Internet use, cardiometabolic multimorbidity, and death in older adults: a multi-cohort study spanning developing and developed countries.

BACKGROUND: Internet use is a double-edged sword for older adults' health. Whether internet use can prevent cardiometabolic diseases and death in older adults remains controversial. METHODS: Four cohorts across China, Mexico, the United States, and Europe were utilized. Internet use was defined using similar questions. Cardiometabolic diseases included diabetes, heart diseases, and stroke, with 2 or more denoting cardiometabolic multimorbidity. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale and Europe-depression scale. The competing risk analysis based on subdistribution hazard regression, random-effects meta-analysis, and mediation analysis were utilized. RESULTS: A total of 104,422 older adults aged 50 or older were included. Internet users (vs. digital exclusion) were at lower risks of diabetes, stroke, and death, with pooled sHRs (95% CIs) of 0.83 (0.74-0.93), 0.81 (0.71-0.92), and 0.67 (0.52-0.86), respectively, which remained significant in sensitivity analyses. The inverse associations of internet use with new-onset cardiometabolic diseases and death were progressively significant in Mexico, China, the United States, and Europe. For instance, older internet users in Europe were at 14-30% lower cardiometabolic risks and 40% lower risk of death. These associations were partially mediated by reduced depressive symptoms and were more pronounced in those with high socioeconomic status and women. Furthermore, patients with prior cardiometabolic conditions were at about 30% lower risk of death if they used the internet, which was also mediated by reduced depressive symptoms. However, certain cardiometabolic hazards of internet use in those aged < 65 years, with low socioeconomic status, men, and single ones were also observed. CONCLUSION: Enhancing internet usage in older adults can reduce depressive symptoms and thus reduce the risks of cardiometabolic diseases and death. The balance of internet use, socioeconomic status, and health literacy should be considered when popularizing the internet in older adults.

Trends and prospects in graphene and its derivatives toxicity research: A bibliometric analysis.

The purpose of this paper is to explore the current research status, hot topics, and future prospects in the field of graphene and its derivatives toxicity. In the article, the Web of Science Core Collection database was used as the data source, and the CiteSpace and VOSviewer were used to conduct a visual analysis of the last 10 years of research on graphene and its derivatives toxicity. A total of 8573 articles were included, and we analyzed the literature characteristics of the research results in the field of graphene and its derivatives toxicity, as well as the distribution of authors and co-cited authors; the distribution of countries and institutions; the situation of co-cited references; and the distribution of journals and categories. The most prolific countries, institutions, journals, and authors are China, the Chinese Academy of Sciences, RSC Advances, and Wang, Dayong, respectively. The co-cited author with the most citations was Akhavan, Omid. The five research hotspot keywords in the field of graphene and its derivatives toxicity were "nanomaterials," "exposure," "biocompatibility," "adsorption," and "detection." Frontier topics were "facile synthesis," "antibacterial activity," and "carbon dots." Our study provides perspectives for the study of graphene and its derivatives toxicity and yields valuable information and suggestions for the development of graphene and its derivatives toxicity research in the future.

Combined therapy with early initiation of infliximab following drainage of perianal fistulising Crohn's disease: a retrospective cohort study.

BACKGROUND: Recent studies have confirmed that combined surgery and anti-TNF therapy could improve outcomes in patients with perianal fistulising Crohn's disease (PFCD). However, the optimal timing for infliximab infusion after surgical intervention is uncertain. We aimed to determine the long-term efficacy of early initiation of infliximab following surgery among PFCD patients. METHODS: We performed a retrospective cohort study of PFCD patients who received combined infliximab and surgical treatment between 2010 and 2018 at a tertiary referral hospital. Patients were grouped according to the time interval between surgery and infliximab infusion, with < 6 weeks into early infliximab induction group and > 6 weeks into delayed infliximab induction group. The primary outcome was to compare surgical re-intervention between early and delayed infliximab induction groups. The secondary outcomes were fistula healing and predictors associated with these outcomes of early infliximab induction approach. RESULTS: One hundred and seventeen patients were included (73 in early infliximab induction, 44 in delayed infliximab induction). The median interval between surgery and infliximab initiation was 9.0 (IQR 5.5-17.0) days in early infliximab induction group and 188.0 (IQR 102.25-455.75) days in delayed infliximab induction group. After followed-up for a median of 36 months, 61.6% of patients in early infliximab induction group and 65.9% in delayed infliximab induction group attained fistula healing (p = 0.643). The cumulative re-intervention rate was 23%, 32%, 34% in early infliximab induction group and 16%, 25%, 25% in delayed infliximab induction group, at 1, 2, and 3 years respectively (p = 0.235). Presence of abscess at baseline (HR = 5.283; 95% CI, 1.61-17.335; p = 0.006) and infliximab maintenance therapy > 3 infusions (HR = 3.691; 95% CI, 1.233-11.051; p = 0.02) were associated with re-intervention in early infliximab induction group. Presence of abscess at baseline also negatively influenced fistula healing (HR = 3.429, 95% CI, 1.216-9.668; p = 0.02). CONCLUSION: Although no clear benefit was shown compared with delayed infliximab induction group, early initiation of infliximab after surgery could achieve promising results for PFCD patients. Before infliximab infusion, durable drainage is required for patients with concomitant abscess or prolonged infliximab maintenance therapy.

Effects of dam impoundment on the soil seed bank in a plateau wetland of China.

Dam impoundment, which rapidly changes hydrologic regimes and greatly alters aquatic environments, plays a critical role in the seed germination and seedling growth of wetland plants, especially influencing their seed banks. In this study, a soil seed bank experiment was carried out along a water level gradient for the Lake Lashi wetland in the Northwest Yunnan Plateau of China. The objectives of this study were to determine the effect, driver and dynamic mechanism of dam impoundment on the soil seed bank of plateau wetlands using partial least squares (PLS) regression and chaotic dynamic methods. The results showed that the soil seed bank had significant differences in seed density, species composition, and water ecotype of the plant species between the flood zone (perennially flooded area, seasonally flooded area, and flood plain area) and nonflood zone (control area) in the plateau wetland. The seed bank density was obviously lower in the perennially flooded area and higher in the seasonally flooded area and flood plain area, with values that were 39.88%, 153.53%, and 146.47% that of the control area, respectively. After dam impoundment, the number of plant species gradually increased; however, the dominance of the dominant species became less obvious, and the species diversity indices decreased significantly, e.g., by 15.47% for the Simpson diversity index and 72.39% for the Shannon Wiener diversity index. Our study showed that dam impoundment has made the Lake Lashi wetland complex chaotic ecosystem switch between order and disorder through self-organization and that the species composition of the soil seed bank continuously experienced self-adaptation. These results provide a reference for scientific evaluations of the effects of dam impoundment on wetland ecosystems and provide guidance for the protection and management of plateau wetland ecosystems.

An ecological scenario prediction model for newly created wetlands caused by coal mine subsidence in the Yanzhou, China.

The ecological model we developed can simulate the state of wetlands and predict ecosystem development by varying both parameter settings and forcing functions. The newly created wetland resulting from large-scale coal mining is a distinct type of wetland, but existing ecological models for this wetland type are limited in number and scope. The Yanzhou coalfield, located in Shandong Province in China, contains a typical newly created wetland that came into being after coal mining subsidence. We developed an ecological model for this wetland that estimates values for four state variables: phytoplankton biomass (A), zooplankton biomass (Z), sediment biomass (D), and hydrophyte biomass (H). Analysis of the results showed that the model was sensitive to changes in nutrient loading. As nutrient loads increased, plankton biomass increased, and the ratio of zooplankton biomass to phytoplankton biomass (Z/A) decreased. We defined three prediction scenarios for the wetland and calculated their eco-exergies to compare the ecological effects for each scenario. The most effective measures to improve the state of the ecosystem are to reduce the subsidence depth and to decrease nutrient loading.

Polycyclic aromatic hydrocarbons exposure and hematotoxicity in occupational population: A two-year follow-up study.

BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental and occupational pollutants. To date, the effect and mechanism by which PAHs exposure impaired hematopoietic system remains unclear. METHODS: We examined the capability of PAHs to disrupt hematopoiesis in a study of 639 male participants in China by measuring complete blood counts (CBC) in 2013 and 2014. Gas chromatography-mass spectrometry (GC/MS) method was used to measure airborne levels of PAHs and benzene. We measured 1-hydroxypyrene (1-OHP), S-phenylmercapturic acid (SPMA) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in urinary by ultra-high performance liquid chromatography-mass spectrometry (UPLC-MS/MS) method. RESULTS: We found decreased dose-response of white blood cells, eosinophils, monocytes and lymphocytes with increased PAHs exposure in two consecutive years. We did not find association between benzene with CBC in our study. After stratification analysis by smoking status, the findings were highly consistent. White blood cells, monocytes and red blood cell counts were decreased in high urinary 8-OHdG group. CONCLUSIONS: Our study showed that PAHs could impair the hematopoietic system independently, and oxidative stress might play an important role in potential hematotoxicity.

Emergy and eco-exergy evaluation of wetland restoration based on the construction of a wetland landscape in the northwest Yunnan Plateau, China.

The synthesis of emergy and eco-exergy is one of the most effective methods in the evaluation of wetland restoration. In this study, the landscape design for the restoration of Napahai wetland in the northwest Yunnan Plateau of China was carried out, and the sustainability and self-organizational level of the wetland before and after restoration were evaluated using eco-exergy and emergy combined with the Lorenz curve method. The results showed that wetland plants rapidly increased from 26 species to 52 species after two years, with a gradual decrease in pollutant-enduring species and the reappearance of the marsh plants Sparganium simplex and Batrachium bungei communities that had disappeared for many years, which speed up the succession and structure organization of the community. The wetland was better for biomass accumulation and soil improvement after restoration, and there were significant decreases in the concentrations of TP, TN and COD in the water body. The sustainability index values for the wetland ranged from 4.17 before restoration to 2385.16 after restoration, and the ecosystem service values for the wetland after restoration was 1.95 times higher than that before restoration. These results confirmed that the wetland after restoration was less environmentally stressed and more sustainable. In addition, the values of eco-exergy and specific eco-exergy after restoration were 1.70 and 1.01 times higher than that before restoration, respectively; the emergy/exergy ratio was lower for the wetland after restoration. These results suggested that the wetland after restoration had higher complexity and self-organizational level, and became a self-sustaining and resilient natural system. This study represents a new exploration of the emergy and eco-exergy evaluation on the wetland restoration, providing an engineering demonstration and a reference for the landscape design of wetland restoration in the plateau region.

Clinical and laboratory features of neurosyphilis: A single-center, retrospective study of 402 patients.

Neurosyphilis is a serious global health issue and a big challenge in developing countries, related risk factors should be taken seriously. Although there are a certain number of studies describing the clinical and laboratory features and risk factors for symptomatic neurosyphilis (SNS), but some risk factors are still controversial. The aim of this research is to investigate the association between asymptomatic neurosyphilis (ANS) and symptomatic neurosyphilis (SNS) and identify risk factors for SNS. This was a single-center retrospective study in a tertiary hospital in Hangzhou, China. The clinical and laboratory features of neurosyphilis patients from January 1, 2011 to July 31, 2020 were retrospectively reviewed. After detailed assessments based on diagnostic criteria, 402 patients with neurosyphilis were enrolled in this study. There were 299 male and 103 female patients. The median age was 53.5 (45, 61) years. Multivariable logistic regression displayed that SNS were correlated with the following factors: male, without anti-syphilis treatment, high pretreatment serum RPR titer and positive CSF RPR. Our findings suggest a potential association between SNS and specific factors, including male gender, elevated pretreatment serum and CSF RPR titers. Moreover, our observations indicate that individuals without anti-syphilis treatment may be at a higher likelihood of manifesting the symptomatic form. This underscores the importance of considering gender, RPR titers, and treatment status as significant contributors to the risk profile for SNS.

Joint daily functional trajectory and risk of new-onset Alzheimer's disease and related dementias in older adults with normal and abnormal weight.

BACKGROUND: Associations between daily functional trajectories and new-onset all-cause dementia and Alzheimer's disease (AD) and the role of body weight are underexplored. METHODS: Data were from the Health and Retirement Study (HRS) 1994-2020. Daily function was assessed using (instrumental) activities of daily living ([I]ADLs). All-cause dementia and AD were defined by self- or proxy-reported physician diagnoses. Body weight was assessed using body mass index (BMI) and categorized as normal (18.5 kg/m2 ≤ BMI < 30 kg/m2) and abnormal (BMI < 18.5 kg/m2 or ≥30 kg/m2). The group-based trajectory modeling and Cox proportional hazards regression were utilized. RESULTS: Of 18,763 adults included, 1236 developed new-onset dementia during a 10-year follow-up. The associations of ADL and IADL limitations at baseline with all-cause dementia and AD were much more pronounced in those with abnormal weight (P for interaction < 0.005). Five joint trajectories of ADL and IADL limitations were identified: No (72.7 %), Recovery (4.0 %), Recent emerging (16.4 %), Early emerging (4.8 %), and Severe (2.1 %). Furthermore, the 'Severe' joint trajectory (vs. 'No') was associated with 3.57- and 3.59-times higher risks of new-onset all-cause dementia and AD in participants with abnormal weight (P for interaction = 0.002 and 0.005). Notably, the Recovery joint trajectory (vs. No) was not associated with increased risks of all-cause dementia or AD. LIMITATIONS: Self-/proxy-reported all-cause dementia and AD may introduce misclassification bias. Lifestyle factors were not quantified. BMI at baseline, but not its trajectory, was utilized. Potential reverse causation deserved attention. CONCLUSIONS: Body weight control can help reduce the risk of progression from functional limitations to all-cause dementia and AD.

Contamination Status and Acute Dietary Exposure Assessment of Paralytic Shellfish Toxins in Shellfish in the Dalian Area of the Yellow-Bohai Sea, China.

The Yellow-Bohai Sea is an important semi-enclosed continental shelf marginal seas with an intensive aquaculture industry in China. The current study analyzed the contamination status and the time variations of paralytic shellfish toxins (PSTs) in shellfish between 2019 and 2020 from the Yellow-Bohai Sea in the Dalian area and estimated the acute health risks to consumers in China. A total of 199 shellfish samples (including 34 Pacific oysters, 25 Mediterranean blue mussels, 34 Manila clams, 36 bay scallops, 34 veined rapa whelks and 36 bloody clams) were analyzed from four representative aquaculture zones around the Yellow-Bohai Sea in Dalian. Among the samples, scallops and blood clams were the shellfish species with the highest detection rate of PSTs (94.4%), and the highest level of PSTs was detected in scallops with 3953.5 µg STX.2HCl eq./kg (µg STX.2HCL equivalents per kg shellfish tissue), followed by blood clams with 993.4 µg STX.2HCl eq./kg. The contents of PSTs in shellfish showed a time variation trend, and autumn was the season of concern for PST contamination in Dalian. For general Chinese consumers, the probability of acute health risks to shellfish consumers from dietary exposure to PSTs was around 13%. For typical consumers in coastal areas of China, especially those with higher shellfish intake, there was an acute health risk associated with exposure to PSTs through shellfish consumption during the occurrence of harmful algal blooms. It is suggested that the government continue to strengthen the monitoring of the source of PSTs and the monitoring of harmful algal blooms and give reasonable advice on shellfish consumption for consumers in coastal areas, such as not eating scallop viscera.

Prognostic impact of age on outcomes of hepatic decompensation in patients with compensated cirrhosis (CHESS2102): an international, multicenter cohort study.

Baveno VII criteria (B7C) and Baveno VI criteria (B6C) have been widely used to estimate the risk of hepatic decompensation. However, the impact of age on these criteria warrants further investigation. The international, multicenter cohort study included 1138 patients with compensated cirrhosis (median follow-up of 40.6 months), aiming to evaluate the value of age in predicting hepatic decompensation. We identified age as an independent predictor of hepatic decompensation, with 60 years determined as the optimal cut-off value. The occurrence of decompensation was 18.7% and 6.7% in the older (age ≥60 years) and younger (age <60 years) groups, respectively (p < 0.001). We subsequently integrated age into the existing Baveno criteria. In patients not meeting Baveno criteria (defined as not meeting B6C or B7C), the older group exhibited a significantly elevated risk of decompensation compared to the younger group (p < 0.05). However, no significant difference was observed between the older and younger groups in patients meeting Baveno criteria (p > 0.05). In conclusion, our study demonstrated that integrating age into the Baveno criteria could enhance the assessment of hepatic decompensation. Age should be considered before discharging patients with compensated cirrhosis from the surveillance of hepatic decompensation.

[Case analysis of telephone interview application effect in Beijing].

OBJECTIVE: To apply Computer Assisted Telephone Interview (CATI) in evaluation on effectiveness of non-communicable diseases control and prevention among general population. METHODS: Totally 2450 permanent residents aged 15 to 69 years old were interviewed by telephone in Xicheng District and Changping District, Beijing. Telephone numbers were selected by simple random sampling. CATI was used to collect data. Focus group interview was used to interview telephone interviewers in order to analyze the reason of the midway refusal. RESULTS: 93,524 telephone numbers were dialed. Survey efficiency, response rate and successful completion rate were 3.8%, 26.2% and 75.1%, respectively. The main cause resulting in low survey efficiency and response rate were no answer, busy, and refusal to answer at the beginning. The main cause which influenced successful completion rate was midway refusal to answer. CONCLUSION: Successful completion rate in this survey was high, so CATI is suitable for this survey. However, survey efficiency and response rate were too low. The emphasis was to reduce the proportion of no answer, busy and refusal in the beginning in order to improve the efficiency of this survey.

Alternative stable state and its evaluation in wetland reconstruction based on landscape design.

An alternative stable state is closely related to the health and sustainable development of ecosystems; however, knowledge of the alternative stable state and its quantitative evaluation in wetland reconstruction remains incomplete. In this study, we used landscape design to reconstruct an optimized ecological polder wetland and a lake wetland in the Yunmeng Marsh area, China, and the alternative stable states of the two wetland ecosystems were assessed from an ecosystem perspective via emergy/eco-exergy and fractal dimensions. The emergy densities for the optimized ecological polder wetland and the lake wetland were 2.35E+13 sej yr-1 m-3 and 2.18E+13 sej m-3, and the emergy sustainability index (ESI) values were 216.57 and 193.31, respectively, indicating that the reconstructed wetland ecosystems were dominated by renewable energy flows and were highly sustainable. The eco-exergy density and emergy/eco-exergy ratio results showed that natural selection self-organized the reconstructed wetland ecosystems to tolerate environmental stresses and changes. In addition, the fractal dimensions of the morphology and contour of the polder wetland, which reflect the space occupation capacity of geometric and physical constraints in the wetland, were 1.57 and 1.75, and those of the lake wetland were 1.03 and 1.47, respectively. The synthetic evaluation results showed that the alternative stable states of both the optimized ecological polder wetland ecosystem and the lake wetland ecosystem were ecofriendly modes of wetland reconstruction, which can be implemented together to create a "lake-polder" ecosystem. Our study on the alternative stable states of wetland ecosystems is helpful for exploring the synergistic symbiosis between traditional culture and the ecological environment in China and other wetland-rich regions and countries with severe disturbances.

Chronic diseases and multimorbidity patterns, their recent onset, and risk of new-onset Parkinson's disease and related functional degeneration in older adults: a prospective cohort study.

Background: Certain chronic diseases contribute to increased risks of Parkinson's disease (PD), but the association between time-varying multimorbidity patterns and new-onset PD remains underexplored. Methods: Data were from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 5-8 conducted between January 2013 and March 2020. Eleven chronic diseases were included, with ≥2 denoting multimorbidity. Three multimorbidity patterns were further defined: somatic multimorbidity (SMM), neuropsychiatric multimorbidity (NPM), and cardiometabolic multimorbidity (CMM). PD-related function degeneration included functional limitations, mobility limitations, depressive symptoms, and cognitive decline. Time-dependent analyses, competing-risk analyses, and mixed-effect models were utilised. Findings: In this prospective cohort study, 557 developed new-onset PD during follow-ups among 64,273 participants included at baseline, as defined by participants' self-reported physician diagnoses. Participants with (vs. without) multimorbidity, SMM, NPM, and CMM were at 1.40-2.70 times higher PD risk after considering the competing role of all-cause death, which remained significant in all sensitivity analyses and were more pronounced in lower-income participants (P for interaction <0.05). Similarly, they tended to develop functional degeneration faster than those without these multimorbidity patterns (P < 0.05). Participants with recent-onset (newly diagnosed in 2015) multimorbidity patterns were at 1.45-3.72 times higher risk of PD than those never diagnosed. Interestingly, they were at comparable or even higher (though P values for >0.05) PD risk compared to participants with multimorbidity patterns diagnosed in 2013 or before. Furthermore, recent-onset (vs. prior diagnosed) NPM exhibited faster functional deterioration and cognitive decline (P for difference <0.05). Interpretation: Our findings suggest that promoting early prevention of multimorbidity, especially recent-onset multimorbidity and NPM, could prevent some subsequent cases of PD and related functional degeneration among older adults. However, further studies are needed to confirm this association. Funding: The National Key Research and Development Program, Ministry of Science and Technology, China; Zhongnanshan Medical Foundation of Guangdong Province; Major Project of the National Social Science Fund of China; Fundamental Research Funds for the Central Universities.

A Link between Prenatal Stage of Life during the Great Chinese Famine and Subsequent Depressive Symptoms among Middle-Aged and Older Adults.

Prenatal malnutrition may increase the risk of depressive symptoms in adulthood. This study investigated the association between prenatal exposure to malnutrition with risk of depressive symptoms in middle-aged and older adults using the Chinese Great Famine of 1959-1961 as a natural experiment. Data were obtained from the China Health and Retirement Longitudinal Study baseline survey (2011). A total of 5391 individuals born from 1956 to 1965 were included in the study. Depressive symptoms were ascertained via the Center for Epidemiological Studies Depression Scale short form. Famine severity was measured using the cohort size shrinkage index. Difference-in-differences models were used to explore the association between prenatal famine exposure and later-life depressive symptoms. Compared with the post-famine cohort (1963-1965), famine cohorts (1959-1962) were 4.74 times (95% CI = 1.28-8.20) as likely to develop depressive symptoms. The stratified analysis found that prenatal exposure to famine was associated with depressive symptoms in rural residents but not those living in urban areas. In rural females, prenatal malnutrition was associated with a higher risk of depressive symptoms. However, there was no significant association between prenatal malnutrition and depressive symptoms in rural males. Our results indicated that prenatal malnutrition may contribute to a higher risk for depressive symptoms in later life among female rural residents.

Mechanism of bacterial communities regulating litter decomposition under climate warming in temperate wetlands.

Plant litter decomposition plays a crucial role in the flow of nutrients and energy in ecosystems. However, the mechanism of bacterial communities regulating litter decomposition under climate warming in temperate wetlands remains largely unknown. The objective of this study was to determine the influences of temperature on decomposition and the bacterial regulatory mechanism under climate warming in temperate wetlands. In this study, we conducted a 1.5-year litter decomposition warming experiment using dominant plant species in the temperate lake wetlands of the North China Plain. Our results showed that the decomposition rate (K) had a significant positive correlation with temperature, and the non-additive effects of litter decomposition could be clearly observed in the mixtures of Phragmites australis and Typha angustata, especially under warming conditions. Among the three types of litter, Phragmites australis had the highest temperature sensitivity (2.75), which meant that it would be most affected by climate change in the future. The concentrations of C and N showed a significant positive correlation with the decomposition rate and were mainly driven by Proteobacteria and Firmicutes, while the concentration of lignin and the lignin:N ratio had a highly significant negative correlation with the decomposition rate and were mainly driven by Bacteroidota and Actinobacteriota. Furthermore, the bacterial cooccurrence network revealed that the abundance of Firmicutes and Desulfobacterota increased significantly, and positive edges accounted for 67.81% ~ 71.14% under warming conditions. The bacterial networks of litter decomposition were mainly composed of symbiotic relationships, and warming was helpful for improving the positive correlations and symbiotic relationships of bacterial flora and sped up the litter decomposition process. These results will be helpful to further understand the mechanism of bacterial communities regulating litter decomposition under climate warming in temperate wetland ecosystems.

The dilution effects of healthy lifestyles on the risk of depressive symptoms attributed to life-course disadvantages among Chinese middle-aged and older adults.

BACKGROUND: Life-course disadvantages and unhealthy lifestyles are well-known to independently induce depressive symptoms, but whether adopting healthy lifestyles can dilute the depressive risks attributed to life-course disadvantages remain unknown in China. METHODS: This population-based cross-sectional study included 5724 middle-aged and older people from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms and healthy lifestyles (including regular exercise, reasonable sleep, never smoking, and no heavy alcohol consumption) were collected in 2018 while life-course disadvantages were collected in 2014. RESULTS: Multiple healthy lifestyles were associated with decreased depressive risks more significantly as the life-course disadvantages increased, with odds ratios (ORs) and 95 % confidence intervals (CIs) of 0.44 (0.25-0.80) and 0.33 (0.21-0.53) for 4 healthy lifestyles in participants with mild and severe life-course disadvantages, respectively. Life-course disadvantages and unhealthy lifestyles had enormous joint effects on depressive symptoms. Finally, adopting multiple healthy lifestyles can dilute the depressive risks attributed to life-course disadvantages and even mask some risks attributed to childhood disadvantages. LIMITATIONS: Given that dietary data were not gathered by the CHARLS, diet was not included in this study. In addition, information on life-course disadvantages was primarily self-reported, which may lead to potential recall bias. Finally, the cross-sectional design of this study cannot capture causal associations well. CONCLUSIONS: Adopting multiple healthy lifestyles can well-dilute the depressive risks attributed to life-course disadvantages in middle-aged and older Chinese, which is of great importance for reducing the depressive burden and the construction of healthy aging in China.

The Spectrum and Age-Sex Patterns Among Outpatients with Allergic Diseases - Yichang City, Hubei Province, China, 2018-2021.

What is already known about this topic?: Allergic diseases have affected an estimated 40% of the population in China. However, our understanding of the full spectrum of these diseases remains insufficient. What is added by this report?: Between 2018 and 2021, Yichang City documented 625,929 outpatient visits mainly related to skin and mucous membrane allergies (77.90%) and allergic respiratory conditions (19.64%). In 2021, the occurrence of outpatient visits for conditions such as allergic rhinitis, acute atopic conjunctivitis, and atopic dermatitis increased. The demographic analysis revealed that male patients comprised the majority of the under 18 age bracket (56.05%), while female patients were predominantly represented in the 18 to 65 age bracket (61.79%). What are the implications for public health practice?: This constitutes the first analysis of the spectrum of allergic diseases, utilizing regional outpatient data, which has substantial implications for understanding the disease burden.

Mumps-specific antibody persistence in children aged 3-7 years immunized with two doses of mumps-containing vaccines: A prospective cohort study in Jiangsu Province, China.

Mumps reemergence has been reported in developed countries with high levels of two-dose mumps-containing vaccine (MuCV) coverage. The effectiveness of the two-dose MuCV may be compromised by limitations in the persistence of immunity. This prospective cohort study evaluated the persistence of immunity of a two-dose MuCV in children aged 3-7 years from 2015 to 2020. Persistence of antibody to mumps, determined as the geometric mean antibody concentration (GMC), and seropositivity were analyzed for both repeated measurements from three follow-ups and on each cross-section, respectively. A total of 105 eligible subjects were recruited. Their overall seropositivity rate was relatively high and stable (92.4%-84.8%), while the overall GMC decreased from 547.6 U/ml to 333.3 U/ml. Analysis of waning immunity in 91 participants showed a significant and consistent downward trend for GMC, which differed significantly in boys and girls. The overall seropositivity rate decreased slightly from 2015 (95.6%) to 2016 (92.3%) but both were significantly higher than in 2018 (84.6%). The rates in girls remained stable, while those in boys declined to 75% in 2018. The seropositivity rate of the cross-section level decreased from 95.4% to 86.4% in 4 years. Although two-dose MuCV may result in a high level of immunity, antibody concentrations decay over 2 years after the second dose. Children with waning immunity after receiving two doses, especially boys, require further surveillance at 4 years and later to avoid future mumps epidemics.Clinical trial registration: NCT02901990.

A Chinese-Specific Reference Amounts Study With TNO Food Allergen Risk Assessment Models - China, 2022.

What is already known about this topic?: There are no consistent regulations on possible unintended allergen presence in food. The Netherlands Organization for Applied Scientific Research (TNO) has been committed to developing a quantitative risk assessment methodology for the unintentional intake of allergens. What is added by this report?: This study aims to derive the optimal food consumption point for a deterministic food allergy risk assessment under the TNO framework based on Chinese national consumption data. A case study has been presented as an illustration. What are the implications for public health practice?: A robust evidence-based food consumption input in quantitative risk assessment of unintended allergens is necessary for future public policy on Precautionary Allergen Labeling for specific products to meet the safety objectives and to be adequately conservative.