Geographically and Temporally Weighted Regression in Assessing Dengue Fever Spread Factors in YunnanBorder Regions.

Objective: This study employs the Geographically and Temporally Weighted Regression (GTWR) model to assess the impact of meteorological elements and imported cases on dengue fever outbreaks, emphasizing the spatial-temporal variability of these factors in border regions. Methods: We conducted a descriptive analysis of dengue fever's temporal-spatial distribution in Yunnan border areas. Utilizing annual data from 2013 to 2019, with each county in the Yunnan border serving as a spatial unit, we constructed a GTWR model to investigate the determinants of dengue fever and their spatio-temporal heterogeneity in this region. Results: The GTWR model, proving more effective than Ordinary Least Squares (OLS) analysis, identified significant spatial and temporal heterogeneity in factors influencing dengue fever's spread along the Yunnan border. Notably, the GTWR model revealed a substantial variation in the relationship between indigenous dengue fever incidence, meteorological variables, and imported cases across different counties. Conclusion: In the Yunnan border areas, local dengue incidence is affected by temperature, humidity, precipitation, wind speed, and imported cases, with these factors' influence exhibiting notable spatial and temporal variation.

Psychological flexibility training for career adaptability improvement among second-year middle-school students / 中国学校卫生

Objective@#To test the effectiveness of psychological flexibility training on career adaptability among middle school students who undertook psychological courses based on acceptance commitment therapy and the adolescent mental flexibility model(DNA-V), and to provide a reference plan to improve the mental health of middle school students.@*Methods@#This study recruited 110 junior high school students (60 boys and 50 girls) from a middle-school in Beijing. The students were randomly divided by class into a DNA-V face-to-face course group(offline group n=33), a DNA-V online course group(online group n=40), and a regular school psychology course group(control group n=37). Louise Hayes DNA-V intervention program was condensed into a six-hour middle-school DNA-V psychology curriculum. Using the Avoidance and Fusion Questionnaire for Youth and the Career Adaptability Scale, changes in psychological flexibility and career adaptability were measured before(T1), one week after(T2), and two months after (T3) the intervention.@*Results@#Linear mixed models were used for the analysis, while controlling for demographic variables. Psychological flexibility and career adaptability in the offline group were higher at T2 and T3 than at T1(psychological flexibility t=4.22, 3.11; career adaptablity t=3.05, 4.16, P<0.01), while the difference between T2 and T3 was not statistically significant. The psychological flexibility and career adaptability of the online group were not statistically significant at T1, T2, and T3. The psychological flexibility and career adaptability of the control group increased from T1 to T2(t=4.64, 2.47, P<0.05), but T3 decreased back to a level close to T1.@*Conclusion@#In terms of both psychological flexibility and career adaptability, the DNA-V face-to-face psychology course resulted in a retention period of at least two months.

Health impact of the 2008 cold spell on mortality in subtropical China: the climate and health impact national assessment study (CHINAs).

BACKGROUND: Many studies have investigated heat wave related mortality, but less attention has been given to the health effects of cold spells in the context of global warming. The 2008 cold spell in China provided a unique opportunity to estimate the effects of the 2008 cold spell on mortality in subtropical regions, spatial heterogeneity of the effects, stratification effect and added effects caused by sustained cold days. METHODS: Thirty-six study communities were selected from 15 provinces in subtropical China. Daily mortality and meteorological data were collected for each community from 2006 to 2010. A distributed lag linear non-linear model (DLNM) with a lag structure of up to 27 days was used to analyze the association between the 2008 cold spell and mortality. Multivariate meta-analyses were used to combine the cold effects across each community. RESULTS: The 2008 cold spell increased mortality by 43.8% (95% CI: 34.8% ~ 53.4%) compared to non-cold spell days with the highest effects in southern and central China. The effects were more pronounced for respiratory mortality (RESP) than for cardiovascular (CVD) or cerebrovascular mortality (CBD), for females more than for males, and for the elderly aged ≥75 years old more than for younger people. Overall, 148,279 excess deaths were attributable to the 2008 cold spell. The cold effect was mainly from extreme low temperatures rather than sustained cold days during this 2008 cold spell. CONCLUSIONS: The 2008 cold spell increased mortality in subtropical China, which was mainly attributable to the low temperature rather than the sustained duration of the cold spell. The cold effects were spatially heterogeneous and modified by individual-specific characteristics such as gender and age.

[Analysis on the clustering of liver cancer mortality in Lingbi county, Anhui province, from 2005 to 2010].

OBJECTIVE: To observe the mortality and its changes on liver cancer in the past 30 years as well as to describe the spatial distribution of liver cancer deaths between 2005 and 2010 in Lingbi, Anhui province. METHODS: Using the mortality data from 1973-1975 and from 2005 to 2010 in Lingbi to compare with the relative national and historical data, to observe the trend of rapid increase on liver cancer mortality in Lingbi. Using the Poisson model, BYM model and hotspot detection method, standardized mortality ratio(SMR), relative risk(RR)value of liver cancer deaths of each village were calculated and the clustering of high liver cancer deaths was identified. RESULTS: Through an increase of 223.7% on the SMR of liver cancer in the past 30 years, the standardized mortality of liver cancer in Lingbi had an increase of 74.1 percent than the national level in 2005-2010 but it was 22.7% lower than the country level in 1973-1975. The SMR and RR values and their P values were higher in the villages which were located along the Kuisui River. Data from the clustering analysis showed that there had been significantly positive autocorrelation at the altitude of 5300 meters, and a very obvious hot spot of liver cancer deaths existing along the Kuisui River, especially at the bifurcation of the old Sui River and new Sui River was observed. CONCLUSION: There was an alarming increase of liver cancer mortality in the past 30 years in Lingbi. The high mortality area mainly covered the villages along the Kuisui River, suggesting that there were common risk factors for hepatocellular carcinoma in the population at risk.

[Association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Anhui province].

OBJECTIVE: To explore the association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Suzhou, Anhui province. METHODS: Using the disease mapping and spatial statistical analysis techniques,we described the spatial distributions of the mortality rate of hepatic carcinoma from 2005 to 2010 in Lingbi county. Taking the distance between villages and polluted rivers as proxy variable of environmental exposure, mortality rate of hepatic carcinoma in each village as dependant variable, and using the Glimmix model and Bayesian spatial model (BYM) to undertake the univariate and multivariate analysis, we investigatived the association between mortality rate of hepatic carcinoma and the water pollution of Suihe River in Lingbi county. RESULTS: Obvious clustering of high mortality rate of hepatic carcinoma along the polluted river was observed in Lingbi county. Results of Glimmix model showed that whether spatial autocorrelation was considered or not, closer to the polluted river has higher mortality rate of hepatic carcinoma. Results of univariate analysis of the BYM model showed that, compared with the villages far from the polluted river more than 12 km (the mortality rate of hepatic carcinoma was 33.12/100 000(1068/3 224 562) ), the RR values of the hepatic carcinoma mortality was 1.38(95%CI:1.06-1.82) for the villages apart from the polluted river within 6 km (the mortality rate of hepatic carcinoma was 42.48/100 000(777/1 829 064)), and 1.13 (95%CI:0.92-1.39) for villages apart from the river between 6 and 12 km (the mortality rate of hepatic carcinoma was 35.65/100 000(651/1 825 848)). In the BYM model multivariate analysis, adding the volume of fertilizer and pesticides used per cultivated area, GDP per capita to do multivariate analysis were, the relation between mortality rate of hepatic carcinoma and distance from polluted rivers remains unchanged. CONCLUSION: The mortality rate of hepatic carcinoma was associated with the exposure to the polluted river in Lingbi county. The polluted river may increase the hepatic carcinoma mortality of nearby residents.

[Differences in serum retinol level between the breastfed and non-breastfed children aged 0 to 23 months].

OBJECTIVE: Some recent studies found that high prevalence of vitamin A deficiency in the breastfed children. This study aimed to understand the differences in serum retinol level between breastfed and bottle-fed children aged 0 to 23 months and the possible causes of low level of serum retinol for the breastfed children. METHODS: Data for children aged 0 to 23 months were extracted from a population-based cross sectional study for vitamin A nutrition status. Fluorescence method was used to measure the serum retinol. Mothers or caregivers were asked to answer a pre-designed questionnaire and socioeconomic status, peri-natal care, breastfeeding status, morbidity histories and other related factors were collected. Semi-quantitative food frequency questionnaire was used to investigate the child's dietary intake one week prior to the survey. Data were analyzed using SAS 8.1. RESULTS: Of 401 children aged 0 to 23 months, the breastfeeding rate was 50.37%. The means of the serum retinol level between bottle-fed (30.67 +/- 0.57) microg/dl and the breastfed children (27.60 +/- 0.56) microg/dl was significantly different (P < 0.01). The corresponding figures were (31.82 +/- 0.98) microg/dl and (29.46 +/- 0.96) microg/dl after adjustment for confounders, which also showed significant difference (P < 0.01). After stratified by age groups, the breastfeeding rates in the 0-, 6-, 12- and 18-months groups were 92.1%, 70.1%, 32.0% and 17.1%, respectively. We calculated the difference in means of the serum retinol level between the bottle-fed and breastfed children for each of four age groups, and the 95% confidence limits of the differences. The differences in means and the 95% confidence limits for 0-, 6-, 12- and 18-months group were 4.70 microg/dl (-2.52-1.92), 0.82 microg/dl (-2.32-3.95), 2.95 microg/dl (-0.68-6.58) and 6.05 microg/dl (2.34-9.77), respectively. After adjustment for confounders and covariates, the adjusted figures were 0.00 microg/dl (-7.18-7.19), 1.35 microg/dl (-1.76-4.45), 2.92 microg/dl (-0.82-6.65) and 4.26 microg/dl (0.71-7.81), respectively. The significant difference in means of serum retinol level was only found in the 18-months group before or after adjustments (P < 0.01 for both). The Cochrane-Atmitage chi square trend test showed that the breastfed children tended to have lower frequencies of complementary dietary intakes than that of the bottle-fed aged 12 months and above. CONCLUSIONS: The breastfed children aged 0 to 23 months had relative low serum retinol level while compared with the bottle-fed. However, the significant differences seemed to be only confined to those aged 18 months and above. Low level of vitamin A in breast milk and low frequent complimentary food supplements might have served as the potential for the differences.

[Evaluation on birth defects surveillance system in four counties of Shanxi province, China].

OBJECTIVE: To evaluate the reliability of the birth defects surveillance system in four counties with high prevalence of birth defects (Pingding, Xiyang, Taigu and Zezhou counties) in Shanxi province, China. METHODS: One township was selected from each county as study site. The health workers chosen from township or village level were trained to visit families on the outcomes of each pregnancy who gave birth during year 2003 in the study site. The number of births and cases collected in the study were compared with that from the surveillance system. The number of births reported by surveillance system in four counties was also compared with the data from the local government. The criteria of evaluation were: 1) number of the missing report of births should < or = 5%, 2) the number of missing report on major external birth defects cases should < or = 10%. Researchers from the Peking University were responsible for examining the quality of surveillance in some terminal units of surveillance system. RESULTS: The numbers of births reported in the study and from the surveillance system for four-township were 1043 and 997, respectively. 46 births were missing and the rate of misreporting for births was 4.4%. The numbers of birth defects cases reported in the study and from the surveillance system were 30 and 29, respectively. 1 case of birth defect as missed, and rate of misreporting for birth defects cases was 3.3%. The total number of births reported from surveillance was similar to that in the study in four counties, with a difference of 1.2%. Birth registry data was rather readable and special health workers responsible for surveillance work were present in all the terminal units of the surveillance system. CONCLUSION: The misreporting of births and cases existed in the birth defects surveillance system of the four counties in Shanxi province, but were lower than the allowable criteria. The surveillance units had better registration, reporting and administration of births and birth defect cases. Hence, the quality of the data from the surveillance system in these four counties was reliable.