Objective:To conduct a scoping review of longitudinal studies related to disease perception in cancer patients and to provide a reference for the improvement of disease perception in cancer patients.Methods:Using the ...Objective:To conduct a scoping review of longitudinal studies related to disease perception in cancer patients and to provide a reference for the improvement of disease perception in cancer patients.Methods:Using the scoping method,PubMed,Web of Science,The Cochrane Library,Medline,CNKI,Wanfang Database,VIP Chinese Scientific and Technical Journals Database,and China Biomedical Literature Database were searched up to July 2023 for analysis and discussion of the included literature.Results:A total of 19 articles were included,distributed across 9 countries including China,the Netherlands,and the United Kingdom,with 8 articles published in China.The study subjects included patients with breast cancer,colorectal cancer,laryngeal cancer,lung cancer,esophageal cancer,and bladder cancer.The content covered dynamic changes in disease perception,the impact of disease perception,and the influencing factors of disease perception.Conclusion:The number of longitudinal studies on disease perception in cancer patients is gradually increasing and becoming more diverse.However,issues such as a small total number of studies,single research methods,and short observation periods persist.In the future,it is necessary to conduct in-depth longitudinal research on disease perception in cancer patients,expand the scope of research fields,and provide more comprehensive theories to guide clinical treatment and nursing practices,ultimately improving the treatment outcomes and quality of life for cancer patients.展开更多
Amnestic mild cognitive impairment （aMCI） is a prodromal stage of Alzheimer＇s disease （AD）, and 75%-80% of aMCI patients finally develop AD. So, early identification of patients with aMCI or AD is of great signif...Amnestic mild cognitive impairment （aMCI） is a prodromal stage of Alzheimer＇s disease （AD）, and 75%-80% of aMCI patients finally develop AD. So, early identification of patients with aMCI or AD is of great significance for prevention and intervention. According to cross-sectional studies, it is known that the hippocampus, posterior cingulate cortex, and corpus callosum are key areas in studies based on structural MRI （sMRI）, functional MRI （fMRI）, and diffusion tensor imaging （DTI） respectively. Recently, longitudinal studies using each MRI modality have demonstrated that the neuroimaging abnormalities generally involve the posterior brain regions at the very beginning and then gradually affect the anterior areas during the progression of aMCI to AD. However, it is not known whether follow-up studies based on multi-modal neuroimaging techniques （e.g., sMRI, fMRI, and DTI） can help build effective MRI models that can be directly applied to the screening and diagnosis of aMCI and AD. Thus, in the future, large-scale multi-center follow-up studies are urgently needed, not only to build an MRI diagnostic model that can be used on a single person, but also to evaluate the variability and stability of the model in the general population. In this review, we present longitudinal studies using each MRI modality separately, and then discuss the future directions in this field.展开更多
BACKGROUND Peer bullying victimization(PBV)is a significant public health issue that adolescents often face,with approximately one-third having experienced PBV.Understanding its interrelationships with mental health p...BACKGROUND Peer bullying victimization(PBV)is a significant public health issue that adolescents often face,with approximately one-third having experienced PBV.Understanding its interrelationships with mental health problems is crucial for effective intervention.This study aims to examine the longitudinal relationships between internalizing problems(depression and anxiety),externalizing problems(aggression),and PBV among middle school students using cross-lagged panel network analysis.AIM To examine the longitudinal relationships between internalizing problems(depression and anxiety),externalizing problems(aggression),and PBV among middle school students using cross-lagged panel network analysis.METHODS A total of 1260 middle school students(54.6%male)participated in this study.Data were collected at two time points(time 1 and time 2)using self-report questionnaires to assess PBV,depression,anxiety,and aggression.Cross-lagged panel network analysis was applied to examine the bi-directional relationships between these variables over time.RESULTS Depression,particularly a“sad mood,”was the most significant predictor of both PBV and aggression.Cyberbullying victimization also emerged as a key factor influencing depression and anxiety.While anxiety had weaker and less consistent effects on PBV,aggression was predominantly influenced by depressive symptoms and sleep disturbances.The analysis also identified key symptoms,such as a“sad mood”and sleep disturbances,as crucial targets for intervention to mitigate the cycle of PBV,depression,anxiety,and aggression.CONCLUSION This study provides important insights for bullying victimization prevention and intervention strategies:(1)Early identification and intervention targeting depression,particularly a“sad mood,”and sleep disturbances;(2)The importance of addressing cyberbullying as a distinct factor influencing mental health;and(3)The need for comprehensive,longitudinal approaches to understanding and intervening in the interconnected mental health issues among adolescents.展开更多
There is no way around it.Regular physical activity(PA)and a high-quality diet are essential to promoting good health and prolonging life in middle-aged and older adults.In the November 2024 Issue of the Journal of Sp...There is no way around it.Regular physical activity(PA)and a high-quality diet are essential to promoting good health and prolonging life in middle-aged and older adults.In the November 2024 Issue of the Journal of Sport and Health Science,Ding et al.展开更多
Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explo...Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk.Methods This study was based on the China Health and Retirement Longitudinal Study.12009 adults aged 45 years and older from five waves were included.CVD events were measured by self-reports of heart disease and stroke.We first used groupbased trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020,and then employed logistic regression models to analyze their risk for CVD.Results We identified three sleep duration and PA trajectories.The risk of heart disease increased by 33%(OR=1.31,95%CI:1.12-1.53)for the short sleep duration trajectory(vs.moderate sleep duration trajectory),by 40%(OR=1.40,95%CI:1.06-1.84)for the high decreasing PA trajectory,and by 20%(OR=1.20,95%CI:1.01-1.42)for the low stable PA trajectory(vs.high stable PA trajectory),respectively.Similar results for stroke and CVD as the outcomes were also observed,but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant.The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory.Conclusions Short total sleep duration,high decreasing PA,and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults.Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has disproportionately impacted individuals with type 2 diabetes mellitus(T2DM),increasing their risk of severe illness and mortality.Vaccination has been a cr...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has disproportionately impacted individuals with type 2 diabetes mellitus(T2DM),increasing their risk of severe illness and mortality.Vaccination has been a crucial intervention in mitigating these risks.However,the metabolic effects of COVID-19 vaccination,particularly the Johnson&Johnson(J&J)vaccine,in diabetic populations remain inadequately explored.This study investigated the longitudinal effects of the J&J vaccine on lipid and eicosanoid biomarkers to assess its metabolic safety and potential cardiovascular benefits.AIM To evaluate the long-term impact of the J&J COVID-19 vaccine on lipid and eicosanoid biomarkers in Ethiopian patients with T2DM.METHODS This prospective cohort study was conducted at Adama Hospital Medical College(Oromia,Ethiopia)from May 2023 to June 2024.A total of 224 T2DM patients(57 vaccinated,167 unvaccinated)were monitored for 1 year.Biomarkers including triglycerides(TGs),high-density lipoprotein(HDL),total cholesterol(TC),pro-staglandins(PGs),and thromboxanes(TXs)were measured at baseline and at 3 months,6 months,9 months,and 1 year post-vaccination.Statistical analyses included Generalized Estimating Equations to assess longitudinal biomarker changes.RESULTS TG and PG levels remained stable across all time points.HDL levels showed a temporary decline at 3 months(mean difference[MD]=-4.33;P<0.001)and 6 months(MD=-2.62;P<0.001)but recovered by 9 months(MD=2.09;P=0.001)and 1 year(MD=2.38;P<0.001).TC exhibited a significant decrease at 3 months(MD=-16.44,P=0.001)before stabilizing.TX levels showed a consistent decline across all follow-ups(e.g.,1 year:MD=-0.08;P=0.036),suggesting a reduced thrombotic risk.Correlation analysis indicated significant interrelations among biomarkers,emphasizing their roles in metabolic and inflammatory pathways.CONCLUSION The J&J COVID-19 vaccine exhibited metabolic safety in patients with T2DM,with transient HDL and TC reductions that later stabilized and a sustained TX decline,suggesting potential cardiovascular benefits.Further studies are needed to explore long-term immunometabolic effects on high-risk populations.展开更多
Objectives Few studies have investigated longitudinal associations of loneliness with health outcomes in Africa.This study aimed to assess the longitudinal associations between loneliness and mental and physical healt...Objectives Few studies have investigated longitudinal associations of loneliness with health outcomes in Africa.This study aimed to assess the longitudinal associations between loneliness and mental and physical health among aging adults in South Africa.Methods Data from the 7-year longitudinal Health and Ageing in Africa(HAALSI)study conducted in South Africa were used in the analysis(analytic sample:n=3707,aged 40 years and older).Loneliness was measured with one question.Longitudinal relationships between loneliness and each health outcome were estimated using Generalized Estimating Equations analysis(GEE),hazard ratios(HRs)(95%CI)were used to determine the relationship between loneliness and 7-year mortality in the entire sample,and correlations between incident health outcomes and loneliness were evaluated using logistic regressions.Results The prevalence of loneliness was 12.1%in 2015,16.9%in 2019,and 16.3%in 2022.Multivariable analysis showed that loneliness was positively associated with the prevalence and/or incidence of four poor mental health indicators(e.g.,poor sleep quality,AOR=1.53,95%CI:1.30–1.80),four physical ill-health indicators(e.g.,incident kidney disease,AOR=2.50,95%CI:1.41–4.42),mortality(Hazard Ratio=1.20,95%CI=1.04–1.39),and three poor behavioral health indicators(e.g.,current tobacco use,AOR=1.21,95%CI=1.04–1.42).Conclusion The study discovered that several outcomes related to mental,physical,and behavioral health were associated with loneliness.Enhancing the detection and management of loneliness could lower mental and physical illness in aging adults in South Africa.展开更多
This paper investigates the problem of collecting multidimensional data throughout time(i.e.,longitudinal studies)for the fundamental task of frequency estimation under Local Differential Privacy(LDP)guarantees.Contra...This paper investigates the problem of collecting multidimensional data throughout time(i.e.,longitudinal studies)for the fundamental task of frequency estimation under Local Differential Privacy(LDP)guarantees.Contrary to frequency estimation of a single attribute,the multidimensional aspect demands particular attention to the privacy budget.Besides,when collecting user statistics longitudinally,privacy progressively degrades.Indeed,the“multiple”settings in combination(i.e.,many attributes and several collections throughout time)impose several challenges,for which this paper proposes the first solution for frequency estimates under LDP.To tackle these issues,we extend the analysis of three state-of-the-art LDP protocols(Generalized Randomized Response–GRR,Optimized Unary Encoding–OUE,and Symmetric Unary Encoding–SUE)for both longitudinal and multidimensional data collections.While the known literature uses OUE and SUE for two rounds of sanitization(a.k.a.memoization),i.e.,L-OUE and L-SUE,respectively,we analytically and experimentally show that starting with OUE and then with SUE provides higher data utility(i.e.,L-OSUE).Also,for attributes with small domain sizes,we propose Longitudinal GRR(L-GRR),which provides higher utility than the other protocols based on unary encoding.Last,we also propose a new solution named Adaptive LDP for LOngitudinal and Multidimensional FREquency Estimates(ALLOMFREE),which randomly samples a single attribute to be sent with the whole privacy budget and adaptively selects the optimal protocol,i.e.,either L-GRR or L-OSUE.As shown in the results,ALLOMFREE consistently and considerably outperforms the state-of-the-art L-SUE and L-OUE protocols in the quality of the frequency estimates.展开更多
BACKGROUND Femoral head necrosis(FHN)can significantly affect patients'psychological well-being and functional outcomes.However,the long-term relationship between postoperative depression,anxiety,and functional re...BACKGROUND Femoral head necrosis(FHN)can significantly affect patients'psychological well-being and functional outcomes.However,the long-term relationship between postoperative depression,anxiety,and functional recovery in patients with FHN remains unclear.AIM To investigate the dynamic changes in postoperative depression and anxiety and their relationship with functional recovery in patients with FHN for 3 years.METHODS Ninety-three patients with FHN who underwent surgical treatment in March 2020 to 2023 were enrolled in this longitudinal study.Depression and anxiety status were assessed using the hospital anxiety and depression scale(HADS)at baseline,6 months,1,2,and 3 years postoperatively.Functional recovery was evaluated using the Harris hip score(HHS).The dynamic changes in HADS and HHS were analyzed using repeated measures ANOVA;the relationship between depre-ssion/anxiety status and functional recovery was examined using Pearson’s correlation analysis.RESULTS The mean HADS-depression(HADS-D)and HADS-anxiety(HADS-A)scores significantly improved over time(P<0.001).The prevalence of depression and anxiety decreased from 36.6%and 41.9%at baseline to 10.8%and 12.9%,respectively,at 3 years postoperatively.The mean HHS increased sig-nificantly from 52.3±10.5 at baseline to 88.1±7.2 at 3 years postoperatively(P<0.001).Significant negative correl-ations were found between HADS-D/HADS-A scores and HHS at all time points(P<0.05).CONCLUSION The severity of depression and anxiety negatively correlated with functional recovery,highlighting the importance of psychological interventions in the management of patients with FHN.展开更多
Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it r...Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it remains unclear whether these indices have a longitudinal relationship with the prevalence of cardiometabolic multimorbidity(CM),a pressing global health issue.This research investigated the association between CVAI and CM compared to other indicators of visceral obesity.Methods 6638 participants(aged>45)from the China Health and Retirement Longitudinal Study(CHARLS)were analyzed for incident CM.Cox proportional models were adopted to explore whether the level of CVAI was correlated with the risk of CM.Harrell's concordance statistic(C-statistic)was applied to compare predictive values.Sensitivity and subgroup analyses were implemented for the steadiness of the results.Results Over 4 years,266(4.01%)participants developed CM.A 1-standard deviation(SD)increase in the levels of CVAI,body mass index(BMI),LAP,and TMI was associated with greater CM risk after adjusting for confounders[hazard ratios(HRs):2.20,95%confidence interval(CI):1.88-2.57,1.92(95%CI:1.55-2.38),1.20(95%CI:1.12-1.27),and 1.50(95%CI:1.35-1.66),respectively].CVAI outperformed other indices in predictive performance.Subgroup analysis revealed younger participants or those living alone were more prone to developing CM.Results were potent after finishing all sensitivity analyses.Conclusions The study highlighted a positive correlation between the level of CVAI and CM risk.CVAI's superior predictive performance positions it as a reliable indicator for identifying individuals at heightened CM risk.展开更多
Objective Burning solid cooking fuel contributes to household air pollution and is associated with frailty.However,how solid cooking fuel use contributes to the development of frailty has not been well illustrated.Met...Objective Burning solid cooking fuel contributes to household air pollution and is associated with frailty.However,how solid cooking fuel use contributes to the development of frailty has not been well illustrated.Methods This study recruited 8,947 participants aged≥45 years from the China Health and Retirement Longitudinal Study,2011–2018.Group-based trajectory modeling was employed to identify frailty trajectories.Multinomial logistic regression was used to assess the association between solid cooking fuel use and frailty trajectories.Population-attributable fractions were used to estimate the frailty burden from solid fuel use.Results We identified three frailty trajectories:low-stable(n=5,789),moderate-increasing(n=2,603),and fast-increasing(n=555).Solid fuel use was associated with higher odds of being in the moderate-increasing(OR:1.24,95%CI:1.08–1.42)and fast-increasing(OR:1.48,95%CI:1.14–1.92)trajectories.These associations were strengthened by longer solid fuel use(P for trend<0.001).Switching to clean fuel significantly reduced the risk of being in these trajectories compared with persistent solid fuel users.Without solid fuel,8%of moderate-and 19%of fast-increasing trajectories demonstrated frailty development like the low-stable group.Conclusion Solid cooking fuel use is associated with frailty trajectories in middle-aged and older Chinese populations.展开更多
Attention-deficit/hyperactivity disorder(ADHD)is increasingly conceptualized as a dynamic neurodevelopmental condition,marked by fluctuating symptom trajectories across development rather than the traditional static p...Attention-deficit/hyperactivity disorder(ADHD)is increasingly conceptualized as a dynamic neurodevelopmental condition,marked by fluctuating symptom trajectories across development rather than the traditional static patterns of persistence or remission.This review synthesizes empirical evidence on the varied trajectories of ADHD symptoms-including late-onset,partial remission,and recurrent fluctuation patterns-and underscores their clinical significance in longterm functioning.We adopt a multifactorial framework to explore how genetic,environmental,and gene–environment interactions contribute to the emergence and evolution of ADHD symptoms over time.In addition,we consider how medication-related variables-particularly tolerance and adherence-may influence symptom fluctuation.Characterizing these developmental dynamics offers critical guidance for designing flexible,personalized interventions that align with individual trajectories and transitional vulnerabilities.展开更多
Objective This study aimed to explore the interplay between the life-course body mass index(BMI)trajectories and insulin resistance(IR)on incident diabetes.Methods This longitudinal cohort included 2,336 participants ...Objective This study aimed to explore the interplay between the life-course body mass index(BMI)trajectories and insulin resistance(IR)on incident diabetes.Methods This longitudinal cohort included 2,336 participants who had BMI repeatedly measured 3–8times between 1989 and 2009,as well as glucose and insulin measured in 2009.BMI trajectories were identified using a latent class growth mixed model.The interplay between BMI trajectories and IR on diabetes was explored using the four-way effect decomposition method.Logistic regression and mediation models were used to estimate the interaction and mediation effects,respectively.Results Three distinct BMI trajectory groups were identified:low-stable(n=1,625),mediumincreasing(n=613),and high-increasing(n=98).Both interaction and mediation effects of BMI trajectories and IR on incident diabetes were significant(P<0.05).The proportion of incident diabetes was higher in the IR-obesity than in the insulin-sensitivity(IS)obesity group(18.9%vs.5.8%,P<0.001).After adjusting for covariates,the odds ratios(95%confidence intervals)of the IR,IS-obesity,and IRobesity groups vs.the normal group were 3.22(2.05,5.16),2.05(1.00,3.97),and 7.98(5.19,12.62),respectively.IR mediated 10.7%of the total effect of BMI trajectories on incident diabetes(P<0.001).Conclusion We found strong interactions and weak mediation effects of IR on the relationship between life-course BMI trajectories and incident diabetes.IS-obesity is associated with a lower risk of incident diabetes than IR-obesity.展开更多
Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified...Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified the factors influencing adherence.Methods: This retrospective cohort study was conducted using data from the Korean National Cancer Screening Program(KNCSP) between 2011 and 2020. The total cohort comprised 400,113 adults aged 40 years who were newly eligible for and participated in GC screening in 2011. The participants were followed up for 10 years to assess their adherence to biennial screening recommendations. They were categorized into two groups: the nonregular screening(non-RS) group, which included individuals who did not participate in subsequent screenings, and the regular screening(RS) group, which included those who participated in at least one follow-up screening.Multiple logistic regression analyses were performed to identify the factors associated with adherence to regular GC screening.Results: Over 10 years, 59% of the participants completed at least four of the five recommended screenings,while 10% did not participate after their initial screening. Male participants had higher odds of non-adherence than females [adjusted odds ratio(aOR)=1.429, 95% confidence interval(95% CI): 1.394-1.464;P<0.001]. Nonadherence was more prevalent among self-employed individuals(aOR=1.208, P<0.001). Among males, those in the lowest income group were 1.267 times more likely to not undergo regular screening than those in the highest income group.Conclusions: Long-term adherence to regular GC screening in South Korea remains suboptimal.Socioeconomic disparities persist, highlighting the need for tailored interventions to improve adherence and enhance public health.展开更多
AIM:To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy(PPV)in patients with primary rhegmatogenous retinal detachment(RRD).METHODS:Clinical data of patients with primary ...AIM:To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy(PPV)in patients with primary rhegmatogenous retinal detachment(RRD).METHODS:Clinical data of patients with primary RRD treated at the Shenzhen Eye Hospital were retrospectively collected.Twenty-four potential influencing factors,including patient characteristics and surgical factors,were selected for analysis.Independent risk factors for secondary cataract were identified through univariate comparisons and multivariate logistic regression analysis.A risk prediction model was constructed and evaluated using receiver operating characteristic(ROC)curves,area under the ROC curve(AUC),calibration plots,and decision curve analysis(DCA)curves.RESULTS:The 386 cases(389 eyes)of patients who underwent PPV and had complete surgical records were ultimately included.Within a 2-year longitudinal observation,41.39%of patients developed cataract secondary to PPV.Logistic regression results identified a history of hypertension[odds ratio(OR)=1.78,95%CI:1.002–3.163,P=0.049],silicone oil tamponade(OR=3.667,95%CI:2.373–5.667,P=0.000),and lens thickness(OR=1.978,95%CI:1.129–3.464,P=0.017)as independent risk factors for cataract secondary to PPV.The constructed nomogram achieved AUC=0.6974.Calibration plots indicated good agreement between predicted and observed outcomes,while DCA curves demonstrated the model’s clinical utility.CONCLUSION:By incorporating a history of hypertension,vitreous substitute type,and lens thickness,this study constructs a prediction model with moderate discriminative ability.This model offers a valuable tool for clinicians to identify high-risk patients early,potentially allowing for more timely interventions and improved patient outcomes.展开更多
Objectives:Positive family functioning(FF)is critical for adolescent development,yet only a few studies have examined this developmental trajectory pathway.This study aimed to identify different types of FF developmen...Objectives:Positive family functioning(FF)is critical for adolescent development,yet only a few studies have examined this developmental trajectory pathway.This study aimed to identify different types of FF development trajectories during junior high school students,investigate their influence on social avoidance(SA),and further examine the mediating role of preference for solitude(PS)between them.Methods:A three-wave longitudinal study was used with six-month intervals.Questionnaire data were collected from 436 junior high school students in Jiangxi Province,China.Participants ranged in age from 11 to 14 years old(Mean=12.89 years,SD=1.08;50.2%male).Results:Four heterogeneous types of FF trajectories were identified:(1)a high and increasing group(14.7%);(2)a consistently high group(36.24%);(3)a consistently moderate group(45.86%);and(4)a rapid growth group(3.2%).The developmental trajectories of FF among junior high students significantly varied in their levels of SA(F(3,432)=32.03,p<0.001).Compared to the high and increasing groups,the consistently high,consistently medium,and rapid growth groups exhibited higher levels of SA.PS mediated the association between the developmental trajectory of FF and SA.Conclusion:There was a close relationship between the developmental trajectory of FF and SA.Interventions focusing on family system optimization and solitary preference management could effectively mitigate SA behaviors.These findings are important for promoting healthy socialization in adolescents.展开更多
Background:Depression represents a significant global mental health burden,particularly among middle-aged and older Chinese with chronic diseases in high-altitude regions,where harsh environmental conditions and limit...Background:Depression represents a significant global mental health burden,particularly among middle-aged and older Chinese with chronic diseases in high-altitude regions,where harsh environmental conditions and limited social support exacerbate mental health disparities.This paper aims to develop an interpretable machine learning prediction framework to identify the key factors of depression in this vulnerable population,thereby proposing targeted intervention measures.Methods:Utilizing data from the China Health and Retirement Longitudinal Study in 2020,this paper screened out and analyzed 2431 samples.Subsequently,Recursive Feature Elimination and Least Absolute Shrinkage and Selection Operator were applied to screen predictors from 32 alternative variables.Furthermore,through hyperparameter tuning and 5-fold cross-validation,8 machine learning modelswere constructed,namely,Random Forest,Extreme Gradient Boosting,Light Gradient Boosting Machine,Gradient Boosting Machine,K-Nearest Neighbor,Naive Bayes Classifier,Support Vector Machine,and Logistic Regression.Finally,the SHAP algorithm was applied to analyze the interpretability of the best-performing model,quantifying nonlinear relationships and threshold effects.Results:Among the respondents,the prevalence of depression was approximately 46.89%.After feature engineering screening,8 variables were retained for inclusion in the prediction model.Furthermore,the Gradient Boosting Machine performed optimally in terms of comprehensive performance,with an Area Under Receiver Operating Characteristic Curve(AUC)of 0.845,an Accuracy of 0.714,a Sensitivity of 0.655,a Precision of 0.711,a Specificity of 0.766,and an F1 of 0.682.In addition,Life satisfaction,PM2.5,Self-rated health,and Education were identified as the top 4 key factors.Meanwhile,the influence of these variables on depression showed nonlinear and threshold effects.Conclusion:This research highlights the value of machine learning in mental health.Based on the identified key factors,this paper proposed a series of policy measures to improve the health pattern of the middle-aged and elderly populations facing the dual challenges of chronic disease and environmental adversity.展开更多
Objective Sleep is fundamental to the physical and mental health of both the general population and pregnant women.Most studies have focused on the impact of certain trimester sleep behaviors on gestational complicati...Objective Sleep is fundamental to the physical and mental health of both the general population and pregnant women.Most studies have focused on the impact of certain trimester sleep behaviors on gestational complications and birth outcomes.This study aimed to explore the association between maternal sleep duration and fetal growth development from as early as 23 gestational weeks to birth.Methods A total of 803 pregnant women were prospectively enrolled.The self-reported maternal nocturnal sleep duration during all 3 trimesters was recorded.The outcome measures were reference-population-based Z-scores of fetal biometric measurements obtained through routine ultrasonographic examination.Results Using multiple linear regression,a marginally significant negative association was observed between second-trimester sleep duration and second-trimester fetal head circumference(HC)and third-trimester fetal biparietal diameter(BPD).Then the associations of long sleep duration in each trimester with fetal biometry extreme values were evaluated.A significant impact of second-trimester long sleep duration on the second-trimester BPD below the 10th percentile of the reference population was observed.Longitudinal analysis reported similar results for BPD and HC.Conclusions Overall,a negative association between sleep duration and fetal biometric measurements was observed.Long sleep durations in the second trimester might negatively impact fetal growth,particularly brain parameters,including BPD and HC.展开更多
AIM： To investigate the changes in the choroidal thickness in healthy pediatric children in a longitudinal study, and to determine the ocular and systemic parameters that were significantly correlated with the change...AIM： To investigate the changes in the choroidal thickness in healthy pediatric children in a longitudinal study, and to determine the ocular and systemic parameters that were significantly correlated with the changes in the choroidal thickness. METHODS： This study included 64 eyes of 34 healthy Japanese children with a mean age（±SD） of 4.4（±0.4）y（range, 3.6-5.8 y） at baseline. Swept-source optical coherence tomography（SS-OCT） was used to record images of the retina and choroid at the baseline and after a mean followup period of about 1.5 y. The 3 D raster scan protocol was used to construct the choroidal thickness map. Mean choroidal thickness was calculated for each of the nine sectors of the Early Treatment Diabetic Retinopathy Study grid. Best-corrected visual acuity, axial length, body height, and weight were also measured. Changes in measurements were defined as the baseline values subtracted from the values at the final visit. A generalized estimating equation was used to eliminate the effect of within-subject intereye correlations. RESULTS： The mean central choroidal thickness was significantly reduced during the follow-up period（baseline, 301.8±8.6 μm; final visit, 286.6±8.0 μm, P〈0.001）. The decrease in the choroidal thickness was greatest in the central sector, followed by the sectors of the inner and outer rings. The inner and outer rings had diameters of 1 to 3 mm and 3 to 6 mm, respectively. The changes in the choroidal thickness in the central, inner ring, and outer ring sectors were significantly and negatively correlated with the age, baseline body height, baseline body weight, and elongation of the axial length. CONCLUSION： These results indicate that the choroidal thickness among preschool-aged Japanese children decreased significantly during the follow-up period. The choroidal thinning is significantly associated with the elongation of axial length. These characteristics should be considered in the evaluation of choroidal thickness in younger children with retinochoroidal disorders.展开更多
Local arterials can be significantly impacted by diversions from adjacent work zones. These diversions often occur on unofficial detour routes due to guidance received on personal navigation devices. Often, these rout...Local arterials can be significantly impacted by diversions from adjacent work zones. These diversions often occur on unofficial detour routes due to guidance received on personal navigation devices. Often, these routes do not have sufficien<span style="font-family:Verdana;">t sensing or communication equipment to obtain infrastructure-based tra</span><span style="font-family:Verdana;">ffic signal performance measures, so other data sources are required to identify locations being significantly affected by diversions. This paper examines the network impact caused by the start of an 18-month closure of the I-65/70 interchange (North Split), which usually serves approximately 214,000 vehicles per day in Indianapolis, IN. In anticipation of some proportion of the public diverting from official detour routes to local streets, a connected vehicle monitoring program was established to provide daily performances measures for over 100 intersections in the area without the need for vehicle sensing equipment. This study reports on 13 of the most impacted signals on an alternative arterial to identify locations and time of day where operations are most degraded, so that decision makers have quantitative information to make informed adjustments to the system. Individual vehicle movements at the studied locations are analyzed to estimate changes in volume, split failures, downstream blockage, arrivals on green, and travel times. Over 130,000 trajectories were analyzed in an 11-week period. Weekly afternoon peak period volumes increased by approximately 455%, split failures increased 3%, downstream blockage increased 10%, arrivals on green decreased 16%, and travel time increase 74%. The analysis performed in this paper will serve as a framework for any agency that wants to assess traffic signal performance at hundreds of locations with little or no existing sensing or communication infrastructure to prioritize tactical retiming and/or longer-term infrastructure investments.</span>展开更多
文摘Objective:To conduct a scoping review of longitudinal studies related to disease perception in cancer patients and to provide a reference for the improvement of disease perception in cancer patients.Methods:Using the scoping method,PubMed,Web of Science,The Cochrane Library,Medline,CNKI,Wanfang Database,VIP Chinese Scientific and Technical Journals Database,and China Biomedical Literature Database were searched up to July 2023 for analysis and discussion of the included literature.Results:A total of 19 articles were included,distributed across 9 countries including China,the Netherlands,and the United Kingdom,with 8 articles published in China.The study subjects included patients with breast cancer,colorectal cancer,laryngeal cancer,lung cancer,esophageal cancer,and bladder cancer.The content covered dynamic changes in disease perception,the impact of disease perception,and the influencing factors of disease perception.Conclusion:The number of longitudinal studies on disease perception in cancer patients is gradually increasing and becoming more diverse.However,issues such as a small total number of studies,single research methods,and short observation periods persist.In the future,it is necessary to conduct in-depth longitudinal research on disease perception in cancer patients,expand the scope of research fields,and provide more comprehensive theories to guide clinical treatment and nursing practices,ultimately improving the treatment outcomes and quality of life for cancer patients.
基金supported by grants from the National Natural Science Foundation of China(30970823,31371007)the Beijing Municipal Science and Technology Commission(Z131100006813022)the National Key Department of Neurology funded by Chinese Health and Family Planning Committee
文摘Amnestic mild cognitive impairment （aMCI） is a prodromal stage of Alzheimer＇s disease （AD）, and 75%-80% of aMCI patients finally develop AD. So, early identification of patients with aMCI or AD is of great significance for prevention and intervention. According to cross-sectional studies, it is known that the hippocampus, posterior cingulate cortex, and corpus callosum are key areas in studies based on structural MRI （sMRI）, functional MRI （fMRI）, and diffusion tensor imaging （DTI） respectively. Recently, longitudinal studies using each MRI modality have demonstrated that the neuroimaging abnormalities generally involve the posterior brain regions at the very beginning and then gradually affect the anterior areas during the progression of aMCI to AD. However, it is not known whether follow-up studies based on multi-modal neuroimaging techniques （e.g., sMRI, fMRI, and DTI） can help build effective MRI models that can be directly applied to the screening and diagnosis of aMCI and AD. Thus, in the future, large-scale multi-center follow-up studies are urgently needed, not only to build an MRI diagnostic model that can be used on a single person, but also to evaluate the variability and stability of the model in the general population. In this review, we present longitudinal studies using each MRI modality separately, and then discuss the future directions in this field.
基金Supported by the Humanities and Social Sciences Youth Foundation of Ministry of Education of China Project,No.22YJC190023.
文摘BACKGROUND Peer bullying victimization(PBV)is a significant public health issue that adolescents often face,with approximately one-third having experienced PBV.Understanding its interrelationships with mental health problems is crucial for effective intervention.This study aims to examine the longitudinal relationships between internalizing problems(depression and anxiety),externalizing problems(aggression),and PBV among middle school students using cross-lagged panel network analysis.AIM To examine the longitudinal relationships between internalizing problems(depression and anxiety),externalizing problems(aggression),and PBV among middle school students using cross-lagged panel network analysis.METHODS A total of 1260 middle school students(54.6%male)participated in this study.Data were collected at two time points(time 1 and time 2)using self-report questionnaires to assess PBV,depression,anxiety,and aggression.Cross-lagged panel network analysis was applied to examine the bi-directional relationships between these variables over time.RESULTS Depression,particularly a“sad mood,”was the most significant predictor of both PBV and aggression.Cyberbullying victimization also emerged as a key factor influencing depression and anxiety.While anxiety had weaker and less consistent effects on PBV,aggression was predominantly influenced by depressive symptoms and sleep disturbances.The analysis also identified key symptoms,such as a“sad mood”and sleep disturbances,as crucial targets for intervention to mitigate the cycle of PBV,depression,anxiety,and aggression.CONCLUSION This study provides important insights for bullying victimization prevention and intervention strategies:(1)Early identification and intervention targeting depression,particularly a“sad mood,”and sleep disturbances;(2)The importance of addressing cyberbullying as a distinct factor influencing mental health;and(3)The need for comprehensive,longitudinal approaches to understanding and intervening in the interconnected mental health issues among adolescents.
文摘There is no way around it.Regular physical activity(PA)and a high-quality diet are essential to promoting good health and prolonging life in middle-aged and older adults.In the November 2024 Issue of the Journal of Sport and Health Science,Ding et al.
基金supported by Peking University,the National Natural Science Foundation of China,the National Institute on Aging and the World Bank。
文摘Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk.Methods This study was based on the China Health and Retirement Longitudinal Study.12009 adults aged 45 years and older from five waves were included.CVD events were measured by self-reports of heart disease and stroke.We first used groupbased trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020,and then employed logistic regression models to analyze their risk for CVD.Results We identified three sleep duration and PA trajectories.The risk of heart disease increased by 33%(OR=1.31,95%CI:1.12-1.53)for the short sleep duration trajectory(vs.moderate sleep duration trajectory),by 40%(OR=1.40,95%CI:1.06-1.84)for the high decreasing PA trajectory,and by 20%(OR=1.20,95%CI:1.01-1.42)for the low stable PA trajectory(vs.high stable PA trajectory),respectively.Similar results for stroke and CVD as the outcomes were also observed,but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant.The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory.Conclusions Short total sleep duration,high decreasing PA,and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults.Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has disproportionately impacted individuals with type 2 diabetes mellitus(T2DM),increasing their risk of severe illness and mortality.Vaccination has been a crucial intervention in mitigating these risks.However,the metabolic effects of COVID-19 vaccination,particularly the Johnson&Johnson(J&J)vaccine,in diabetic populations remain inadequately explored.This study investigated the longitudinal effects of the J&J vaccine on lipid and eicosanoid biomarkers to assess its metabolic safety and potential cardiovascular benefits.AIM To evaluate the long-term impact of the J&J COVID-19 vaccine on lipid and eicosanoid biomarkers in Ethiopian patients with T2DM.METHODS This prospective cohort study was conducted at Adama Hospital Medical College(Oromia,Ethiopia)from May 2023 to June 2024.A total of 224 T2DM patients(57 vaccinated,167 unvaccinated)were monitored for 1 year.Biomarkers including triglycerides(TGs),high-density lipoprotein(HDL),total cholesterol(TC),pro-staglandins(PGs),and thromboxanes(TXs)were measured at baseline and at 3 months,6 months,9 months,and 1 year post-vaccination.Statistical analyses included Generalized Estimating Equations to assess longitudinal biomarker changes.RESULTS TG and PG levels remained stable across all time points.HDL levels showed a temporary decline at 3 months(mean difference[MD]=-4.33;P<0.001)and 6 months(MD=-2.62;P<0.001)but recovered by 9 months(MD=2.09;P=0.001)and 1 year(MD=2.38;P<0.001).TC exhibited a significant decrease at 3 months(MD=-16.44,P=0.001)before stabilizing.TX levels showed a consistent decline across all follow-ups(e.g.,1 year:MD=-0.08;P=0.036),suggesting a reduced thrombotic risk.Correlation analysis indicated significant interrelations among biomarkers,emphasizing their roles in metabolic and inflammatory pathways.CONCLUSION The J&J COVID-19 vaccine exhibited metabolic safety in patients with T2DM,with transient HDL and TC reductions that later stabilized and a sustained TX decline,suggesting potential cardiovascular benefits.Further studies are needed to explore long-term immunometabolic effects on high-risk populations.
基金HAALSI(Health and Aging in Africa:A Longitudinal Study of an INDEPTH Community in South Africa)is sponsored by the National Institute on Aging(grant number 5P01AG041710-05)and is conducted by the Harvard Center for Population and Development Studies in Partnership with Witwatersrand UniversityThe Agincourt HDSS was supported by the Wellcome Trust,UK(058893/Z/99/A,069683/Z/02/Z,085477/Z/08/Z and085477/B/08/Z),the University of the Witwatersrand and South African Medical Research Council.
文摘Objectives Few studies have investigated longitudinal associations of loneliness with health outcomes in Africa.This study aimed to assess the longitudinal associations between loneliness and mental and physical health among aging adults in South Africa.Methods Data from the 7-year longitudinal Health and Ageing in Africa(HAALSI)study conducted in South Africa were used in the analysis(analytic sample:n=3707,aged 40 years and older).Loneliness was measured with one question.Longitudinal relationships between loneliness and each health outcome were estimated using Generalized Estimating Equations analysis(GEE),hazard ratios(HRs)(95%CI)were used to determine the relationship between loneliness and 7-year mortality in the entire sample,and correlations between incident health outcomes and loneliness were evaluated using logistic regressions.Results The prevalence of loneliness was 12.1%in 2015,16.9%in 2019,and 16.3%in 2022.Multivariable analysis showed that loneliness was positively associated with the prevalence and/or incidence of four poor mental health indicators(e.g.,poor sleep quality,AOR=1.53,95%CI:1.30–1.80),four physical ill-health indicators(e.g.,incident kidney disease,AOR=2.50,95%CI:1.41–4.42),mortality(Hazard Ratio=1.20,95%CI=1.04–1.39),and three poor behavioral health indicators(e.g.,current tobacco use,AOR=1.21,95%CI=1.04–1.42).Conclusion The study discovered that several outcomes related to mental,physical,and behavioral health were associated with loneliness.Enhancing the detection and management of loneliness could lower mental and physical illness in aging adults in South Africa.
基金supported by the Agence Nationale de la Recherche(ANR)(contract“ANR-17-EURE-0002”)by the Region of Bourgogne Franche-ComtéCADRAN Projectsupported by the European Research Council(ERC)project HYPATIA under the European Union's Horizon 2020 research and innovation programme.Grant agreement n.835294。
文摘This paper investigates the problem of collecting multidimensional data throughout time(i.e.,longitudinal studies)for the fundamental task of frequency estimation under Local Differential Privacy(LDP)guarantees.Contrary to frequency estimation of a single attribute,the multidimensional aspect demands particular attention to the privacy budget.Besides,when collecting user statistics longitudinally,privacy progressively degrades.Indeed,the“multiple”settings in combination(i.e.,many attributes and several collections throughout time)impose several challenges,for which this paper proposes the first solution for frequency estimates under LDP.To tackle these issues,we extend the analysis of three state-of-the-art LDP protocols(Generalized Randomized Response–GRR,Optimized Unary Encoding–OUE,and Symmetric Unary Encoding–SUE)for both longitudinal and multidimensional data collections.While the known literature uses OUE and SUE for two rounds of sanitization(a.k.a.memoization),i.e.,L-OUE and L-SUE,respectively,we analytically and experimentally show that starting with OUE and then with SUE provides higher data utility(i.e.,L-OSUE).Also,for attributes with small domain sizes,we propose Longitudinal GRR(L-GRR),which provides higher utility than the other protocols based on unary encoding.Last,we also propose a new solution named Adaptive LDP for LOngitudinal and Multidimensional FREquency Estimates(ALLOMFREE),which randomly samples a single attribute to be sent with the whole privacy budget and adaptively selects the optimal protocol,i.e.,either L-GRR or L-OSUE.As shown in the results,ALLOMFREE consistently and considerably outperforms the state-of-the-art L-SUE and L-OUE protocols in the quality of the frequency estimates.
基金Supported by Baoshan District Key Specialized Class A,Clinical Medical Center for Integrated Traditional Chinese and Western Medicine Treatment of Neck,Shoulder,Lumbar and Leg Pain,No.BSZK-2023-Z07.
文摘BACKGROUND Femoral head necrosis(FHN)can significantly affect patients'psychological well-being and functional outcomes.However,the long-term relationship between postoperative depression,anxiety,and functional recovery in patients with FHN remains unclear.AIM To investigate the dynamic changes in postoperative depression and anxiety and their relationship with functional recovery in patients with FHN for 3 years.METHODS Ninety-three patients with FHN who underwent surgical treatment in March 2020 to 2023 were enrolled in this longitudinal study.Depression and anxiety status were assessed using the hospital anxiety and depression scale(HADS)at baseline,6 months,1,2,and 3 years postoperatively.Functional recovery was evaluated using the Harris hip score(HHS).The dynamic changes in HADS and HHS were analyzed using repeated measures ANOVA;the relationship between depre-ssion/anxiety status and functional recovery was examined using Pearson’s correlation analysis.RESULTS The mean HADS-depression(HADS-D)and HADS-anxiety(HADS-A)scores significantly improved over time(P<0.001).The prevalence of depression and anxiety decreased from 36.6%and 41.9%at baseline to 10.8%and 12.9%,respectively,at 3 years postoperatively.The mean HHS increased sig-nificantly from 52.3±10.5 at baseline to 88.1±7.2 at 3 years postoperatively(P<0.001).Significant negative correl-ations were found between HADS-D/HADS-A scores and HHS at all time points(P<0.05).CONCLUSION The severity of depression and anxiety negatively correlated with functional recovery,highlighting the importance of psychological interventions in the management of patients with FHN.
基金supported by the National Natural Science Foundation of China(No.82074295)the Science and Technology Program of Tibet Grant(No.XZ202201ZY0051G)。
文摘Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it remains unclear whether these indices have a longitudinal relationship with the prevalence of cardiometabolic multimorbidity(CM),a pressing global health issue.This research investigated the association between CVAI and CM compared to other indicators of visceral obesity.Methods 6638 participants(aged>45)from the China Health and Retirement Longitudinal Study(CHARLS)were analyzed for incident CM.Cox proportional models were adopted to explore whether the level of CVAI was correlated with the risk of CM.Harrell's concordance statistic(C-statistic)was applied to compare predictive values.Sensitivity and subgroup analyses were implemented for the steadiness of the results.Results Over 4 years,266(4.01%)participants developed CM.A 1-standard deviation(SD)increase in the levels of CVAI,body mass index(BMI),LAP,and TMI was associated with greater CM risk after adjusting for confounders[hazard ratios(HRs):2.20,95%confidence interval(CI):1.88-2.57,1.92(95%CI:1.55-2.38),1.20(95%CI:1.12-1.27),and 1.50(95%CI:1.35-1.66),respectively].CVAI outperformed other indices in predictive performance.Subgroup analysis revealed younger participants or those living alone were more prone to developing CM.Results were potent after finishing all sensitivity analyses.Conclusions The study highlighted a positive correlation between the level of CVAI and CM risk.CVAI's superior predictive performance positions it as a reliable indicator for identifying individuals at heightened CM risk.
基金supported by the National Natural Science Foundation of China(82222064,81973147)the National Key Research and Development Program(2022YFC2010100)the Shandong University Distinguished Young Scholars。
文摘Objective Burning solid cooking fuel contributes to household air pollution and is associated with frailty.However,how solid cooking fuel use contributes to the development of frailty has not been well illustrated.Methods This study recruited 8,947 participants aged≥45 years from the China Health and Retirement Longitudinal Study,2011–2018.Group-based trajectory modeling was employed to identify frailty trajectories.Multinomial logistic regression was used to assess the association between solid cooking fuel use and frailty trajectories.Population-attributable fractions were used to estimate the frailty burden from solid fuel use.Results We identified three frailty trajectories:low-stable(n=5,789),moderate-increasing(n=2,603),and fast-increasing(n=555).Solid fuel use was associated with higher odds of being in the moderate-increasing(OR:1.24,95%CI:1.08–1.42)and fast-increasing(OR:1.48,95%CI:1.14–1.92)trajectories.These associations were strengthened by longer solid fuel use(P for trend<0.001).Switching to clean fuel significantly reduced the risk of being in these trajectories compared with persistent solid fuel users.Without solid fuel,8%of moderate-and 19%of fast-increasing trajectories demonstrated frailty development like the low-stable group.Conclusion Solid cooking fuel use is associated with frailty trajectories in middle-aged and older Chinese populations.
基金Supported by the Shenzhen Science and Technology Program,No.RCYX20221008092849069The Guangdong High-Level Hospital Construction Fund.
文摘Attention-deficit/hyperactivity disorder(ADHD)is increasingly conceptualized as a dynamic neurodevelopmental condition,marked by fluctuating symptom trajectories across development rather than the traditional static patterns of persistence or remission.This review synthesizes empirical evidence on the varied trajectories of ADHD symptoms-including late-onset,partial remission,and recurrent fluctuation patterns-and underscores their clinical significance in longterm functioning.We adopt a multifactorial framework to explore how genetic,environmental,and gene–environment interactions contribute to the emergence and evolution of ADHD symptoms over time.In addition,we consider how medication-related variables-particularly tolerance and adherence-may influence symptom fluctuation.Characterizing these developmental dynamics offers critical guidance for designing flexible,personalized interventions that align with individual trajectories and transitional vulnerabilities.
基金supported by Grant 82222064 from the National Natural Science Foundation of Chinathe Shandong University Distinguished Young Scholars。
文摘Objective This study aimed to explore the interplay between the life-course body mass index(BMI)trajectories and insulin resistance(IR)on incident diabetes.Methods This longitudinal cohort included 2,336 participants who had BMI repeatedly measured 3–8times between 1989 and 2009,as well as glucose and insulin measured in 2009.BMI trajectories were identified using a latent class growth mixed model.The interplay between BMI trajectories and IR on diabetes was explored using the four-way effect decomposition method.Logistic regression and mediation models were used to estimate the interaction and mediation effects,respectively.Results Three distinct BMI trajectory groups were identified:low-stable(n=1,625),mediumincreasing(n=613),and high-increasing(n=98).Both interaction and mediation effects of BMI trajectories and IR on incident diabetes were significant(P<0.05).The proportion of incident diabetes was higher in the IR-obesity than in the insulin-sensitivity(IS)obesity group(18.9%vs.5.8%,P<0.001).After adjusting for covariates,the odds ratios(95%confidence intervals)of the IR,IS-obesity,and IRobesity groups vs.the normal group were 3.22(2.05,5.16),2.05(1.00,3.97),and 7.98(5.19,12.62),respectively.IR mediated 10.7%of the total effect of BMI trajectories on incident diabetes(P<0.001).Conclusion We found strong interactions and weak mediation effects of IR on the relationship between life-course BMI trajectories and incident diabetes.IS-obesity is associated with a lower risk of incident diabetes than IR-obesity.
基金supported by the National R&D Program for Cancer Control through the National Cancer Center funded by the Ministry of Health & Welfare, Republic of Korea (No. HA21C0225)。
文摘Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified the factors influencing adherence.Methods: This retrospective cohort study was conducted using data from the Korean National Cancer Screening Program(KNCSP) between 2011 and 2020. The total cohort comprised 400,113 adults aged 40 years who were newly eligible for and participated in GC screening in 2011. The participants were followed up for 10 years to assess their adherence to biennial screening recommendations. They were categorized into two groups: the nonregular screening(non-RS) group, which included individuals who did not participate in subsequent screenings, and the regular screening(RS) group, which included those who participated in at least one follow-up screening.Multiple logistic regression analyses were performed to identify the factors associated with adherence to regular GC screening.Results: Over 10 years, 59% of the participants completed at least four of the five recommended screenings,while 10% did not participate after their initial screening. Male participants had higher odds of non-adherence than females [adjusted odds ratio(aOR)=1.429, 95% confidence interval(95% CI): 1.394-1.464;P<0.001]. Nonadherence was more prevalent among self-employed individuals(aOR=1.208, P<0.001). Among males, those in the lowest income group were 1.267 times more likely to not undergo regular screening than those in the highest income group.Conclusions: Long-term adherence to regular GC screening in South Korea remains suboptimal.Socioeconomic disparities persist, highlighting the need for tailored interventions to improve adherence and enhance public health.
基金Supported by the Shenzhen Science and Technology Program(No.JCYJ20220818103207015)the SanMing Project of Medicine in Shenzhen(No.SZSM202311012).
文摘AIM:To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy(PPV)in patients with primary rhegmatogenous retinal detachment(RRD).METHODS:Clinical data of patients with primary RRD treated at the Shenzhen Eye Hospital were retrospectively collected.Twenty-four potential influencing factors,including patient characteristics and surgical factors,were selected for analysis.Independent risk factors for secondary cataract were identified through univariate comparisons and multivariate logistic regression analysis.A risk prediction model was constructed and evaluated using receiver operating characteristic(ROC)curves,area under the ROC curve(AUC),calibration plots,and decision curve analysis(DCA)curves.RESULTS:The 386 cases(389 eyes)of patients who underwent PPV and had complete surgical records were ultimately included.Within a 2-year longitudinal observation,41.39%of patients developed cataract secondary to PPV.Logistic regression results identified a history of hypertension[odds ratio(OR)=1.78,95%CI:1.002–3.163,P=0.049],silicone oil tamponade(OR=3.667,95%CI:2.373–5.667,P=0.000),and lens thickness(OR=1.978,95%CI:1.129–3.464,P=0.017)as independent risk factors for cataract secondary to PPV.The constructed nomogram achieved AUC=0.6974.Calibration plots indicated good agreement between predicted and observed outcomes,while DCA curves demonstrated the model’s clinical utility.CONCLUSION:By incorporating a history of hypertension,vitreous substitute type,and lens thickness,this study constructs a prediction model with moderate discriminative ability.This model offers a valuable tool for clinicians to identify high-risk patients early,potentially allowing for more timely interventions and improved patient outcomes.
基金supported by the National Natural Science Foundation of China(72164018)National Social Science Fund Project(BFA200065)Jiangxi Social Science Foundation Project(21JY13).
文摘Objectives:Positive family functioning(FF)is critical for adolescent development,yet only a few studies have examined this developmental trajectory pathway.This study aimed to identify different types of FF development trajectories during junior high school students,investigate their influence on social avoidance(SA),and further examine the mediating role of preference for solitude(PS)between them.Methods:A three-wave longitudinal study was used with six-month intervals.Questionnaire data were collected from 436 junior high school students in Jiangxi Province,China.Participants ranged in age from 11 to 14 years old(Mean=12.89 years,SD=1.08;50.2%male).Results:Four heterogeneous types of FF trajectories were identified:(1)a high and increasing group(14.7%);(2)a consistently high group(36.24%);(3)a consistently moderate group(45.86%);and(4)a rapid growth group(3.2%).The developmental trajectories of FF among junior high students significantly varied in their levels of SA(F(3,432)=32.03,p<0.001).Compared to the high and increasing groups,the consistently high,consistently medium,and rapid growth groups exhibited higher levels of SA.PS mediated the association between the developmental trajectory of FF and SA.Conclusion:There was a close relationship between the developmental trajectory of FF and SA.Interventions focusing on family system optimization and solitary preference management could effectively mitigate SA behaviors.These findings are important for promoting healthy socialization in adolescents.
基金supported by the Project of Zhongyuan Medical Innovation Foundation Hospital Management Research(25YCG1004).
文摘Background:Depression represents a significant global mental health burden,particularly among middle-aged and older Chinese with chronic diseases in high-altitude regions,where harsh environmental conditions and limited social support exacerbate mental health disparities.This paper aims to develop an interpretable machine learning prediction framework to identify the key factors of depression in this vulnerable population,thereby proposing targeted intervention measures.Methods:Utilizing data from the China Health and Retirement Longitudinal Study in 2020,this paper screened out and analyzed 2431 samples.Subsequently,Recursive Feature Elimination and Least Absolute Shrinkage and Selection Operator were applied to screen predictors from 32 alternative variables.Furthermore,through hyperparameter tuning and 5-fold cross-validation,8 machine learning modelswere constructed,namely,Random Forest,Extreme Gradient Boosting,Light Gradient Boosting Machine,Gradient Boosting Machine,K-Nearest Neighbor,Naive Bayes Classifier,Support Vector Machine,and Logistic Regression.Finally,the SHAP algorithm was applied to analyze the interpretability of the best-performing model,quantifying nonlinear relationships and threshold effects.Results:Among the respondents,the prevalence of depression was approximately 46.89%.After feature engineering screening,8 variables were retained for inclusion in the prediction model.Furthermore,the Gradient Boosting Machine performed optimally in terms of comprehensive performance,with an Area Under Receiver Operating Characteristic Curve(AUC)of 0.845,an Accuracy of 0.714,a Sensitivity of 0.655,a Precision of 0.711,a Specificity of 0.766,and an F1 of 0.682.In addition,Life satisfaction,PM2.5,Self-rated health,and Education were identified as the top 4 key factors.Meanwhile,the influence of these variables on depression showed nonlinear and threshold effects.Conclusion:This research highlights the value of machine learning in mental health.Based on the identified key factors,this paper proposed a series of policy measures to improve the health pattern of the middle-aged and elderly populations facing the dual challenges of chronic disease and environmental adversity.
基金supported by the National Natural Science Foundation of China(No.81873843)the National Science and Technology Pillar Program of China during the Twelfth Five-Year Plan Period(No.2014BAI05B05)the Fundamental Research Funds for the Central Universities(No.2017KFYXJJ102 and 2019KFYXKJC053).
文摘Objective Sleep is fundamental to the physical and mental health of both the general population and pregnant women.Most studies have focused on the impact of certain trimester sleep behaviors on gestational complications and birth outcomes.This study aimed to explore the association between maternal sleep duration and fetal growth development from as early as 23 gestational weeks to birth.Methods A total of 803 pregnant women were prospectively enrolled.The self-reported maternal nocturnal sleep duration during all 3 trimesters was recorded.The outcome measures were reference-population-based Z-scores of fetal biometric measurements obtained through routine ultrasonographic examination.Results Using multiple linear regression,a marginally significant negative association was observed between second-trimester sleep duration and second-trimester fetal head circumference(HC)and third-trimester fetal biparietal diameter(BPD).Then the associations of long sleep duration in each trimester with fetal biometry extreme values were evaluated.A significant impact of second-trimester long sleep duration on the second-trimester BPD below the 10th percentile of the reference population was observed.Longitudinal analysis reported similar results for BPD and HC.Conclusions Overall,a negative association between sleep duration and fetal biometric measurements was observed.Long sleep durations in the second trimester might negatively impact fetal growth,particularly brain parameters,including BPD and HC.
文摘AIM： To investigate the changes in the choroidal thickness in healthy pediatric children in a longitudinal study, and to determine the ocular and systemic parameters that were significantly correlated with the changes in the choroidal thickness. METHODS： This study included 64 eyes of 34 healthy Japanese children with a mean age（±SD） of 4.4（±0.4）y（range, 3.6-5.8 y） at baseline. Swept-source optical coherence tomography（SS-OCT） was used to record images of the retina and choroid at the baseline and after a mean followup period of about 1.5 y. The 3 D raster scan protocol was used to construct the choroidal thickness map. Mean choroidal thickness was calculated for each of the nine sectors of the Early Treatment Diabetic Retinopathy Study grid. Best-corrected visual acuity, axial length, body height, and weight were also measured. Changes in measurements were defined as the baseline values subtracted from the values at the final visit. A generalized estimating equation was used to eliminate the effect of within-subject intereye correlations. RESULTS： The mean central choroidal thickness was significantly reduced during the follow-up period（baseline, 301.8±8.6 μm; final visit, 286.6±8.0 μm, P〈0.001）. The decrease in the choroidal thickness was greatest in the central sector, followed by the sectors of the inner and outer rings. The inner and outer rings had diameters of 1 to 3 mm and 3 to 6 mm, respectively. The changes in the choroidal thickness in the central, inner ring, and outer ring sectors were significantly and negatively correlated with the age, baseline body height, baseline body weight, and elongation of the axial length. CONCLUSION： These results indicate that the choroidal thickness among preschool-aged Japanese children decreased significantly during the follow-up period. The choroidal thinning is significantly associated with the elongation of axial length. These characteristics should be considered in the evaluation of choroidal thickness in younger children with retinochoroidal disorders.
文摘Local arterials can be significantly impacted by diversions from adjacent work zones. These diversions often occur on unofficial detour routes due to guidance received on personal navigation devices. Often, these routes do not have sufficien<span style="font-family:Verdana;">t sensing or communication equipment to obtain infrastructure-based tra</span><span style="font-family:Verdana;">ffic signal performance measures, so other data sources are required to identify locations being significantly affected by diversions. This paper examines the network impact caused by the start of an 18-month closure of the I-65/70 interchange (North Split), which usually serves approximately 214,000 vehicles per day in Indianapolis, IN. In anticipation of some proportion of the public diverting from official detour routes to local streets, a connected vehicle monitoring program was established to provide daily performances measures for over 100 intersections in the area without the need for vehicle sensing equipment. This study reports on 13 of the most impacted signals on an alternative arterial to identify locations and time of day where operations are most degraded, so that decision makers have quantitative information to make informed adjustments to the system. Individual vehicle movements at the studied locations are analyzed to estimate changes in volume, split failures, downstream blockage, arrivals on green, and travel times. Over 130,000 trajectories were analyzed in an 11-week period. Weekly afternoon peak period volumes increased by approximately 455%, split failures increased 3%, downstream blockage increased 10%, arrivals on green decreased 16%, and travel time increase 74%. The analysis performed in this paper will serve as a framework for any agency that wants to assess traffic signal performance at hundreds of locations with little or no existing sensing or communication infrastructure to prioritize tactical retiming and/or longer-term infrastructure investments.</span>
