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BackgroundStudies on the relationships of environmental noise exposure with negative emotions and sleep quality have long been reported. Self-perceived noise intensity is not only related to environmental noise exposure, but also reflects an individual's susceptibility to noise; however, few studies on self-perceived noise intensity, negative emotions, and sleep quality have been reported, and it is not clear whether negative emotions play a mediating role in the relationship between self-perceived noise intensity and sleep quality. ObjectiveTo analyze the mediating role of negative emotions (anxiety, depression, and stress) in the relationship between self-perceived noise intensity and sleep quality in noise-exposed workers, and to provide a scientific basis for addressing psychological problems and sleep quality induced by noise exposure. MethodsStratified cluster sampling was used to select noise-exposed workers from a large equipment manufacturing plant in Chengdu from May to June 2023, and demographic characteristics were investigated using a self-designed general information questionnaire; self-perceived noise intensity was reported by the study subjects as the noise intensity of their workplaces; sleep quality was synthesized from three indicators: night sleep duration, self-perceived sleep quality, and sleep-related symptoms; the Anxiety-Depression-Stress Scale (DASS-21 scale) was used to evaluate anxiety, depression, and stress of a worker. Structural equation modeling was used to analyze the pathways of negative emotions (anxiety, depression, and stress) between self-perceived noise intensity and sleep quality. ResultsThe positive rates of negative emotions were 33.1% (anxiety symptoms, 215/649), 26.0% (depression symptoms, 169/649), and 14.0% (stress symptoms, 91/649), respectively in a total of 649 noise-exposed workers. Self-perceived noise intensity was positively correlated with sleep quality score (r=0.218, P

Abstract Background A major shift in the “dynamic zero-COVID” policy was announced by China’s National Health Commission on December 7, 2022, and the subsequent immediate large-scale outbreak of SARS-CoV-2 infections in the entire country has caused worldwide concern. This observational cross-sectional study aimed to describe the epidemiological characteristics of this outbreak in Sichuan, China. Methods All data were self-reported online by volunteers. We described the epidemic by characterizing the infection, symptoms, clinical duration, severity, spatiotemporal clustering, and dynamic features of the disease. Prevalence ratio (PR), Odds ratios (ORs) and adjusted ORs were calculated to analyze the associations between risk factors and infection and the associations of risk factors with clinical severity using log-binomial and multivariable logistic regression models; 95% confidence intervals (CIs) and Wald test results were reported. The prevalence rates and clinical severity among different subgroups were compared using the Chi-square and trend Chi-square tests. Results Between January 6 and 12, 2023, 138,073 volunteers were enrolled in this survey, and 102,645 were infected with COVID-19, holding a prevalence rate of 74.34%; the proportion of asymptomatic infections was 1.58%. Log-binomial regression revealed that the risk of infection increased among those living in urban areas. Multivariable logistic regression analysis showed that female sex, chronic diseases, older age and the fewer doses of vaccine received were associated with an increased risk of severe clinical outcomes after infection. We estimated the mean reproduction number during this pandemic was 1.83. The highest time-dependent reproduction number was 4.15; this number decreased below 1 after 11 days from December 7, 2022. Temporal trends revealed a single peak curve with a plateau pattern of incidence during the outbreak, whereas spatiotemporal clustering analysis showed that the onset in 21 cities in the Sichuan province had four-wave peaks. Conclusions The peak of the first wave of Omicron infection in Sichuan Province had passed and could be considered a snapshot of China under the new control strategy. There were significant increases in the risk of severe clinical outcomes after infection among females, with chronic diseases, and the elderly. The vaccines have been effective in reducing poor clinical outcomes.

Abstract Background Person-environment fit (PEF) theory, one of the foundational theories of occupational stress, has primarily found applications in organizational behavior and human resource management. Given the alignment between the definition of occupational stress and the essence of PEF, we introduced the concept of worker-occupation fit (WOF). To validate our theoretical model, the development of an instrument to measure WOF becomes imperative. Methods The Worker-Occupation Fit Inventory (WOFI) comprises three dimensions: personal trait fit (PTF), need-supply fit (NSF) and demand-ability fit (DAF). Job-related mental disorders (JRMDs) were assessed using the DASS-21. During the pre-investigation, items of the WOFI underwent screening through classic test theory (CTT) analysis. In the formal investigation, item response theory (IRT) analysis was employed to evaluate the selected items. The relationship between WOF and JRMD was verified by Pearson’s correlation analysis and multiple logistic regression analysis. Results The initial version consisted of 26 items. Three common factors were extracted by exploratory factor analysis (EFA): 6 items were included in the PTF, 6 items were included in the NSF, 4 items were included in the DAF, and 10 items were deleted because of unacceptable factor loadings. The confirmatory factor analysis (CFA) verified the structure of the WOFI with χ2/df = 1.822, CFI = 0.947, and SRMSR = 0.056. The Cronbach's alpha coefficients of the PTF, NSF, and DAF were 0.91, 0.92, and 0.80, respectively. In IRT analysis, the discrimination values of all items ranged from 1.25 to 2.53, and the difficulty values of all items ranged from -6.28 to 1.30 (with no difficulty of reversal). The WOF was negatively related to job-related stress (r = -0.34, p

BackgroundThe correlation between noise exposure and negative emotions of noise-exposed workers has received increasing attention and related studies have been reported. However, there is a lack of research on the path and effect analysis of the relationship between noise exposure and negative emotions, which will contribute to a more comprehensive understanding of the health damage characteristics of noise in addition to hearing loss.ObjectiveTo explore the path and effects of cumulative noise exposure, tested hearing thresholds, and conscious hearing level of noise-exposed workers on negative emotions.MethodsUsing stratified random sampling, 312 noise-exposed workers from a machinery and equipment manufacturing enterprise were selected. Occupational history, negative emotions (including the feelings of stress, anxiety, and depression), and conscious hearing level of the workers were investigated using the Depression-Anxiety-Stress Scale (DASS-21) and a self-made questionnaire. The hearing threshold of the workers was measured by pure tone air conduction audiometry. Sound level meter was used to measure noise equivalent sound level at selected work sites. Individual cumulative noise exposure was estimated based on work site noise level and personal noise exposure history. Path analysis was used to analyze potential mediating effects of workers' hearing thresholds and conscious hearing levels on the relationship between noise exposure and negative emotions (including stress, anxiety, and depression).ResultsThe positive rates of negative emotions among the 312 noise-exposed workers were 18.27% (57/312) for stress, 46.79% (146/312) for anxiety, and 28.53% (89/312) for depression; the cumulative noise exposure ranged from 101.0 to 136.1 dB(A)·d, with an average of 125.69 dB(A)·d. The distributions of tested hearing thresholds and conscious hearing levels among the workers exposed to noise were significantly inconsistent (P

ObjectiveThe complicated association of daytime napping, biological aging and cognitive function remains inconclusive. We aimed to evaluate the cross-sectional and longitudinal associations of daytime napping and two aging measures with cognition and to examine whether napping affects cognition through a more advanced state of aging.MethodsData was collected from the China Health and Retirement Longitudinal Study. Napping was self-reported. We calculated two published biological aging measures: Klemera and Doubal biological age (KDM-BA) and physiological dysregulation (PD), which derived information from clinical biomarkers. Cognitive z-scores were calculated at each wave. Linear mixed models were used to explore the longitudinal association between napping, two aging measures, and cognitive decline. Mediation analyses were performed to assess the mediating effects of biological age acceleration on the association between napping and cognition.ResultsParticipants aged over 45 years were included in the analyses. Non-nappers had greater KDM-BA and PD [LS means (LSM) = 0.255, p = 0.007; LSM = 0.085, p = 0.011] and faster cognitive decline (LSM = −0.061, p = 0.005)compared to moderate nappers (30–90 min/nap). KDM-BA (β = −0.007, p = 0.018) and PD (β = −0.034, p

Abstract Objective To summarise the dynamic characteristics of COVID-19 transmissibility; To analyse and quantify the effect of control measures on controlling the transmissibility of COVID-19; To predict and compare the effectiveness of different control measures. Methods We used the basic reproduction number ( $${R}_{0}$$ R 0 ) to measure the transmissibility of COVID-19, the transmissibility of COVID-19 and control measures of 176 countries and regions from January 1, 2020 to May 14, 2022 were included in the study. The dynamic characteristics of COVID-19 transmissibility were summarised through descriptive research and a Dynamic Bayesian Network (DBN) model was constructed to quantify the effect of control measures on controlling the transmissibility of COVID-19. Results The results show that the spatial transmissibility of COVID-19 is high in Asia, Europe and Africa, the temporal transmissibility of COVID-19 increases with the epidemic of Beta and Omicron strains. Dynamic Bayesian Network (DBN) model shows that the transmissibility of COVID-19 is negatively correlated with control measures. Restricting population mobility has the strongest effect, nucleic acid testing (NAT) has a strong effect, and vaccination has the weakest effect. Conclusion Strict control measures are essential for controlling the COVID-19 outbreak; Restricting population mobility and nucleic acid testing (NAT) have significant impacts on controlling the COVID-19 transmissibility, while vaccination has no significant impact. In light of these findings, future control measures may include the widespread use of new NAT technology and the promotion of booster immunization.

BackgroundThe positive rate of sputum bacteria in patients with pneumoconiosis complicated with pulmonary tuberculosis is lower than that in patients with simple tuberculosis, which makes the disease assessment more difficult.ObjectiveTo compare the differences of blood test indexes between patients with pneumoconiosis complicated with bacteriologically negative and bacteriologically positive pulmonary tuberculosis, so as to provide a basis for the assessment of lesions in patients with pneumoconiosis complicated with pulmonary tuberculosis.MethodsThe relevant information of 329 patients with pneumoconiosis complicated with tuberculosis diagnosed from 2010 to 2020 was retrospectively collected, including 260 cases of pneumoconiosis complicated with bacteriologically negative tuberculosis (B-TB) and 69 cases of pneumoconiosis complicated with bacteriologically positive tuberculosis (B+TB). The demographic characteristics and blood test indexes of the two groups of patients were analyzed and compared, and logistic regression analysis was conducted to identify factors associated with pneumoconiosis complicated with bacteriologically positive tuberculosis.ResultsBody mass index (BMI) was significantly different between the two groups (P

Background:Meteorological factors can affect the emergence of scrub typhus for a period lasting days to weeks after their occurrence. Furthermore, the relationship between meteorological factors and scrub typhus is complicated because of lagged and non-linear patterns. Investigating the lagged correlation patterns between meteorological variables and scrub typhus may promote an understanding of this association and be beneficial for preventing disease outbreaks.MethodsWe extracted data on scrub typhus cases in rural areas of Panzhihua in Southwest China every week from 2008 to 2017 from the China Information System for Disease Control and Prevention. The distributed lag non-linear model (DLNM) was used to study the temporal lagged correlation between weekly meteorological factors and weekly scrub typhus.ResultsThere were obvious lagged associations between some weather factors (rainfall, relative humidity, and air temperature) and scrub typhus with the same overall effect trend, an inverse-U shape; moreover, different meteorological factors had different significant delayed contributions compared with reference values in many cases. In addition, at the same lag time, the relative risk increased with the increase of exposure level for all weather variables when presenting a positive association.ConclusionsThe results found that different meteorological factors have different patterns and magnitudes for the lagged correlation between weather factors and scrub typhus. The lag shape and association for meteorological information is applicable for developing an early warning system for scrub typhus.

ObjectiveDuring the COVID-19 pandemic, the occupational stress of medical staff has been a major issue. This study aimed to suggest a new strategy to identify high-risk factor sets of occupational stress in medical staff using fuzzy-set qualitative comparative analysis (fs-QCA) and provide ideas for the prevention and intervention of occupational stress.MethodsA total of 1,928 medical staff members were surveyed and tested using the Acceptance and Action Questionnaire-II (AAQ-II), Occupational Stress Inventory-Revised edition (OSI-R), and Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RSC). The fs-QCA was used to explore the high-risk factors for occupational stress among medical staff.ResultsThe psychological strain (PSY) score of the medical staff was 26.8 ± 7.13, and the physical strain (PHS) score was 24.3 ± 6.50. Low psychological flexibility score-introversion-high role overload, introversion-neuroticism-high role overload, and low psychological flexibility score-neuroticism were high-risk factor sets for PSY. Low psychological flexibility score-introversion-high role overload, low psychological flexibility score-introversion-neuroticism, low psychological flexibility score-neuroticism-high role overload, low psychological flexibility score-psychoticism-neuroticism, and psychoticism-neuroticism-high role overload were high-risk factor sets for PHS.ConclusionThere are different combinations of high-risk factors for occupational stress among the medical staff. For occupational stress intervention and psychological counseling, targeted and individualized health intervention measures should be implemented according to specific characteristic combinations of different individuals.

ObjectiveEvidence is scarce about the effect of noise exposure on the risk of dementia. We conducted a systematic review and dose-response meta-analysis, aiming to explore the association between noise exposure and the risk of dementia.MethodsWe searched PubMed, EMBASE and the Cochrane Library to collect studies on chronic noise exposure and the risk of dementia from database inception to September 18, 2021 without language limitations. Two authors independently screened the literature, extracted data and assessed the risk of bias of the included studies. A dose-response meta-analysis and subgroup analysis were then conducted to detect the association between noise exposure and the risk of dementia by using Stata 14.0 software. This study is registered on PROSPERO (CRD42021249243).ResultsA total of 11 studies were eligible for qualitative synthesis, and nine were eligible for quantitative data synthesis. All of them showed moderate to high quality scores in the assessment of risk of bias. We found a positive linear association between the noise increment and dementia risk (R2 = 0.58). When noise exposure increased 57 dB, the RR of dementia was 1.47 (95% CI: 1.21–1.78). From the outcome subgroup of AD, AD and dementia, VaD and NAD, we also found a positive association (R2 = 0.68, 0.68, 0.58, respectively). When noise exposure increased by 25 dB, the RRs were 1.18 (95% CI: 1.14–1.23), 1.19 (95% CI: 1.14–1.23) and 1.17 (95% CI: 1.06–1.30), respectively. We found a nonlinear association between the noise increment and dementia risk when only cohort studies were included (R2 = 0.58). When noise exposure increased by 25 dB, the RR of dementia was 1.16 (95% CI: 1.12–1.20). From the subgroup of AD, AD and dementia, VaD and NAD of cohort studies, the regression curve showed a nonlinear positive association (R2 = 0.74, 0.71, 0.43, respectively). When noise exposure increased by 25 dB, the RRs were 1.17 (95% CI: 1.12–1.21), 1.17 (95% CI: 1.12–1.22) and 1.13 (95% CI: 0.99–1.28), respectively.ConclusionBased on the current evidence, exposure to noise may be a specific risk factor for dementia. To better prevent dementia, more rigorously designed studies are needed to explore the etiological mechanism of noise and dementia.

Abstract Background High-frequency hearing loss is a significant occupational health concern in many countries, and early identification can be effective for preventing hearing loss. The study aims to construct and validate a risk model for HFHL, and develop a nomogram for predicting the individual risk in noise-exposed workers. Methods The current research used archival data from the National Key Occupational Diseases Survey-Sichuan conducted in China from 2014 to 2017. A total of 32,121 noise-exposed workers completed the survey, of whom 80% workers (n = 25,732) comprised the training cohort for risk model development and 20% workers (n = 6389) constituted the validation cohort for model validation. The risk model and nomogram were constructed using binary logistic models. The effectiveness and calibration of the model were evaluated with the receiver operating characteristic curve and calibration plots, respectively. Results A total of 10.06% of noise-exposed workers had HFHL. Age (OR = 1.09, 95% CI: 1.083–1.104), male sex (OR = 3.25, 95% CI: 2.85–3.702), noise exposure duration (NED) (OR = 1.15, 95% CI: 1.093–1.201), and a history of working in manufacturing (OR = 1.50, 95% CI: 1.314–1.713), construction (OR = 2.29, 95% CI: 1.531–3.421), mining (OR = 2.63, 95% CI: 2.238–3.081), or for a private-owned enterprise (POE) (OR = 1.33, 95% CI: 1.202–1.476) were associated with an increased risk of HFHL (P

Abstract Background With the recent emerge of dynamic prediction model on the use of diabetes, cardiovascular diseases and renal failure, and its advantage of providing timely predicted results according to the fluctuation of the condition of the patients, we aim to develop a dynamic prediction model with its corresponding risk assessment chart for clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy by combining baseline factors and postoperative time-relevant drainage fluid amylase level and C-reactive protein-to-albumin ratio. Methods We collected data of 251 patients undergoing LPD at West China Hospital of Sichuan University from January 2016 to April 2019. We extracted preoperative and intraoperative baseline factors and time-window of postoperative drainage fluid amylase and C-reactive protein-to-albumin ratio relevant to clinically relevant pancreatic fistula by performing univariate and multivariate analyses, developing a time-relevant logistic model with the evaluation of its discrimination ability. We also established a risk assessment chart in each time-point. Results The proportion of the patients who developed clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy was 7.6% (19/251); preoperative albumin and creatine levels, as well as drainage fluid amylase and C-reactive protein-to-albumin ratio on postoperative days 2, 3, and 5, were the independent risk factors for clinically relevant postoperative pancreatic fistula. The cut-off points of the prediction value of each time-relevant logistic model were 14.0% (sensitivity: 81.9%, specificity: 86.5%), 8.3% (sensitivity: 85.7%, specificity: 79.1%), and 7.4% (sensitivity: 76.9%, specificity: 85.9%) on postoperative days 2, 3, and 5, respectively, the area under the receiver operating characteristic curve was 0.866 (95% CI 0.737–0.996), 0.896 (95% CI 0.814–0.978), and 0.888 (95% CI 0.806–0.971), respectively. Conclusions The dynamic prediction model for clinically relevant postoperative pancreatic fistula has a good to very good discriminative ability and predictive accuracy. Patients whose predictive values were above 14.0%, 8.3%, and 7.5% on postoperative days 2, 3, and 5 would be very likely to develop clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy.

ObjectiveOccupational stress is generally acknowledged as a global phenomenon with significant health and economic consequences. The medical worker is a vulnerable group at a high-level risk for depression symptoms. This study aimed to examine the mediating effect of worker-occupation fit (WOF) in relation to occupational stress and depression symptoms among 1988 medical workers in China.MethodsA multi-center cross-sectional study was conducted during June and October 2020 in Henan Province, China. The participants were medical workers from four targeted hospitals (included one general and three specialized hospitals). The Depression, Anxiety, and Stress Scale (DASS-21 Scale), Worker-Occupation Fit Inventory (WOFI), as well as questions about demographic and occupational information were administered in questionnaires distributed to 1988 medical workers. Hierarchical linear regression analysis was used to examine the mediating role of worker occupation fit.ResultsIn this study, there are 43.5% (n = 864) of medical workers experienced depression symptoms. The mean score of WOF was 31.6 ± 7.1, characteristic fit, need supply fit and demand ability fit were 11.3 ± 2.5, 10.1 ± 2.7, 12.9 ± 2.2, respectively. The occupational stress was negatively related to worker occupation fit (r = −0.395, P < 0.001), characteristic fit (r = −0.529, P < 0.001), need supply fit (r = −0.500, P < 0.001), and demand ability fit (r = −0.345, P < 0.001). The occupational stress and depression symptoms have a positive relationship (r = 0.798, P < 0.001). The proportion of worker occupation fit mediation was 6.5% of total effect for depression symptoms.ConclusionOccupational stress has been identified as a risk factor for depression symptoms. Practical strategies for improving medical workers' WOF level would help them better cope with various work-related stressors to reduce depression symptoms. Hospital administrators could reduce medical workers' depression symptoms by taking comprehensive measures to improve the WOF.

This study aimed to analyze the bibliometric characteristics of the publications on occupational stress and highlight key research topics and future trends. The Web of Science Core Collection database was searched to collect publications on occupational stress, from inception to December 9, 2020. Two authors independently screened eligible literature and extracted the data. Bibliometric analyses were performed using VOSviewer 1.6.6 and R 3.6.3 software. Overall, 6,564 publications on occupational stress were included. “Stress,” with a total link strength of 1,252, appeared as the most co-occurrence keyword, followed by “occupational stress,” “job stress,” and “job satisfaction.” All studies were published between 1956 and 2020. Among them, 6,176 (94.35%) papers were written in English, and 4,706 (70.25%) were original articles. The top three Web of Science categories were “public environmental occupational health” (n = 1,711), “psychology, applied” (n = 846), and “psychology, multidisciplinary” (n = 650). The 100 top-cited articles were mentioned a total of 36,145 times, with a median of 361, ranging from 174 to 5,574. The United States was the most productive country, with 1,780 publications. The main partners of the United States were England and China. Three themes of occupational stress research were identified: job satisfaction, burnout, and occupational stress-related health problems. This bibliometric analysis provides a comprehensive understanding of the trends and most influential contributions to the field of occupational stress, thus promoting ideas for future research.

BackgroundFrom 2013 to 2017, more than one thousand avian influenza A (H7N9) confirmed cases with hundreds of deaths were reported in mainland China. To identify priorities for epidemic prevention and control, a risk assessing framework for subnational variations is needed to define the epidemic potential of A (H7N9).MethodsWe established a consolidated two-stage framework that outlined the potential epidemic of H7N9 in humans: The Stage 1, index-case potential, used a Boosted Regression Trees model to assess population at risk due to spillover from poultry; the Stage 2, epidemic potential, synthesized the variables upon a framework of the Index for Risk Management to measure epidemic potential based on the probability of hazards and exposure, the vulnerability and coping capacity.ResultsProvinces in southern and eastern China, especially Jiangsu, Zhejiang, Guangzhou, have high index-case potential of human infected with A (H7N9), while northern coastal provinces and municipalities with low morbidity, i.e. Tianjin and Liaoning, have an increasing risk of A (H7N9) infection. Provinces in central China are likely to have high potential of epidemic due to the high vulnerability and the lack of coping capacity.ConclusionsThis study provides a unified risk assessment of A (H7N9) to detect the two-stage heterogeneity of epidemic potential among different provinces in mainland China, allowing proactively evaluate health preparedness at subnational levels to improve surveillance, diagnostic capabilities, and health promotion.

Objective To evaluate the performance of China’s infectious disease automated alert and response system in the detection of outbreaks of hand, foot and mouth (HFM) disease. Methods We estimated size, duration and delay in reporting HFM disease outbreaks from cases notified between 1 May 2008 and 30 April 2010 and between 1 May 2010 and 30 April 2012, before and after automatic alert and response included HFM disease. Sensitivity, specificity and timeliness of detection of aberrations in the incidence of HFM disease outbreaks were estimated by comparing automated detections to observations of public health staff. Findings The alert and response system recorded 106 005 aberrations in the incidence of HFM disease between 1 May 2010 and 30 April 2012 – a mean of 5.6 aberrations per 100 days in each county that reported HFM disease. The response system had a sensitivity of 92.7% and a specificity of 95.0%. The mean delay between the reporting of the first case of an outbreak and detection of that outbreak by the response system was 2.1 days. Between the first and second study periods, the mean size of an HFM disease outbreak decreased from 19.4 to 15.8 cases and the mean interval between the onset and initial reporting of such an outbreak to the public health emergency reporting system decreased from 10.0 to 9.1 days. Conclusion The automated alert and response system shows good sensitivity in the detection of HFM disease outbreaks and appears to be relatively rapid. Continued use of this system should allow more effective prevention and limitation of such outbreaks in China.

Timely reporting, effective analyses and rapid distribution of surveillance data can assist in detecting the aberration of disease occurrence and further facilitate a timely response. In China, a new nationwide web-based automated system for outbreak detection and rapid response was developed in 2008. The China Infectious Disease Automated-alert and Response System (CIDARS) was developed by the Chinese Center for Disease Control and Prevention based on the surveillance data from the existing electronic National Notifiable Infectious Diseases Reporting Information System (NIDRIS) started in 2004. NIDRIS greatly improved the timeliness and completeness of data reporting with real time reporting information via the Internet. CIDARS further facilitates the data analysis, aberration detection, signal dissemination, signal response and information communication needed by public health departments across the country. In CIDARS, three aberration detection methods are used to detect the unusual occurrence of 28 notifiable infectious diseases at the county level and to transmit that information either in real-time or on a daily basis. The Internet, computers and mobile phones are used to accomplish rapid signal generation and dissemination, timely reporting and reviewing of the signal response results. CIDARS has been used nationwide since 2008; all Centers for Disease Control and Prevention (CDC) in China at the county, prefecture, provincial and national levels are involved in the system. It assists with early outbreak detection at the local level and prompts reporting of unusual disease occurrences or potential outbreaks to CDCs throughout the country.

We evaluated a novel strategy to improve the performance of outbreak detection algorithms, namely setting the alerting threshold separately in each region according to the disease incidence in that region. By using data on hand, foot and mouth disease in Shandong province, China, we evaluated the impact of disease incidence on the performance of outbreak detection algorithms (EARS-C1, C2 and C3). Compared to applying the same algorithm and threshold to the whole region, setting the optimal threshold in each region according to the level of disease incidence (i.e., high, middle, and low) enhanced sensitivity (C1: from 94.4% to 99.1%, C2: from 93.5% to 95.4%, C3: from 91.7% to 95.4%) and reduced the number of alert signals (the percentage of reduction is C1∶4.3%, C2∶11.9%, C3∶10.3%). Our findings illustrate a general method for improving the accuracy of detection algorithms that is potentially applicable broadly to other diseases and regions.

OBJECTIVE: This study was conducted to assess the relationship of mortality from lung cancer and other selected causes to asbestos exposure levels. METHODS: A cohort of 1539 male workers from a chrysotile mine in China was followed for 26 years. Data on vital status, occupation and smoking were collected from the mine records and individual contacts. Causes and dates of death were further verified from the local death registry. Individual cumulative fibre exposures (f-yr/ml) were estimated based on converted dust measurements and working years at specific workshops. Standardized mortality ratios (SMRs) for lung cancer, gastrointestinal (GI) cancer, all cancers and nonmalignant respiratory diseases (NMRD) stratified by employment years, estimated cumulative fibre exposures, and smoking, were calculated. Poisson models were fitted to determine exposure-response relationships between estimated fibre exposures and cause-specific mortality, adjusting for age and smoking. RESULTS: SMRs for lung cancer increased with employment years at entry to the study, by 3.5-fold in ≥ 10 years and 5.3-fold in ≥ 20 years compared with

Background Clinical practice guidelines in primary care are important tools to guide primary care practice, but they are found with relatively low quality and unstandardized reporting on the whole. Objective To develop the reporting guideline for clinical practice guidelines in primary care based on the Reporting Items for practice Guidelines in HealThcare (RIGHT) . Methods According to the reporting methods recommended by EQUATOR Network, an item development group and an expert consensus group were established to develop reporting guideline for clinical practice guidelines in primary care. Content analysis, brainstorming, and topic analysis were used in developing the initial items. The Delphi survey was conducted to determine the final items. Results Thirteen items (five were modified and eight were added) were developed initially, covering five domains: guideline title, health issues, intended setting, recommendations and suggestions for future research. Then the initial item checklist was revised to a final version consisting of 15 items according to the results of two rounds of Delphi survey (with 100% response rates from 22 experts) conducted from December 2 to December 26, 2022. Conclusion This reporting checklist will provide a detailed guide for developers of guidelines in primary care, which will further improve the reporting quality of guidelines in primary care, especially that of those in China.

Background The clinical practice guidelines in general practice can improve healthcare quality in primary health care, however, no study has yet systematically investigated the current status and quality of the guidelines in China. Objective To investigate the current status and influencing factors of quality of the guidelines in China. Methods We searched China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Chinese biomedical literature database, and CQVIP website, and included the published guidelines in China. We analyzed the basic characteristics and used RIGHT to evaluate the reporting quality and AGREE-China for methodological quality. Results A total of 150 guidelines were included, mainly published from 2019 to 2021. Most of the guidelines〔108 (72.0%) 〕focused on the diagnosis and treatment of diseases. The top three specialties were cardiovascular disease〔40 (26.7%) 〕, gastroenterology〔31 (20.7%) 〕, and clinical pharmacy〔27 (18.0%) 〕. The main development institutions were the Chinese Medical Association and its branches〔123 (82.0%) 〕, the editorial committee of the Chinese Journal of General Practitioners〔119 (79.3%) 〕, and the Chinese Medical Journals Publishing House〔116 (77.3%) 〕. In terms of reporting quality, the average reporting rate of RIGHT was 23.6% (11.4%-42.9%) ; the reporting rate of basic information (59.8%) was higher, and that of evidence (0.3%) was the lowest. As for methodological quality, the average AGREE-China score was 23.4 (12.0-40.0) ; the reporting rates of conflicts of interest (63.0%) and availability/feasibility (53.0%) were higher, and that of economics (7.0%) was the lowest. Conclusion The number of Chinese clinical practice guidelines in general practice has increased rapidly in the past five years, which has played an important role in promoting the quality of primary health care. In the future, it is necessary to further develop the guidelines in different specialties and diseases and accelerate the methodology of development and reporting of the guidelines.