Individuals In China Research Articles

Prevalence of Lipoprotein(a) Measurement and its Association with Arteriosclerosis in Asymptomatic Individuals in China.

Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD), and its level is genetically determined. Although guidelines and consensuses in various cardiovascular fields have emphasized the importance of Lp(a), screening for Lp(a) in China has not been well studied. A cross-sectional study was conducted using a random sample of 30,000 medical examiners from each of the five health check-up centres. The distribution of Lp(a) was described for those who completed Lp(a) testing, and logistic regression modelling was used to evaluate the relationship between Lp(a) levels and vascular structure and function in the population who underwent carotid ultrasound and brachial‒ankle pulse wave velocity (baPWV) measurements. Lp(a) was measured in only 4400 (3.02%) of the 150,000 participants. Among those tested for Lp(a), the median concentration was 15.85 mg/dL. The proportion of participants with Lp(a) levels ≥ 30 mg/dL was 15.00%. Multiple logistic regression analysis revealed a significant correlation between Lp(a) and cIMT ≥ 1.0 mm (OR: 1.008, 95% CI: 1.001-1.014, P=0.020) and carotid artery plaques (OR: 1.010, 95% CI: 1.004-1.016, P=0.001) but no correlation with baPWV ≥ 1400 (OR: 0.999, 95% CI: 0.993-1.005, P=0.788) or baPWV ≥ 1800 (OR: 1.002, 95% CI: 0.993-1.011, P=0.634). The detection rate of Lp(a) at health checkups is low, and Lp(a) is positively associated with cervical vascular sclerosis and plaque but not with baPWV. Therefore, the testing rate of Lp(a) and the awareness of the risk of vascular structural changes due to Lp(a) should be further improved.

The Research on the Depiction of Female Identity in Eileen Chang’s Novellas

Female liberation is a grand topic in Chinese modernization. Analyzing female identity in Chinese literature in the 20th century, especially in female authors’ works, helps people get a closer picture of the traits and processes of the women’s rights movement. This paper provides a close reading of the female identity in four well-known Eileen Chang’s novellas, "Love in a Fallen City", "Aloeswood Incense", "The Golden Cangue" and "Lust, Caution" as a way to discuss Eileen Chang’s attitude towards female individualism and female liberation in China. Female autonomy and subjectivity are two themes that Eileen Chang repeatedly discusses in her novellas, emphasizing her wish and support for female individualism in China. However, her female characters’ pain and tragic ending reveal Eileen Chang’s pessimistic attitude towards the resolution of female struggles and the uncertainty towards female liberation in China.The author hopes to make some contributions to relevant fields through this research.

Clustering of lifestyle behaviours and analysis of their associations with MAFLD: a cross-sectional study of 196,515 individuals in China

BackgroundThe aggregation of lifestyle behaviours and their association with metabolic-associated fatty liver disease (MAFLD) remain unclear. We identified lifestyle patterns and investigated their association with the risk of developing MAFLD in a sample of Chinese adults who underwent annual physical examinations.MethodsAnnual physical examination data of Chinese adults from January 2016 to December 2020 were used in this study. We created a scoring system for lifestyle items combining a statistical method (multivariate analysis of variance) and clinical expertise (Delphi method). Subsequently, principal component analysis and two-step cluster analysis were implemented to derive the lifestyle patterns of men and women. Binary logistic regression analysis was used to explore the prevalence risk of MAFLD among lifestyle patterns stratified by sex.ResultsA total of 196,515 subjects were included in the analysis. Based on the defined lifestyle scoring system, nine and four lifestyle patterns were identified for men and women, respectively, which included “healthy or unhealthy” patterns and mixed patterns containing a combination of healthy and risky lifestyle behaviours. This study showed that subjects with an unhealthy or mixed pattern had a significantly higher risk of developing MAFLD than subjects with a relatively healthy pattern, especially among men.ConclusionsClusters of unfavourable behaviours are more prominent in men than in women. Lifestyle patterns, as important factors influencing the development of MAFLD, show significant sex differences in the risk of MAFLD. There is a strong need for future research to develop targeted MAFLD interventions based on the identified behavioural clusters by sex stratification.

New Changes and Challenges in the Youth Employment in China After Covid-19

Employment in the younger generation is related to citizens’ well-being, social development, and political stability. In comparison with other demographic groups, young individuals more often face various challenges. These include greater vulnerability in the labor market, dissatisfaction with their employment status, notable structural disparities in employment opportunities, and inadequate effectiveness of policy support in employment. This article focuses on the current employment difficulties faced by college students and other young individuals in China. Drawing insights from official data, survey data, and platform monitoring data, the analysis points out notable shifts in youth employment. These new changes encompass a rise in employment within state-owned enterprises and an increase in the proportion of flexible employment. The youth are now facing new challenges which involve the coexistence of both periodic unemployment and structural unemployment, as well as high education and high unemployment. To address these issues effectively, it is recommended to merge short-term stable economic growth with long-term structural adjustment, thereby improving the quantity and quality of employment opportunities for the youth.

Research on the Requirements and Functions of Mobile Applications for Tourism among Disabled Individuals in China

There is a large number of disabled people, and the number of disabled people will continue to grow in the future. With the booming development of the tourism industry, the demand for travel by disabled people is also increasing, but the travel experience of most disabled people is ignored. Developers of tourism mobile applications pay little attention to the travel needs of disabled people. Due to the lack of attention to this group, there is great room for improvement in the travel experience of disabled people. This article focuses on the needs of Chinese disabled people for mobile applications for tourism. Through user interviews and semantic analysis, this groups needs for application functions are studied. Then, through a questionnaire survey based on the Kano model, the priority of application functions is analyzed. This study believes that the psychological needs of disabled people to be respected should be the top priority, followed by the needs for affordability, safe travel, and convenient access to information, and finally, social needs.

Cultural tightness–looseness and normative social influence in eight Asian countries: Associations of individual and collective norms with vaccination intentions

RationaleCountries worldwide faced the same public health crisis that required promoting the same health behavior—vaccinations—during the COVID-19 pandemic. Thus, scholars have a unique opportunity to test behavioral change theories across countries with different cultural backgrounds. ObjectiveEmploying the extended theory of social normative behavior, this study examines the influence of individual and collective norms on COVID-19 vaccination intention across eight Asian countries. We examine how cultural tightness–looseness, defined as the degree of a culture's emphasis on norms and tolerance of deviant behavior, shapes normative social influence on COVID-19 vaccination intention. MethodsWe conducted a multicountry online survey (N = 2676) of unvaccinated individuals in China, Indonesia, Japan, Malaysia, Singapore, South Korea, Thailand, and Vietnam in May and June 2021, when COVID-19 vaccination mandates had not yet been implemented in those countries. We conducted hierarchical regression analyses with interaction terms for the total sample and then re-categorizied the eight countries as either “tight” (n = 1102) or “loose” (n = 1574) to examine three-way interactions between individual norms, collective norms, and cultural tightness-looseness. ResultsPerceived injunctive norms exerted the strongest impact of all normative factors on vaccination intention. Collective injunctive norms’ influence depended on both perceived injunctive and descriptive norms, which was larger when norms were lower (vs. higher). The interactive pattern between perceived and collective norms was more pronounced in countries with greater cultural tightness. ConclusionOur findings reveal nuanced patterns of how individual and collective social norms influence health behavioral decisions, depending on the degree of cultural tightness–looseness.

Digital health care service reform and health inequity for older people: a quasi-natural experiment in China.

Addressing health inequity (HI) for older people is a pivotal global public health concern, as it impedes the process of healthy ageing. The digital health care service reform (DHSR) emerges as a progressive public health approach to enhance the health and well-being of older adults by providing comprehensive and equitable medical services. This study elucidates the association between DHSR and HI for older individuals to augment comprehension of DHSR implementation. The initiation of the action plan for smart health and eldercare (SHE) in 2017 serves as a quasi-natural experiment. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018, a propensity score matching (PSM) method was used to select samples, and a difference-in-differences (DID) regression was used to ascertain the net effect of DHSR on HI for older individuals in China. This methodology mitigates selection bias and segregates the DHSR effect from temporal shifts or other occurrences. The PSM-DID analysis reveals that DHSR reduced the HI index for older individuals by 0.301 (p < 0.01). Heterogeneity analyses indicate that the effect of DHSR was more pronounced in older males (-0.333, p < 0.01) than females (-0.251, p < 0.05). The impact of DHSR was notably higher for older population in the western (-0.557, p < 0.01) and central regions (-0.318, p < 0.05) compared to the eastern region, where the relationship was statistically non-significant. The results demonstrate that DHSR plays a vital role in diminishing HI, fostering inclusive growth in public health. The study underscores the imperative of sustained DHSR endeavours and allocating resources to key older demographics to substantially mitigate HI.

Acalabrutinib in Chinese Patients (Pts) with Relapsed/Refractory (R/R) Chronic Lymphocytic Leukemia (CLL): 12-Month Efficacy and Safety Results from an Open-Label, Multicenter Phase 1/2 Trial

Background: CLL is a rare, incurable, relapsing disease occurring in approximately 0.3/100,000 individuals in China. Acalabrutinib (acala) is a highly selective Bruton tyrosine kinase inhibitor with minimal off-target activity approved in the US and Europe for treatment of CLL. Pivotal studies supporting acala's approval had limited inclusion of Asian populations. In the first phase 1/2 trial (NCT03932331) in Chinese pts with R/R CLL, acala demonstrated high response rates and acceptable tolerability at the 6-mo follow-up (Yang S et al. HemaSphere, 2023;7(S3):3716). We present 12-mo results from this trial. Methods: Adults with active CLL, Eastern Cooperative Oncology Group (ECOG) performance status ≤2, and who received ≥1 prior systemic therapies for CLL were enrolled to receive acala 100 mg twice daily in 28-day cycles until disease progression or treatment discontinuation due to adverse events (AEs) presenting substantial clinical risk. The primary endpoint was overall response rate (ORR) per 2018 International Workshop on Chronic Lymphocytic Leukemia criteria as assessed by blinded independent central review (BICR). Secondary endpoints included duration of response (DOR) and progression-free survival (PFS) as assessed by BICR; ORR, DOR, and PFS as assessed by investigators (INV); overall survival (OS); and AEs. Results: Sixty pts from 20 sites in China received acala (median age 62 y; 31.7% female; 21.7% with del(17p) and/or TP53 mutation; 51.7% with unmutated IGHV; median 1 prior line of therapy). At the updated data cutoff of December 22, 2022, 53 pts (88.3%) were receiving acala; reasons for acala discontinuation were progressive disease (5.0%; n=3), AEs (3.3%; n=2), pt decision (1.7%; n=1), and other (1.7%; n=1). Median duration of treatment was 19.4 mo (range 0.6-28.2). BICR-assessed ORR was 85.0% (95% CI 73.4, 92.9); no pt had complete response (CR). Median DOR by BICR was not reached (NR). At a median follow-up of 20.2 mo, median PFS by BICR was NR; the estimated 12-mo and 18-mo PFS rates were 91.5% (95% CI 80.9, 96.4) and 78.8% (95% CI 60.9, 89.2), respectively ( Figure). When assessed by INV, ORR was 85.0% (95% CI 73.4, 92.9) with 1 pt having CR, median DOR was NR, and median PFS was NR; estimated 12-mo and 18-mo PFS rates were 95.0% (95% CI 85.2, 98.3) and 87.2% (95% CI 69.1, 95.0), respectively. Median OS was also NR; the estimated 12-mo and 18-mo OS rates were both 96.7% (95% CI 87.3, 99.2). AEs of any grade were reported in 58 pts (96.7%); 25 pts (41.7%) had grade ≥3 AEs, most commonly decreased neutrophil count (13.3%, n=8), pneumonia, and upper respiratory tract infection (each 6.7%, n=4) ( Table). AEs leading to treatment discontinuation included paraneoplastic pemphigus (n=1) and rectal neoplasm (n=1). AEs leading to dose interruption were reported in 13 pts (21.7%), most commonly COVID-19 (5.0%), neutrophil count decreased (3.3%), and platelet count decreased (3.3%). Nine pts (15.0%) had serious AEs (SAEs); only 1 SAE occurred in &amp;gt;1 pt (pneumonia, n=2). Fatal AEs (occurring ≤30 d after last dose) were reported in 1 pt (cardiac arrest in a 73-y-old pt with multiple cardiorespiratory comorbidities on study day 34). Among events of clinical interest, neutropenia was reported in 24 pts (40.0%) and hypertension was reported in 3 pts (5.0%). There were no cases of atrial fibrillation/flutter, major hemorrhage, interstitial lung disease/pneumonitis, second primary malignancies, or tumor lysis syndrome. Conclusions: Twelve-mo data in Chinese pts with R/R CLL treated with acala demonstrated a high ORR, with responses that were durable and clinically meaningful. Continuous treatment with acala was well tolerated with manageable toxicities; no unexpected safety observations were observed in Chinese pts with R/R CLL.

An Analyze about the Impact of TikTok on the Perpetuating Factors of Stereotypes and Biases Toward Elderly Individuals in China

Nowadays, social media platforms, particularly TikTok, have become an integral part of modern netizens daily lives and have the potential to shape their views on various societal issues. This research aims to explore how TikTok perpetuates negative stereotypes and biases toward older people. And the results will be presented quantitatively, including the frequency and percentage of videos portraying older people in each of the three aspects and identifying patterns and themes. This essay analyzes the impact of TikTok(Chinese) (TikTok in China) on perpetuating negative stereotypes and biases toward elderly individuals. It will explore the potential positive or negative effects of TikTok(Chinese) on the perception of elderly individuals and examines the reasons behind the platforms potential contribution to perpetuating stereotypes and biases toward the elderly population. The research data shows that TikTok amplifies stereotypical impressions of older people by portraying them as preachy, lacking manners, and only good at cooking. The essay concludes with the impact of TikTok on the stereotypical impressions of older people and also the potential effects of TikTok on perpetuating negative stereotypes and biases towards more senior people in China.

Inflation Rate Prediction based on SARIMA-RF

Accurate prediction of the inflation rate can help governments prevent social problems caused by inflation, maintain social stability, and is crucial for the economy and society. Considering the nonlinear characteristics of China's inflation rate series, this paper uses the month-on-month Consumer Price Index (CPI) data from January 2011 to March 2023 to measure the inflation rate in China. Firstly, the monthly inflation rate series from January 2011 to December 2021 is analyzed to identify significant and complex seasonal effects. Therefore, suitable SARIMA models and Random Forest (RF) models are separately constructed. In order to better capture the nonlinear features of the inflation rate series, this paper proposes a SARIMA-RF fusion model based on simple linear weighting. Using monthly data from December 2022 to March 2023, the mean absolute error and root mean square error are used as evaluation metrics for forecasting errors. The results indicate that the prediction error of the SARIMA-RF fusion model is significantly lower than that of the SARIMA model and the RF model. The proposed model can more effectively extract the nonlinear features of China's inflation rate series and accurately predict its changes. It has valuable implications for the government, society, and individuals in China.

A large survey on COVID-19 vaccination in patients with Parkinson’s disease and healthy population

BackgroundA full rollout of COVID-19 vaccination offers the most promising prospect of bringing the pandemic to an end. This study aimed to compare the coverage, safety, and confidence of COVID-19 vaccination between patients with Parkinson’s disease (PD) and healthy individuals so as to give suggestions for future immunization programs. MethodsA web-based, nationwide, multicenter survey was carried out in China from 2021 to 2022. The age and sex-standardized vaccination rate was calculated. Multivariate stepwise logistic regression models were used to estimate the influencing factors of vaccination status. We also investigated vaccination safety, willingness, confidence, and reasons for hesitancy with some ad hoc questions. ResultsA total of 962 PD patients and 1208 healthy individuals participated in this survey with a vaccination rate of 71.1% vs 94.4% respectively. PD patients living in first-tier cities, with comorbidities, experiencing unstable PD with a longer course and levodopa use were less likely to get vaccinated, while healthy individuals living in first-tier cities and feeling physically poor exhibited a lower vaccination rate. For PD patients, concern about the adverse impact on existing illness and disagreement from doctors were the most common reasons for vaccination hesitancy. Whereas, no evidence was present that they experienced any local or systematic adverse events more frequently or seriously than healthy individuals, or their state of PD and comorbidities was seriously exacerbated after vaccination. A prominent transition from a little concerned to unconcerned about the security and efficacy of vaccines was evident among both two populations from pre-vaccination to post-vaccination. ConclusionsThe COVID-19 vaccination rate was remarkably lower in PD patients than healthy individuals in China. The approved vaccines have shown an acceptable safety profile. Our findings would offer a reference to guide future clinical decision-making of COVID-19 vaccination and improve the immunization management of PD patients.

Correlation between air pollution and cognitive impairment among older individuals: empirical evidence from China

BackgroundLittle information is available regarding the impact of air pollution on cognitive impairment in older individuals in developing countries. This study empirically tested the impacts of the air quality index (AQI), air pollution intensity (quantified by the number of days of extreme air pollution in a year), and different pollutants on the cognitive abilities of older Chinese individuals.MethodsA panel of 28,395 participants spanning 122 cities in 2015 and 2018 was used, based on 3-year follow-up survey data from the China Health and Retirement Longitudinal Study (CHARLS) database. Data from the two phases of the CHARLS microsurvey were combined with relevant statistical data on air pollution in each region in the current year. These two surveys were used to investigate changes in basic health and macro-environmental indicators in older individuals in China, and a mean difference test was conducted. We then reduced the sample selection error by controlling for environmental migration and used two-way fixed and instrumental variable methods for endogenous treatment to avoid the estimation error caused by missing variables.ResultsAir pollution had a significantly negative effect on the cognitive abilities of older individuals (odds ratio [OR]: 1.4633; 95% confidence interval [95% CI]: 1.20899–1.77116). Different pollution intensities(only AQI value is greater than 200 or more) had apparent effects on cognitive impairment, with an OR of approximately 1.0. Sulfur dioxide had significantly negative effects on cognitive ability, with OR of 1.3802 (95% CI: 1.25779–1.51451). Furthermore, air pollution impact analysis showed heterogeneous results in terms of age, sex, education, and regional economic development level. In addition, social adaptability (calculated using social participation, learning, adaptability, and social support) not only had a significant positive effect on the cognitive abilities of older individuals, but also regulated the cognitive decline caused by air pollution.ConclusionsAir pollution affects cognitive impairment in older individuals, especially in those with lower education levels, and living in economically underdeveloped areas. This effect is synchronous and has a peak at an AQI of > 200.

Research progress on the comorbidity between hepatitis B virus infection and noncommunicable diseases

With the decline in hepatitis B virus (HBV) incidence and the increase in the life expectancy of infected individuals, the population infected with HBV is experiencing rapid aging, leading to an escalating risk of co-morbid chronic noncommunicable diseases (NCDs). This study summarizes research related to the comorbidity between HBV and NCDs, discussing the aging of the HBV-infected population, the mechanisms, prevalence, and management of this comorbidity. This study provides insights into potential directions for future research on the comorbidity between HBV and NCDs and aims to provide a basis for further research and the development of prevention and treatment strategies for the comorbidity of NCDs among HBV-infected individuals in China.

Optimal cut-off MoCA score for screening for mild cognitive impairment in elderly individuals in China: A systematic review and meta-analysis.

To evaluate the optimal cut-off MoCA score for elderly individuals with MCI. A systematic review and meta-analysis. Articles were retrieved from PubMed, Ovid, Embase, The Cochrane Library, PsycINFO, CBM, CNKI, WanFang and CQVIP and were assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Figures of the assessment were made by using Review Manager 5.3, and a meta-analysis of the data was conducted by using Bivariate Random-effects Meta-Analysis (BRMA) via Stata 14.0. Seventeen articles were retrieved from the database, and when the cut-offs were 24/25 and 25/26, they represented the same diagnostic value; in addition, the AUC was 0.96, which demonstrated high predictive validity for mild cognitive impairment screening. However, the sensitivity was higher with 25/26 (se=0.95, sp=0.80), whereas the specificity was higher with 24/25 (se=0.92, sp=0.89).

Prevalence of social frailty and its associated factors in the older Chinese population: a national cross-sectional study

BackgroundSocial frailty has not been comprehensively studied in China. Our objective is to investigate the prevalence of social frailty among the older population in China, as well as identify relevant factors and urban-rural differences.MethodsWe obtained data from the Fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) database. The study employed a multistage, stratified, cluster-sampling method, recruiting a total of 224,142 adults aged 60 years or older. Participants were interviewed to gather demographic data and information on family, health and medical conditions, health care service status, living environment conditions, social participation, protected rights status, spiritual and cultural life, and health. Social frailty was assessed using the HALFE Social Frailty Index. A score of three or above indicated social frailty.ResultsWe analyzed a total of 222,179 cases, and the overall prevalence of social frailty was found to be 15.2%. The highest prevalence was observed among participants aged 75–79 years (18.0%). The prevalence of social frailty was higher in rural older populations compared to urban older populations (19.9% in rural vs. 10.9% in urban, P < 0.0001). In urban areas, women had a higher prevalence than men (11.7% in women vs. 9.9% in men, P < 0.0001), while in rural areas, men had a higher prevalence than women (20.6% in men vs. 19.2% in women, P < 0.0001). Multivariate regression analysis revealed that living in a rural/urban environment (OR 1.789, 95% CI 1.742–1.837), absence of a spouse/spousal presence (OR 4.874, 95% CI 4.743–5.009), self-assessed unhealthy/health status (OR 1.696, 95% CI 1.633–1.761), and housing dissatisfaction/satisfaction (OR 2.303, 95% CI 2.233–2.376) were all significantly associated with social frailty.ConclusionsUsing the HALFE social frailty index, we found a prevalence of 15.2% among older people in China, with the highest prevalence observed in the 75–79 age group. Social frailty was more prevalent in rural areas than in urban areas. Various factors, including spousal presence, housing satisfaction, health status, and urban-rural residential differences, were significantly associated with social frailty. These findings highlight the modifiable and non-modifiable factors that contribute to social frailty among older individuals in China.

Health indicators, mode choice, and trip time-cost trade-offs: Evidence from out-patient trips to health care facilities

This paper analyzes whether health indicators affect the values that out-patient trip-makers place upon their travel times. Data for the analysis is a biennial longitudinal sample from 2011 to 2015, comprising individuals in China 45 years of age and older. For nineteen health factors that characterize health behaviors, disease events, physical mobility, and mental health, the analysis estimates baseline mode-choice models and separate models for respondents with and without a negative health factor present. The study documents increasing trends in travel time sensitivities and values of travel time, and finds that health status affects travel time sensitivities and values of travel time. Problems with physical mobility lower out-patient trip makers' values of travel time, whereas health factors related to non-physical mobility conditions tend to raise values of travel time. The study includes robustness tests and a discussion of endogeneity. The study's findings have implications for older population mode choices, transport and health infrastructure projects focused on providing more access, and for cost-benefit analyses whose benefits include value of travel time savings.

Heterogeneity of Orofacial Clefts and Associated Anomalies in China.

Despite the large number of affected individuals in China, information on the descriptive epidemiology of orofacial clefts in the Chinese population remains limited. Therefore, the authors aimed to report a detailed clinical classification of orofacial clefts, including microform cleft lip (CL), and associated malformations in patients from a major cleft surgical unit in China. The authors reviewed the medical records of 718 patients who underwent primary cleft repair surgery at their center between December 2016 and April 2023. The sex distribution varied with cleft type and extent, and males had a higher proportion of clefts with increased severity than females. In patients with a unilateral CL, the ratio of left-to-right-sided clefts was 1.85:1. The frequency of associated congenital malformations in patients with microform CL only, overt CL only, CL and palate, and cleft palate only was 8.0%, 7.6%, 14.9%, and 30.9%, respectively. A total of 98 malformations were observed in 69 patients with congenital anomalies of unknown origin. Among these, cardiovascular anomalies were the most common, identified in 27 patients (39.1%), followed by head and neck and musculoskeletal anomalies. The high risk of heart defects highlights the importance of routine echocardiography. Microform CL exhibited increased prevalence and a similar frequency of associated malformations with overt CL, suggesting that this mild phenotype requires further attention by clinicians.

Public Attitudes About the Use of Gene Therapy in Mainland China

In addition to technical barriers, public attitudes about the use of gene therapy have an important association with the clinical implementation of gene therapy. To investigate the factors associated with public acceptance of gene therapy among individuals in China. This cross-sectional study used data from a survey conducted among 21 880 individuals in mainland China from June 20 to August 31, 2022. Stepwise linear regression was used to analyze factors associated with public acceptance of gene therapy in 5 key areas: basic personal information (gender, region, age, and educational level), family situation (marital status, children, and cousins), economic status (assets, debts, and insurance coverage), health knowledge (health literacy score and media use), and physical health status (chronic illness, cancer, European Quality of Life 5-Dimension 5-Level version [EQ-5D-5L] score, and Brief Illness Perception Questionnaire [BIPQ] score). Acceptance scores were calculated based on a visual analog scale (range, 0-100, with higher scores indicating higher acceptance of gene therapy). Further subgroup analysis was carried out in different age subgroups and populations with or without chronic diseases. A total of 21 880 participants (mean [SD] age, 39.4 [18.9] years; 10 947 female participants [50.0%]; 10 933 male participants [50.0%]) were analyzed in this study. The mean (SD) acceptance score of gene therapy in the survey was 60.56 (27.60). Compared with people aged 60 years or older, those aged 12 to 18 years had higher acceptance of gene therapy (β = 1.48 [95% CI, 0.09-2.88]), while groups aged 19 to 30 years (β = -3.43 [95% CI, -4.80 to -2.07]), 31 to 44 years (β = -1.44 [95% CI, -2.76 to -0.12]), and 45 to 59 years (β = -2.05 [95% CI, -3.27 to -0.83]) had lower acceptance. Compared with people living in Eastern China, those in Central China had lower acceptance of gene therapy (β = -1.58 [95% CI, -2.54 to -0.62]), while those in Western China had higher acceptance (β = 0.92 [95% CI, 0.09-1.76]). Higher educational level (undergraduate or above vs junior high or below) was associated with higher acceptance of gene therapy (β = 1.56 [95% CI, 0.49-2.63]). Number of properties owned was also associated with higher acceptance of gene therapy (2 vs 0: β = 2.38 [95% CI, 1.04-3.72]; ≥3 vs 0: β = 4.66 [95% CI, 2.92-6.39]). Diagnosis of chronic disease was associated with lower acceptance of gene therapy (β = -17.86 [95% CI, -20.49 to -15.24]), while diagnosis of cancer was associated with higher acceptance (β = 6.99 [95% CI, 1.84-12.14]). Higher BIPQ score (β = 0.40 [95% CI, 0.34-0.45]), higher health literacy score (β = 0.70 [95% CI, 0.62-0.78]), and media use (β = 0.49 [95% CI, 0.41-0.57]) were all associated with high acceptance of gene therapy, while a higher EQ-5D-5L score was associated with lower acceptance (β = -0.29 [95% CI, -0.47 to -0.11]). For older people, being in debt, not having health insurance, and the EQ-5D-5L score were uniquely relevant factors. For people with chronic disease, having an undergraduate degree or higher, a diagnosis of cancer, and the BIPQ score were uniquely relevant factors. These results suggest that basic personal information, economic status, health knowledge, and physical health status were the main factors associated with the acceptance of gene therapy. Improving the health literacy of the population and promoting trust in gene therapy may be effective ways to increase the acceptance of gene therapy. Poorer economic levels and worse disease states may reduce the public's willingness to accept gene therapy.

Relationship between depressive symptoms and anemia among the middle-aged and elderly: a cohort study over 4-year period

BackgroundThe association between anemia and depression has been demonstrated in previous studies, but it's still unclear whether depressive symptoms as a hazard factor for anemia. The findings of a large-scale cross-sectional and longitudinal examination of such an association of among the middle-aged and elderly individuals in China were presented in our study.MethodsThe data from China Health and Retirement Longitudinal Study in 2011 and 2015 were evaluated. 10,179 and 5,887 participants were included in cross-sectional and longitudinal study, respectively. According to the World Health Organization, hemoglobin concentrations below 13 g/dL for males and 12 g/dL for females are considered anemia. The research population was separated into two groups based on scores of the 10-item short form of the Center for Epidemiologic Studies Depression Scale (CES-D-10): the group with depressed symptoms had a score of more than 10 points, and the group with depressive disorder had a score of more than 20 points. Multilevel logistic regression analyses were conducted to explore the relationship between anemia and varying degrees of depressive symptoms, utilizing three models based on adjusting for different types of covariates.ResultsIn our cross-sectional investigation, depression disorders were more likely to link to the occurrence of anemia (OR, 1.34; 95% CI, 1.02–1.77; P = 0.035). Additionally, there seems a linear connection between depression questionnaire scores and hemoglobin concentrations (r = - 0.053, P < 0.001). Depressive symptom was significantly associated with anemia over 4 years of follow-up, and the more intense the depressive symptoms, the greater the danger of anemia (depressive symptoms group: OR, 1.27; 95% CI, 1.02–1.57, P = 0.032; depressive disorder group: OR, 1.59; 95% CI, 1.12–2.25, P = 0.010).ConclusionsOur findings suggest that depression symptoms seem related to anemia in the middle-aged and elderly in China cross-sectionally and longitudinally, and that the risk of anemia increases with the severity of depressive symptoms.

Association of frailty with health service use among older Chinese adults: analysis of population-based panel data.

Frailty is a common syndrome characterized by rapid growth in the aging population that has an impact on healthcare systems. This study aimed to investigate the impact of frailty on health service use and whether this effect varies with chronic diseases and socioeconomic status among older individuals in China. A balanced panel data analysis was conducted on 3,306 older individuals who completed follow-ups for the three waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, and 2015. The Physical Frailty Phenotype (PFP) Scale was used to assess frailty status. Negative binomial regression was used to test the associations between frailty status, outpatient visits in the past 4 weeks, and annual inpatient hospital days. Compared with robust individuals, individuals with pre-frail or frail status were likely to report a higher number of outpatient visits [pre-frail: incidence rate ratio (IRR) = 1.28, 95% CI = 1.16-1.41; frail: IRR = 1.45, 95% CI = 1.23-1.71], and inpatient hospital days (pre-frail: IRR = 1.40, 95% CI = 1.24-1.58; frail: IRR = 2.17, 95% CI = 1.81-2.60) after controlling for all covariates. All five frailty components (weight loss, exhaustion, low physical activity, slowness, and weakness) were associated with a higher number of inpatient hospital days, and two components (weight loss and exhaustion) were associated with a higher number of outpatient visits. The effect of frailty on inpatient hospital stays persisted in different socioeconomic groups, across all health insurance programmes and physical comorbidities. Frailty is associated with greater health service use among older individuals. Effective screening, prevention, intervention, and management of frailty may be important to reduce health service use.