Seasonality of influenza-like illness and short-term forecasting model in Chongqing from 2010 to 2022.

BACKGROUND: Influenza-like illness (ILI) imposes a significant burden on patients, employers and society. However, there is no analysis and prediction at the hospital level in Chongqing. We aimed to characterize the seasonality of ILI, examine age heterogeneity in visits, and predict ILI peaks and assess whether they affect hospital operations. METHODS: The multiplicative decomposition model was employed to decompose the trend and seasonality of ILI, and the Seasonal Auto-Regressive Integrated Moving Average with exogenous factors (SARIMAX) model was used for the trend and short-term prediction of ILI. We used Grid Search and Akaike information criterion (AIC) to calibrate and verify the optimal hyperparameters, and verified the residuals of the multiplicative decomposition and SARIMAX model, which are both white noise. RESULTS: During the 12-year study period, ILI showed a continuous upward trend, peaking in winter (Dec. - Jan.) and a small spike in May-June in the 2-4-year-old high-risk group for severe disease. The mean length of stay (LOS) in ILI peaked around summer (about Aug.), and the LOS in the 0-1 and ≥ 65 years old severely high-risk group was more irregular than the others. We found some anomalies in the predictive analysis of the test set, which were basically consistent with the dynamic zero-COVID policy at the time. CONCLUSION: The ILI patient visits showed a clear cyclical and seasonal pattern. ILI prevention and control activities can be conducted seasonally on an annual basis, and age heterogeneity should be considered in the health resource planning. Targeted immunization policies are essential to mitigate potential pandemic threats. The SARIMAX model has good short-term forecasting ability and accuracy. It can help explore the epidemiological characteristics of ILI and provide an early warning and decision-making basis for the allocation of medical resources related to ILI visits.

Early Weight Status and Human Capital in Adulthood: A 32-Year Follow-Up of the 1970 British Cohort Study.

Objectives: To prospectively evaluate the effects of early weight status (childhood and adolescence) and changes in obesity status on human capital in adulthood. Methods: We employed data from the 1970 Birth Cohort Study in the United Kingdom. Data on height and weight during childhood and adolescence, human capital variables in adulthood were collected from 2,444 participants. Human capital includes cognitive ability, non-cognitive skill, educational attainment and health status. Data were analyzed through linear regression and logistic regression models. Results: Our results showed that obesity during adolescence was negatively associated with cognitive ability (ß = -0.83, p < 0.01), educational attainment (ß = -0.49, p < 0.01), and some health outcomes; and that underweight in childhood also adversely affected educational attainment in females (ß = -0.66, p < 0.05). In terms of changes in obesity status, becoming obese in adolescence negatively affected cognitive ability (ß = -1.18, p < 0.01), educational attainment (ß = -0.62, p < 0.05) and some health outcomes, remaining obese was associated with all adverse health outcomes. Conclusion: Our results suggest that obesity during adolescence negatively affects a range of human capital outcomes in adulthood, and adolescence is a critical period during which early obesity affects adult human capital.

Association between cultural capital and health literacy during the COVID-19 pandemic among community residents in China: the mediating effect of social capital.

Background: Health literacy is crucial for managing pandemics such as COVID-19 and maintaining the health of the population; our goal was to investigate the impact of cultural capital on health literacy during the COVID-19 pandemic among community residents and to further examine the mediating role of social capital in the relationship between cultural capital and health literacy. Methods: A cross-sectional study was conducted among 1,600 community residents selected in Chongqing, China using a stratified random sampling method. Data were gathered through a questionnaire survey, including sociodemographic characteristics, cultural capital, social capital, and health literacy. Chi-square analysis, one-way ANOVA, t-test, and hierarchical linear regression were used to analyze the level of health literacy among community residents and the related elements; the structural equation model (SEM) was used to explore the influential mechanisms of health literacy and explore whether social capital acted as a mediator in the relationship between cultural capital and health literacy. Results: Cultural capital, community participation, community trust, reciprocity, and cognitive social capital had a significant positive effect on health literacy. In addition, the results of SEM indicated that cultural capital not only directly influences health literacy (ß = 0.383, 95% CI = 0.265-0.648), but also indirectly influences health literacy through three types of social capital (ß = 0.175, 95% CI = 0.117-0.465; ß = 0.191, 95% CI = 0.111-0.406; ß = 0.028, 95% CI = 0.031-0.174); its mediating effect accounting for 50.7% of the overall effect. Conclusions: Our results highlight the empirical link between cultural capital and health literacy, and suggest that social capital mediates this connection. These findings suggest that governments and communities should focus on the construction of community cultural capital and provide residents with better social capital to improve their health literacy to prepare for future pandemics.

The impact of patient safety incidents during hip and knee replacements on patients' health related quality of life: a before and after study using longitudinal data linked to patient-reported outcome measures.

BACKGROUND: The burden of patient safety incidents (PSIs) is often characterized by their impact on mortality, morbidity, and treatment costs. Few studies have attempted to estimate the impact of PSIs on patients' health-related quality of life (HRQoL) and the studies that have made such estimates primarily focus on a narrow set of incidents. The aim of this paper is to estimate the impact of PSIs on HRQoL of patients undergoing elective hip and knee surgery in England. PATIENTS AND METHODS: A unique linked longitudinal data set consisting of patient-reported outcome measures for patients with hip and knee replacements linked to Hospital Episode Statistics (HES) collected between 2013/14 and 2016/17 was examined. Patients with any of nine US Agency for Healthcare Research and Quality (AHRQ) PSI indicators were identified. HRQoL was measured using the general EuroQol five dimensions questionnaire (EQ-5D) before and after surgery. Exploiting the longitudinal structure of the data, exact matching was combined with difference in differences to estimate the impact of experiencing a PSI on HRQoL and its individual dimensions, comparing HRQoL improvements after surgery in similar patients with and without a PSI in a retrospective cohort study. This design compares the change in HRQoL before and after surgery in patients who experience a PSI to those who do not. RESULTS: The sample comprised 190 697 and 204 649 observations for patients undergoing hip replacement and knee replacement respectively. For six out of nine PSIs, patients who experienced a PSI reported improvements in HRQoL that were 14-23% lower than those who did not experience a PSI during surgery. Those who experienced a PSI were also more likely to report worse health states after surgery than those without a PSI on all five dimensions of HRQoL. CONCLUSION: PSIs are associated with a substantial negative impact on patients' HRQoL.

A Systematic Review of the Costs Relating to Non-pharmaceutical Interventions Against Infectious Disease Outbreaks.

BACKGROUND: Non-pharmaceutical interventions (NPIs) are the cornerstone of infectious disease outbreak response in the absence of effective pharmaceutical interventions. Outbreak strategies often involve combinations of NPIs that may change according to disease prevalence and population response. Little is known with regard to how costly each NPI is to implement. This information is essential to inform policy decisions for outbreak response. OBJECTIVE: To address this gap in existing literature, we conducted a systematic review on outbreak costings and simulation studies related to a number of NPI strategies, including isolating infected individuals, contact tracing and quarantine, and school closures. METHODS: Our search covered the MEDLINE and EMBASE databases, studies published between 1990 and 24 March 2020 were included. We included studies containing cost data for our NPIs of interest in pandemic, epidemic, and outbreak response scenarios. RESULTS: We identified 61 relevant studies. There was substantial heterogeneity in the cost components recorded for NPIs in outbreak costing studies. The direct costs of NPIs for which costing studies existed also ranged widely: isolating infected individuals per case: US$141.18 to US$1042.68 (2020 values), tracing and quarantine of contacts per contact: US$40.73 to US$93.59, social distancing: US$33.76 to US$167.92, personal protection and hygiene: US$0.15 to US$895.60. CONCLUSION: While there are gaps and heterogeneity in available cost data, the findings of this review and the collated cost database serve as an important resource for evidence-based decision-making for estimating costs pertaining to NPI implementation in future outbreak response policies.

Isocyano(triphenylphosphoranylidene)acetates: Key to the One-Pot Synthesis of Oxazolo[4,5-c]quinoline Derivatives via a Sequential Ugi/Wittig/aza-Wittig Cyclization Process.

A one-pot novel strategy is described for the construction of various oxazolo[4,5-c]quinoline derivatives starting from the isocyano(triphenylphosphoranylidene)acetates, aldehydes, amines, and 2-azidobenzoic acids. The reactions generated the target products directly in moderate to good yields via a sequential Ugi/Wittig/aza-Wittig cyclization process. The salient features of the method are that all three groups of the multifunctional isocyanides were involved in the reaction with broad substituent scopes and mild reaction conditions, making the protocol a useful contribution to the synthesis of oxazolo[4,5-c]quinoline heterocycles.

Detection and Management of Diabetes in England: Results from the Health Survey for England.

INTRODUCTION: As part of a control strategy current guidance in the UK recommends more intense surveillance of HbA1C levels among those of South-east Asian or Chinese ethnicity above specified BMI thresholds. The objective of this study was to determine whether disparities in the identification and control of diabetes in England persisted despite these guidelines and assess current strategies in light of these findings. METHODS: Data were extracted from the 2013 Health Survey for England that included ethnicity, BMI status and HbA1C levels. Descriptive statistics and logistic regression analyses were used to examine relationships among undetected diabetes, poorly controlled diabetes and a range of covariates including ethnicity and BMI. Concentration indices were used to examine the socio-economic gradient in disease detection and control among and between ethnic groups. RESULTS: In regression models that controlled for a range of covariates Asians were found to have a 5% point higher risk of undetected diabetes than Whites. With respect to disease management, Bangladeshis and Pakistanis were found to be at a 28% point and 21% point higher risk of poor disease control respectively than Whites. Concentration indices revealed better disease control among more affluent Whites than poor Whites, no significant pattern between income and disease management was found among Pakistanis and poorer disease control was more evident among more affluent than poorer Bangladeshis. CONCLUSION: In the UK current guidance recommends practitioners consider testing for diabetes among South-east Asians and Chinese where BMI exceeds 23. Our findings suggest that the risk experienced by Asians in disease detection is independent of BMI and may warrant a more active screening policy than currently recommended. With respect to disease management, our findings suggest that Indians and Pakistanis experience particularly high levels of poor disease control that may also be usefully reflected in guidance.

The intergenerational transmission of body mass index across countries.

There is a worldwide epidemic of obesity. We are just beginning to understand its consequences for child obesity. This paper addresses one important component of the crisis; namely the extent to which adiposity, or more specifically, BMI, is passed down from one generation to the next. We find that the intergenerational elasticity of BMI is very similar across countries and relatively constant - at 0.2 per parent. Our substantive finding is that this elasticity is very comparable across time and countries - even if these countries are at very different stages of economic development. Quantile analysis suggests that this intergenerational transmission mechanism is substantively different across the distribution of children's BMI; more than double for the most obese children what it is for the thinnest children. These findings have important consequences for the health of the world's children.1.

The intergenerational transmission of BMI in China.

Based on the China Health and Nutrition Survey longitudinal data from 1989 to 2009 and using BMI z-score as the measure of adiposity, we estimate the intergenerational transmission of BMI in China. The OLS estimates suggest that a one standard deviation increase in father's or mother's BMI is associated with an increase of around 20% in child's Body Mass Index (BMI) z-score. These estimates decrease to around 14% when we control for family fixed effects. We examine the heterogeneity of this BMI intergenerational transmission process across family income, parental occupation and poverty status and also find this intergenerational correlation tends to be higher among children of higher BMI levels, though this tendency becomes weaker as children approach adulthood.