Influence of metabolic syndrome on activities of daily living in middle-aged and elderly population in China: a prospective cohort study / 中华流行病学杂志

Objective: To examine the associations between metabolic syndrome (MS) and the risks for impaired activities of daily living (ADL) in the middle-aged and elderly population in China and provide basis for improving healthy life expectancy. Methods: Prospective cohort study design was used in this study. Based the data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 and the baseline data in 2011, the follow up for ADL outcomes was conducted in 2013, 2015 and 2018 respectively, and the participants recruited in 2013 and 2015 were new baseline populations. The participants with impaired ADL in three baseline populations were excluded. Cox proportional hazard model was used to estimate the effect of different components and number of MS components on the risk for ADL impairment in the middle-aged and elderly population in China. Results: In 59 795 person-years of follow-up, a total of 1 011 cases of ADL impairments were recorded. The incidence density of ADL impairment was 16.91 per 1 000 person-year; The findings of Cox regression analysis showed that compared with the middle aged and elderly people without MS, the risk for ADL impairments was 1.29 times higher (95%CI: 1.12-1.50) for those with one component of MS, 1.32 times higher (95%CI:1.07-1.64) for those with hyperlipemia complicated with diabetes, 1.78 times higher (95%CI: 1.22-2.59) for those with obesity and one component of MS, 2.48 times higher (95%CI:1.59-3.85) for those with hypertension complicated with hyperlipemia, 3.51 times higher (95%CI:1.66-7.43) for those with hypertension complicated with diabetes, 1.80 times higher (95%CI: 1.40-2.32) for those with ≥3 MS, respectively. Compared with the middle-aged and elderly population without MS, the risk for impaired ADL increased by 30% (HR=1.30, 95%CI: 1.13-1.51), 54% (HR=1.54, 95%CI: 1.28-1.85) and 87% (HR=1.87, 95%CI:1.45-2.41), respectively, in the middle-aged and elderly with one, two, and more than three components of MS, with a significant dose-response relationship that ADL impaired risks increased as the number of MS components increased (P<0.001). Conclusions: Our findings suggested that MS is a risk factor for ADL impairment in middle-aged and elderly population in China. Prevention and early intervention of obesity, hypertension, hyperlipemia, diabetes and metabolic syndrome could help to reduce or delay the incidence of ADL impairment.

Risk factors of high birth weight in rural areas of Shanxi Province / 中华疾病控制杂志

@# Objective To estimate the association between the risk of high birth weight(HBW) and maternal environmental and behavioral factors exposure during pregnancy in rural areas. Methods Data were collected from the surveillance system of birth population and adverse pregnancy outcome in Pingding County, Shanxi Province during 2007 and 2012, where we followed up 204 controls with normal birth weight, 125 cases with HBW≥4 200 g and 171 cases with HBW 4 000-4 200 g. Case control study was performed to explore the potential risk factors of HBW. Results The total number of births was 18 749, including 1 177 cases of high birth weight, with an incidence rate of 6.28% between 2007 and 2012. Concerning the case control study on HBW<4 200 g, after adjusting parental reproductive age and parity, the risk of HBW was 3.10(95% CI：1.67-5.76)times higher among women with gestational weeks ≥42 than that of women with gestational weeks < 42. The risk of HBW in boys was 2.30(95% CI：1.46-3.63)times higher than that in girls. No significant association was observed between maternal BMI before pregnancy and the risk of HBW；Regarding the case control study on HBW≥4200 g, after adjusting maternal reproductive age and parity, the risk of HBW was 3.01(95% CI:1.49-6.08) times higher among women with gestational weeks≥42 than that of those with gestational weeks <42. The risk of HBW was 1.91(95% CI:1.15-3.16)times higher among women with pre-pregnancy BMI≥24 than that of those with pre-pregnancy BMI< 24. The risk of HBW was 2.59(95% CI:1.06-6.32)times higher in women who ate soybean products ≥4 times a week than that of those who ate soybean products less than once a week. Conclusion It would be of public health significance to reduce the risk of high birth weight, which can be reduced by managing pre-pregnancy BMI, diet during pregnancy and controlling gestational week.

PSO/ACO algorithm-based risk assessment of human neural tube defects in Heshun County, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To develop a new technique for assessing the risk of birth defects, which are a major cause of infant mortality and disability in many parts of the world.</p><p><b>METHODS</b>The region of interest in this study was Heshun County, the county in China with the highest rate of neural tube defects (NTDs). A hybrid particle swarm optimization/ant colony optimization (PSO/ACO) algorithm was used to quantify the probability of NTDs occurring at villages with no births. The hybrid PSO/ACO algorithm is a form of artificial intelligence adapted for hierarchical classification. It is a powerful technique for modeling complex problems involving impacts of causes.</p><p><b>RESULTS</b>The algorithm was easy to apply, with the accuracy of the results being 69.5%±7.02% at the 95% confidence level.</p><p><b>CONCLUSION</b>The proposed method is simple to apply, has acceptable fault tolerance, and greatly enhances the accuracy of calculations.</p>

Unusual patterns of neural tube defects in a high risk region of northern China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the prevalence of different types of neural tube defects (NTDs) in Luliang Prefecture, Shanxi province, where the prevalence of NTDs is unusually high and the correlation between NTDs prevalence and patterns.</p><p><b>METHODS</b>A surveillance population-based birth defects was performed in Luliang Prefecture, Shanxi province.</p><p><b>RESULTS</b>The results of our study showed that the prevalence of NTDs was 2-fold higher in Luliang Prefecture than in other areas of Shanxi province. Unusual patterns of NTDs were found, however, multiple NTDs were relatively common in Luliang Prefecture, accounting for over 13% of all NTDs cases in China.</p><p><b>CONCLUSION</b>The prevalence of NTDs is associated with its patterns.</p>

Spatiotemporal property analysis of birth defects in Wuxi, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To describe the temporal trends and spatial patterns of birth defects occurring in Wuxi, a developed region of China.</p><p><b>METHODS</b>Wavelet analysis was used to decompose the temporal trends of birth defect prevalence based on the birth defect rates over the past 16 years. Birth defect cases with detailed personal and family information were geo-coded and the relative risk in each village was calculated. General G statistic was used to test the spatial property with different scales.</p><p><b>RESULTS</b>Wavelet analysis showed an increasing temporal trend of birth defects in this region. Clustering analysis revealed that changes continued in the spatial patterns with different scales.</p><p><b>CONCLUSION</b>Wuxi is confronted with severe challenges to reduce birth defect prevalence. The risk factors are stable and show no change with spatial scale but an increasing temporal trend. Interventions should be focused on villages with a higher prevalence of birth defects.</p>

Epidemiology of birth defects in high-prevalence areas of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the levels of prevalence and to describe the epidemiological features of birth defects in high-prevalence areas in China.</p><p><b>METHODS</b>A population-based retrospective study was conducted in two counties of Shanxi province that including birth defects among fetuses and live births born after 20 weeks' gestational age in the study areas from 2002 through 2004.</p><p><b>RESULTS</b>During 2002 - 2004, the prevalence of birth defects was 844.2 per 10 000 births in study areas and the first five main birth defects were inguinal hernia (182.2 per 10,000 births), anencephaly (104.4 per 10 000 births), congenital mental retardation (79.4 per 10,000 births), congenital heart diseases (73.2 per 10,000 births) and spina bifida (63.9 per 10,000 births). These five main birth defects accounted for about 60% of total birth defect cases. Inguinal hernia, undescended testicle, congenital mental retardation were usually not included for statistical analysis on birth defect. Excluding these birth defects, the prevalence of birth defects in study areas was 537.2 per 10,000 births and the first five main birth defects were anencephaly, congenital heart diseases, spina bifida, hydrocephaly (40.5 per 10 000 births) and encephalocele (31.2 per 10 000 births). The male prevalence of birth defects was 966.2 per 10 000 births, which was significantly higher than prevalence in females. The prevalence rates of birth defects for maternal age groups under 20 years old and over 30 years old were remarkably higher than those for 20-24 year and 25-29 year old mothers. The teenage mothers were at higher risk of having a child with neural tube defects(NTDs) or congenital heart diseases. Prevalence rates under 20 year maternal age group were 408.8 and 188.7 per 10 000 births for NTDs and congenital heart diseases respectively, whereas corresponding rates were 204.8 and 91.0 per 10 000 births for groups over 30 years of age. The prevalence rates increased with increasing gravidity or parity.</p><p><b>CONCLUSION</b>This study showed that the patterns of birth defects in study areas were very different from those of other areas, with an unusually high prevalence of NTDs. The study also suggested that both young and advanced mothers were at increased risk of having a child with a birth defect.</p>

A simulation on the emerging of birth defects in China with Kriging interpolation method / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the regional patterns of emerging level on birth defects with simulated map by original studied and reference data.</p><p><b>METHODS</b>Based on geographical information system, Kriging interpolation method was used and some related environmental factors were drawn from geographic information system software.</p><p><b>RESULTS</b>The Kriging method had drawn continual and smooth map on birth defect emerging level and shown some clues with environmental factors.</p><p><b>CONCLUSION</b>Kriging method and advanced spatial statistical and analytical methods were helpful in public health studies while simulated map suggested the feasibility of sampled data on national disease surveillance and giving some useful clues to etiological analysis.</p>

Analysis on the multi-distribution and the major influencing factors on severe acute respiratory syndrome in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyse the multi-dimension nature of severe acute respiratory syndrome (SARS) transmission.</p><p><b>METHODS</b>Based on the data of SARS in 2003 and the geographic information system of Beijing, as well as under the broad range of the theorems and techniques of data-driven and model-driven knowledge mining, hierarchical techniques were used to test the hot spots. Wavelet technique was also used to decompose Moran's I frequency to survey the spatial clustering process of SARS. For factors analysis, BW test was used to distinguish factors which influencing SARS process. In temporal aspects, susceptive-infective-removal model (SIR) without Taylor expansion was solved by a genetic-simulated annealing algorithm, that directly provided a new approach to obtain epidemic parameters from the SIR model.</p><p><b>RESULTS</b>Different order of spatial hot spots were noticed and the clustering were relevant with the means of transportation. Diffusion dynamics were changed along with the temporal process of SARS. Regarding factor analysis, geographic relationship, population density, the amount of doctors and hospitals appeared to be the key elements influencing the transmission of SARS. The predictable number of SARS cases evolving with time were also calculated.</p><p><b>CONCLUSIONS</b>Cluster detection of close contacts of SARS infective in Beijing revealed the spatial characters of urban population flow and having important implications in the prevention and control of this communicable diseases. Some human and physical environment factors played statistical significant roles in different periods during SARS epidemics. An efficient algorithm was developed to solve SIR model directly, enabling the estimation of epidemic parameters from SIR and early forecast.</p>