Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and ...Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.展开更多
Background:Ambient temperature has been shown to have a positive association with the increasing emergency department burden.However,no studies have investigated the effects of ambient temperature on the number of eme...Background:Ambient temperature has been shown to have a positive association with the increasing emergency department burden.However,no studies have investigated the effects of ambient temperature on the number of emergency department visits(EDVs)for abdominal pain.Therefore,we conducted this study to evaluate the relationship between the two,with the aim of rationally allocating medical resources.Methods:We collected daily numbers of EDVs for abdominal pain data from the Zhongnan Hospital of Wuhan University and daily meteorological data from Wuhan from January 1,2016,to December 31,2018.We chose a generalized additive model combined with a distributed lag nonlinear model to assess the short-term effects of ambient temperature on EDVs for abdominal pain.We conducted stratification analyses according to sex,age,and the Chinese Emergency Triage Scale.Results:A total of 16,318 visits for abdominal pain were identified during the study period.The significant effects of extremely low temperature(-1°C)and moderately high temperature(26°C)were observed at Lag 0 day and Lag 0-1 day models.In the Lag 0 day model,the relative risks for extremely low and moderately high temperatures were 0.83(95%confidence interval[CI]:0.70-0.99;P=0.038)and 1.15(95%CI:1.06-1.25;P=0.001),respectively.Younger people were more likely to be affected by temperature.Cold and mildly hot weather were associated with the L2 and L3 levels,respectively.Moreover,low temperatures were negatively correlated with the risk of urolithiasis and cholecystitis.Conclusion:Low temperatures significantly reduced abdominal pain-related EDVs,whereas high temperatures had the opposite effect.展开更多
目的探究气象因素和PM2.5对山东省0~14岁人群中流行性腮腺炎(简称“流腮”)发病的影响,并分析其交互作用,为制定有效的预防控制策略提供科学依据。方法描述2015—2022年山东省流腮病例的流行病学特征,使用分布滞后非线性模型分析气...目的探究气象因素和PM2.5对山东省0~14岁人群中流行性腮腺炎(简称“流腮”)发病的影响,并分析其交互作用,为制定有效的预防控制策略提供科学依据。方法描述2015—2022年山东省流腮病例的流行病学特征,使用分布滞后非线性模型分析气象因素和PM2.5对流腮发病的非线性效应和滞后关系,计算相对超额危险度(relative excess risk due to interaction,RERI)和交互作用归因比(attributable proportion due to interaction,AP),以定量评估气象因素与PM2.5之间的交互作用。结果2015—2022年期间,山东省0~14岁人群累计报告流腮38330例,占总人群的82.89%,2015—2019年平均发病率为36.28/10万,高于2020—2022年平均发病率(19.27/10万);男女性别比为1.91∶1,学生和幼托儿童为主要感染对象。温度与流腮发病的总体效应呈“S”形,26℃时发病风险最大,RR值为1.38(95%CI:1.20~1.60);降水量的最大影响出现在累积降水量为3 mm且累积滞后4周时,RR值为1.31(95%CI:1.12~1.52);风速在3.9 m/s时对流腮发病的影响最高,RR值为1.41(95%CI:1.15~1.73);PM2.5对流腮的发病风险随质量浓度的增加而增加。温度与PM2.5、相对湿度与PM2.5对流腮发病有协同作用,RERI分别为0.28(95%CI:0.22~0.34)、0.19(95%CI:0.14~0.24),AP分别为0.27(95%CI:0.21~0.33)、0.20(95%CI:0.15~0.25);风速和PM2.5、气压和PM2.5对流腮发病表现为拮抗作用,RERI分别为-0.13(95%CI:-0.19~-0.07)、-0.12(95%CI:-0.19~-0.06),AP分别为-0.14(95%CI:-0.20~-0.08)、-0.16(95%CI:-0.24~-0.07)。结论高温、低降水、高风速和高质量浓度的PM2.5均是流腮发病的危险因素,温度与PM2.5、相对湿度与PM2.5之间存在协同作用,提示卫生部门应考虑气象条件和PM2.5浓度在学校开展流腮的防控工作,学校和幼儿园在日常预防中应加强对儿童个人卫生的教育及监督。展开更多
基金supported by ScientificResearch Fund of National Health Commission of the People’s Republic of China-Major Science and Technology Program for Medicine and Health in Zhejiang Province(WKJ-ZJ-2406).
摘要Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.
基金supported by the Department of Finance of Hubei Province,Hospital Discipline Capacity Building Project (grant number:YYXKNLJS2024013)the Hubei Provincial Natural Science Foundation of China (grant number:2024AFB797)
摘要Background:Ambient temperature has been shown to have a positive association with the increasing emergency department burden.However,no studies have investigated the effects of ambient temperature on the number of emergency department visits(EDVs)for abdominal pain.Therefore,we conducted this study to evaluate the relationship between the two,with the aim of rationally allocating medical resources.Methods:We collected daily numbers of EDVs for abdominal pain data from the Zhongnan Hospital of Wuhan University and daily meteorological data from Wuhan from January 1,2016,to December 31,2018.We chose a generalized additive model combined with a distributed lag nonlinear model to assess the short-term effects of ambient temperature on EDVs for abdominal pain.We conducted stratification analyses according to sex,age,and the Chinese Emergency Triage Scale.Results:A total of 16,318 visits for abdominal pain were identified during the study period.The significant effects of extremely low temperature(-1°C)and moderately high temperature(26°C)were observed at Lag 0 day and Lag 0-1 day models.In the Lag 0 day model,the relative risks for extremely low and moderately high temperatures were 0.83(95%confidence interval[CI]:0.70-0.99;P=0.038)and 1.15(95%CI:1.06-1.25;P=0.001),respectively.Younger people were more likely to be affected by temperature.Cold and mildly hot weather were associated with the L2 and L3 levels,respectively.Moreover,low temperatures were negatively correlated with the risk of urolithiasis and cholecystitis.Conclusion:Low temperatures significantly reduced abdominal pain-related EDVs,whereas high temperatures had the opposite effect.
摘要目的探究气象因素和PM2.5对山东省0~14岁人群中流行性腮腺炎(简称“流腮”)发病的影响,并分析其交互作用,为制定有效的预防控制策略提供科学依据。方法描述2015—2022年山东省流腮病例的流行病学特征,使用分布滞后非线性模型分析气象因素和PM2.5对流腮发病的非线性效应和滞后关系,计算相对超额危险度(relative excess risk due to interaction,RERI)和交互作用归因比(attributable proportion due to interaction,AP),以定量评估气象因素与PM2.5之间的交互作用。结果2015—2022年期间,山东省0~14岁人群累计报告流腮38330例,占总人群的82.89%,2015—2019年平均发病率为36.28/10万,高于2020—2022年平均发病率(19.27/10万);男女性别比为1.91∶1,学生和幼托儿童为主要感染对象。温度与流腮发病的总体效应呈“S”形,26℃时发病风险最大,RR值为1.38(95%CI:1.20~1.60);降水量的最大影响出现在累积降水量为3 mm且累积滞后4周时,RR值为1.31(95%CI:1.12~1.52);风速在3.9 m/s时对流腮发病的影响最高,RR值为1.41(95%CI:1.15~1.73);PM2.5对流腮的发病风险随质量浓度的增加而增加。温度与PM2.5、相对湿度与PM2.5对流腮发病有协同作用,RERI分别为0.28(95%CI:0.22~0.34)、0.19(95%CI:0.14~0.24),AP分别为0.27(95%CI:0.21~0.33)、0.20(95%CI:0.15~0.25);风速和PM2.5、气压和PM2.5对流腮发病表现为拮抗作用,RERI分别为-0.13(95%CI:-0.19~-0.07)、-0.12(95%CI:-0.19~-0.06),AP分别为-0.14(95%CI:-0.20~-0.08)、-0.16(95%CI:-0.24~-0.07)。结论高温、低降水、高风速和高质量浓度的PM2.5均是流腮发病的危险因素,温度与PM2.5、相对湿度与PM2.5之间存在协同作用,提示卫生部门应考虑气象条件和PM2.5浓度在学校开展流腮的防控工作,学校和幼儿园在日常预防中应加强对儿童个人卫生的教育及监督。