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Zhou, Zexu, Xuedong Zhang, Mengwei Li, and Xuedi Wang. "An SCM-G2SFCA Model for Studying Spatial Accessibility of Urban Parks." International Journal of Environmental Research and Public Health 20, no. 1 (December 30, 2022): 714. http://dx.doi.org/10.3390/ijerph20010714.
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The urban park is the main leisure and entertainment place in residents’ daily lives. The accessibility of parks is closely related to the physical and mental health of the residents. Although many scholars have conducted a great deal of research on the spatial accessibility of urban parks, they have rarely considered the supply competition among different parks and the impact of multiple travel modes on the spatial accessibility of parks. Therefore, based on Baidu map navigation data, in this paper, the park Baidu score is used to represent the competitive relationship among different parks, and the impact of multiple travel modes on the spatial accessibility of parks is considered. A supply competition and multiple travel modes Gaussian two-step floating catchment area (SCM-G2SFCA) model is established to evaluate the spatial accessibility of the parks in the Wuhou District, Chengdu, China. The results show that (1) compared with traditional methods, the SCM-G2SFCA model can obtain more accurate results using Baidu map navigation data. (2) There are obvious spatial differences in the accessibility distribution of the parks in the Wuhou District, Chengdu, with high accessibility in the south and low accessibility in the north. The Jinyang and Huaxing sub-districts in the southern suburbs have the highest park accessibility and can obtain more adequate park services. The Fangcaojie and Cujin sub-districts in the northern urban areas have the lowest park accessibility and are relatively lacking in park services. The research results of this study have important reference value for the rational planning of urban parks and the improvement of the spatial accessibility of urban parks in the Wuhou District of Chengdu and similar urban areas.
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Hoffman, Sheila K., Aya Tanaka, Bai Xue, Ni Na Camellia Ng, Mingyuan Jiang, Ashleigh McLarin, Sandra Kearney, Riria Hotere-Barnes, and Sumi Kim. "Exhibition Reviews." Museum Worlds 9, no. 1 (July 1, 2021): 175–207. http://dx.doi.org/10.3167/armw.2021.090114.
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Museum of Russian Icons, Clinton, Massachusetts by Sheila K. HoffmanLocal Cultures Assisting Revitalization: 10 Years Since the Great East Japan Earthquake, National Museum of Ethology (Minpaku), Osaka by Aya TanakaTianjin Museum of Finance, Tianjin by Bai XueVegetation and Universe: The Collection of Flower and Bird Paintings, Zhejiang Provincial Museum, Hangzhou by Ni Na Camellia NgThree Kingdoms: Unveiling the Story, Tokyo National Museum and Kyushu National Museum, Japan, and China Millennium Monument, Nanshan Museum, Wuzhong Museum, and Chengdu Wuhou Shrine, People’s Republic of China by Mingyuan JiangTempest, Tasmanian Museum and Art Gallery, Hobart by Ashleigh McLarinWonders from the South Australian Museum, South Australian Museum, Adelaide by Sandra KearneyBrett Graham, Tai Moana, Tai Tangata, Govett Brewster Art Gallery, New Plymouth by Riria Hotere-BarnesThe “Inbetweenness” of the Korean Gallery at the Musée Guimet, Paris by Sumi Kim
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Zhang, Haomiao. "The social assistance policy in urban China: a critical review." International Journal of Sociology and Social Policy 35, no. 5/6 (June 8, 2015): 403–18. http://dx.doi.org/10.1108/ijssp-07-2014-0055.
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Purpose – The purpose of this paper is to assess China’s urban social assistance policy, mainly by examining the findings of in-depth interviews with urban Dibao recipients in Chengdu about their experiences with social assistance, and by comparing what the social assistance offers with the urban poor households’ actual needs and vulnerabilities. Design/methodology/approach – In this study, the author interviewed 15 people from urban Dibao Households in Wuhou District and Qingyang District of Chengdu, China. The interviews were conducted from April to August in 2013, usually in their homes. The small sample naturally limits generalizations, however it can point to directions for future research. Findings – It is found out that urban Dibao which is the core of social assistance policy provides insufficient cash support and other special assistance programs are more of tokenistic which do not offer much help. Besides, due to lack of psychological aid, many recipients show negative and pessimistic attitudes toward life. Originality/value – Regarding the assessment of social assistance policy in China, the international literature has shown little interest. Several Chinese scholars have analyzed urban social assistance system, but they tend to examine or assess from the perspective of policy makers and focus on making policy suggestions. Thus, there is not much information about whether what the social assistance offers could meet the urban poor households’ actual needs and vulnerabilities. An interesting endeavor would be to explore and assess the urban social assistance policy from the perspective of the recipients, and this is exactly what this paper aims to do.
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Chen, Xiang-Ji, Wenqiang Zhang, Rui-Li Yuan, Xiao-Bo Huang, Ya Liu, Rong-Hua Xu, Dong Wei, and Wei-Wei Tang. "Hyperuricaemia and associated factors among the oldest-old population in the urban areas of Chengdu, China: a community-based cross-sectional study." BMJ Open 11, no. 12 (December 2021): e055881. http://dx.doi.org/10.1136/bmjopen-2021-055881.
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ObjectivesTo investigate the prevalence of hyperuricaemia among the oldest-old persons in Chengdu and identify associated factors to provide information on achieving healthy ageing in China.DesignA community-based cross-sectional study.SettingJinjiang, Qingyang, Longquanyi locating in the southeast, the northwest and the east of Chengdu, respectively, were chosen as the study sites.ParticipantsA representative sample of 1391 people aged over 80 years were enrolled from September 2015 to June 2016, and 106 participants were excluded due to missing information. Thus, a total of 1285 participants were analysed in this study.Outcome measuresHyperuricaemia was defined as serum uric acid >420 µmol/L in men or serum uric acid >360 µmol/L in women. A univariable logistic regression model and a multivariable logistic regression model were used to estimate the ORs and 95% CI to explore the associated risk factors of hyperuricaemia.ResultsThe overall prevalence of hyperuricaemia among the oldest-old was 29.6%. There was no significant sex difference in the prevalence of hyperuricaemia, 29.1% in men vs 30.0% in women (p>0.05). Hyperlipidaemia and overweight were associated with the risk of hyperuricaemia both in men (OR 1.86; 95% CI 1.27 to 2.72; OR 2.44; 95% CI 1.42 to 4.19) and in women (OR 1.78; 95% CI 1.23 to 2.58; OR 2.95; 95% CI 1.89 to 4.61). Additionally, diabetes mellitus was associated with an increased prevalence of hyperuricaemia only in women (OR 1.99; 95% CI: 1.34 to 2.97).ConclusionThe burden of hyperuricaemia is substantial among the oldest-old population in the urban areas of Chengdu, China.
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Li, Yuan, Qinxi Liu, Yi Yang, Shuangfeng Fan, Yang Liu, and Na Li. "A Study on the Association Between Family Support and High-Risk Sexual Behavior of Elderly Men in Rural China." American Journal of Men's Health 16, no. 4 (July 2022): 155798832211077. http://dx.doi.org/10.1177/15579883221107729.
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Our study aimed to understand the relationship between the status of high-risk sexual behaviors of male ≥50 years old (elderly men) and their family support in a rural county-level city in Chengdu. Multi-stage sampling was used to select rural elderly men from six towns to conduct an interview questionnaire survey. Ordinal logistic regression was used to analyze the relationship between high-risk sexual behavior and family factors. A total of 790 samples were included, and the prevalence of high-risk sexual behavior was 16.2%. Two-hundred thirty-nine men (30.3%) had three close family members. More than half of the men ( n = 397) had never been provided financial support by family members (50.3%). More than half of men ( n = 406) never communicate deeply with family members (51.4%). Logistic analysis reported that 50−59 years old (odds ratio [OR] = 1.928, 95% confidence interval [CI] = [1.070, 3.477]), unmarried, divorced/widowed, married and separated (OR = 8.232, 95% CI = [2.640, 25.673]; OR = 3.589, 95% CI = [1.713, 7.520]; OR = 3.003, 95% CI = [1.238, 7.280]) elderly men were more likely to be involved in commercial sex. Meanwhile, either never or often family financial support (OR = 0.435, 95% CI = [0.228, 0.830]; OR = 0.288, 95% CI = [0.095, 0.876]) helped elderly men to avoid commercial sex. This study predicts family factors may be affected by loneliness, life satisfaction, disposable economic condition, family responsibilities as the middle path, thus affect high-risk sexual behaviors in elderly men.
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Huang, Jiaqi, Yue Ma, Qiang Lv, Yaqiong Liu, Tao Zhang, Fei Yin, and Tiejun Shui. "Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study." BMJ Open 12, no. 11 (November 2022): e067127. http://dx.doi.org/10.1136/bmjopen-2022-067127.
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ObjectivesHand, foot, and mouth disease (HFMD) is a viral infectious disease that poses a substantial threat in the Asia-Pacific region. It is widely reported that meteorological factors are associated with HFMD. However, the relationships between air pollutants and HFMD are still controversial. In addition, the interactive effects between meteorological factors and air pollutants on HFMD remain unknown. To fill this research gap, we conducted a time-series study.DesignA time-series study.Setting and participantsDaily cases of HFMD as well as meteorological and air pollution data were collected in Chengdu from 2011 to 2017. A total of 184 610 HFMD cases under the age of 15 were included in our study.Outcome measuresDistributed lag nonlinear models were used to investigate the relationships between HFMD and environmental factors, including mean temperature, relative humidity, SO2, NO2, and PM10. Then, the relative excess risk due to interaction (RERI) and the proportion attributable to interaction were calculated to quantitatively evaluate the interactions between meteorological factors and air pollutants on HFMD. Bivariate response surface models were used to visually display the interactive effects.ResultsThe cumulative exposure–response curves of SO2and NO2were inverted ‘V’-shaped and ‘M’-shaped, respectively, and the risk of HFMD gradually decreased with increasing PM10concentrations. We found that there were synergistic interactions between mean temperature and SO2, relative humidity and SO2, as well as relative humidity and PM10on HFMD, with individualRERIs of 0.334 (95% CI 0.119 to 0.548), 0.428 (95% CI 0.214 to 0.642) and 0.501 (95% CI 0.262 to 0.741), respectively, indicating that the effects of SO2and PM10on HFMD were stronger under high temperature (>17.3°C) or high humidity (>80.0%) conditions.ConclusionsThere were interactive effects between meteorological factors and air pollutants on HFMD. Our findings could provide guidance for targeted and timely preventive and control measures for HFMD.
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Ran, Mao-Sheng, Cecilia Lai-Wan Chan, Eric Yu-Hai Chen, Wen-Jun Mao, Shi-Hui Hu, Cui-Ping Tang, Fu-Rong Lin, and Yeates Conwell. "Differences in mortality and suicidal behaviour between treated and never-treated people with schizophrenia in rural China." British Journal of Psychiatry 195, no. 2 (August 2009): 126–31. http://dx.doi.org/10.1192/bjp.bp.108.055301.
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BackgroundMany people with schizophrenia remain untreated in the community. Long-term mortality and suicidal behaviour among never-treated individuals with schizophrenia in the community are unknown.AimsTo explore 10-year mortality and suicidal behaviour among never-treated individuals with schizophrenia.MethodWe used data from a 10-year prospective follow-up study (1994–2004) among people with schizophrenia in Xinjin County, Chengdu, China.ResultsThe mortality rate for never-treated individuals with schizophrenia was 2761 per 100 000 person-years during follow-up. There were no significant differences of rates of suicide and all-cause mortality between never-treated and treated individuals. The standardised mortality ratio (SMR) for never-treated people was 10.4 (95% CI 7.2–15.2) and for treated individuals 6.5 (95% CI 5.2–8.5). Compared with treated people, never-treated individuals were more likely to be older, poorer, have a longer duration of illness, marked symptoms and fewer family members.ConclusionsThe never-treated individuals have similar mortality to and a higher proportion of marked symptoms than treated people, which may reflect the poor outcome of the individuals without treatment. The higher rates of mortality, homelessness and never being treated among people with schizophrenia in low- and middle-income nations might challenge presumed wisdom about schizophrenia outcomes in these countries.
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Ma, Lu, Zeping Fang, Liwang Gao, Yaling Zhao, Hong Xue, Ke Li, and Youfa Wang. "A 3-year Longitudinal Study of Pocket Money, Eating Behavior, Weight Status: The Childhood Obesity Study in China Mega-Cities." International Journal of Environmental Research and Public Health 17, no. 23 (December 7, 2020): 9139. http://dx.doi.org/10.3390/ijerph17239139.
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The associations between children’s pocket money and their eating behaviors and weight status have not been examined using longitudinal data in China. Examined child and parental factors associated with children’s pocket money, and longitudinal effects of pocket money on children’s eating behaviors and weight status. Data were collected in 2015, 2016, and 2017 from 3261 school-age children and their parents in mega-cities across China (Beijing, Shanghai, Nanjing, Xi’an, Chengdu). Children’s weight, height, and waist circumference were measured; pocket money and eating behaviors were self-reported. Mixed effect models were used. Older children received more pocket money than younger children (incident rate ratio (IRR) = 1.21, 95% confidence interval (CI): 1.15, 1.26). Fathers gave their children more pocket money than mothers did (IRR = 1.22, 95% CI: 1.16, 1.30). Children with fathers having ≥ college education received more pocket money than the others did (IRR = 1.20, 95% CI: 1.04, 1.40). Some nutrition-related parenting behaviors and attitude were also associated with children’s pocket money. Compared with children receiving no weekly pocket money, those having 1–10 or 10–30 or >30-yuan weekly pocket money were 12.0–136% more likely to consume unhealthy foods and were 66–132% more likely to be overweight or obese. Some child and parental factors were associated with children’s pocket money, which increased risks of having unhealthy eating behaviors and being overweight and obese.
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Qu, Zhan, Monica Parry, Fang Liu, Xiulin Wen, Jieqiong Li, Yanan Zhang, Duolao Wang, and Xiaomei Li. "Self-management and blood pressure control in China: a community-based multicentre cross-sectional study." BMJ Open 9, no. 3 (March 2019): e025819. http://dx.doi.org/10.1136/bmjopen-2018-025819.
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ObjectivesThis study explored the relationship between self-management and blood pressure (BP) control in China.DesignA cross-sectional study.SettingEight community health centres from four cities in the Northeast (Shenyang), Northwest (Xi’an), Southwest (Chengdu) and South (Changsha) of China.ParticipantsA total of 873 adults with hypertension, including 360 men and 513 women. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg.Outcome measurementsBP control was the primary outcome variable. This was categorised as good control if individuals with hypertension reduced their BP to <140/90 mm Hg, otherwise, it was categorised as poor control. Secondary outcomes included self-management, defined as: (1) context or condition-specific factors or physical/social environments (eg, age, sex, marital status, education, personal income and health insurance) and (2) process or knowledge/beliefs, self-regulation skills/abilities and social facilitation (eg, treatment, diet, exercise and risk factor management). Data were analysed using logistic regression models using SPSS V.20.ResultsA total of 67.1% (n=586) participants had poor BP control. Limited outpatient care benefits in mainly rural residents (OR 2.26, 95% CI 1.06 to 4.81) and longer disease duration (OR 1.03, 95% CI 1.01 to 1.04) were associated with poor BP control. Self-management practices reduced the odds of having poor BP control (OR 0.98, 95% CI 0.97 to 0.99).ConclusionsThe individual and family self-management theory can serve as an effective theory for understanding the key contexts, processes and outcomes essential for BP control in China. Future research should evaluate the effect of a self-management intervention (eg, self-monitoring, medication adherence, regular and routine doctor visits, and social supports) for BP control in China using a multisite cluster randomised controlled trial. Sex and gender difference, cost and patient-reported outcomes should also be examined.
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Liu, Yisi, Bowen Lan, Jeff Shirai, Elena Austin, Changhong Yang, and Edmund Seto. "Exposures to Air Pollution and Noise from Multi-Modal Commuting in a Chinese City." International Journal of Environmental Research and Public Health 16, no. 14 (July 16, 2019): 2539. http://dx.doi.org/10.3390/ijerph16142539.
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Background: Modern urban travel includes mixtures of transit options, which potentially impact individual pollution exposures and health. This study aims to investigate variations in traffic-related air pollution and noise levels experienced in traffic in Chengdu, China. Methods: Real-time PM2.5, black carbon (BC), and noise levels were measured for four transportation modes (car, bus, subway, and shared bike) on scripted routes in three types of neighborhoods (urban core, developing neighborhood, and suburb). Each mode of transportation in each neighborhood was sampled five times in summer and winter, respectively. After quality control, mixed effect models were built for the three pollutants separately. Results: Air pollutants had much higher concentrations in winter. Urban Core had the highest PM2.5 and BC concentrations across seasons compared to the other neighborhoods. The mixed effect model indicated that car commutes were associated with lower PM2.5 (−34.4 μg/m3; 95% CI: −47.5, −21.3), BC (−2016.4 ng/m3; 95% CI: −3383.8, −648.6), and noise (−9.3 dBA; 95% CI: −10.5, −8.0) levels compared with other modes; subway commutes had lower PM2.5 (−11.9 μg/m3; 95% CI: 47.5, −21.3), but higher BC (2349.6 ng/m3; 95% CI: 978.1, 3722.1) and noise (3.0 dBA; 95% CI: 1.7, 4.3) levels than the other three modes of transportation. Conclusion: Personal exposure to air pollution and noise vary by season, neighborhood, and transportation modes. Exposure models accounting for environmental, meteorological, and behavioral factors, and duration of mixed mode commuting may be useful for health studies of urban traffic microenvironments.
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Yin, Yuan, Na Wei, Zhiqiang Zheng, and Hongliang Liang. "Relationship between apoA-I, chemerin, Procalcitonin and severity of hyperlipidaemia-induced acute pancreatitis." Journal of the Pakistan Medical Association 72, no. 6 (June 22, 2022): 1201–4. http://dx.doi.org/10.47391/jpma.3700.
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The aim of this study was to investigate the relationship between apoA-I, chemerin, and Procalcitonin (PCT) and the severity of hyperlipidaemia-induced acute pancreatitis (HLAP), as well as the importance of their application in the diagnosis of severe HLAP. This study was conducted at the 363 Hospital, Chengdu City, China, from January 2016 to August 2020. There were significant differences in the levels of serum apoA-I, chemerin, and PCT among the three—mild, moderate and severe—groups (all p <0.001). Serum apoA-I was negatively correlated with chemerin and PCT levels in the severe group (p=0.006, p=0.011, respectively). Serum chemerin and PCT levels in the severe group was a positive correlation (p=0.032). Receiver Operating Characteristic (ROC) curve area of serum apoA-I in the diagnosis of severe HLAP was 0.808 (95% CI:0.727-0.888, p value <0.001), which was higher than that in serum chemerin and PCT, ---Continue
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Gao, Yun, Tianpeng Zheng, Xingwu Ran, Yan Ren, Tao Chen, Li Zhong, Donge Yan, Fangfang Yan, Qianlin Wu, and Haoming Tian. "Vitamin D and Incidence of Prediabetes or Type 2 Diabetes: A Four-Year Follow-Up Community-Based Study." Disease Markers 2018 (2018): 1–8. http://dx.doi.org/10.1155/2018/1926308.
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Aim. To examine whether the baseline 25-hydroxyvitamin D [25(OH)D] level was predictive of the onset of prediabetes or type 2 diabetes (T2DM) in the Chinese population. Methods. This was a 4-year follow-up study that was conducted in the Chengdu region of China as part of the China National Diabetes and Metabolic Disorders Study. The study included 490 participants that were free of prediabetes and type 2 diabetes mellitus (T2DM) at baseline and had complete data by follow-up examinations. Glucose, insulin, and 25(OH)D levels were measured at baseline and at 4 years later. Prediabetes and T2DM were defined by results obtained from an oral glucose tolerance test. Results. Over a 4-year follow-up, 95 (48.5‰) developed prediabetes and 31 (15.8‰) individuals developed diabetes. Low 25(OH)D status was significantly associated with the risk of developing prediabetes [OR 3.01 (95% CI: 1.50–6.06), P=0.002] and T2DM [OR 5.61 (95% CI: 1.73–18.27), P=0.004] after adjustment for multiple potential confounders. In a multiple linear regression analysis, low baseline levels of 25(OH)D were an independent predictor of increased insulin resistance over a 4-year period (P<0.05). Conclusions. The current prospective study suggests that low 25(OH)D levels might have contributed to the incidence of prediabetes or T2DM in Chinese individuals. This trial is registered with TR-CCH-ChiCTR-OCS-09000361.
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He, Pingping, Rui Jiang, Jianhao Li, Peng Wang, and Feizhou Du. "Risk factors of cerebral microbleeds in young and middle-aged patients with hypertension." Neurology Asia 26, no. 4 (September 2021): 685–91. http://dx.doi.org/10.54029/2021yny.
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Background & Objectives: This study aimed to explore the incidence and potential risk factors of cerebral microbleeds (CMBs) in young and middle-aged patients with hypertension. Methods: We retrospectively analyzed the clinical data of young and middle-aged patients with hypertension in the Department of Neurology, General Hospital of Western Theater Command, Chengdu, China between August 2018 and December 2020. The demographic baseline, laboratory parameters and clinical imaging data were collected. Microbleed anatomical rating scale (MARS) was applied to evaluate the presence, amount, and topographical distributions of CMBs. Results: Among 196 young and middle-aged patients with hypertension, 84 (42.9%) patients had CMBs. CMBs were more likely to occur in the deep brain tissue regions (41.8%), followed by lobar or infratentorial region. White matter hyperintensity (OR, 5.262; 95%CI, 1.314-21.075; P=0.019), abnormal lipid metabolism (OR, 3.832; 95%CI, 1.578-9.306; P=0.003), usage of anti-platelet aggregation drugs (OR, 2.947; 95%CI, 1.138-7.632; P=0.026), smoking history (OR, 3.218; 95%CI, 1.073-9.651; P=0.037), and hyperhomocysteinemia (OR, 1.415; 95%CI, 1.018-1.967; P=0.039) were independently associated with deep or infratentorial CMBs in young and middle-aged patients with hypertension. However, the occurrence of strictly lobar CMBs was only independently associated with abnormal lipid metabolism (OR, 4.162; 95%CI, 1.685-10.282; P=0.002). Conclusions: The rate of CMBs was high in young and middle-aged patients with hypertension, most commonly occurring in the deep brain tissue region. While multiple risk factors were identified to be associated with deep or infratentorial CMBs, the occurrence of strictly lobar CMBs was only associated with abnormal lipid metabolism.
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Pan, Zihan, Andrew P. Dickens, Chunhua Chi, Xia Kong, Alexandra Enocson, Brendan G Cooper, Peymané Adab, et al. "Accuracy and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among primary care patients (≥40 years) in China: a cross-sectional screening test accuracy study: findings from the Breathe Well group." BMJ Open 11, no. 9 (September 2021): e051811. http://dx.doi.org/10.1136/bmjopen-2021-051811.
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ObjectivesTo examine the accuracy and cost-effectiveness of various chronic obstructive pulmonary disease (COPD) screening tests and combinations within a Chinese primary care population.DesignScreening test accuracy study.SettingUrban and rural community health centres in four municipalities of China: Beijing (north), Chengdu (southwest), Guangzhou (south) and Shenyang (northeast).ParticipantsCommunity residents aged 40 years and above who attended community health centres for any reason were invited to participate. 2445 participants (mean age 59.8 (SD 9.6) years, 39.1% (n=956) male) completed the study (February–December 2019), 68.9% (n=1684) were never-smokers and 3.6% (n=88) had an existing COPD diagnosis. 13.7% (n=333) of participants had spirometry-confirmed airflow obstruction.InterventionsParticipants completed six index tests (screening questionnaires (COPD Diagnostic Questionnaire, COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE), Chinese Symptom-Based Questionnaire (C-SBQ), COPD-SQ), microspirometry (COPD-6), peak flow (model of peak flow meters used in the study (USPE)) and the reference test (ndd Easy On-PC).Primary and secondary outcomesCases were defined as those with forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) below the lower limit of normal (LLN-GLI) on the reference test. Performance of individual screening tests and their combinations was evaluated, with cost-effectiveness analyses providing cost per additional true case detected.ResultsAirflow measurement devices (sensitivities 64.9% (95% CI 59.5% to 70.0%) and 67.3% (95% CI 61.9% to 72.3%), specificities 89.7% (95% CI 88.4% to 91.0%) and 82.6% (95% CI 80.9% to 84.2%) for microspirometry and peak flow, respectively) generally performed better than questionnaires, the most accurate of which was C-SBQ (sensitivity 63.1% (95% CI 57.6% to 68.3%) specificity 74.2% (95% CI 72.3% to 76.1%)). The combination of C-SBQ and microspirometry used in parallel maximised sensitivity (81.4%) (95% CI 76.8% to 85.4%) and had specificity of 68.0% (95% CI 66.0% to 70.0%), with an incremental cost-effectiveness ratio of £64.20 (CNY385) per additional case detected compared with peak flow.ConclusionsSimple screening tests to identify undiagnosed COPD within the primary care setting in China is possible, and a combination of C-SBQ and microspirometry is the most sensitive and cost-effective. Further work is required to explore optimal cut-points and effectiveness of programme implementation.Trial registration numberISRCTN13357135.
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Sun, Hui, Huishan Wang, Lizheng Shi, Meifeng Wang, Junling Li, Jufang Shi, Ming Ni, Xianzhi Hu, and Yingyao Chen. "Physician preferences for chemotherapy in the treatment of non-small cell lung cancer in China: evidence from multicentre discrete choice experiments." BMJ Open 10, no. 2 (February 2020): e032336. http://dx.doi.org/10.1136/bmjopen-2019-032336.
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ObjectiveTo evaluate physician risk-benefit preferences and trade-offs when making chemotherapy decisions for patients with non-small cell lung cancer (NSCLC).DesignA discrete choice experiment (DCE).SettingsTertiary hospitals in Beijing, Shanghai, Guangzhou and Chengdu of China.ParticipantsThe participants were 184 physicians (mean age of 37 years) with more than 1 year of NSCLC chemotherapy practice.OutcomesThe DCE survey was constructed by six attributes: progression-free survival (PFS), disease control rate (DCR), risk of moderate side effects, risk of severe side effects, mode of administration and out-of-pocket costs. Physicians’ relative preferences and trade-offs in patient out-of-pocket costs for each attribute level were estimated using a mixed logit model, and interaction terms were added to the model to assess preferences variation among physicians with different sociodemographic factors.ResultsPhysicians had the strongest preferences for improvements in PFS, followed by reducing the risk of severe side effects. The DCR, risk of moderate side effects and mode of administration were ranked in decreasing order of importance. There was little variation in preferences among physicians with different sociodemographic characteristics. Physicians were willing to trade $4814 (95% CI $4149 to $5480) of patient out-of-pocket costs per month for a chemotherapy that guaranteed 11 months of PFS, followed by $1908 (95% CI $1227 to $2539) for reducing the risk of severe side effects to 2%.ConclusionsWith regard to chemotherapy for patients with NSCLC, prolonging PFS, reducing severe and moderate side effects were primary considerations for physicians in China. The mode of administration and treatment costs significantly influenced physicians’ therapeutic decision. The current findings could add some evidence to inform NSCLC chemotherapy implementation and promote shared decision-making.
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Duan, Peipei, Wenwen Qu, Shujuan Zou, Yangxi Chen, Hui Lan, Mauro Farella, and Li Mei. "Influence of fixed orthodontic treatment on the menstrual cycle of adult females: A prospective longitudinal study." Angle Orthodontist 86, no. 3 (August 19, 2015): 475–80. http://dx.doi.org/10.2319/121814-922.1.
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ABSTRACT Objective: To investigate the influence of fixed orthodontic treatment on the menstrual cycle, including menstrual cycle length (MCL) and duration of menstrual bleeding (DMB), in adult female patients. Materials and Methods: This was a prospective longitudinal study conducted in Chengdu, China. A total of 164 adult women with normal menstrual cycles were recruited in the study, with 79 patients undergoing orthodontic treatment and 85 serving as controls. Data of MCL, DMB, and accompanying symptoms were collected over six consecutive menstrual cycles in each participant. Student’s t test, Chi-square test, Moses extreme reaction test, and repeated measures analysis of variance were used for statistical analysis. Results: The MCL of the first menstrual cycle (T1) was significantly elongated by 2.1 ± 0.5 days compared with baseline (P = .003, 95% CI [−3.7, −0.5]). Variability of MCL of the orthodontic group at T1 was also significantly greater (range, 15–46 days) than that of the control group (range, 24–36 days) (P < .05). No significant difference in MCL was found in the subsequent five menstrual cycles (T2–T6) compared with baseline, and no significant differences in DMB or other accompanying symptoms were observed throughout the study. Conclusion: Fixed orthodontic treatment may influence the MCL of adult females in the first month after bonding, but showed no effect on DMB or subsequent MCL through the follow-ups.
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Wang, Xueping, Jie Zhong, Ting Lei, Deng Chen, Haijiao Wang, Lina Zhu, Shanshan Chu, and Ling Liu. "An Artificial Neural Network Prediction Model for Posttraumatic Epilepsy: Retrospective Cohort Study." Journal of Medical Internet Research 23, no. 8 (August 19, 2021): e25090. http://dx.doi.org/10.2196/25090.
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Background Posttraumatic epilepsy (PTE) is a common sequela after traumatic brain injury (TBI), and identifying high-risk patients with PTE is necessary for their better treatment. Although artificial neural network (ANN) prediction models have been reported and are superior to traditional models, the ANN prediction model for PTE is lacking. Objective We aim to train and validate an ANN model to anticipate the risks of PTE. Methods The training cohort was TBI patients registered at West China Hospital. We used a 5-fold cross-validation approach to train and test the ANN model to avoid overfitting; 21 independent variables were used as input neurons in the ANN models, using a back-propagation algorithm to minimize the loss function. Finally, we obtained sensitivity, specificity, and accuracy of each ANN model from the 5 rounds of cross-validation and compared the accuracy with a nomogram prediction model built in our previous work based on the same population. In addition, we evaluated the performance of the model using patients registered at Chengdu Shang Jin Nan Fu Hospital (testing cohort 1) and Sichuan Provincial People’s Hospital (testing cohort 2) between January 1, 2013, and March 1, 2015. Results For the training cohort, we enrolled 1301 TBI patients from January 1, 2011, to December 31, 2017. The prevalence of PTE was 12.8% (166/1301, 95% CI 10.9%-14.6%). Of the TBI patients registered in testing cohort 1, PTE prevalence was 10.5% (44/421, 95% CI 7.5%-13.4%). Of the TBI patients registered in testing cohort 2, PTE prevalence was 6.1% (25/413, 95% CI 3.7%-8.4%). The results of the ANN model show that, the area under the receiver operating characteristic curve in the training cohort was 0.907 (95% CI 0.889-0.924), testing cohort 1 was 0.867 (95% CI 0.842-0.893), and testing cohort 2 was 0.859 (95% CI 0.826-0.890). Second, the average accuracy of the training cohort was 0.557 (95% CI 0.510-0.620), with 0.470 (95% CI 0.414-0.526) in testing cohort 1 and 0.344 (95% CI 0.287-0.401) in testing cohort 2. In addition, sensitivity, specificity, positive predictive values and negative predictors in the training cohort (testing cohort 1 and testing cohort 2) were 0.80 (0.83 and 0.80), 0.86 (0.80 and 0.84), 91% (85% and 78%), and 86% (80% and 83%), respectively. When calibrating this ANN model, Brier scored 0.121 in testing cohort 1 and 0.127 in testing cohort 2. Compared with the nomogram model, the ANN prediction model had a higher accuracy (P=.01). Conclusions This study shows that the ANN model can predict the risk of PTE and is superior to the risk estimated based on traditional statistical methods. However, the calibration of the model is a bit poor, and we need to calibrate it on a large sample size set and further improve the model.
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Chen, Ying, Xiao-Ping Zhang, Jie Yuan, Bo Cai, Xiao-Li Wang, Xiao-Li Wu, Yue-Hua Zhang, et al. "Association of body mass index and age with incident diabetes in Chinese adults: a population-based cohort study." BMJ Open 8, no. 9 (September 2018): e021768. http://dx.doi.org/10.1136/bmjopen-2018-021768.
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ObjectiveType 2 diabetes mellitus is increasing in young adults, and greater adiposity is considered a major risk factor. However, whether there is an association between obesity and diabetes and how this might be impacted by age is not clear. Therefore, we investigated the association between body mass index (BMI) and diabetes across a wide range of age groups (20–30, 30–40, 40–50, 50–60, 60–70 and ≥70 years old).DesignWe performed a retrospective cohort study using healthy screening programme data.SettingA total of 211 833 adult Chinese persons >20 years old across 32 sites and 11 cities in China (Shanghai, Beijing, Nanjing, Suzhou, Shenzhen, Changzhou, Chengdu, Guangzhou, Hefei, Wuhan, Nantong) were selected for the study; these persons were free of diabetes at baseline.Primary and secondary outcome measuresFasting plasma glucose levels were measured and information regarding the history of diabetes was collected at each visit. Diabetes was diagnosed as fasting plasma glucose ≥7.00 mmol/L and/or self-reported diabetes. Patients were censored at the date of diagnosis or the final visit, whichever came first.ResultsWith a median follow-up of 3.1 years, 4174 of the 211 833 participants developed diabetes, with an age-adjusted incidence rate of 7.35 per 1000 persons. The risk of incident diabetes increased proportionally with increasing baseline BMI values, with a 23% increased risk of incident diabetes with each kg/m2increase in BMI (95% CI 1.22 to 1.24). Across all age groups, there was a linear association between BMI and the risk of incident diabetes, although there was a stronger association between BMI and incident diabetes in the younger age groups (age×BMI interaction, p<0.0001).ConclusionsAn increased BMI is also independently associated with a higher risk of developing diabetes in young adults and the effects of BMI on incident diabetes were accentuated in younger adults.
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Liu, Yuwei, Changqing Liu, Min Gao, Yan Wang, Yangjing Bai, Ruihua Xu, and Renrong Gong. "Evaluation of a wearable wireless device with artificial intelligence, iThermonitor WT705, for continuous temperature monitoring for patients in surgical wards: a prospective comparative study." BMJ Open 10, no. 11 (November 2020): e039474. http://dx.doi.org/10.1136/bmjopen-2020-039474.
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ObjectivesTo evaluate a new-generation, non-invasive, wireless axillary thermometer with artificial intelligence, iThermonitor (WT705, Raiing Medical, Beijing, China), and to ascertain its feasibility for perioperative continuous body temperature monitoring in surgical patients.SettingDepartments of Biliary Surgery and Operating Room and the post-anaesthesia care unit of a university teaching hospital in Chengdu, China.ParticipantsA total of 526 adult surgical patients were consecutively enrolled.DesignThis was a prospective observational study. Axillary temperatures were continuously recorded with iThermonitor throughout the whole perioperative period. The temperatures of the contralateral armpit were measured with mercury thermometers at 8:00, 12:00, 16:00 and 20:00 every day and were used as references.Outcome measuresThe outcomes were the accuracy and precision of the temperatures measured with iThermonitor, the validity to detect fever and the feasibility of continuous wear. Pairs of temperatures were evaluated with Student’s t-test, Pearson’s correlation and repeated-measures Bland-Altman plot.ResultsA total of 3621 pairs of body temperatures were obtained. The temperatures measured with iThermonitor agreed with those measured with the mercury thermometers overall, with a mean difference of 0.03°C±0.35°C and a moderate correlation (r=0.755, p<0.001). The 95% limits of agreement (LoA) ranged from −0.63°C to 0.73°C, with 5.11% of the differences outside the 95% LoA. The intraclass correlation coefficient was 0.753. Continuous temperature monitoring captured more fevers than intermittent observation (117/526 vs 91/526, p<0.001), detected fever up to 4.35 hours earlier, and captured a higher peak temperature (0.29°C±0.27°C, 95% CI: 0.26–0.31). All subjects felt that wearing iThermonitor was more or less comfortable and did not affect their daily activities.ConclusionsiThermonitor is promising for continuous remote temperature monitoring in surgical patients. However, further developments are still needed to improve the precision of this device, especially for temperature detection in underweight patients and those with lower body temperature.Trial registration numberChiCTR1900024549; Results (registered on 5 July 2019).
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Chen, Rui, Yong-Feng Liu, Gao-Duan Huang, and Peng-Cheng Wu. "The relationship between physical exercise and subjective well-being in Chinese older people: The mediating role of the sense of meaning in life and self-esteem." Frontiers in Psychology 13 (November 10, 2022). http://dx.doi.org/10.3389/fpsyg.2022.1029587.
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PurposeThis study explores the relationship between physical exercise and older people’s subjective well-being and the mediating role of a sense of meaning in life and self-esteem by using a structural equation modeling (SEM) approach, in order to provide some suggestions for improving older people’s subjective well-being.MethodsIn this study, a cross-sectional survey was conducted offline using a simple random method of collection, and the Physical Activity Rating Scale (PARS-3), the Subjective Well-being Scale (SWB), the Meaningfulness of Life Scale (MLQ), and the Self-Esteem Scale (SES) were applied to 419 older adults who participated in physical exercise from Chengdu (Qingyang District, Wuhou District, and Chenghua District), Sichuan Province, China, with the voluntary participation of the subjects. 197 males and 222 females, with a mean age of 72.49 (SD = 1.57). The study used SPSS 25.0 and Process 3.5 plug-in for statistical processing of the data, Cronbach’s alpha coefficient for intra-variate consistency testing, Harman’s one-way test for common method bias testing and multiple covariance diagnosis, and finally regression analysis and Bootstrap sampling test for significance of mediating effects.ResultsPhysical exercise was able to have a positive effect on the level of subjective well-being of older adults (β = 0.0305; 95% confidence interval (CI): 0.0226, 0.0384; p < 0.05), and a mediation analysis of sense of meaning in life and self-esteem revealed that they were able to have independent and chained mediation effects, with four pathways: first, physical exercise directly affected subjective well-being of older adults (β = 0.0149; 95% CI: 0.0072, 0.0226; p < 0.05; β = 0.0149; 95% CI: 0.0072, 0.0226; p < 0.05); secondly, sense of meaning in life mediated the relationship between physical exercise and subjective well-being of older adults (β = 0.0075; 95% CI: 0.0041, 0.0115; p < 0.05); thirdly, self-esteem mediated the relationship between physical exercise and subjective well-being of older adults (β = 0.0075; 95% CI: 0.0041, 0.0115; p < 0.05). (β = 0.0061; 95% CI: 0.0034, 0.0094; p < 0.05); fourth, a chain mediating effect of sense of meaning in life and self-esteem in the relationship between physical exercise and subjective well-being in older adults (β = 0.0021; 95% CI: 0.0010, 0.0035; p < 0.05).Conclusion and prospectsAs indicated by the results, physical exercise can enhance the subjective well-being of older adults through sense of meaning in life and self-esteem, therefore, in order to be able to enhance the subjective well-being of older adults, enhancing the level of sense of meaning in life and self-esteem of older adults is an effective means.
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Wang, Chaojie, Bingbing Niu, Qiyue Zhang, Wen Tian, and Jianfei Liu. "An Evaluation System of Urban Smart Growth in Wuhou District of Chengdu, China." Research & Reviews: Journal of Material Sciences 05, no. 06 (2017). http://dx.doi.org/10.4172/2321-6212.1000200.
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"Case 3. Jiang Tao v. Chengdu Branch, People's People's Bank of China: Opinion by the People's Court in Wuhou District, Chengdu, Sichuan Province." Chinese Education & Society 39, no. 4 (August 2006): 80–83. http://dx.doi.org/10.2753/ced1061-1932390405.
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Tan, Renhua, Ruiqi Wang, Yu Wang, Disheng Yi, Yan Chen, Wenting Cai, and Xiangchun Wang. "The Park city perspective study: Revealing the park accessibility influenced by experiences of visitors under different travel modes." Frontiers in Environmental Science 10 (September 14, 2022). http://dx.doi.org/10.3389/fenvs.2022.924996.
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With social media platforms becoming popular in recent years, Big Data has become an effective way to explore human-oriented service capability of parks. In this research, the spatial accessibility of urban parks under four different travel modes (driving, transiting, biking, and walking) and multiple modes was analyzed by integrating the actual experiences of visitors and real travel time. We took the built-up area of Chengdu, Sichuan Province, China as the research area and drew conclusions as follows: 1) park accessibility of Chengdu still has a large space for promotion. 2) Residents living in the east region of Qingyang District and Wuhou District, north area of Jinniu District, and Chenghua District are more convenient to visit parks, as well as the population center of Longquanyi District, Shuangliu District, and Pidu District. In addition, riders and walkers are more likely to go to the nearest park. 3) Accessibility of parks would be affected significantly during peak hours and weekends by driving and multiple modes, while the other travel modes had little influence. 4) Spatial aggregation was more obvious during the peak hours of weekdays under driving modes, while there were obvious cold spot areas distributed continuously for riders. 5) Park desert was found in Yongquan Subdistrict, Jitouqiao Subdistrict, and Chenglonglu Subdistrict, which were near the downtown. Overall, Chengdu must make rational use of small and micro spaces in the city to add greenery to the corners of the city and integrate parks with other surrounding industries to inspire the entertainment, economy, and tourism function of parks. Through the modified 2SFCA method, this study provide a more realistic and human-oriented way to demonstrate the accessibility. Also, the results can guide cities to understand what reasonable and appropriate parks they need to build to achieve the equalization of park recreation services.
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Wang, Mengmeng, Ya Wang, Jiajun Xu, Na Meng, Xiaolin Li, Zheng Liu, and Junqiang Huang. "Individual-level socioeconomic status and contact or familiarity with people with mental illness: a cross-sectional study in Wuhou District, Chengdu, Southwest China." BMC Family Practice 22, no. 1 (April 9, 2021). http://dx.doi.org/10.1186/s12875-021-01422-y.
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Abstract Background People with mental illness (PWMI) often suffer from public stigma, which can make them unwilling to seek help and reduce access to early treatment. The aims of this study were to determine attitudes towards PWMI among the general public in a Chinese sample and to explore the relationships with sociodemographic characteristics. Methods A community-based, cross-sectional study was conducted from March to June 2019. The participants’ attitudes towards PWMI were evaluated by the Chinese version of the Social Distance Scale (SDSC). An independent-sample T-test and one-way ANOVA were used to determine the association of categorical variables with the outcome variable. Multiple linear regression and Spearman correlations were computed to explore the correlation between SDSC scores and individual-level socioeconomic status (SES). Results A total of 1437 participants were recruited, and their total SDSC score was 12.53 (SD: 3.11). Univariate analysis results showed that age, education level, educational attainment, and individual-level SES as well as whether they were caregivers/family members of PWMI were correlated with SDSC scores. The results of regression analysis showed a significant effect caused by contact or familiarity with PWMI (B = -1.134, β = -.190, P < 0.001), as well as for individual-level SES (B = -.339, β = -.110, P < 0.001). Spearman correlation results showed that SDSC scores were negatively correlated with individual-level SES (r = -.078, p < 0.01) and contact or familiarity with PWMI (r = -.168, p < 0.001). Conclusion This study reveals that public stigma towards PWMI is common in Southwest China. Individuals who are not a family member or a caregiver of PWMI or have low education level or low individual-level SES need to be provided more anti-stigma interventions. Contacting with PWMI is also a potentially beneficial measure to reduce social distance.
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You, Xinyi, Stuart Gilmour, Wangnan Cao, Joseph Tak-fai Lau, Chun Hao, Jing Gu, Phuong Mai Le, et al. "HIV incidence and sexual behavioral correlates among 4578 men who have sex with men (MSM) in Chengdu, China: a retrospective cohort study." BMC Public Health 21, no. 1 (April 26, 2021). http://dx.doi.org/10.1186/s12889-021-10835-4.
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Abstract Background The prevalence of HIV among men who have sex with men (MSM) in southwest China is still increasing. This study aimed to investigate the trend in HIV incidence and its associated risk factors among MSM in Chengdu, China. Method Incidence data were collected from the largest local non-governmental organization (NGO) serving MSM in Chengdu between 2012 and 2018, while information on sexual behaviors was collected from 2014. All MSM who received voluntary counseling and testing services (VCT) in the collaborating NGO at least twice during the study period were included. We calculated the HIV incidence density among MSM every 2 years and the overall incidence rate. A Cox proportional hazards regression model was employed to identify risk factors for HIV infection. Result A total of 4578 HIV-negative participants were included in the cohort. The total incidence density was 5.95 (95% CI: 5.37–6.56)/100 person-years (PYs) between 2012 and 2018. The segmented incidence density was 9.02 (95% CI: 7.46–10.78), 5.85 (95% CI: 4.86–6.97), 5.43 (95% CI: 4.53–6.46), and 3.09 (95% CI: 2.07–4.41)/100 PYs in 2012–2013, 2014–2015, 2016–2017, and 2018, respectively. After adjusting for sociodemographic characteristics, compared to participants without sexual partners within 6 months, MSM with one fixed partner (Adjusted Hazard Ratio, AHR = 1.18, 95% CI: 0.44–3.19) and more than five partners (AHR = 2.24, 95% CI: 0.81–6.20) had increased risk of HIV infection. MSM who used condom inconsistently had a higher risk of HIV infection (AHR = 1.87, 95% CI: 1.46–2.38) compared to consistent condom users. Conclusion The decreased HIV incidence density among MSM was potentially related to the successful comprehensive HIV prevention strategies in Chengdu. Multiple male sexual partnerships and inconsistent condom use during anal intercourse were risk factors associated with HIV occurrence.
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Tan, Yinliang, Zhilan Xie, Ying Qian, Jie Gu, Yundan Bai, Xiaoqing Gu, Zheng Ye, Jianmin Feng, and Jiaoling Huang. "Accelerate the process of getting vaccinated: factors associated with consideration of and accessibility to COVID-19 vaccination in metropolises of China." BMC Public Health 22, no. 1 (June 14, 2022). http://dx.doi.org/10.1186/s12889-022-13567-1.
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Abstract Background Rapid mutation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is sweeping the world and delaying the full reopening of society. Acceleration of the vaccination process may be the key element in winning the race against this virus. We examine factors associated with personal considerations of and accessibility to the corona virus disease 2019 (COVID-19) vaccination in metropolises of China. Methods This multi-center, cross-sectional research was conducted using online questionnaires from April 1 to June 1, 2021, in community health service centers of Shanghai, Chengdu and Fuzhou. 9,047 vaccinated participants were included and data for 8,990 individuals were eligible for analysis. Chi-square test was conducted to find potential predictors, which were included in the logistic regressions. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the influence of region, socio-economic status (SES), and attitudes on vaccination process. Results In consideration phase, participants in Fuzhou (OR:2.26, 95%CI: 1.90 to 2.68) and Chengdu (OR: 2.48, 95%CI: 2.17 to 2.83) were more likely than those in Shanghai to consider longer than one month. These odds increased for participants with master or above degree (reference: illiteracy and primary school), higher monthly household income (reference: < ¥5000), and greater vaccination hesitancy (reference: low hesitancy). Unemployed and household-based participants (OR: 3.37, 95%CI: 1.69 to 6.75, reference: farmer) and participants without brand preference (OR:1.13, 95%CI:1.02 to 1.26) may take longer time of consideration. In the accessibility phase, participants in Fuzhou (OR: 8.82, 95%CI: 7.28 to 10.68) and Chengdu (OR: 2.28, 95%CI: 1.98 to 2.63) were more likely to wait longer than one week. These odds decreased for participants with master or above degree (reference: illiteracy and primary school), monthly household income from ¥5000 to ¥10,000 (reference: < ¥5000), and teacher or student (reference: farmer). Participants without brand preference (OR: 0.86, 95%CI: 0.77 to 0.95) were likely to wait shorter after appointment, while participants with higher risk awareness of domestic epidemic (medium, OR: 1.24, 95%CI: 1.12 to 1.37, reference: low) may wait longer. Conclusions The influential factors changed over two phases of vaccination process. Regional disparity affected both consideration and accessibility phases. Expect that, SES, and hesitancy were major factors of the consideration phase, but had limited impact on accessibility phase.
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Zhang, Wenqiang, Yong Yue, Min Hu, Changhui Du, Cheng Wang, Xiaoli Tuo, Xiaoman Jiang, et al. "Epidemiological characteristics and quarantine assessment of imported international COVID-19 cases, March to December 2020, Chengdu, China." Scientific Reports 12, no. 1 (December 7, 2022). http://dx.doi.org/10.1038/s41598-022-20712-8.
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AbstractInternational flights have accelerated the global spread of Coronavirus Disease 2019 (COVID-19). Determination of the optimal quarantine period for international travelers is crucial to prevent the local spread caused by imported COVID-19 cases. We performed a retrospective epidemiological study using 491 imported COVID-19 cases in Chengdu, China, to describe the characteristic of the cases and estimate the time from arrival to confirmation for international travelers using nonparametric survival methods. Among the 491 imported COVID-19 cases, 194 (39.5%) were asymptomatic infections. The mean age was 35.6 years (SD = 12.1 years) and 83.3% were men. The majority (74.1%) were screened positive for SARS-CoV-2, conducted by Chengdu Customs District, the People’s Republic of China. Asymptomatic cases were younger than presymptomatic or symptomatic cases (P < 0.01). The daily number of imported COVID-19 cases displayed jagged changes. 95% of COVID-19 cases were confirmed by PT-PCR within 14 days (95% CI 13–15) after arriving in Chengdu. A 14-day quarantine measure can ensure non-infection among international travelers with a 95% probability. Policymakers may consider an extension of the quarantine period to minimize the negative consequences of the COVID-19 confinement and prevent the international spread of COVID-19. Nevertheless, the government should consider the balance between COVID-19 and socioeconomic development, which may cause more serious social and health crises.
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Yang, Yi, Hua Deng, Huan He, Shuang Feng Fan, Yuan Li, Xia Wu, Na Li, et al. "Lifetime commercial heterosexual behavior among HIV negative elderly men from rural Chengdu, China: a modified knowledge-attitude-practice perspective." BMC Public Health 21, no. 1 (November 15, 2021). http://dx.doi.org/10.1186/s12889-021-12139-z.
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Abstract Background China is facing big challenges to achieve the “90–90-90 targets”. The HIV prevalence of elderly (≥50 years) men have been steadily increasing in China, mainly through the sexual transmission route, but sexual behaviors of them are far from well-studied. In 2019, elderly men accounted for 59.2% of HIV/AIDS cases in Sichuan, China. Methods The research design is a cross-sectional study. Face-to-face interviews were conducted among 795 HIV negative elderly men from rural Chengdu, capital City of Sichuan. Bivariate and multivariate logistic regression models were applied to examine factors associated with commercial heterosexual behavior from a modified Knowledge-Attitude-Practice (KAP) perspective. Results 129 (16.23%) respondents admitted high-risk sexual behaviors, including 11.07% commercial heterosexual behavior, 6.16% extramarital, 2.89% casual and 0.25% homosexual behavior, and no one used condom consistently. 427(68.43%) had ever gotten HIV-related Health Education (HRHE), mainly through mass media (70.49%). The HIV-related knowledge awareness rate was only 31.41%. Migration history (AOR =2.46,95% CI = 1.02–5.91), age(≥60 vs. 50–59, OR = 0.41, 95% CI = 0.19–0.91), receiving HRHE from mass media (OR = 0.37, 95%CI = 0.16–0.85), marital status (married vs. never married, OR = 0.04, 95%CI = 0–0.52), and undecided (AOR =0.02, 95%CI = 0.01–0.09) and objection (AOR =0.04, 95%CI = 0.01–0.1) attitude toward commercial sex were related to lifetime commercial heterosexual behavior. Conclusions High-risk sexual behaviors are common among elderly men from rural areas in Chengdu. Receiving HRHE from mass media and undecided and objection attitude toward commercial sex prevent elderly from being involving in commercial heterosexual behavior. According to the results, health facilities should continue to conduct systematic interventions, paying more attention to 50–59 years old group. Sex and condom use need to be talked in public. Working with mass media, health facilities give elderly men education not only focusing on HIV/AIDS, but also on knowledge and skills of condom use.
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Wu, Chenyao, Baiyang Zhang, Zhen Dai, Qianwen Zheng, Zhenhua Duan, Qinying He, and Cairong Zhu. "Impact of immediate initiation of antiretroviral therapy among men who have sex with men infected with HIV in Chengdu, southwest China: trends analysis, 2008–2018." BMC Public Health 21, no. 1 (April 8, 2021). http://dx.doi.org/10.1186/s12889-021-10580-8.
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Abstract Background Given the rampant HIV epidemic among men who have sex with men (MSM) in Chengdu, southwest China, Treat All policy, defined as immediate antiretroviral therapy (ART) initiation after HIV diagnosis, was implemented since 2014. Real-world research evaluating impacts of immediate ART on HIV epidemics is needed to optimize policy-making as national and international guidelines have been lowering ART eligibility threshold. The purpose of this study is to: assess temporal trends of the HIV epidemic and impacts of Treat All policy among MSM; and lay foundation for HIV-related policy evaluation using longitudinal routine data from health information systems. Methods Data used in this study were HIV sentinel seroprevalence, annual reported HIV cases and ART coverage rate among MSM in Chengdu from 2008 to 2018, derived from national HIV/AIDS information system. Temporal trends of the HIV epidemic were described using Joinpoint Regression Program. Interrupted time-series method was deployed to evaluate Treat All policy. Results HIV sentinel seroprevalence rose from 11.20% in 2008 to 17.67% in 2013 and Annual Percent Change (APC) was 8.25% (95% CI − 2.40%, 20.07%), then decreased to 5.17% in 2018 (APC = − 19.63%, 95% CI − 27.54%, − 10.86%). Newly reported HIV cases increased from 168 cases in 2008 to 1232 cases in 2015 (APC = 26.99%, 95% CI 21.32%, 32.93%), and reduced to 1014 cases in 2018 (APC = − 8.80%, 95% CI − 18.45%, 2.01%). ART coverage rate has been climbing from 11.11% in 2008 to 92.29% in 2018 and Average Annual Percent Change was 16.09% (95% CI 11.76%, 20.59%). Results of interrupted time-series models showed that compared to an annual increase of 0.87% during pre-policy period, there was a decline of 3.08% (95% CI − 0.0366%, − 0.0250%) per year of HIV sentinel seroprevalence since 2014; and compared to an annual increase of 116 cases before 2014, there was an annual drop of 158 newly reported HIV cases (95% CI − 194.87%, − 121.69%) during the post-policy period. Conclusions Immediate ART after HIV diagnosis could potentially curb HIV transmission at population level among MSM, along with other strategies. Future assessment of HIV prevention and control policy can be carried out using routinely collected longitudinal data from health information systems.
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Guo, Pengyue, Fengsu Hou, Wangnan Cao, Yawei Guo, Dannuo Wei, Jinghua Li, and Yuantao Hao. "Intimate Partner Violence and Willingness to Use Pre-Exposure Prophylaxis Among Men Who Have Sex With Men in Chengdu, China." Journal of Interpersonal Violence, October 19, 2022, 088626052211271. http://dx.doi.org/10.1177/08862605221127197.
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Intimate partner violence (IPV) is common in men who have sex with men (MSM). MSM also face increased risk of human immunodeficiency virus infection. However, it is not known whether IPV experience of MSM in China would affect their attitudes toward pre-exposure prophylaxis (PrEP) use. A cross-sectional study was conducted to explore the associations between different types of IPV and willingness to use PrEP in a sample of 608 MSM from November 2018 to May 2019 in Chengdu, China. Univariate and multivariate logistic regression analyses were used to explore the associations between different types of IPV and willingness to use PrEP. The average age of the participants was 31.8 ± 12.3 years, 48.9% of them were aware of PrEP before this study, and only 7.2% were aware of long-acting injectable PrEP (LAI-PrEP). The overall willingness to use any type of PrEP in the next 6 months was 82.2%. Approximately one third of the participants ( n = 198) had experienced at least one type of IPV. We found that experience of sexual perpetration was negatively associated with the willingness to use on-demand PrEP (adjusted odds ratio [ORa] = 0.33, 95% CI = 0.16–0.67) and the overall willingness to use any type of PrEP (ORa = 0.31, 95% CI = 0.15–0.64). The willingness to use LAI-PrEP also had negative associations with any type of monitoring IPV (ORa = 0.58, 95% CI = 0.38–0.91), controlling victimization (ORa = 0.41, 95% CI = 0.21–0.82), and emotional victimization (ORa = 0.58, 95% CI = 0.35–0.97). The findings of this study demonstrate that IPV experiences are negatively associated with willingness to use PrEP among MSM, suggesting that PrEP promotion programs should consider IPV screening and develop explicit intervention strategies for both perpetrators and victims.
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Wei, Dannuo, Fengsu Hou, Chun Hao, Jing Gu, Rubee Dev, Wangnan Cao, Liping Peng, Stuart Gilmour, Keru Wang, and Jinghua Li. "Prevalence of Intimate Partner Violence and Associated Factors Among Men Who Have Sex with Men in China." Journal of Interpersonal Violence, December 2, 2019, 088626051988993. http://dx.doi.org/10.1177/0886260519889935.
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Intimate partner violence (IPV) in the heterosexual population has gained increasing public concern in China, but little is known about it among men who have sex with men (MSM).1 This study aimed to investigate the prevalence of IPV and associated factors among MSM in Chengdu, China. Participants were recruited from a local MSM-friendly health consulting center. This study used the adjusted Intimate Partner Violence Scale among Gay and Bisexual Men (IPV-GBM scale) to capture lifetime IPV experiences including physical, sexual and emotional violence, monitoring, and controlling behaviors. Among 431 participants, 153 (35.5%) reported any IPV experiences, and 119 (27.6%) reported themselves as being the perpetrator. Adjusted logistic regression models revealed that having been engaged in transactional sex was positively associated with victimization through monitoring behaviors (adjusted odds ratio [ORa] = 2.7, 95% confidence interval CI = [1.7, 7.4]) and perpetration of monitoring behaviors (ORa = 3.9, 95% CI = [1.5, 13.3]); drug use was positively associated with victimization through controlling behaviors (unadjusted odds ratio [ORu] = 2.5, 95% CI = [1.2, 5.0]) and emotional violence (ORa = 1.9, 95% CI = [1.0, 3.5]); older age (≥18 years) of first homosexual intercourse was negatively associated with perpetration of physical violence (ORu = 0.3, 95% CI = [0.2, 0.7]) and sexual violence (ORu = 0.4, 95% CI = [0.2, 1.0]); higher self-esteem was negatively associated with both victimization and perpetration of sexual and emotional violence. We found that victimization and perpetration experiences were correlated in all dimensions of IPV. Violence was prevalent among MSM and merits public attention. This study provides more evidence about IPV among Chinese MSM and identifies two significant factors contributing to IPV (self-esteem and age of first homosexual intercourse), which have been overlooked in previous studies. Researchers should take these factors into consideration for interventions developments.
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Chen, Jianyu, Chunli Shi, Yang Li, Hongzhen Ni, Jie Zeng, Rong Lu, and Li Zhang. "Effects of short-term exposure to ambient airborne pollutants on COPD-related mortality among the elderly residents of Chengdu city in Southwest China." Environmental Health and Preventive Medicine 26, no. 1 (January 12, 2021). http://dx.doi.org/10.1186/s12199-020-00925-x.
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Abstract Background Chronic obstructive pulmonary disease (COPD) has become a severe global burden in terms of both health and the economy. Few studies, however, have thoroughly assessed the influence of air pollution on COPD-related mortality among elderly people in developing areas in the hinterland of southwestern China. This study is the first to examine the association between short-term exposure to ambient airborne pollutants and COPD-related mortality among elderly people in the central Sichuan Basin of southwestern China. Methods Data on COPD-related mortality among elderly people aged 60 and older were obtained from the Population Death Information Registration and Management System (PDIRMS). Data on airborne pollutants comprised of particulate matter < 2.5 μm in aerodynamic diameter (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were derived from 23 municipal environmental monitoring sites. Data on weather conditions, including daily mean temperature and relative humidity, were obtained from the Chengdu Meteorological Bureau. All data were collected from January 1, 2015, to December 31, 2018. A quasi-Poisson general additive model (GAM) was utilized to assess the effects of short-term exposure to airborne pollutants on COPD-related mortality among elderly people. Results A total of 61,058 COPD-related deaths of people aged 60 and older were obtained. Controlling the influences of daily temperature and relative humidity, interquartile range (IQR) concentration increases of PM2.5 (43 μg/m3), SO2 (8 μg/m3), NO2 (18 μg/m3), CO (0.4 mg/m3), and O3 (78 μg/m3) were associated with 2.7% (95% CI 1.0–4.4%), 4.3% (95% CI 2.1–6.4%), 3.6% (95% CI 1.7–5.6%), 2.7% (95% CI 0.6–4.8%), and 7.4% (95% CI 3.6–11.3%) increases in COPD-related mortality in people aged 60 and older, respectively. The exposure-response curves between each pollutant and the log-relative risk of COPD-related mortality exhibited linear relationships. Statistically significant differences in the associations between pollutants and COPD-related mortality were not observed among sociodemographic factors including age, gender, and marital status. The effects of O3 remained steady after adjusting for PM2.5, SO2, NO2, and CO each time in the two-pollutant models. Conclusions Increased concentrations of ambient airborne pollutants composed of PM2.5, SO2, NO2, O3, and CO were significantly and positively associated with COPD-related mortality in the central Sichuan Basin, which is located in the hinterland of southwestern China. The adverse effects of O3 were stable, a finding that should receive more attention.
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Zhang, Yan, Lun Luo, Pan Li, Yun Xu, and Zi Chen. "Risk factors for college students’ online lending between different genders-A cross-sectional study in China." Frontiers in Psychology 14 (January 17, 2023). http://dx.doi.org/10.3389/fpsyg.2023.965049.
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BackgroundOnline lending on campus is given more attention by researchers as its prominent adverse effects on students. The deficiencies of the previous studies on its psychological factors and intervention strategies were only based on qualitative research. Moreover, there is no study on gender differences. Therefore, our study aims to analyze the gender differences in psychological risk factors and give some practical suggestions for the intervention by quantitative methods.MethodThis is a cross-sectional survey among medical college students in Chengdu. A total of 984 effective questionnaires were collected. The questionnaire includes demographic data, monthly expenses, self-evaluation for three central psychology causing online lending based on empiricism (conformity, comparison, and hedonism), and three psychological assessment instruments (the Chinese version of the Satisfaction with Life Scale, Egna Minnen av Barndoms Uppfostran, and 144-item version of Temperament and Character Inventory). T-test/χ2-test and Binary logistic regression were used to analyze the gender differences in variables and the risk factors of online lending for males and females, respectively.ResultsThe utilization rate of online lending exhibited a significant gender difference (p < 0.001). In addition, there were gender differences in the scores on SWLS and some subscales of C-EMBU and TCI-144. The risk factors for males’ were family members using online lending (OR = 5.527, 95% CI = 1.784–17.125) and lower scores on HA (OR = 0.938, 95% CI = 0.888–0.990). The risk factors for females’ online lending were family members using online lending (OR = 2.288, 95% CI = 1.201–4.362), hedonism (OR = 5.913, 95% CI = 1.327–26.341), and higher scores on mother’s punishment (OR = 1.099, 95% CI = 1.007–1.199).ConclusionThe utilization rate of online lending in males was significantly higher than in females. More attention should be paid to gender differences and the impact of family members’ using online lending on students when intervening in online lending.
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Xu, Wenli, Ling Yi, Changfei Deng, Ziling Zhao, Longrong Ran, Zhihong Ren, Shunxia Zhao, et al. "Maternal periconceptional folic acid supplementation reduced risks of non-syndromic oral clefts in offspring." Scientific Reports 11, no. 1 (June 10, 2021). http://dx.doi.org/10.1038/s41598-021-91825-9.
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AbstractMaternal periconceptional folic acid supplementation (FAS) has been documented to be associated with decreased risk of nonsyndromic oral clefts (NsOC). However, the results remain inconclusive. In this population-based case–control study of 807 singletons affected by NsOC and 8070 healthy neonates who were born between October 2010 and September 2015 in Chengdu, China, we examined the association of maternal FAS with the risk of nonsyndromic cleft lip with or without cleft palate (NsCL/P), and cleft palate (NsCP). Unconditional logistic regression analysis was used to estimate the crude and adjusted odds ratios (ORs) and 95% confidential intervals (CI). Significant associations were found between maternal periconceptional FAS and decreased risk of NsCL/P (aOR = 0.41, 95% CI 0.33–0.51). This protective effect was also detected for NsCL (aOR = 0.42, 95% CI 0.30–0.58) and NsCLP (aOR = 0.41, 95% CI 0.31–0.54). Both maternal FAS started before and after the last menstrual period (LMP) were inversely associated with NsCL/P (before LMP, aOR = 0.43, 95% CI 0.33–0.56; after LMP, aOR = 0.41, 95% CI 0.33–0.51). The association between NsCP and maternal FAS initiating before LMP was also found (aOR = 0.52, 95% CI 0.30–0.90). The findings suggest that maternal periconceptional FAS can reduce the risk of each subtype of NsCL/P in offspring, while the potential effect on NsCP needs further investigations.
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Ran, Mao-Sheng, Yunyu Xiao, Seena Fazel, Yeonjin Lee, Wei Luo, Shi-Hui Hu, Xin Yang, et al. "Mortality and suicide in schizophrenia: 21-year follow-up in rural China." BJPsych Open 6, no. 6 (October 15, 2020). http://dx.doi.org/10.1192/bjo.2020.106.
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Background Little is known about the trend and predictors of 21-year mortality and suicide patterns in persons with schizophrenia. Aims To explore the trend and predictors of 21-year mortality and suicide in persons with schizophrenia in rural China. Method This longitudinal follow-up study included 510 persons with schizophrenia who were identified in a mental health survey of individuals (≥15 years old) in 1994 in six townships of Xinjin County, Chengdu, China, and followed up in three waves until 2015. Kaplan–Meier survival analysis and Cox hazard regressions were conducted. Results Of the 510 participants, 196 died (38.4% mortality) between 1994 and 2015; 13.8% of the deaths (n = 27) were due to suicide. Life expectancy was lower for men than for women (50.6 v. 58.5 years). Males consistently showed higher rates of mortality and suicide than females. Older participants had higher mortality (hazard ratio HR = 1.03, 95% CI 1.01–1.05) but lower suicide rates (HR = 0.95, 95% CI 0.93–0.98) than their younger counterparts. Poor family attitudes were associated with all-cause mortality and death due to other causes; no previous hospital admission and a history of suicide attempts independently predicted death by suicide. Conclusions Our findings suggest there is a high mortality and suicide rate in persons with schizophrenia in rural China, with different predictive factors for mortality and suicide. It is important to develop culture-specific, demographically tailored and community-based mental healthcare and to strengthen family intervention to improve the long-term outcome of persons with schizophrenia.
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Yang, Genglin, Liantian Tian, Yang Wang, Jin Li, Peiyuan Qiu, Shan Rao, and Weihong Kuang. "Prevalence and relative factors of health anxiety of elders in community healthcare centers." International Psychogeriatrics, January 28, 2022, 1–8. http://dx.doi.org/10.1017/s1041610221002854.
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ABSTRACT Objective: The study’s aims were (i) to identify the prevalence of health anxiety (HA) among the elderly in urban community healthcare centers and (ii) to determine whether HA is related to social, physical, or psychological factors. Design: It is a population-based observational study. Setting: Data were collected from urban community healthcare centers in Chengdu, China, from October 2016 to March 2017. Participants: A total of 893 participants aged ≥ 60 years. Measurements: The Short HA Inventory was used for HA assessment. Mental health status was assessed using the Geriatric Depression Inventory and Mini-Mental State Examination. Other information was collected through face-to-face interviews. Data analysis was performed using SPSS 19.0. Results: The point prevalence rate of HA was 9.53% (95%CI = 6.99%–12.07%). The number of chronic diseases was a positive factor associated with HA in a regression analysis. As compared with participants without chronic diseases, people with one (OR = 1.796; 95%CI = 0.546–5.909), two (OR = 2.922; 95%CI = 0.897–9.511), and three chronic diseases (OR = 6.448; 95%CI = 2.147–19.363) had higher odds of suffering from HA. Conclusions: The prevalence of HA was high in the elderly population. Certain physical conditions, such as having chronic diseases, were significant impact factors. More attention should be paid to the situation of HA in this population.
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Ma, Tianpei, and Bo Gao. "The Association of Social Capital and Self-Rated Health Between Urban Residents and Urbanized Rural Residents in Southwest China." Frontiers in Public Health 9 (August 25, 2021). http://dx.doi.org/10.3389/fpubh.2021.718793.
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China has seen an accelerated process of urbanization in the past 30 years. The influence of urbanization on health is complex and primarily influenced by changes in social capital. The purpose of this research was to compare the social capital between urban residents and urbanized rural residents of southwest China and its relationship with self-rated health. It is of great significance to study the difference of social capital between urban and urbanized rural residents to help urbanized rural residents improve their social adaptability and health. Data was collected from 1,646 residents between November and December of 2017 in Chengdu. Three logistic regressions were used to investigate the association between social capital and self-rated health by controlling for demographic variables, lifestyles factors, and health status factors. We observed that urban residents' self-rated health had a higher proportion of “good” than that of urbanized rural residents (P = 0.017). After controlling for factors such as health status and demographic characteristics, participants with higher social capital had better self-rated health. Urbanized rural residents with higher community trust and belonging had better self-rated health (OR = 0.701, 95% CI = 0.503~0.978), however urban residents with higher personal social networks and family relationships had better self-rated health (OR = 0.676, 95% CI = 0.490~0.933 and OR = 0.666, 95% CI = 0.450~0.987, respectively). Different types of communities should focus on the types of social capital from different sources, so as to take more targeted measures to improve the social support of residents and improve their health. Improving residents' social trust and sense of belonging may help urbanized rural residents better adapt to the new living environment and help them complete the identity transformation.
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Lin, Jianfeng, Hua Zheng, Peng Xia, Xinqi Cheng, Wei Wu, Yang Li, Chaochao Ma, et al. "Long-term ambient PM2.5 exposure associated with cardiovascular risk factors in Chinese less educated population." BMC Public Health 21, no. 1 (December 2021). http://dx.doi.org/10.1186/s12889-021-12163-z.
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Abstract Introduction Long-term exposure to ambient air pollution is related to major cardiovascular risk factors including diabetes, hypertension, hyperlipidemia and overweight, but with few studies in high-concentration nations like China so far. We aimed to investigate the association between long-term exposure to ambient fine particulate matter (particles with an aerodynamic diameter ≤ 2.5 μm, PM2.5) and major cardiovascular risk factors in China. Methods Adult participants with selected biochemical tests were recruited from the Chinese Physiological Constant and Health Condition (CPCHC) survey conducted from 2007 to 2011. Gridded PM2.5 data used were derived from satellite-observed data with adjustment of ground-observed data. District-level PM2.5 data were generated to estimate the association using multivariate logistic regression model and generalized additive model. Results A total of 19,236 participants from the CPCHC survey were included with an average age of 42.8 ± 16.1 years, of which nearly half were male (47.0%). The annual average PM2.5 exposure before the CPCHC survey was 33.4 (14.8–53.4) μg/m3, ranging from 8.0 μg/m3 (Xiwuqi) to 94.7 μg/m3 (Chengdu). Elevated PM2.5 was associated with increased prevalence of hypertension (odds ratio (OR) =1.022, 95% confidence interval (95%CI): 1.001, 1.043) and decreased prevalence of overweight (OR = 0.926, 95%CI: 0.910, 0.942). Education significantly interacted with PM2.5 in association with all the interesting risk factors. Each 10 μg/m3 increment of PM2.5 was associated with increased prevalence of diabetes (OR = 1.118, 95%CI: 1.037, 1.206), hypertension (OR = 1.101, 95%CI: 1.056, 1.147), overweight (OR = 1.071, 95%CI: 1.030, 1.114) in participants with poor education, but not in well-educated population. PM2.5 exposure was negatively associated with hyperlipidemia in all participants (OR = 0.939, 95%CI: 0.921, 0.957). The results were robust in all the sensitivity analyses. Conclusion Association between long-term PM2.5 exposure and cardiovascular risk factors might be modified by education. PM2.5 was associated with a higher prevalence of diabetes, hypertension, and overweight in a less-educated population with time-expose dependency. Long-term exposure to PM2.5 might be associated with a lower prevalence of hyperlipidemia.
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Gao, Liwang, Lu Ma, Hong Xue, Jungwon Min, Huijun Wang, and Youfa Wang. "A 3-year Longitudinal Study of Effects of Maternal Perception of Children's Ideal Body Image on Child Weight Change: The Children Obesity Study in China Mega-cities (P21-061-19)." Current Developments in Nutrition 3, Supplement_1 (June 1, 2019). http://dx.doi.org/10.1093/cdn/nzz041.p21-061-19.
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Abstract Objectives This study examined: 1) prevalence of overweight and obesity (ov/ob) in children and maternal perception of children's ideal body image in China, 2) associations between maternal perception of children's ideal body image and changes in children's body mass index (BMI) over 3 years. Methods The Children Obesity Study in China Mega-cities is a NIH-funded cohort study and includes Beijing, Shanghai, Xian, Nanjing and Chengdu across China. Data have been collected from school children, their parents and school in 2015 to 2017 (3298 children). Maternal perception of ideal body image of children, child lifestyle behaviors were assessed using questionnaires; child weight and height were measured in schools. The longitudinal analysis included 1691 children (had >= two BMI measurements) aged 6–18 years. Results More boys than girls were overweight or obese (40.6% vs 25.1%). Parents reported very different preferred body shape for boys vs girls (based on sex-specific 8-silhouette body shapes: we grouped 1–4 as thin, 4–5 as normal, 6–8 as overweight). Parents were about 3 times more likely to select ‘overweight’ ones as ideal for boys than for girls (4.3% vs 1.5%). In longitudinal analysis, compared with boys whose parents selected ‘normal weight’ as ideal at baseline, boys whose parents selected ‘overweight’ as ideal were 4 times more likely to develop obesity: OR(95%CI) = 4.06 (2.18,9.03), and they increased their BMI (kg/m2) β (95%CI) = 2.48(1.60–3.36). Girls whose parents selected ‘thin’ as ideal their BMI decreased during the follow-up than girls whose parents selected ‘normal weight’ as ideal: β (95%CI) = −0.46(−0.80, −0.11). Conclusions Chinese parents preferred heavier body shape for boys and thinness for girls. This has contributed to the much higher overweight/obesity rates in boys than girls in China. Parents’ ideal body image regarding their children affects their children's weight change. Funding Sources The US National Institutes of Health (NIH U54HD070725). Supporting Tables, Images and/or Graphs
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Qu, Xing, Shannon H. Houser, Meirong Tian, Qiong Zhang, Jay Pan, and Wei Zhang. "Effects of early preventive dental visits and its associations with dental caries experience: a cross-sectional study." BMC Oral Health 22, no. 1 (April 29, 2022). http://dx.doi.org/10.1186/s12903-022-02190-6.
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Abstract Objectives Limited information is known about preventive dental visits (PDVs) before seven years of age among children in China. This study aimed to examine the early PDV rate, identify the impact of PDV on dental caries and untreated dental caries, and explore the factors related to PDV among Chinese sampled children under seven years old. Methods A cross-sectional survey was conducted in five selected primary health care facilities in Chengdu, China, from May to August 2021. Parent–child dyads during regular systematic medical management were recruited to participate. Children's dental caries were identified through dental examinations and documented as decayed, missing and filled teeth index (dmft) by trained primary care physicians. Dental-related information was collected through a questionnaire. Zero-inflated negative binomial (ZINB) regression was used to test the effect of early PDV on the dmft value, and logistic regression was used to analyse impact factors on the early PDV. Results A total of 2028 out of 2377 parent–child dyads were qualified for analysis. Half of the children (50.4%) were male, with a mean age of 4.8 years. Among all the children, 12.1% had their first dental visit for preventive purposes, 34.4% had their first dental visit for symptomatic purposes, and more than half had never visited a dentist. The results showed that a lower dmft value (adjusted OR: 0.69, 95% CI: 0.48–0.84), a higher rate of caries-free (aOR: 6.5, 95% CI: 3.93–10.58), and a lower rate of untreated dental caries (aOR: 0.40, 95% CI: 0.21–0.76) were associated with early PDV utilization. Children who had a higher rate of PDV were positively associated with living in a family with better parental behaviours (aOR: 2.30, 95% CI: 1.71–3.08), better parental oral health perception (aOR: 1.23, 95% CI: 1.06–1.32), fathers who had no untreated caries (aOR: 0.68, 95% CI: 0.47–0.97), families with higher socioeconomic status (aOR: 1.09, 95% CI: 1.04–1.16), and dental health advice received from well-child care physicians (aOR: 1.47, 95% CI: 1.08–2.00). Conclusions Early PDV was associated with a lower rate of dental caries prevalence and untreated dental caries among sampled children younger than seven in Western China. Underutilization and social inequities existed in PDV utilization. Public health strategies should be developed to increase preventive dental visits and eliminate social disparities that prevent dental care utilization.
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Pan, Wei, Jiang Lin, Li Zheng, Weizhong Lan, Guishuang Ying, Zhikuan Yang, and Xiaoning Li. "Myopia and axial length in school-aged children before, during, and after the COVID-19 lockdown–A population-based study." Frontiers in Public Health 10 (December 15, 2022). http://dx.doi.org/10.3389/fpubh.2022.992784.
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BackgroundMyopic shift had been observed during the COVID-19 lockdown in young school children. It remains unknown whether myopic shift is accompanied with increase in axial length. We aimed to evaluate the impact of the COVID-19 lockdown on myopia and axial length of school children in China by comparing them before, during and after the lockdown.MethodsIn this population-based cross-sectional study, school-based myopia screenings were conducted in the Fall of 2019, 2020, and 2021 (representing before, during and after COVID-19 lockdown respectively) in Chengdu, China. Myopia screenings were performed on 83,132 students aged 6 to 12 years. Non-cycloplegic refractive error was examined using NIDEK auto-refractor (ARK-510A; NIDEK Corp., Tokyo, Japan) and axial length was measured using AL-Scan (NIDEK Corp., Tokyo, Japan). Spherical equivalent (SER, calculated as sphere+ 0.5*cylinder), prevalence of myopia (SER ≤ -0.50 D), and axial length were compared across 3 years stratified by age.ResultsMyopia prevalence rate was 45.0% (95% CI: 44.6–45.5%) in 2019, 48.7% (95% CI: 48.3–49.1%) in 2020, and 47.5% (95% CI: 47.1–47.9%) in 2021 (p < 0.001). The mean non-cycloplegic SER (SD) was −0.70 (1.39) D, −0.78 (1.44) D, and −0.78 (1.47) D respectively (p < 0.001). The mean (SD) axial length was 23.41 (1.01) mm, 23.45 (1.03) mm, and 23.46 (1.03) mm across 3 years respectively (p < 0.001). From the multivariable models, the risk ratio (RR) of myopia was 1.07 (95% CI: 1.06–1.08) times, the SER was 0.05 D (95% CI: 0.04 D to 0.06 D) more myopic and the mean axial length increased by 0.01 mm (95% CI: 0.01 mm to 0.02 mm) in 2020 compared to 2019. In 2021, the risk ratio (RR) of myopia was 1.05 (95% CI: 1.04–1.06), the mean SER was 0.06 D (95% CI: 0.05 D to 0.07 D) more myopic, and the mean axial length increased by 0.03 mm (95% CI: 0.02 mm to 0.04 mm) compared to 2019.ConclusionsThe COVID-19 lockdown had significant impact on myopia development and axial length, and these impacts remained 1 year after the lockdown. Further longitudinal studies following-up with these students are needed to help understand the long-term effects of COVID-19 lockdown on myopia.
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Chen, Xiaoyan, Lisha Hou, Ying Zhang, Shuyue Luo, and Birong Dong. "The accuracy of the Ishii score chart in predicting sarcopenia in the elderly community in Chengdu." BMC Geriatrics 21, no. 1 (May 8, 2021). http://dx.doi.org/10.1186/s12877-021-02244-4.
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Abstract Background Sarcopenia is a disorder associated with age that reduces the mass of skeletal muscles, the strength of muscles, and/or physical activity. It increases the risk of fall incidence which can result in fractures, hospitalizations, limited movement, and considerably decreased quality of life. Hence, it is needed to explore candidate screening tools to evaluate sarcopenia in the initial phases. The reported studies have been revealed that the sensitivity and specificity of the Ishii score chart are higher. However, the Ishii score chart is principally based on the European Working Group on Sarcopenia in Older People (EWGSOP) consensus. Recently, the Asian Working Group for Sarcopenia (AWGS) 2019 consensus has updated its diagnostic criteria for sarcopenia,which was previously similar to the EWGSOP. Hence, it is necessary to determine whether the Ishii score chart is appropriate for use among the elderly population in China. The current study aimed to validate the precision of the Ishii score chart, within the Chinese old aged community to establish an effective model for the evaluation of sarcopenia. Methods The AWGS2019 sarcopenia diagnostic criteria were used as a standard, and among the elderly community, the accuracy of the Ishii score chart was determined by using indicators, including specificity, sensitivity, negative and positive predictive values, negative and positive likelihood ratios, Youden index, and receiver operating characteristic (ROC) curve. Results In the elderly Chengdu community, the prevalence rate of sarcopenia was 18.38 %, 19.91 % for males and 16.91 % for females. The Ishii score chart predicts sarcopenia at an AUC value of 0.84 with 95 % confidence interval (CI), ranging between 0.80 and 0.89 for females, and at an AUC value of 0.81 with 95 % CI, ranging between 0.75 and 0.86 for males.According to the original cut-off, which was set at 120 points for females, the corresponding sensitivity was 46.91 % and the specificity was 93.22 %. The 105 cut-off points (original) set for males revealed a corresponding sensitivity of 64.94 % and the specificity of 85.46 %. However, the original cut-off value exhibited low sensitivity, hence, we selected a new cut-off value. With the new cut-off value, the sensitivity, specificity, positive and negative predictive values for sarcopenia were 75.31 %, 79.9 %, 43 %, and 94 % for females, and 70.65 %, 81.35 %, 49 %, and 92 % for males, respectively. Conclusions The Ishii score chart was used for the prediction of sarcopenia in the old-age people of the Chengdu community and the obtained results showed a high value of predictability. Hence, more than 95 and 102 points were suggested for males and females, accordingly which can set to be the diagnostic cut-off values for the prediction of sarcopenia.
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Diao, Sha, Xueyao Wu, Xiaofan Zhang, Yu Hao, Bin Xu, Xu Li, Lulu Tian, et al. "Obesity-related proteins score as a potential marker of breast cancer risk." Scientific Reports 11, no. 1 (April 15, 2021). http://dx.doi.org/10.1038/s41598-021-87583-3.
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AbstractThere is strong evidence to suggest that obesity-related proteins play a key role in pathways that are related to breast cancer. In this study, we aimed to establish a robust obesity-related protein score (ORPS) that could be used to assess breast cancer risk. Based on evidence from high-quality systematic reviews and population studies, we selected nine such proteins that are stable in vitro, and measured their circulating concentrations by ELISA in a case–control study conducted in Chengdu, Sichuan, China, with 279 breast cancer cases and 260 healthy controls. Two obesity-related protein scores (ORPS) were calculated using a three-step method, with linear-weighted summation, and the one with a larger area under the curve was chosen for further evaluation. As a result, ORPS (PS5pre or PS4post) was positively correlated with breast cancer risk (premenopausal: OR≤63 VS >63 3.696, 95% CI 2.025–6.747; postmenopausal: OR≤38 VS >38 7.100, 95% CI 3.134–16.084), and represented a better risk predictor among obese women compared to non-obese in pre- and postmenopausal women. Among different molecular subtypes, ORPS was positively correlated with Luminal breast cancer, with additionally positive association with triple-negative breast cancer in premenopausal women. The ORPS might be a potential marker of breast cancer risk among Chinese women.
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Zhang, Yiqi, Xi Lan, Congjie Cai, Run Li, Yan Gao, Liuqing Yang, Cheng Wu, et al. "Associations between Maternal Lipid Profiles and Pregnancy Complications: A Prospective Population-Based Study." American Journal of Perinatology, December 31, 2019. http://dx.doi.org/10.1055/s-0039-3402724.
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Abstract Objective To investigate whether plasma lipid profiles are independently associated with pregnancy complications including gestational diabetes mellitus (GDM), hypertensive disorder complicating pregnancy (HDCP), and intrahepatic cholestasis of pregnancy (ICP). Study Design A prospective study was conducted among 1,704 pregnant women at three medical institutions in Chengdu, China. The concentrations of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured at gestational weeks 12 ± 1, 24 ± 1, and 34 ± 1. Logistic regression models were used to estimate the association between lipid profiles and pregnancy complications. Receiver operating characteristic analysis was performed to determine the value of lipid profiles to predict GDM and HDCP. Results After adjusting for potential confounders, TG, TC, and LDL-C in the first trimester were independently associated with GDM (TG: odds ratio [OR] =2.00, 95% confidence interval [CI]: 1.57–2.56; TC: OR = 1.38, 95% CI: 1.16–1.64; LDL-C: OR = 1.43, 95% CI: 1.14–1.79) and HDCP (TG: OR = 2.42, 95% CI: 1.56–3.78, TC: OR = 1.64, 95% CI: 1.04–2.57; LDL-C: OR = 1.87, 95% CI: 1.07–3.25). The TC concentration during the whole pregnancy (first trimester: OR = 1.53, 95% CI: 1.13–2.08; second trimester: OR = 1.31, 95% CI: 1.06–1.61; third trimester: OR = 1.39, 95% CI: 1.17–2.04) and LDL-C in the last two trimesters (second trimester: OR = 1.62, 95% CI: 1.30–2.04; third trimester: OR = 1.56, 95% CI: 1.29–1.88) were positively associated with ICP. HDL-C in the third trimester was negatively associated with the risk of ICP (OR = 0.46, 95% CI: 0.22–0.98). Combining lipid profiles in the first trimester with the other common predictors to predict GDM or HDCP owned stronger predictive power with the largest area under the curve (GDM: 0.643 [95% CI: 0.613–0.673], HDCP: 0.707 [95% CI: 0.610–0.804]) than either indicator alone. Conclusion Maternal lipid profiles during the whole pregnancy are significantly associated with GDM, HDCP, and ICP. Combining lipid profiles in the first trimester with the other common predictors could effectively improve the power of predicting GDM and HDCP.
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Lin, Li, Ciyong Lu, Weiqing Chen, Chunrong Li, and Vivian Yawei Guo. "Parity and the risks of adverse birth outcomes: a retrospective study among Chinese." BMC Pregnancy and Childbirth 21, no. 1 (March 26, 2021). http://dx.doi.org/10.1186/s12884-021-03718-4.
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Abstract Background Nulliparity is considered to be a risk factor of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). With the new two-child policy launched in 2016, more Chinese women have delivered their 2nd baby. Yet few studies have assessed the impact of parity on adverse birth outcomes in China. This study aimed to examine the association between parity and risks of PTB, LBW and SGA in a Chinese population. The combined effects of maternal age and parity on adverse birth outcomes were also assessed. Methods This retrospective study included all non-malformed live births born during January 1, 2014 and December 31, 2018 in Chengdu, China. A total of 746,410 eligible live singletons with complete information were included in the analysis. Parity was classified into nulliparity (i.e. has never delivered a newborn before) and multiparity (i.e. has delivered at least one newborn before). Log-binomial regression analyses were applied to evaluate the association between parity and PTB, LBW and SGA. We further divided maternal age into different groups (< 25 years, 25–29 years, 30–34 years and ≥ 35 years) to assess the combined effects of maternal age and parity on adverse birth outcomes. Results Multiparity was associated with reduced risks of PTB (aRR = 0.91, 95% CI: 0.89–0.93), LBW (aRR = 0.74, 95% CI: 0.72–0.77) and SGA (aRR = 0.67, 95% CI: 0.66–0.69) compared with nulliparity. In each age group, we observed that multiparity was associated with lower risks of adverse birth outcomes. Compared to nulliparous women aged between 25 and 29 years, women aged ≥35 years had greater risks of PTB and LBW, regardless of their parity status. In contrast, multiparous women aged ≥35 years (aRR = 0.73, 95% CI: 0.70–0.77) and those aged < 25 years (aRR = 0.88, 95% CI: 0.84–0.93) were at lower risk of SGA compared with nulliparous women aged between 25 and 29 years. Conclusion Multiparity was associated with lower risks of all adverse birth outcomes. Special attention should be paid to nulliparous mothers and those with advanced age during antenatal care, in order to reduce the risks of adverse birth outcomes.
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Li, J., P. K. H. Mo, C. W. Kahler, and J. T. F. Lau. "A three-arm randomised controlled trial to evaluate the efficacy of a positive psychology and social networking intervention in promoting mental health among HIV-infected men who have sex with men in China." Epidemiology and Psychiatric Sciences 30 (2021). http://dx.doi.org/10.1017/s2045796021000081.
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Abstract Aims There is a lack of mental health promotion and treatment services targeting HIV-positive men who have sex with men (HIVMSM) in China. The aim of this study was to evaluate the mental health promotion efficacy of an online intervention that combined Three Good Things (TGT) with electronic social networking (TGT-SN) and an intervention that used TGT only (TGT-only), compared with a control group. Methods We conducted a randomised controlled trial among HIVMSM in Chengdu, China. The participants were randomly assigned to the TGT-SN, TGT-only, and control groups. The participants in the TGT-SN group were divided into five social network groups and asked to post brief messages to the group about three good things that they had experienced and for which they felt grateful. The participants in the TGT-only group were only required to write down their three good things daily without sharing them with others. The control group received information about mental health promotion once a week for a month. The primary outcome was probable depression. Secondary outcomes were anxiety, positive and negative affect, gratitude, happiness and social support. These outcomes were assessed at baseline, 1, 3, 6 and 12 months after the intervention. Repeated-measures analyses were conducted using generalised estimation equations. The study was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-13003252). Results Between June 2013 and May 2015, 404 participants were enrolled and randomly assigned to either the TGT-SN (n = 129), TGT-only (n = 139) or control group (n = 136). The main effects of TGT-SN (adjusted odds ratio (aOR) = 0.75, 95% CI 0.52–1.09; p = 0.131) and TGT-only (aOR = 0.83, 95% CI 0.57–1.21; p = 0.332) in reducing depression were statistically non-significant. The participants of the TGT-SN group showed significantly lower anxiety symptoms (aOR = 0.62, 95% CI 0.43–0.89; p = 0.009) and negative affect (β = −1.62, 95% CI 2.98 to −0.26; p = 0.019) over time compared with those of the control group. No significant main effect was found for any secondary outcomes for the TGT-only group. Conclusions The novel intervention combining the TGT exercise with electronic social networking was found effective in reducing anxiety and negative affect among HIVMSM.
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Li, Ping, You Lu, Di Qie, Ling Feng, Guoqian He, Sufei Yang, and Fan Yang. "Early-life weight gain patterns of term small-for-gestational-age infants and the predictive ability for later childhood overweight/obesity: A prospective cohort study." Frontiers in Endocrinology 13 (November 22, 2022). http://dx.doi.org/10.3389/fendo.2022.1030216.
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ObjectivesWe aimed to identify the weight gain patterns of small-for-gestational age (SGA) infants in early life and to explore the predictive value for later overweight/obesity in childhood.MethodsWe obtained data from a prospective cohort including term SGA infants born between January 2006 and November 2015 who received regular health care from birth to 5 years in West China Second University Hospital, Chengdu, China. A latent class growth analysis (LCGA) was applied to group children with similar growth trajectory patterns. Multiple logistic regression was performed to examine the association between weight gain patterns and later overweight/obesity.ResultsA total of 296 term SGA infants were finally included. Five weight gain trajectories were identified, including excessive rapid catch-up growth (ERCG) (class 1, 10.9%), rapid catch-up growth (RCG) (class 2, 17.9%), appropriate catch-up growth (ACG) (class 3, 53.0%), slow catch-up growth (SCG) (class 4, 13.4%) and almost no catch growth (NCG) (class 5, 4.8%). SGA infants in class 1 and class 2 had a higher BMI according to age- and sex-specific Z scores from 2–5 years of age. In addition, 25% of SGA infants in class 1 and 13.2% of SGA infants in class 2 were found to be overweight/obese at 2-5 years of age. After adjusting for confounders, we found that extremely rapid weight gain (class 1) in the first 2 years of life increased the risk of overweight/obesity by 2.1 times at 2 to 5 years of age (aOR=2.1, 95% CI: 1.3~4.8; P<0.05). Furthermore, the increment of ΔWAZ between 0 and 4 mo was prominently related to the risk of overweight/obesity at 2 to 5 years for term SGA infants (aOR=3.2, 95% CI: 1.7~8.1; P<0.001). A receiver operating characteristic (ROC) curve showed the area under curve (AUC) was 0.7, with a 95% confidence interval (CI) from 0.6 to 0.8 (P<0.001).ConclusionsThe extremely rapid weight gain pattern of term SGA infants in the first 2 years of life increased the risk of overweight/obesity at 2 to 5 years of age. It suggests monitoring weight gain across the infant period represents a first step towards primary prevention of childhood obesity.
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Ma, Lu, Liwang Gao, Hong Xue, Jungwon Min, Huijun Wang, and Youfa Wang. "A 3-year Longitudinal Study on Interaction Effects Between Self-perceived Weight Status and Lifestyle Behaviors on Obesity: The Children Obesity Study in China Mega-cities (P21-044-19)." Current Developments in Nutrition 3, Supplement_1 (June 1, 2019). http://dx.doi.org/10.1093/cdn/nzz041.p21-044-19.
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Abstract Objectives This study examined Chinese children's self-perceived and measured weight status, the main and interaction effects of children's self-perceived weight status and lifestyle behaviors on changes in their body mass index (BMI) over 3 years. Methods Children's weight, height, self-perceived weight status, and lifestyle behaviors (food intake, sedentary behavior, off-campus physical activity) were measured for 3298 children aged 6–18 years in Beijing, Shanghai, Xian, Nanjing, and Chengdu across China in 2015, 2016 and 2017. This analysis included the 1691 children who had >= two repeated BMI measurements during 2015–2017. Results The self-perceived weight status of half (49.9% of boys’ and 51.3% of girls’) was consistent with that based on measured weight and height; 45.2% of boys and 29.8% of girls underestimated their weight status. Boys were more likely to self-perceive as having a normal weight even when being obese. In longitudinal analysis, self-perceived weight status was positively associated with BMI among children (β = 4.99, P < 0.01), however, neither the lifestyle behaviors were significantly associated with BMI. Significant interactions between self-perceived weight status and lifestyle behaviors were only found among girls, not in boys. Additive interaction between self-perceived weight status and off-campus physical activity was statistically significant in girls (attributable proportion (95%CI) = 0.404 (0.143,0.666)). Conclusions In China, it is common children underestimated their own weight status. This leads to subsequent increased BMI. Off-campus physical activity could moderate the association. Future interventions are needed to empower children to have accurate assessment of their weight status and to promote physical activity. Funding Sources The US National Institutes of Health (NIH U54HD070725).
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Zhang, Xuhui, Qiannan Chen, Xiaohui Sun, Qiong Wu, Zongxue Cheng, Qingguo Lv, Jiaqiang Zhou, and Yimin Zhu. "Association between MRI-based visceral adipose tissues and metabolic abnormality in a Chinese population: a cross-sectional study." Nutrition & Metabolism 19, no. 1 (March 5, 2022). http://dx.doi.org/10.1186/s12986-022-00651-x.
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Abstract Background Previous studies have indicated that the deposition of abdominal adipose tissue was associated with the abnormalities of cardiometabolic components. The aim of this study was to examine the relationship of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and metabolic status and the different effects between males and females. Methods The 1388 eligible subjects were recruited in a baseline survey of metabolic syndrome in China, from two communities in Hangzhou and Chengdu. Areas of abdominal VAT and SAT were measured by magnetic resonance imaging (MRI). Serum total triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) were measured by an automated biochemical analyzer. Metabolic abnormality (MA) was defined more than one abnormal metabolic components, which was based on the definition of metabolic syndrome (IDF 2005). Multiple logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (95%CI). Predictive value was assessed by area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI), respectively. Results Their mean age was 53.8 years (SD: 7.1 years), the mean body mass index (BMI) was 23.7 kg/m2, and 44.8% of the subjects were male. Both male and female with MA had higher VAT levels compared to subjects with normal metabolism (MN), and male had higher SAT levels than female (P < 0.05). Higher VAT was significantly associated with MA with ORs in the fourth quartile (Q4) of 6.537 (95% CI = 3.394–12.591) for male and 3.364 (95% CI = 1.898–5.962) for female (P for trend < 0.05). In female, VAT could increase the risk of metabolic abnormalities, but SAT could increase the risk of MA in the second and fourth quartiles (Q2 and Q4) only at BMI > 24 kg/m2. In male, VAT improved the predictive value of MA compared to BMI and waist circumference (WC), the AUC was 0.727 (95% CI = 0.687–0.767), the NRI was 0.139 (95% CI = 0.070–0.208) and 0.106 (95% CI = 0.038–0.173), and the IDI was 0.074 (95% CI = 0.053–0.095) and 0.046 (95% CI = 0.026–0.066). Similar results were found in female. Conclusions In male, VAT and SAT could increase the risk of metabolic abnormalities both at BMI < 24 kg/m2 and at BMI ≥ 24 kg/m2. In female, VAT could increase the risk of metabolic abnormalities but SAT could increase the risk of MA in the second and fourth quartiles (Q2 and Q4) only at BMI > 24 kg/m2. Deposition of abdominal adipose tissue was associated with metabolic abnormalities. VAT improved the predictive power of MA.
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Jia, Sheng, Xinyue Wang, Qing Yao, and Jian Gao. "High pulse pressure is associated with an increased risk of diabetes in females but not in males: a retrospective cohort study." Biology of Sex Differences 13, no. 1 (December 19, 2022). http://dx.doi.org/10.1186/s13293-022-00482-8.
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Abstract Objective Accumulating evidence suggests a close relationship between metabolic disturbance and increased arterial stiffness. However, whether there is an association between pulse pressure (PP) and diabetes and how this association might be impacted by sex is not clear. Methods A total of 209,635 adult Chinese individuals > 20 years old across 32 sites and 11 cities in China (Shanghai, Beijing, Nanjing, Suzhou, Shenzhen, Changzhou, Chengdu, Guangzhou, Hefei, Wuhan, Nantong) were included in the study; participants were free of diabetes at baseline. In the present study, we analyzed the relationship between PP at baseline and incident diabetes using the Cox proportional hazard model. Results During a median follow-up of 2.99 years, a total of 3971 participants (2885 men and 1086 women) developed diabetes, and the incidence was 6.3 per 1000 person-years. With each 10 mmHg increase in PP, the multivariable adjusted hazard ratio (HR) (95% confidence interval) for incident diabetes was 1.117 (1.061, 1.176) in females and 0.981 (0.951, 1.012) in males. Using the lowest quartile of PP as the reference category, the hazard ratio (HR) (95% CI) of the highest quartile of PP for incident diabetes was 1.494 (1.225, 1.822) in females and 0.939 (0.843, 1.045) in males. Smooth plots revealed a significant difference between males and females in the HRs for new-onset diabetes according to PP. Conclusion Higher PP was related to future diabetes development in females but not in males and further research is needed to explore the mechanism.