Excess multi-cause mortality linked to influenza virus infection in China, 2012-2021: a population-based study.

Objectives: The aim of this study is to estimate the excess mortality burden of influenza virus infection in China from 2012 to 2021, with a concurrent analysis of its associated disease manifestations. Methods: Laboratory surveillance data on influenza, relevant population demographics, and mortality records, including cause of death data in China, spanning the years 2012 to 2021, were incorporated into a comprehensive analysis. A negative binomial regression model was utilized to calculate the excess mortality rate associated with influenza, taking into consideration factors such as year, subtype, and cause of death. Results: There was no evidence to indicate a correlation between malignant neoplasms and any subtype of influenza, despite the examination of the effect of influenza on the mortality burden of eight diseases. A total of 327,520 samples testing positive for influenza virus were isolated between 2012 and 2021, with a significant decrease in the positivity rate observed during the periods of 2012-2013 and 2019-2020. China experienced an average annual influenza-associated excess deaths of 201721.78 and an average annual excess mortality rate of 14.53 per 100,000 people during the research period. Among the causes of mortality that were examined, respiratory and circulatory diseases (R&C) accounted for the most significant proportion (58.50%). Fatalities attributed to respiratory and circulatory diseases exhibited discernible temporal patterns, whereas deaths attributable to other causes were dispersed over the course of the year. Conclusion: Theoretically, the contribution of these disease types to excess influenza-related fatalities can serve as a foundation for early warning and targeted influenza surveillance. Additionally, it is possible to assess the costs of prevention and control measures and the public health repercussions of epidemics with greater precision.

Effects of bilateral repetitive transcranial magnetic stimulation on prospective memory in patients with schizophrenia: A double-blind randomized controlled clinical trial.

AIMS: To investigate effects of repetitive transcranial magnetic stimulation (rTMS) on the prospective memory (PM) in patients with schizophrenia (SCZ). METHODS: Fifty of 71 patients completed this double-blind placebo-controlled randomized trial and compared with 18 healthy controls' (HCs) PM outcomes. Bilateral 20 Hz rTMS to the dorsolateral prefrontal cortex at 90% RMT administered 5 weekdays for 4 weeks for a total of 20 treatments. The Positive and Negative Symptom Scale (PANSS), the Scale for the Assessment of Negative Symptoms (SANS), and PM test were assessed before and after treatment. RESULTS: Both Event-based PM (EBPM) and Time-based PM (TBPM) scores at baseline were significantly lower in patients with SCZ than that in HCs. After rTMS treatments, the scores of EBPM in patients with SCZ was significantly improved and had no differences from that in HCs, while the scores of TBPM did not improved. The negative symptom scores on PANSS and the scores of almost all subscales and total scores of SANS were significantly improved in both groups. CONCLUSIONS: Our findings indicated that bilateral high-frequency rTMS treatment can alleviate EBPM but not TBPM in patients with SCZ, as well as improve the negative symptoms. SIGNIFICANCE: Our results provide one therapeutic option for PM in patients with SCZ.

Association of Blood Selenium Levels with Diabetes and Heart Failure in American General Adults: a Cross-sectional Study of NHANES 2011-2020 pre.

Selenium is an essential trace element closely related to human health; however, the relationship between blood selenium levels, diabetes, and heart failure remains inconclusive. Therefore, this study aimed to explore the relationship between blood selenium levels and the prevalence of diabetes as well as heart failure in American general adults aged 20 years or older. This study utilized data from four survey cycles from NHANES 2011-2020 pre. Blood selenium levels were considered as both a continuous variable and quartiles, and logistic regression was employed to investigate the associations between blood selenium levels with diabetes and heart failure. Nonlinear relationships were examined by restricted cubic spline regression. The analysis included a total of 16311 participants aged 20 years or older. After adjustment for all potential confounder, we found when the blood selenium levels increased by 10 ug/L, the average risk of diabetes increased by 4.2% (95% CI: 1.5%, 7.0%), and the average risk of heart failure decreased by 5.0% (95% CI: 0.1%, 9.8%). In addition, compared with the lowest reference group, blood selenium levels were significantly positively associated with risk of diabetes in participants in the fourth quartile (OR=1.458, 95% CI: 1.173, 1.812), while significantly negatively associated with the risk of heart failure in participants in the second, third and fourth quartiles (Q2, OR=0.677, 95% CI: 0.471, 0.974) (Q3, OR=0.609, 95% CI: 0.426, 0.870) (Q4, OR=0.653, 95% CI: 0.443, 0.961). There was a nonlinear and reverse L-shaped association between blood selenium and diabetes, while a negative dose-response association between blood selenium and heart failure. Furthermore, the association between blood selenium levels and heart failure was more pronounced in participants with poor glycemic control, rather than diabetic patients. High blood selenium levels may be positively related to diabetes, while low blood selenium levels may be associated to heart failure. Appropriate blood selenium levels may help prevent diabetes and heart failure.

Effect of Isoflavones on Blood Lipid Alterations in Postmenopausal Females: A Systematic Review and Meta-Analysis of Randomized Trials.

The effects of isoflavones on postmenopausal female's blood lipid profile have yielded conflicting results in previous studies. Further investigation is necessary to determine the potential benefits of isoflavone therapy in managing cardiovascular health in this population. This meta-analysis aimed to assess the effects of isoflavones on blood lipid concentrations in postmenopausal females. A comprehensive search was conducted in major databases for randomized controlled trials published between 2000 and 2023. Eighteen studies were included in the analysis, which examined the impact of isoflavone intake on blood lipids in postmenopausal females. Isoflavone consumption resulted in a significant reduction in triacylglycerol (TG) concentrations (-12.50 mg/dL; 95% CI: -23.09, -1.91) and a modest increase in high-density lipoprotein cholesterol (HDL cholesterol) concentrations (1.83 mg/dL; 95% CI: 0.03, 3.64). Subgroup analysis showed that isoflavones significantly decreased TG (-15.79 mg/dL; 95% CI: -28.36, -3.22) and increased HDL cholesterol (2.49 mg/dL; 95% CI: 1.80, 3.19) in postmenopausal females under 65 y old. No significant effects were observed in females over 65 y old. Both low (≤80 mg/d) and high (>80 mg/d) doses of isoflavones exhibited TG-lowering effects, whereas only the high dose increased HDL cholesterol. Longer treatment duration (≥24 wk) was associated with a significant reduction in TG, whereas HDL cholesterol improvement occurred during the early period (<24 wk) of supplementation. The consumption of isoflavones resulted in a significant reduction in TG concentrations and an increase in HDL cholesterol concentrations among postmenopausal females under 65 y of age.

Frailty Index and Cardiovascular Disease among Middle-Aged and Older Chinese Adults: A Nationally Representative Cross-Sectional and Follow-Up Study.

Evidence for the association between the frailty index and cardiovascular disease (CVD) is inconclusive, and this association has not been evaluated in Chinese adults. We aim to examine the association between the frailty index and CVD among middle-aged and older Chinese adults. We conducted cross-sectional and cohort analyses using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS). From 2011 to 2018, 17,708 participants aged 45 years and older were included in the CHARLS. The primary outcome was CVD events (composite of heart disease and stroke). Multivariable adjusted logistic regression and Cox proportional hazards models were used to estimate the association between the frailty index and CVD in cross-sectional and follow-up studies, respectively. A restricted cubic spline model was used to characterize dose−response relationships. A total of 16,293 and 13,580 participants aged 45 years and older were included in the cross-sectional and cohort analyses, respectively. In the cross-sectional study, the prevalence of CVD in robust, pre-frailty and frailty was 7.83%, 18.70% and 32.39%, respectively. After multivariable adjustment, pre-frailty and frailty were associated with CVD; ORs were 2.54 (95% confidence interval [CI], 2.28−2.84) and 4.76 (95% CI, 4.10−5.52), respectively. During the 7 years of follow-up, 2122 participants without previous CVD developed incident CVD; pre-frailty and frailty were associated with increased risk of CVD events; HRs were 1.53 (95% CI, 1.39−1.68) and 2.17 (95% CI, 1.88−2.50), respectively. Furthermore, a stronger association of the frailty index with CVD was observed in participants aged <55, men, rural community-dwellers, BMI ≥ 25, without hypertension, diabetes or dyslipidemia. A clear nonlinear dose−response pattern between the frailty index and CVD was widely observed (p < 0.001 for nonlinearity), the frailty index was above 0.08, and the hazard ratio per standard deviation was 1.18 (95% CI 1.13−1.25). We observed the association between the frailty index and CVD among middle-aged and elderly adults in China, independent of chronological age and other CVD risk factors. Our findings are important for prevention strategies aimed at reducing the growing burden of CVD in older adults.

Effect of a Community-Based Hepatitis B Virus Infection Detection Combined with Vaccination Program in China.

Evidence on the effectiveness of hepatitis B virus (HBV) infection screening and vaccination programs remains rare in China. We used a quasi-experimental method, propensity score matching, to evaluate the effects of a community-based HBV infection detection combined with vaccination (HBVIDV) program in a pilot. Data were retrieved from the HBVIDV program implemented between July 2019 and June 2020. Outcomes were the difference between the treatment and control groups in hepatitis B vaccination (≥1 dose), hepatitis B vaccine series completion (≥3 doses), and serologic evidence of vaccine-mediated immunity. Altogether, 26,180 individuals were included, where 6160 (23.5%) individuals were assigned to the treatment group, and 20,020 (76.5%) individuals were assigned to the control group. After propensity score matching, 5793 individuals were matched. The rates of hepatitis B vaccination, hepatitis B vaccine series completion, and prevalence of vaccine-mediated immunity in the treatment and control groups were 29.0% vs. 17.8%, 22.1% vs. 13.1%, and 38.2% vs. 27.6%, respectively. The HBVIDV program was significantly associated with increased hepatitis B vaccination rate (OR, 1.884, 95% CI 1.725-2.057), hepatitis B vaccine series completion rate (OR, 1.872, 95% CI 1.696-2.065), and prevalence of vaccine-mediated immunity (OR, 1.623, 95% CI 1.501-1.755). The greater magnitude of association between HBVIDV program and outcomes was observed among adults aged 35-54 years and adults who live in rural areas. The HBVIDV program was effective in increasing the hepatitis B vaccination rate, hepatitis B vaccine series completion rate, and prevalence of vaccine-mediated immunity among adults in the pilot. Further focusing the program on special populations and regions may produce more effective results.

A disease category feature database construction method of brain image based on deep convolutional neural network.

BACKGROUND: Constructing a medical image feature database according to the category of disease can achieve a quick retrieval of images with similar pathological features. Therefore, this approach has important application values in the fields such as auxiliary diagnosis, teaching, research, and telemedicine. METHODS: Based on the deep convolutional neural network, an image classifier applicable to brain disease was designed to distinguish between the image features of the different brain diseases with similar anatomical structures. Through the extraction and analysis of visual features, the images were labelled with the corresponding semantic features of a specific disease category, which can establish an association between the visual features of brain images and the semantic features of the category of disease which will permit to construct a disease category feature database of brain images. RESULTS: Based on the similarity measurement and the matching strategy of high-dimensional visual feature, a high-precision retrieval of brain image with semantics category was achieved, and the constructed disease category feature database of brain image was tested and evaluated through large numbers of pathological image retrieval experiments, the accuracy and the effectiveness of the proposed approach was verified. CONCLUSION: The disease category feature database of brain image constructed by the proposed approach achieved a quick and effective retrieval of images with similar pathological features, which is beneficial to the categorization and analysis of intractable brain diseases. This provides an effective application tool such as case-based image data management, evidence-based medicine and clinical decision support.

Association between earthquake experience and depression 37 years after the Tangshan earthquake: a cross-sectional study.

OBJECTIVE: To investigate the association between the Tangshan earthquake and depression after 37 years. DESIGN AND SETTING: A cross-sectional study conducted in Tangshan from 2013 to 2014. PARTICIPANTS: The sample included 5024 participants born before 28 July 1976 the date of the Tangshan earthquake, with available data on their earthquake experiences and depression 37 years post-earthquake. OUTCOMES AND VARIABLES: The outcome was depression measured using the Center for Epidemiological Study and Depression Scale. The independent variable was earthquake experience, which was classified into three groups: no earthquake experience, earthquake experience without bereavement and earthquake experience with bereavement. Multivariable logistic regression analysis was used to evaluate the association between earthquake experience and depression after adjusting for gender, age at the time of the earthquake, smoking status, drinking status, education, income, residence in Tangshan 1 to 2 years post-earthquake, hypertension, diabetes and dyslipidaemia. RESULTS: Of the 5024 participants, 641 experienced the Tangshan earthquake, and 98 experienced bereavement due to the earthquake. 37 years after the earthquake, survivors who had lost relatives during the earthquake were nearly three times (OR 2.82, 95% CI 1.24 to 6.39) as likely to have depression as those who had not experienced the earthquake, while those who had not lost relatives were 1.69 times as likely (OR 1.69, 95% CI 0.93 to 3.08). Stratified analyses showed that earthquake was significantly associated with depression in women with (OR 3.51, 95% CI 1.21 to 10.16) or without bereavement (OR 3.07, 95% CI 1.44 to 6.56) but not in men; this association was also significant in individuals over 18 years old at the time of the earthquake with (OR 13.16, 95% CI 3.08 to 56.3) or without bereavement (OR 3.39, 95% CI 1.31 to 8.87) but not in individuals less than 18 years old. CONCLUSIONS: 37 years after the Tangshan earthquake, earthquake experience was associated with depression among bereaved survivors, women and individuals over 18 years old at the time of the earthquake.

Demand Analysis and Function Design of Health Decision Support System in China.

In order to improve the level of health decision-making, based on health information resources and decision support function types, this study summarized five core functions of health decision support system: information support, monitoring and early warning, analysis and evaluation, trend prediction, comprehensive optimization; And from the perspective of business functions, business processes and business activities of business domains, the demand of Health Decision Support System is refined in to six parts, such as public health, medical care, drug management, medical insurance, comprehensive management, grass-roots health. On this basis, the overall design of the system is carried out.

Analysis and Measurement of China's Population Health Informatization Development Strategy.

This paper analyzes the development strategy of population health informatization in China, and summarizes the measurement direction and evaluation elements of population health informatization. Methods: Literature and field investigation, expert consultation and PEST analysis were used to determine the development level measurement and evaluation framework. Results: Based on the PEST analysis framework, the development level measurement and evaluation factors were defined, and the evaluation framework was established, which included system construction, IT application, information financing, information personnel, information policy and management, and information application effect. The information from hospitals and grass- roots medical and health institutions was also provided. From the perspective of the level of development, the framework of informatization evaluation is further refined.

Gender differences in the relationship between alcohol consumption and insomnia in the northern Chinese population.

BACKGROUND: Insomnia is one of the main symptoms of sleep disorders. Previous studies have suggested that alcohol intake is associated with several adverse health outcomes. The association between alcohol consumption and insomnia has been addressed in several studies with different results. However, whether gender may modify the association between alcohol consumption and insomnia is not clear. This study will focus on gender differences in the relationship between alcohol consumption and insomnia. METHODS: The final study includes 8081 subjects aged between 18 and 65 years from the Jidong cohort. The data on alcohol consumption is collected by questionnaires, and insomnia problems are assessed using the entire 8-item Athens Insomnia Scale (AIS-8). Logistic analysis is used to evaluate the association between alcohol consumption and insomnia. RESULTS: Among the 8081 participants in this study, 2618 (32.4%) are alcohol drinkers, including 2424 males and 194 females. The prevalence of insomnia is 9.6% in the male and 10.6% in the female. The adjusted odds ratios (ORs) with 95% confidence interval (CI) of mild-to-moderate drinkers and heavy drinkers for insomnia are 1.27 (1.02-1.58) and 1.02 (0.79-1.32), respectively. Heavy alcohol consumption is significantly correlated with insomnia in the female, after controlling for potential confounding factors (OR: 2.11, 95% CI: 1.28-3.49, p for interaction = 0.002). CONCLUSION: A significant association between alcohol consumption and insomnia is found in females, but not in males from the northern Chinese population.

Association between Nonalcoholic Fatty Liver Disease and Carotid Artery Disease in a Community-Based Chinese Population: A Cross-Sectional Study.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases with a high prevalence in the general population. The association between NAFLD and cardiovascular disease has been well addressed in previous studies. However, whether NAFLD is associated with carotid artery disease in a community-based Chinese population remained unclear. The aim of this study was to investigate the association between NAFLD and carotid artery disease. METHODS: A total of 2612 participants (1091 men and 1521 women) aged 40 years and older from Jidong of Tangshan city (China) were selected for this study. NAFLD was diagnosed by abdominal ultrasonography. The presence of carotid stenosis or plaque was evaluated by carotid artery ultrasonography. Logistic regression was used to analyze the association between NAFLD and carotid artery disease. RESULTS: Participants with NAFLD have a higher prevalence of carotid stenosis (12.9% vs. 4.6%) and carotid plaque (21.9% vs. 15.0%) than those without NAFLD. After adjusting for age, gender, smoking status, income, physical activity, diabetes, hypertension, triglyceride, waist-hip ratio, and high-density lipoprotein, NAFLD is significantly associated with carotid stenosis (odds ratio [OR]: 2.06, 95% confidence interval [CI]: 1.45-2.91), but the association between NAFLD and carotid plaque is not statistically significant (OR: 1.10, 95% CI: 0.8-1.40). CONCLUSION: A significant association between NAFLD and carotid stenosis is found in a Chinese population.

Developing a Basic Medical Insurance Statement in Chinese Underdeveloped Areas.

BACKGROUND: We presented the running state of rural basic medical insurance system in Henan and discussed the enforcements and development experiences of underdeveloped areas. We provided data evidence to support the improvement and development of a basic rural medical insurance system. METHODS: We selected Henan Province, China as a sample, using the method of cluster sampling, from policy documents published in the national and provincial level of the new rural cooperative medical policy and work documents, data from 2004 to 2014, the National Health Statistical Yearbook of health statistics yearbook of Henan Province and relevant statistical data of the province. RESULTS: The new rural cooperative policy has covered the whole population in Henan Province. The number of individual received benefits is increasing. In 2013, the number of persons counted has reached to 270 million, funds raised and expenditures reached 38.5 billion and 26 billion, respectively. The operational task force has been developed rapidly. In 2013, on average each staff managed the cases for 16.4 thousand rural residents. CONCLUSION: The major implementation and development experience from the new rural cooperative policy of Henan province include: education of related knowledge, optimization of compensation plan, development of operational system and framework, improvement of management rules, reinforcement of information system development and financial supervision and increment of investment in rural medical healthcare.

A Robust and Accurate Non-rigid Medical Image Registration Algorithm Based on Multi-level Deformable Model.

BACKGROUND: Compared to the rigid image registration task, the non-rigid image registration task faces much more challenges due to its high degree of freedom and inherent requirement of smoothness in the deformation field. The purpose was to propose an efficient coarse-to-fine non-rigid medical image registration algorithm based on a multilevel deformable model. METHODS: In this paper, a robust and efficient coarse-to-fine non-rigid medical image registration algorithm is proposed. It contains three level deformation models, i.e., the global homography model, the local mesh-level homography model, and the local B-spline FFD (Free-Form Deformation) model. The coarse registration is achieved by the first two level models. In the global homography model, a robust algorithm for simultaneous outliers (error matched feature points) removal and model estimation is applied. In the local mesh-level homography model, a new similarity measure is proposed to improve the robustness and accuracy of local mesh based registration. In the fine registration, a local B-spline FFD model with normalized mutual information gradient is employed. RESULTS: We verified the effectiveness of each stage of the proposed registration algorithm with many non-rigid transformation image pairs, and quantitatively compared our proposed registration algorithm with the HBFFD method which is based on the control points of multi-resolution. The experimental results show that our algorithm is more accurate than the hierarchical local B-spline FFD method. CONCLUSION: Our algorithm can achieve high precision registration by coarse-to-fine process based on multi-level deformable model, which ourperforms the state-of-the-art methods.

Design and Construction for Community Health Service Precision Fund Appropriation System Based on Performance Management.

Allowing for the differences in economy development, informatization degree and characteristic of population served and so on among different community health service organizations, community health service precision fund appropriation system based on performance management is designed, which can provide support for the government to appropriate financial funds scientifically and rationally for primary care. The system has the characteristic of flexibility and practicability, in which there are five subsystems including data acquisition, parameter setting, fund appropriation, statistical analysis system and user management.

Application of Ontology Technology in Health Statistic Data Analysis.

Research Purpose: establish health management ontology for analysis of health statistic data. Proposed Methods: this paper established health management ontology based on the analysis of the concepts in China Health Statistics Yearbook, and used protégé to define the syntactic and semantic structure of health statistical data. RESULTS: six classes of top-level ontology concepts and their subclasses had been extracted and the object properties and data properties were defined to establish the construction of these classes. By ontology instantiation, we can integrate multi-source heterogeneous data and enable administrators to have an overall understanding and analysis of the health statistic data. CONCLUSION: ontology technology provides a comprehensive and unified information integration structure of the health management domain and lays a foundation for the efficient analysis of multi-source and heterogeneous health system management data and enhancement of the management efficiency.

A Study of Evaluation and Automation Instruction of Management by Law of Community Health Service in China.

The goal is to explore a concrete mode for the health administrative department to manage community health service. On the basis of existing health laws and regulations, the study synthesized computer technology, set up the automation system of community health service supervision and management, drew up management norm, management procedure, evaluation system, designed corresponding software, and then completed the spot usage. Four changes of community health service management are realized.

Effects of New Rural Cooperative Medical Scheme on Medical Service Utilization and Medical Expense Control of Inpatients: A 3-year Empirical Study of Hainan Province in China.

BACKGROUND: The New Rural Cooperative Medical Scheme (NCMS) has been further adjusted and optimized to reduce the financial burden of rural residents and to achieve universal coverage for them. In this study, we aimed to explore the impact of NCMS on medical service utilization and medical expense of inpatients in recent years. METHODS: The research data of Hainan Province were extracted from the Chinese NCMS platform from 2012 to 2014. Detailed information included total expenditure, average inpatients costs, average out-of-pocket payments, actual reimbursement rate, and average annual growth rate of the above indicators. Descriptive analysis was used to gauge the effects of NCMS. RESULTS: In the utilization of medical services, NCMS inpatients in tertiary hospital decreased from 25.49% in 2012 to 20.39% in 2014, inpatients in county hospitals increased from 39.49% to 55.92%, simultaneously. The total expenditure in county hospitals rose steadily from 28.46% to 46.66%, meanwhile, the total expenditure in tertiary hospitals fell from 60.44% to 44.51%.The average out-of-pocket costs of rural inpatients remained stable over the years. Furthermore, the compensation fund of NCMS inpatients grew significantly. The actual inpatient reimbursement rate at township health centers increased from 76.93% to 84.04%. Meanwhile, the rate at county hospitals and tertiary hospitals increased slightly from 59.37% and 46.10% to 61.25% and 47.71%, respectively. CONCLUSIONS: With the improvement of the reimbursement ability, especially after the new health care reform in 2009, the NCMS have been playing a prominent role in alleviating the economic burden of farmers' medical treatment. Meanwhile, more patients go to primary hospitals than tertiary hospitals, and the capability of primary hospitals has been greatly improved.