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:To estimate the burden of chronic obstructive pulmonary disease (COPD) and lower respiratory tract infections (LRIs) stratified by geographic location, and social-demographic status for 21 regions across the world from 1990 to 2019. STUDY DESIGN:The analysis utilized data from the Global Burden of Disease (GBD) Study, focusing on mortality and disability-adjusted life years (DALYs) as measures of COPD and LRI burden. Trend analyses using the Joinpoint model were conducted across five socio-demographic index (SDI) quintiles. METHODS:We investigated the burden of COPD and LRIs employing restricted cubic splines to flexibly identify relationships between DALY rates and SDI. This method allowed for detailed examination of trends over time across different regions and socio-demographic contexts. RESULTS:From 1990 to 2019, the ASMR of COPD attributed to PM for global and five SDI quintiles decreased 61.80 %, 53.41 %, 63.04 %, 63.00 %, 40.98 %, 12.14 % respectively. In terms of PM Pollution, there was an inverted U-shaped association between the DALY and SDI for COPD, the DALY rate associated with LRIs due to PM pollution exhibited a progressive decline as SDI increased. CONCLUSION:Even though the trend in mortality and DALY of COPD and LRIs decreased globally, the COPD and LRI burden attributed to PM pollution remains high, particularly in lower SDI quintiles.

Background Childhood and adolescent leukemia represent a significant disease burden worldwide, making research on leukemia in this population and its attributable risk factors highly valuable. The aim of this study is to estimate the burden of leukemia in children and adolescents, as well as the social-demographic status, for 21 regions around the world from 1990 to 2019. Methods We collected data of childhood and adolescent leukemia from the Global Burden of Disease (GBD) 2019 including, incidence, death, and Disability-adjusted life-years (DALYs). We also conducted an analysis of the Joinpoint model to estimate the time trend of incidence, death, and DALYs rate of leukemia. Results According to our analysis, the middle Socio-Demographic Index (SDI) experienced the highest decrease in incidence rate between 1990 and 2019, with an average annual percent change (AAPC) of -2.8* [95% CI, -3.0, -2.6]. On the other hand, the High-middle SDI witnessed the highest decrease in death rate, with an AAPC of -3.1* [95% CI, -3.30, -3.00].From 1990 to 2019, the incidence, mortality and DALYs of leukemia decreased by 51.46%, 53.87% and 54.46%, respectively, for both genders globally. We showed that DALYs of children leukemia is 155.98 (95%UI 127.18, 182.64) for global male, however, global female leukemia DALYs is 117.65(95%UI 102.07, 132.70). We also observed that in the two most representative regions of East Asia and Eastern Sub-Saharan Africa in 2019. Conclusions Despite the observed decline in the incidence, mortality, and DALYs of leukemia over the last three decades, the burden of childhood and adolescent leukemia remains high, particularly in areas with lower SDI.

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.

BackgroundThis study aims to evaluate the long-term trend of prevalence and DALY (disability-adjusted life-year) rate on the age, period and cohort (APC) of the BRICS (Brazil, Russia, India, China and South Africa) country for autoimmune diseases (rheumatoid arthritis (RA), inflammatory bowel disease (IBD), multiple sclerosis (MS) and psoriasis).MethodsThe data are sourced from the Global Burden of Disease Study 2019, and it uses the Joinpoint regression model to estimate the time trends of autoimmune diseases from 1990 to 2019. Additionally, it employs the Age-Period-Cohort (APC) model to estimate the age, period, and cohort effects from 1990 to 2019.ResultsFor 1990 to 2019, the ASPR (age-standardised prevalence rate) of IBD increased significantly for China and South Africa, and decreased significantly for Brazil, India, Russian. The Russian ASPR of MS demonstrated a significantly decreasing trend (average annual percent change=−0.5%, 95% CI −0.6 to −0.5), with the most increased occurring in Brazil at 2009–2014. The cohort effect on DALY rates for Psoriasis displayed an ongoing decreasing trend from the 1929–1933 birth cohort to the 1999–2003 birth cohort. Specifically, the five countries relative risk values (RRs) of DALYs due to RA increased significantly by 7.98, 16.07, 5.98, 3.19, 9.13 times, from 20 to 24 age group to 65 to 69 age group.ConclusionsThe population of the BRICS countries accounts for more than 40% of the global population. And we found that the age effect of various autoimmune diseases is heavily influenced by population ageing.

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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.

To investigate the association between exposure to anesthesia during three periods of pregnancy, delivery, and childhood and autism spectrum disorder (ASD). PubMed, Scopus, Web of Science, Embase, Google Scholar, PsycArticles, and PsycINFO were searched from the date of database inception to 1 December 2022. Studies reported the association between exposure to anesthesia during pregnancy, delivery, and childhood and ASD were included. Extracted variables included hazard ratio (HR), relative risk or odds ratio, standard error, and 95

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.

BACKGROUND:Severe periodontitis is one of the most prevalent diseases and a global public health problem due to its high incidence and prevalence. However, there are few studies on the burden of periodontitis in different regions of the world.METHODS:We extracted data on the incidence, prevalence, and disability-adjusted life years (DALYs) from the Global Burden of Disease study as severe periodontitis burden measures. We also explored the global burden of severe periodontitis according to 21 world regions and Socio-Demographic Index (SDI) quintiles. The joinpoint model was used to analyze temporal trends of major regions from 1990 to 2019, and the age-period-cohort model was used to estimate age, period, and cohort trends in severe periodontitis.RESULTS:Globally, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and disability-adjusted life years (DALYs) rate increased from 1990 to 2019 (percentage change: 5.77%, 7.78%, and 8.01%, respectively), with average annual percent changes of 0.2%, 0.3%, and 0.3%, respectively. The region with the highest DALY rate was western sub-Saharan Africa with a value of 142.5 (95% uncertainty interval: 56.3, 303.7) per 100,000 in 2019. For the ASIR, ASPR, and DALY, the age effect of severe periodontitis showed an increase followed by a decrease, the period effect showed an upward trend, the cohort effect showed an overall decreasing trend, and the cohort relative risk for incidence for some SDI quintiles showed a slight increase in recent years.CONCLUSIONS:Oral health varies significantly across regions, and it is essential to address inequalities in oral health between countries. Effective measures to prevent severe periodontitis risk factors should also be taken in regions with low SDI.

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.

Summary Background The progress of genome‐wide association studies (GWAS) in childhood obesity and its indicators is challenging and there are differences in genetic studies in children and adults. Objective To illustrate the history of the development of GWAS in childhood obesity and its indicators and summarize the GWAS loci. Methods PubMed, Web of Science, Embase and GWAS Catalog databases were systematically searched from 1 January 2005 to 19 October 2022 for literature related to GWAS of childhood BMI, body fatness and obesity. The nearest genes were used as positional genes to perform gene set analyses including the enrichment of pathways, tissues and diseases. Results Twenty articles published between 2007 and 2021 were included in this scoping review, which identified 116 SNPs reaching genome‐wide significance with childhood BMI ( n = 50), body fatness ( n = 31) and obesity ( n = 35). The study populations were European in 16 studies, non‐European in three studies (1 East Asian; 1 American; 1 Mexican) and trans‐ancestry in one study. Several enriched pathways, tissues and diseases were identified through enrichment analysis of genes associated with childhood obesity and its indicators. Conclusions The innovations in tools and methods enable GWAS to better explore the genetic characteristics of obesity in children and adolescents. However, the number of GWAS in American, Asian and African populations is limited compared to the European population.

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 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.