenital musculoskeletal and limb anomalies, incidence of the remaining categories of birth defects were higher in boys than that in girls.CONCLUSIONS:The disease burden of congenital birth defects in children under 5 years old in China is decreased substantially from 1990 to 2019, but the burden of congenital heart anomalies is still serious and the incidence of some birth defect diseases is on the rise, and it is still crucial to strengthen the prevention and treatment for birth defects in children and propose targeted measures according to their gender characteristics.

Global warming in the twenty-first century has gradually made high temperatures a major threat to the global population. Health problems associated with extreme temperatures have become a growing public health concern worldwide. This study aimed to estimate road injuries stratified by sex, age, geographic location, and sociodemographic status attribute to high, low, and non-optimal temperatures in 21 regional and global. We used the Global Burden of Disease (GBD) Study Results Tool to examine the age-standardized death rates (ASDR) and disability-adjusted life years (DALYs) due to road injuries in 2019 by Joinpoint regression. In addition, we reported high, low, and non-optimal temperature exposures for road injuries across different groups by gender, age, region, and disease. Moreover, we examined temporal trends in the burden of road disease caused by high, low, and non-optimum temperatures from 1990 to 2019. Trend analyzes were conducted for five sociodemographic index (SDI) regions. Globally, both ASDR and DALY declined from 1990 to 2019, with average annual percent change (AAPC) values of − 1.3% and − 1.2%, respectively. In 2019, the indicators (death and DALYs) steadily declined, while SDI quintile increased in most regions. Road injuries related to death and DALYs rate attributed to high temperatures were 0.17 and 8.50, respectively, in 2019. From 1990 to 2019, DALYs for road injuries caused by low temperatures showed the most significant upward trend in most regions, especially in low-latitude countries. This study provides a comprehensive understanding of the road injury burden caused by high, low, and non-optimum temperatures, which remains high in regions with low SDI. Therefore, special attention should be paid to road injuries in poor countries or in areas with extreme temperatures.

目的 利用概率回归和截尾回归模型,估算儿童常见恶性肿瘤伤残权重(disability weight,DW),为儿童恶性肿瘤疾病负担评估提供先决条件.方法 采用配对比较法和人数健康等值法进行面对面调查,使用Probit回归和截尾回归对数据进行处理,通过线性回归和逆logit转化把DW锚定在 0～1 之间.结果 本调查纳入 288 名受访者,女性189 人(65.6%);年龄<35 岁 185 人(64.2%);本科学历及以上 139 人(15.2%);具有医学背景 67 人(23.3%).9 种儿童恶性肿瘤的DW估算值范围在 0.136～0.662 之间,最大为中枢神经系统肿瘤 0.662(95%UI:0.604～0.733),最小为肾母细胞瘤 0.136(95%UI:0.074～0.208).亚组分析发现不同人群对同一种儿童恶性肿瘤DW的评估存在差异.结论 儿童常见的恶性肿瘤均对儿童健康造成严重的损伤,最重为中枢神经系统肿瘤,最轻为肾母细胞瘤.

Abstract This study aimed to compare the prognostic efficiency of N stage from the American Joint Committee on Cancer (AJCC) staging system, lymph nodes ratio (LNR) and log odds of positive lymph nodes (LODDS) in patients with stage III non-small cell lung cancer (NSCLC). A nomogram based on LODDS was developed and validated to predict overall survival (OS) of patients with stage III NSCLC. A total of 2896 stage III NSCLC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015 and divided into training and validation sets. The prognostic efficiency of N stage, LNR, and LODDS were compared using the Harrell concordance index (C-index), the Akaike information criterion (AIC), and area under the receiver operating characteristic (ROC) curve (AUC). A multivariate Cox analysis was performed to determine the independent prognostic factors, and constructed a nomogram based on LODDS. LODDS showed a slight advantage in predicting OS for NSCLC among three lymph node staging systems. In the training set, the C-index of the LODDS-based model was 0.645, the AIC was 18383.43. The AUCs were 0.708, 0.675 and 0.671 for predicting 1-year, 3-year and 5-year OS. The calibration plots showed the superior clinical applicability of the nomogram. These results were confirmed in the validation set. As an independent prognostic factor for stage III NSCLC, LODDS showed superior prognostic efficiency among the three lymph node staging systems. This LODDS-based nomogram demonstrated better performance than the AJCC tumor-node-metastasis (TNM) staging system in predicting OS for stage III NSCLC.

Abstract Background The exposure to risk factors (Smoking, High fasting plasma glucose and High BMI) are considered a major health concern. However, previous studies focused on changes in the global age-specific incidence and mortality, failed to distinguish between cohort and period effects, and did not discuss risk factors separately. Methods This study to estimate the burden of Alzheimer's disease and other dementias stratified by gender, age, locations, and social-demographic status for 21 regions across the world from 1990 to 2019. Besides, trend analyzes were conducted for major regions and risk factors for DALYs were also analyzed using age-period-cohort model and Join-point model. Results Globally, the age standardized incidence rate(ASIR), age standardized death rate(ASDR), and age standardized DALY rates for Alzheimer's disease have an upward trend from 1990 to 2019.(percentage change: 1.5%,3.0%,3.5%, respectively) with average annual percent change. In most regions, indicators (incidence, mortality, and DALYs) increased steadily with SDI increased. By APC analysis, substantially increasing age effects were presented for Alzheimer's disease and other dementias from 40 to 95 years. The cohort effects RRs had a rapid reduction attribute to Smoking, High fasting plasma glucose and High BMI. Conclusions As the burden of Alzheimer's disease remains high in areas with low SDI. Therefore, rapid and effective government responses are needed to tackle and control dementia risk factors to reduce the disease burden in middle-low and low SDI countries.

Abstract Background The warming of the 21st century has made high temperatures a major threat to the global population. Health problems associated with increased ambient temperatures have become a growing public health problem worldwide.Aim To study the attribute to high, low, and non-optimum temperatures of road injuries in 21 regions and global stratified by sex, age, geographic location and socio-demographic status from 1990 to 2019.Methods We used the Global Burden of Disease Study (GBD) Results Tool to examine the age-standardized death rates and disability-adjusted life years (DALYs) due to road injuries in 2019 by Join-point. Moreover, we report that high, low, and non-optimum temperatures exposure on road injuries for different groups by sex, age, region, and disease. In addition, we examined temporal trends in the burden of road disease caused by high, low, and non-optimum temperatures from 1990 to 2019. Trend analyzes were conducted for major socio-demographic index (SDI) regions.Results Globally, both the age-standardized death rate (ASDR) and DALY declined from 1990 to 2019, with average annual percent change (AAPC) values of −1.3% and −1.2%, respectively. In 2019, the indicators (death, and DALYs) steadily declined with SDI quintile increased in most regions. And road injuries related death and DALYs rate attributed to high temperatures were 0.17 and 8.50 respectively in 2019. From 1990 to 2019, DALYs for road injuries caused by low temperatures showed the most significant upward trend in most regions, especially in low-latitude countries.Conclusions This study provides a comprehensive understanding of the road injury burden caused by high, low, and non-optimum temperatures, which remains high in regions with low SDI. Therefore, special attention should be paid to road injuries in poor countries or in areas with extreme temperatures.

Objectives: Studies have shown that the frequent participation of the elderly in cognitive stimulation activities is associated with a reduced risk of dementia, but the prospective evidence of this association is limited.Methods: We used data from a prospective cohort study of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), and included 11,821 community-living Chinese individuals aged 65 years or older at 2008 baseline who were free of dementia, and were followed up every 2–3 years until 2018. Cox proportional hazards models were applied to generate the hazard ratios (HRs) and 95% confidence intervals (CIs) for analyzing the associations between the frequency of playing cards/mahjong and the incidence of dementia.Results: A total of 821 participants were diagnosed with dementia during the 10-year follow-up. The average age of patients with dementia and non dementia were 89 and 90 years old, respectively. Compared with participants who rarely or never played cards/mahjong, participants who played cards/mahjong almost every day had a significantly lower risk of dementia (HR = 0.63; 95%CI, 0.42–0.95) after the multivariable-adjusted model. Similar results were observed in subgroup analyses based on sex (male: HR = 0.52, 0.28–0.96; female: HR = 0.62, 0.36–0.98), age (<85years: HR = 0.55, 0.32–0.89), regularly exercise (yes: HR = 0.44, 0.28–0.87) and MMSE score [above median (25): HR = 0.66, 0.41–0.92].Conclusions: Playing cards/mahjong in the elderly may contribute to reducing the risk of dementia.

Objective Disability and social support can impact depressive symptoms of the elderly. Yet, studies infrequently discuss the moderating role of social support when evaluating the association between disability and depressive symptoms. The purpose of this study was to explore the association between disability, social support, and depressive symptoms among the Chinese elderly, and further examine the moderating effect of social support. Materials and methods Using the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) data set, we finally selected 9,231 Chinese elderly after screening. The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to evaluate depressive symptoms in the elderly. Disability was measured by basic activities of daily living (B-ADL) and instrumental activities of daily living (I-ADL). Social support included contact with family and friends, sick care, and money received, measured by five self-reported questions. We used multiple linear regression and moderating model to explore the association between disability, social support, and depressive symptoms. Results A total of 9,231 patients were included in this study, and approximately 26.75% of the elderly had depressive symptoms. Study found that depressive symptoms were associated with social support (βB−ADL = −0.108, 95% CI: −0.168– −0.047; βI−ADL = −0.098, 95% CI: −0.156– −0.039), βB−ADL (β = 0.296, 95% CI: 0.248−0.343) and I-ADL (β = 0.174, 95% CI: 0.152–0.195). Moreover, the result also showed that social support moderated the effects of B-ADL (βB-ADL*socialsupport = 0.034, 95% CI: 0.014–0.053, F = 11.57, p = 0.001) and I-ADL (βI-ADL*socialsupport = 0.025, 95% CI: 0.017–0.033) on depressive symptoms. Conclusions The study suggests that disability and social support can affect depressive symptoms, and social support moderates the effect of disability on depressive symptoms. Therefore, taking effective measures to reduce the elderly disability rate of disability and increase their social support are necessary condition for realizing mental health.