A machine learning screening model for identifying the risk of high-frequency hearing impairment in a general population.

BACKGROUND: Hearing impairment (HI) has become a major public health issue in China. Currently, due to the limitations of primary health care, the gold standard for HI diagnosis (pure-tone hearing test) is not suitable for large-scale use in community settings. Therefore, the purpose of this study was to develop a cost-effective HI screening model for the general population using machine learning (ML) methods and data gathered from community-based scenarios, aiming to help improve the hearing-related health outcomes of community residents. METHODS: This study recruited 3371 community residents from 7 health centres in Zhejiang, China. Sixty-eight indicators derived from questionnaire surveys and routine haematological tests were delivered and used for modelling. Seven commonly used ML models (the naive Bayes (NB), K-nearest neighbours (KNN), support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGBoost), boosting, and least absolute shrinkage and selection operator (LASSO regression)) were adopted and compared to develop the final high-frequency hearing impairment (HFHI) screening model for community residents. The model was constructed with a nomogram to obtain the risk score of the probability of individuals suffering from HFHI. According to the risk score, the population was divided into three risk stratifications (low, medium and high) and the risk factor characteristics of each dimension under different risk stratifications were identified. RESULTS: Among all the algorithms used, the LASSO-based model achieved the best performance on the validation set by attaining an area under the curve (AUC) of 0.868 (95% confidence interval (CI): 0.847-0.889) and reaching precision, specificity and F-score values all greater than 80%. Five demographic indicators, 7 disease-related features, 5 behavioural factors, 2 environmental exposures, 2 hearing cognitive factors, and 13 blood test indicators were identified in the final screening model. A total of 91.42% (1235/1129) of the subjects in the high-risk group were confirmed to have HI by audiometry, which was 3.99 times greater than that in the low-risk group (22.91%, 301/1314). The high-risk population was mainly characterized as older, low-income and low-educated males, especially those with multiple chronic conditions, noise exposure, poor lifestyle, abnormal blood indices (e.g., red cell distribution width (RDW) and platelet distribution width (PDW)) and liver function indicators (e.g., triglyceride (TG), indirect bilirubin (IBIL), aspartate aminotransferase (AST) and low-density lipoprotein (LDL)). An HFHI nomogram was further generated to improve the operability of the screening model for community applications. CONCLUSIONS: The HFHI risk screening model developed based on ML algorithms can more accurately identify residents with HFHI by categorizing them into the high-risk groups, which can further help to identify modifiable and immutable risk factors for residents at high risk of HI and promote their personalized HI prevention or intervention.

Status and Influential Factors of Intelligent Healthcare in Nursing Homes in China.

With the support of the Chinese government, nursing homes have increasingly adopted Internet and intelligent information technology to provide daily healthcare services to residents. However, no research has reported the status of intelligent healthcare in nursing homes. From September 2017 to May 2018, we conducted a survey of 197 nursing homes and collected information on their general characteristics, the intelligent healthcare services provided, the effectiveness of the application products used, and the attitudes of the staff and residents toward intelligent healthcare. Overall, 79.69% of the surveyed nursing homes have provided intelligent healthcare services, including medical care services (eg, chronic disease management and intelligent nursing) and daily life services (eg, fall monitoring and wireless positioning). Portable health monitoring devices and data management and service platforms are the most used healthcare products. The attitudes of staff probably affected the development of intelligent healthcare. Financial investment and the attitudes of staff and residents are factors that influence the effectiveness of the application of intelligent healthcare products in nursing homes. With the support of national policies, nursing homes have implemented primary intelligent healthcare. Stakeholders play pivotal roles in the provision of intelligent healthcare services.

Associations of noise kurtosis, genetic variations in NOX3 and lifestyle factors with noise-induced hearing loss.

BACKGROUND: Noise-induced hearing loss (NIHL) is a complex disease caused by environmental and genetic risk factors. This study was to explore the association of noise kurtosis, triphosphopyridine nucleotide oxidase 3 (NOX3) and lifestyles with NIHL. METHODS: This case-control study included 307 patients with NIHL and 307 matched control individuals from Zhejiang province of China. General characteristics, noise exposure data, the exfoliated cells of the oral mucosa, and lifestyle details of individuals were collected. The kompetitive allele specific polymerase chain reaction (KASP) method was used to analyze the genotypes of three single nucleotide polymorphisms (SNPs) of NOX3. RESULTS: People who exposed to complex noise had a higher risk of NIHL than those exposed to steady noise (adjusted: OR = 1.806, P = 0.002). The GT genotype of additive model and TT + GT genotype of dominant model in NOX3 rs12195525 decreased the risk of NIHL (adjusted: OR = 0.618, P = 0.043; OR = 0.622, P = 0.036). Smoking and exposure to high video volume increased the risk of NIHL (adjusted: OR = 1.486, P = 0.038; OR = 1.611, P = 0.014). Oppositely, regular physical exercise decreased the risk of NIHL (adjusted: OR = 0.598, P = 0.004). A positive interaction was found between complex noise and lifestyles including high video volume exposure and no physical exercise in the additive models (RERI = 1.088, P < 0.001; RERI = 1.054, P = 0.024). A positive interaction was also found between NOX3 rs12195525 GG genotype and lifestyles including smoking and high video volume exposure in the additive models (RERI = 1.042, P = 0.005; RERI = 0.774, P = 0.044). CONCLUSIONS: Noise temporal structure, NOX3 rs12195525 polymorphism, and the three lifestyles of smoking, video volume, and physical exercise were related to the NIHL. There were the interactions between noise temporal structure and the lifestyle of video volume or physical exercise, as well as between NOX3 and the lifestyle of smoking or video volume. These results provide a theoretical basis for the prevention and genetic testing of NIHL.

Higher serum magnesium concentration is associated with lower hearing thresholds and risk of hearing loss among a Chinese population.

BACKGROUND AND OBJECTIVES: Hearing loss is a sensory impairment caused by genetic and environmental factors. Previous epidemiological studies of magnesium intake and hearing loss have yielded conflicting results. METHODS AND STUDY DESIGN: We investigated the association between serum magnesium concentrations and hearing loss in a population from the Zhejiang region of China. A cross-sectional study of 3,267 participants aged 18 years and older from five hospitals was conducted from October 2016 to May 2018. An audiometric examination was conducted, and hearing thresholds were computed as pure-tone averages (PTAs) at speech (0.5, 1, 2, and 4 kHz) and high frequencies (3, 4, and 6 kHz). Magnesium concentrations were measured using an inductively coupled plasma mass spectrometer. RESULTS: A linear regression analysis revealed a negative association between magnesium levels and hearing losses from lower to high PTAs. After the adjustment of potential confounders, participants in the highest magnesium quartile had a lower PTA (quartile 4: -1.89%; 95% confidence interval (CI: -3.07 to -0.701); p=0.022) and high PTA (quartile 4: -3.05%; 95% CI: -4.64 to -1.46; p=0.005) than those in the lowest quartile. A logistic regression analysis showed a dose-dependent reduction in the odds of high frequency hearing loss across magnesium quartiles. In model 3, after adjusting for all potential confounders, participants with the highest magnesium quartiles had a 54.0% (OR: 0.460; 95% CI: 0.339-0.587) reduction in the odds of high-frequency hearing loss. CONCLUSIONS: Higher whole blood levels of magnesium in this population were associated with lower hearing thresholds and risk of hearing loss.

Carotenoid metabolic (BCO1) polymorphisms and personal behaviors modify the risk of coronary atherosclerosis: a nested case-control study in Han Chinese with dyslipidaemia (2013-2016).

BACKGROUND AND OBJECTIVES: ß-Carotene-15,15'-oxygenase (BCO1) is a key enzyme involved in carotenoid metabolism and has been linked with the development of coronary atherosclerosis. This study investigated the association between BCO1 polymorphisms and the risk of coronary atherosclerosis in dyslipidemia participants, and analyzed the influence of personal behaviors on coronary atherosclerosis. METHODS AND STUDY DESIGN: A nested case-control study was conducted from 2013 to 2016 in which 1359 dyslipidemia participants were recruited. Personal lifestyle parameters, mainly physical activities and diet, were obtained by questionnaires and the genotypes of rs11641677, rs11646692, rs12934922, rs6564851 and rs7501331 in BCO1 were analyzed by ligase detection reaction. In 2016, 166 participants were diagnosed with coronary atherosclerosis and 498 age-and gendermatched controls were recruited. The association between BCO1 polymorphisms and risk of coronary atherosclerosis were analyzed with logistic regression, and the effect of gene-behaviors interaction on the risk of coronary atherosclerosis were determined with crossover analysis. RESULTS: After adjustment for potential confounders, logistic regression analysis showed that fried food intake (OR=1.637, 95% CI: 1.127~2.378; p=0.010), dessert intake (OR=1.733, 95% CI: 1.158~2.595; p=0.008), and physical activity (OR=0.511, 95% CI: 0.309~0.846; p=0.009) were risk factors for coronary atherosclerosis. Rs12934922 and rs11646692 reflected high susceptibility to coronary atherosclerosis. Crossover analysis indicated that rs12934922 and rs11646692 interacted with physical activity (Inter-OR=8.82; Inter-OR=3.69), fried food intake (Inter-OR=2.95; Inter-OR=2.36) and dessert intake (Inter-OR=3.95; Inter-OR=2.39) to influence the risk of coronary atherosclerosis. CONCLUSIONS: In dyslipidemia patients, rs12934922 and rs11646692 may influence the development of coronary atherosclerosis. A combination of BCO1 polymorphisms and several behavioral factors may affect the development of coronary atherosclerosis.

Associations between social capital and maternal depression: results from a follow-up study in China.

BACKGROUND: This study aims to investigate the association between social capital (SC) and depressive symptoms among Chinese primiparas at different time-points from their late pregnancy to postpartum. METHODS: A total of 450 primiparas were recruited for the current study. The assessments were conducted at three different time-points: T1 - while the participants were recruited at their 30-36 weeks of pregnancy in the antenatal clinic in the maternity hospital in Zhejiang, China; T2 - at their 2nd or 3rd days in the wards after delivery; T3 - at week 6 to 8 after the delivery in the postpartum examination clinic. SC was measured by the 29-item SC scale; while depressive symptoms were measured by the Edinburgh Postnatal Depression Scale. The relationships between SC and depressive symptoms were explored separately at each of the three time-points. RESULTS: The prevalence of depression among the primiparas was 25% at T1, 13.5% at T2 and 20.8% at T3, respectively. However, the score of SC and its components at three time-points followed an opposite 'V' direction, with the highest score at T2, following by T3 and T1. At T1, the analysis suggested that depressive symptoms among the primiparas were negatively correlated with their social trust and social network levels. At T2, only social trust was negatively associated with depression. While at T3, it is social trust and social participations that were significantly negatively associated with depression. CONCLUSIONS: SC was associated with depression at all three time-points during and after pregnancy. More attention should be given to SC in the maternal health promotion programs of community pregnancy health care management.

Interactions between ALDH2 rs671 polymorphism and lifestyle behaviors on coronary artery disease risk in a Chinese Han population with dyslipidemia: A guide to targeted heart health management.

BACKGROUND: Both aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism and lifestyle behaviors are involved in coronary artery disease (CAD), while the interaction between them is currently unknown. METHODS: A nested case-control study was conducted in 161 patients with CAD and 495 controls in dyslipidemia population in Yinzhou District, Ningbo, Zhejiang Province, China, in August 2013. Anthropometric data and blood samples were collected, demographic characteristics and lifestyle behaviors information were obtained by a face-to-face interview, dietary intake was assessed by a food frequency questionnaire, and genomic DNA was genotyped. RESULTS: Carriers with increasing number of A alleles had an elevated CAD risk compared with G allele carriers (adjusted OR = 1.483, 95% CI = 1.114-1.974). Carriers of rs671 A/G and A/A genotypes had a higher CAD risk than carriers of G/G genotype (adjusted OR = 1.492, 95% CI = 1.036-2.148). Similarly, individuals with rs671 A/A genotype had a higher CAD risk than individuals with A/G and G/G genotypes (adjusted OR = 2.161, 95% CI = 1.139-4.101). We found a borderline additive interaction between regular fried food intake and A/A and A/G genotypes, and a significantly additive interaction between sedentary/light physical activity and A/A and A/G genotypes. CONCLUSIONS: Individuals with A/A or A/G genotypes of rs671 have a higher CAD risk, if they lack physical activity and take fried food regularly, than individuals with G/G genotypes. These findings can help to provide a guide to targeted heart health management.

Associations of genetic variation in CASP3 gene with noise-induced hearing loss in a Chinese population: a case-control study.

BACKGROUND: Noise-induced hearing loss (NIHL) is a complex disease caused by environmental and genetic risk factors. This study explored the relationship between the genetic variations in the CASP gene and the risk of developing NIHL among Chinese workers exposed to occupational noise. METHODS: A case-control study of 272 NIHL workers and 272 normal-hearing workers matched for age, sex and years of noise exposure was conducted. Fifteen single-nucleotide polymorphisms (SNP) in the CASP1, CASP3, CASP4, CASP5, CASP6, CASP8, CASP9, CASP10 and CASP14 genes were genotyped using the polymerase chain reaction-ligase detection reaction method. Using conditional logistic regression models, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of genetic variations associated with NIHL risk were calculated. RESULTS: Two SNPs in the CASP3 gene were associated with NIHL risk. For rs1049216, TT genotype was associated with a decreased risk of NIHL (OR = 0.246, 95% CI = 0.069-0.886) when compared with the CC genotype. For rs6948, the AC and CC genotype were associated with a decreased NIHL risk (OR = 0.568, 95% CI = 0.352-0.916) compared with AA genotype. There were joint effects of working time and CASP3 polymorphisms on NIHL risk (P < 0.05). CONCLUSIONS: Genetic variations in the CASP3 gene and the joint effects of working time and CASP3 polymorphisms may modify the risk of developing NIHL.

Oncomirs miRNA-221/222 and Tumor Suppressors miRNA-199a/195 Are Crucial miRNAs in Liver Cancer: A Systematic Analysis.

BACKGROUND: The high mortality rate of hepatocellular carcinoma (HCC) is partly due to a lack of good diagnostic markers and treatment strategies. Recently, several microRNA (miRNA) profiling studies were conducted with HCC; however, their inconsistency means that their diagnostic or therapeutic value is debatable. AIMS: This study aims to systematically evaluate the consistency of miRNAs from multiple independent studies. METHODS: A systematic analysis of miRNAs from eligible publications was conducted, followed by real-time PCRs. The targets of highly consistent miRNAs were collected using online programs, followed by enrichment analyses for gene ontology terms and Kyoto encyclopedia of genes and genomes pathways. RESULTS: In total, 241 differentially expressed miRNAs were reported in 13 HCC profiling studies, of which 137 were upregulated and 104 downregulated. Among consistently upregulated miRNAs (cutoff > fourfold), miRNA-222, miRNA-21, miRNA-221, miRNA-210, and miRNA-224 were found increased in 8, 6, 6, 5, and 5 different studies, respectively. Among 137 downregulated miRNAs, miRNA-195, miRNA-199a, miRNA-125b, and miRNA-99a were reported in 8, 8, 5, and 5 studies, respectively. These results were confirmed by real-time PCR. Enrichment analyses demonstrated that programmed cell death and proliferation play important roles during the interplay of miRNA with HCC. CONCLUSIONS: miRNAs most consistently related to HCC are oncomirs miRNA-221/222 and tumor suppressors miRNA-199a/195.

[Effects of family and peer support upon the stages of health-related behavior in adolescent].

OBJECTIVE: To investigate the stages of health-related behaviors, family and peer support situation about adolescent in Wuhan, and to provide evidence for health intervention and health promotion. METHODS: Based on the principle of multi-stage stratified cluster sampling, extracted two junior middle school and two high school in two cities in Wuhan from March 2012 to May. A total of 1 200 students, which were part of the first and second grade class in middle school and high school, toke as the investigation object. The study surveyed following content, including the demographic situation, adolescent health-related behavior (physical activity, sedentary behavior, high-fat diet behavior, fruit and vegetable intaking behavior), stages of adolescent health related behavior (precontemplation, contemplation, preparation, action, maintenance) and adolescent support got from family and peer. The questionnaire was distributed in 1 200 copies, the valid questionnaires were 1 052 and the effective rate was 87.67%. Using χ² test to compare the different stages of change in health related behavior, t test was used to compare different groups of social support and using analysis of variance and post test to analyze social support of the four types behavior. RESULTS: In 1 052 students, there was 555 (52.8%) middle school students, 497 (47.2%) high school students, and 553 (52.6%) boys, 499 (47.4%) girls. In physical exercise and sedentary behavior, numbers of precontemplation was respectively accounting for 42.2% (444/1 200) and 28.4% (299/1 200). In high-fat diet behavior, the stages of preparation and maintain was occupied 46.7% (492/1 200). In fruit and vegetable intake behavior, there was 32.9% (346/1200) students in contemplation. Numbers in action stage was both less in the above four behavior, accounting for 6.2% (65/1 200), 8.9% (94/1 200), 14.0% (147/1 200) and 6.3% (66/1 200) separately. Adolescent peer support score respectively (2.9 ± 0.7), (2.8 ± 0.8) and (2.9 ± 0.9), which was higher than the family support scores ((2.7 ± 1.1), (2.5 ± 1.2) and (2.9 ± 1.2)) (t values were -8.72, -11.22 and -2.59, respectively. All P values were < 0.001) in physical exercise, sedentary behavior and high fat diet, but in the intake of fruits and vegetables behavior, family support score was higher than peer support (score was respectively (3.3 ± 0.9) and (3.5 ± 1.2); t < 9.97, P < 0.001). ANOVA and post hoc comparison showed that the score of family and peer support in the after-action stage was significantly higher than that the before-action stage in physical exercise, high-fat diet and fruit and vegetable intake behavior, while the differences in sedentary behavior was not significant. CONCLUSION: Youth health-related behaviors remained in its infancy, there was a certain impact on its stages which showed that the higher social support the more advanced stages of behavior.

[The relationship between fat intake behavior and psychological impact factor in adolescent].

OBJECTIVE: To learn the dietary fat intake behavior status and influencing psychological factors in teenagers. METHODS: According to the multi-stage stratified cluster sampling method, students were recruited from middle and high schools in Hangzhou, Wuhan and Xi'an from March to May, 2012. Chinese version of adolescent dietary fat intake behavior of psychological measurement scales was utilized in field investigations with 3 448 effective questionnaires. Under the transtheoretical model, the status quo of teenagers fat intake behavior was analyzed and it shows the relationship between stages and psychological variables, including strategy of change, decision balance and self-efficacy. RESULTS: In the 3 448 participants, the proportion of girls were 52.4% (1 806/3 448) and boys were 47.6% (1 642/3 448), while the mean age was (14.85 ± 1.46). There are significant differences among distributed stages of behavior change, grouped by gender, grade and region (χ(2) values were 33.59, 20.53, 27.92, P < 0.001). In different gender groups, the number of boys in precontemplation came to the first and accounted for 24.2% (438/1 806), and the number of girls were more in contemplation and preparation stage, which accounted for 49.5% (813/1 642), and it was the least both in the action stage with the ratio 12.1% (218/1 806) and 14.7% (241/1 642) respectively; in different grade groups, the numbers of student in middle school and high school were the largest in contemplation and precontemplation stage, accounted for 24.9% (494/1 986) and 23.4% (343/1 462); and among different regions, the proportion in precontemplation, contemplation and preparation stage was not a few, and this ratio in Hangzhou, Wuhan, Xi'an area was 70.6% (801/1 135), 61.7% (649/1 052) and 68.8% (867/1 261), respectively. The number in action stage was the least of all, which were 144, 147, 168, respectively. Ordinal logistic mode showed that the four variables, including the scores of process of change, decision balance (pros), decision balance (cons) and self-efficacy, were factors which significantly affected the stages of behavior change, which showed a significant difference (F values were 155.12, 19.86, 44.59, 94.27, P < 0.001) in different stages. From precontemplation stage to action stage, the score of the process of change, decision balance (pros) and self-efficacy showed an upward trend, and achieved the highest score in the action stage (from 32.6 ± 12.8, 8.4 ± 2.9, 19.7 ± 6.9 to 48.4 ± 12.6, 10.1 ± 2.5, 25.9 ± 6.9, respectively); contrarily, the decision balance (cons) decreased with the development of behavioral stage (from 14.7 ± 4.4 to 12.2 ± 3.9). Post hoc comparison also found that the score of process of change, decision balance (pros) and self-efficacy after action stages were higher than those before action, while the score of decisional balance (cons) in the precontemplation stage was higher than that in the other 4 stages. CONCLUSION: Fat intake behavior in teenagers showed different stages, whose psychological factors had significant influences, with decision balance (pros) hindered the progress of stages of behavior change, while other three factors played a positive role.

[Evaluation on the Chinese version of adolescent fat intake behavior of psychological measurement scale and its reliability and validity].

OBJECTIVE: To develop a suitable fat intake behavior of psychological measurement scales for the Chinese adolescents and evaluate its validity and reliability. METHODS: According to the multi-stage stratified cluster sampling principle, a total of 3 600 junior students were recruited from the classes in 12 selected high schools in Hangzhou, Wuhan and Xi'an from March to May, 2012. Based on introducing and translating the original scale abroad, Chinese version of adolescent fat intake behavior of psychological measurement scales was utilized in field investigations. The reliability was assessed, using Cronbach's α and split-half reliability; while exploratory factor analysis used to test its validity, with entries-dimension correlation coefficient (IIC), correlation coefficient between the scores and the dimension, and the dimension of correlation coefficient test content validity. RESULTS: The valid subject of the study was 3 448(of whom males were 52.4% (1 806/3 448) and female were 47.6% (1 642/3 448)), while the mean age was (14.85 ± 1.46) years old. The internal consistency reliability (Cronbach's α) for total scale score and four domains were 0.922,0.933, 0.660, 0.773 and 0.869 respectively, whose split-efficacy reliability were separately 0.927, 0.933, 0.790, 0.624 and 0.889. Data from the exploratory factor analysis revealed the following dimensions:the entries were all inclusive, with the cumulative contribution rate at 59.453%, 56.062% and 52.668%, respectively. The results of IIC showed that in the four dimensions, the contained entries between Spearman correlation coefficient have statistically significant, with the r value range of 0.584-0.793, 0.665-0.818, 0.654-0.765 and 0.622-0.747 severely, while other dimensions from weak to moderate relationships, the r value ranged from -0.028 to 0.614. CONCLUSION: The reliability and validity of the adolescent fat intake behavior of psychological measurement scales (Chinese version) were good, and could be used to measure the fat intake behavior of psychological conditions in Chinese adolescents.

[SNP of rs17321515 homologous with Trib1 in Han population and its correlation with blood lipid].

OBJECTIVE: To study on genotype distribution of rs17321515 which is homologous with Trib1 and its associativity with blood lipid parameters and diagnosis. METHOD: Collecting 1 014 blood samples to measure its lipid levels, then detecting rs17321515 locus's SNP by MALDI-TOF mass spectrometry technology. RESULTS: Three genotypes (A/A, A/G, G/G) proportions in the population were 13.8%, 50.2% and 36.0%, allele frequencies were A: G = 38.9% : 61.1%. In variance analysis, variation of TG of male was statistical significant (F = 4.46, P = 0.01), TG level of male who carried AG is lower than GG carries ( t = 0.29, P = 0.02). Logistic regression analysis showed that, hypertriglyceridemia prevalence of male who carried AA is lower than GG carries (OR = 0.45, P = 0.04). Low HDL-c acidosis prevalence of male who carried AG is lower than GG carries (OR = 0.62, P = 0.03). Hypercholesterolemia prevalence of female who carried AG is lower than GG carries (OR = 0.58, P = 0.01). CONCLUSION: Allele frequencies of rs17321515 varies in different ethnic groups; The locus' polymorphism distribution is relevant with a certain lipid indicators and lipid diagnosis, but there exist gender differences on these relevance.

Design and Preliminary Realization of a Screening and Early Warning Health Management System for Populations at High Risk for Depression.

Depression has a high incidence in the world. Based on the concept of preventive treatment of disease of traditional Chinese medicine, timely screening and early warning of depression in populations at high risk for this condition can avoid, to a certain extent, the dysfunctions caused by depression. This work studied a method to collect information on depression, generate a database of depression features, design algorithms for screening populations at high risk for depression and creating an early warning model, develop an early warning short-message service (SMS) platform, and implement a scheme of depression screening and an early warning health management system. The implementation scheme included mobile application (app), cloud form, screening and early warning model, cloud platform, and computer software. Multiple modules jointly realized the screening, early warning, and management of the health functions of individuals at high risk for depression. At the same time, function modules such as mobile app and cloud form for collecting depression health information, early warning SMS platform, and health management software were designed, and the functions of the modules were preliminarily developed. Finally, the black-box test and white-box test were used to assess the system's functions and ensure the reliability of the system. Through the integration of mobile app and computer software, this study preliminarily realized the screening and early warning health management of a population at high risk for depression.

Association Between ABCA1 Gene Polymorphisms and the Risk of Hypertension in the Chinese Han Population.

Background: Hypertension is rising as a major public health burden around the world. This study explored the association between single-nucleotide polymorphisms (SNPs) in the adenosine triphosphate (ATP)-Binding Cassette Subfamily A1 (ABCA1) gene and hypertension among Chinese Han adults. Method: A total of 2,296 Han Chinese in southeast China were recruited for this study. We collected medical reports, lifestyle details, and blood samples from individuals. The polymerase chain reaction-ligase detection reaction (PCR-LDR) method was used to detect the genotypes of these SNPs in the ABCA1 gene. Results: After adjusting some covariates, the additive and recessive models of the rs2472510 and rs2515614 were significantly associated with hypertension. The haplotypes TCTA (rs2297406-rs2472433-rs2472510-rs2515614) were associated with high SBP, and the haplotypes CCTA, TCTA, and TTTA were associated with high diastolic blood pressure (DBP). Conclusion: The results of the relationship between the polymorphisms of rs2297406, rs2472433, rs2472510, and rs2515614 in ABCA1 and hypertension in southeastern China would provide a theoretical basis for genetic screening and disease prevention.

Health Education Intervention on Hearing Health Risk Behaviors in College Students.

Young people, like college students, are at risk of hearing loss from prolonged and excessive exposure to loud sounds. However, behavioral interventional studies on them are inadequate. This study explored the application of a health belief model to the health education intervention on college students for improving hearing health knowledge, health belief, and hearing behaviors. From November 2017 to September 2018, a cluster randomized controlled trial was conducted, enrolling 830 college students, with 419 in the intervention group and 411 in the control group. The intervention group received a 3-month hearing health education, while the control group received no intervention. The information of hearing health knowledge, health belief, and hearing behaviors were collected using hearing health questionnaires before the intervention, after the intervention, and 3 months after the intervention cessation. The intervention significantly improved hearing health knowledge, health belief, perceived severity, and self-efficacy in female students, and effectively reduced the frequency of using headphones per day, duration of using headphones each time, and proportion of using headphones at high volume in female students, and reduced the behaviors of sleeping with headphones listening in females and males. Therefore, this study confirms the effectiveness of health belief model-based intervention for changing hearing loss-related risk behaviors.

Relationship between cigarette smoking and hearing loss in China: A cross-sectional study in Zhejiang province.

INTRODUCTION: Hearing loss and cigarette smoking are major challenges that affect public health in China. Revealing the effect of smoking on hearing loss in the Chinese general population is critical for hearing health protection. We investigated the relationship between smoking status and hearing loss in China, especially in stratified sex and age groups. METHODS: A cross-sectional study was conducted on 4685 individuals aged 20- 80 years in Zhejiang province from 2016 to 2018, with audiometric testing for hearing loss and a structured questionnaire for collecting smoking status and covariates. Logistic regression was used to estimate the association between smoking and hearing loss. RESULTS: Cigarette smoking was not significantly associated with hearing loss in females and young males. In middle-aged males, after adjusting for covariates, current smokers and past smokers had a significantly higher prevalence of speech-frequency loss (OR=1.65; 95% CI: 1.17-2.33 and OR=1.88; 95% CI: 1.11-3.17; respectively) and high-frequency hearing loss (OR=2.01; 95% CI: 1.43-2.84 and OR=2.64; 95% CI: 1.50-4.66; respectively). In older males, only past smokers had a significantly higher prevalence of speech-frequency hearing loss than never smokers (OR=2.58; 95% CI: 1.38-4.85). Regarding middle-aged and older current smokers, a dose-dependent relationship between smoking intensity and hearing loss was found. Passive smoking was not significantly associated with an increased hearing loss risk in all the three male groups. CONCLUSIONS: The relationship between cigarette smoking and hearing loss varied according to gender and age. Therefore, the interventions for smoking need to be tailored according to age in males.

Construction and Evaluation of a High-Frequency Hearing Loss Screening Tool for Community Residents.

Early screening and detection of individuals at high risk of high-frequency hearing loss and identification of risk factors are critical to reduce the prevalence at community level. However, unlike those for individuals facing occupational auditory hazards, a limited number of hearing loss screening models have been developed for community residents. Therefore, this study used lasso regression with 10-fold cross-validation for feature selection and model construction on 38 questionnaire-based variables of 4010 subjects and applied the model to training and testing cohorts to obtain a risk score. The model achieved an area under the curve (AUC) of 0.844 in the model validation stage and individuals' risk scores were subsequently stratified into low-, medium-, and high-risk categories. A total of 92.79% (1094/1179) of subjects in the high-risk category were confirmed to have hearing loss by audiometry test, which was 3.7 times higher than that in the low-risk group (25.18%, 457/1815). Half of the key indicators were related to modifiable contexts, and they were identified as significantly associated with the incident hearing loss. These results demonstrated that the developed model would be feasible to identify residents at high risk of hearing loss via regular community-level health examinations and detecting individualized risk factors, and eventually provide precision interventions.

Environmental exposure to organochlorine pesticides and its association with the risk of hearing loss in the Chinese adult population: A case-control study.

Hearing loss is a common chronic sensory deficit that has become a major public health concern worldwide. Hearing loss is well documented to be induced by noise and ototoxic drugs, and the association of hearing loss with environmental pollutants has received increasing attention. Organochlorine pesticides (OCPs) are an important group of environmental pollutants that exist ubiquitously in the human body and continue to represent a significant environmental health concern. Our case-control study was performed to explore the association between serum levels of OCPs and the risk of hearing loss in China, including 87 case-control pairs. Serum concentrations of 15 OCPs were measured. Pearson's correlation analysis and principal component analysis of frequently detected (>80%) OCPs showed a different distribution pattern, indicating possible exposure sources/scenarios for the case-control adult population. A higher α-hexachlorocyclohexane (α-HCH) level was a risk factor for an increased prevalence of hearing loss. The risk of hearing loss was increased by approximately 5.25-fold in the highest tertile compared with the lowest tertile. Furthermore, a significant association of the α-HCH level with an increased hearing threshold was observed at mid/high frequencies. This study provided the first evidence indicating that exposure to α-HCH might be a potential risk factor for hearing loss.