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Background: The self-reported KIDSCREEN questionnaires are ideal for capturing children’s and adolescents’ health-related quality of life (HRQoL) and have gained worldwide popularity. Responding to demands for the concise nature of KIDSCREEN among Chinese Mainland researchers and practitioners, this study aimed to evaluate the psychometric properties of the Mandarin Chinese self-reported KIDSCREEN-27 (KS-27) and KIDSCREEN-10 index (KS-10), which are short versions of the self-reported KIDSCREEN-52 (KS-52). Methods: This study reanalyzed the validation dataset of the Mandarin Chinese self-reported KS-52. The dataset originated from a cross-sectional survey conducted in Weifang City, the Chinese Mainland, from October to November 2016. Adolescents aged 11–17 years (N = 4385) were surveyed, and sub-samples (N = 841) were retested. Statistical analyses were conducted on the feasibility, item and dimension properties, reliability, and validity of the Mandarin Chinese self-reported KS-27 and KS-10. Results: Indirect evidence from the Small Group Pilot Survey indicated that the Mandarin Chinese self-reported KS-27 and KS-10 can be completed on average in less than 12.33 mins. Their response rate exceeded 90% regardless of the unit- and item (dimension)-level. The psychometric properties of items and dimensions were likewise found to be satisfactory. Internal consistency was robust with inter-item and item-total correlations (0.173–0.873, 0.422–0.786), Cronbach’s alpha (0.786–0.881), Guttman’s lambda-2 and - 6 (0.807–0.889, 0.829–0.896), and McDonald’s omega (0.725–0.886). Test–retest reliability at both item- and dimension-level was excellent, with intraclass correlation coefficients (ICCs) of (0.590–0.696, 0.785–0.842); standard error of measurements (SEMs) of (0.352–0.635, 0.949–1.949). Confirmatory factor analysis (CFA) confirmed their five- and one-dimensional structures, albeit with slight modifications. Moreover, the multi-group confirmatory factor analysis (MG-CFA) substantiated their configural and metric invariance across gender and grade groups. Convergent validity was robust, with stronger correlations observed with comparable dimensions of the Mandarin Chinese self-reported PedsQL™ 4.0, while discriminant validity was evident with low correlations observed with less comparable dimensions. The known-group validity was mainly supported by medium to large effect sizes concerning differences in socioeconomic status (η2 = 0.07–0.17, Cohen’s d = 0.55–1.03) and mental health status (η2 = 0.09–0.40, Cohen’s d = 0.73–1.83). The Mandarin Chinese self-reported KS-52 served as the criterion; the ICCs between the Mandarin Chinese self-reported KS-27 and KS-10 and their comparable dimensions were stronger, indicating robust criterion validity. Conclusions: The Mandarin Chinese self-reported KS-27 and KS-10 demonstrated excellent psychometric properties, indicating their good potential for measuring HRQoL for children and adolescents in the Chinese Mainland. [ABSTRACT FROM AUTHOR]

Background: From January 2020 to June 2022, strict interventions against COVID-19 were implemented in Guangdong Province, China. However, the evolution of COVID-19 dynamics remained unclear in this period. Objectives: This study aims to investigate the evolution of within- and between-city COVID-19 dynamics in Guangdong, specifically during the implementation of rigorous prevention and control measures. The intent is to glean valuable lessons that can be applied to refine and optimize targeted interventions for future crises. Methods: Data of COVID-19 cases and synchronous interventions from January 2020 to June 2022 in Guangdong Province were collected. The epidemiological characteristics were described, and the effective reproduction number (Rt) was estimated using a sequential Bayesian method. Endemic-epidemic multivariate time-series model was employed to quantitatively analyze the spatiotemporal component values and variations, to identify the evolution of within- and between-city COVID-19 dynamics. Results: The incidence of COVID-19 in Guangdong Province was 12.6/100,000 population (15,989 cases) from January 2020 to June 2022. The Rt predominantly remained below 1 and increased to a peak of 1.39 in Stage 5. As for the evolution of variations during the study period, there were more spatiotemporal components in stage 1 and 5. All components were fewer from Stage 2 to Stage 4. Results from the endemic-epidemic multivariate time-series model revealed a strong follow-up impact from previous infections in Dongguan, Guangzhou and Zhanjiang, with autoregressive components of 0.48, 0.45 and 0.36, respectively. Local risk was relatively high in Yunfu, Shanwei and Shenzhen, with endemic components of 1.17, 1.04 and 0.71, respectively. The impact of the epidemic on the neighboring regions was significant in Zhanjiang, Shenzhen and Zhuhai, with epidemic components of 2.14, 1.92, and 1.89, respectively. Conclusion: The findings indicate the presence of spatiotemporal variation of COVID-19 in Guangdong Province, even with the implementation of strict interventions. It's significant to prevent transmissions within cities with dense population. Preventing spatial transmissions between cities is necessary when the epidemic is severe. To better cope with future crises, interventions including vaccination, medical resource allocation and coordinated non-pharmaceutical interventions were suggested. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus type 1 CRF59_01B, identified in China in 2013, has been detected nationwide, exhibiting notably high prevalence in Guangzhou and its vicinity. This study aimed to unravel its origin and migration. A data set was established, incorporating all available CRF59_01B pol gene sequences and their metadata from Guangzhou and the public database. Bayesian phylogeographic analysis demonstrated that CRF59_01B originated in Shenzhen, the neighboring city of Guangzhou, around 1998 with posterior probability of 0.937. Molecular network analysis detected 1131 transmission links and showed a remarkably high clustering rate (78.9%). Substantial inter‐city transmissions (26.5%, 300/1131) were observed between Shenzhen and Guangzhou while inter‐region transmissions linked Guangzhou with South (46) and Southwest (64) China. The centre of Guangzhou was the hub of CRF59_01B transmission, including the inflow from Shenzhen (3.57 events/year) and outflow to the outskirts of Guangzhou (>2 events/year). The large‐scale analysis revealed significant migration from Shenzhen to Guangzhou (5.08 events/year) and North China (0.59 events/year), and spread from Guangzhou to Central (0.47 events/year), East (0.42 events/year), South (0.76 events/year), Southwest China (0.76 events/year) and Shenzhen (1.89 events/year). Shenzhen and Guangzhou served as the origin and the hub of CRF59_01B circulation, emphasizing inter‐city cooperation and data sharing to confine its nationwide diffusion. [ABSTRACT FROM AUTHOR]

Background: Hand, foot, and mouth disease (HFMD) is a major public health issue in China while temperature and humidity are well-documented predictors. However, evidence on the combined effect of temperature and humidity is still limited. It also remains unclear whether such an effect could be modified by the enterovirus 71 (EV71) vaccination. Methods: Based on 320,042 reported HFMD cases during the summer months between 2012 and 2019, we conducted a study utilizing Distributed Lag Non-Linear Models (DLNM) and time-varying DLNM to examine how China's HFMD EV71 vaccine strategy would affect the correlation between meteorological conditions and HFMD risk. Results: The incidence of HFMD changed with the Discomfort Index in an arm-shaped form. The 14-day cumulative risk of HFMD exhibited a statistically significant increase during the period of 2017–2019 (following the implementation of the EV71 vaccine policy) compared to 2012–2016 (prior to the vaccine implementation). For the total population, the range of relative risk (RR) values for HFMD at the 75th, 90th, and 99th percentiles increased from 1.082–1.303 in 2012–2016 to 1.836–2.022 in 2017–2019. In the stratified analyses, Han Chinese areas show stronger relative growth, with RR values at the 75th, 90th, and 99th percentiles increased by 14.3%, 39.1%, and 134.4% post-vaccination, compared to increases of 22.7%, 41.6%, and 38.8% in minority areas. Similarly, boys showed greater increases (24.4%, 47.7%, 121.5%) compared to girls (8.1%, 28.1%, 58.3%). Additionally, the central Guizhou urban agglomeration displayed a tendency for stronger relative growth compared to other counties. Conclusions: Although the EV71 vaccine policy has been implemented, it hasn't effectively controlled the overall risk of HFMD. There's been a shift in the main viral subtypes, potentially altering population susceptibility and influencing HFMD occurrences. The modulating effects of vaccine intervention may also be influenced by factors such as race, sex, and economic level. Author summary: Hand, foot, and mouth disease (HFMD) is one of the most common childhood enteric infections worldwide and an important public health problem in China. In this study, we analyzed the relationships among HFMD cases, meteorological factors, and vaccine factors using time-varying distributed lag nonlinear models. We found that the susceptibility of the population may have changed after the implementation of the HFMD EV71 vaccine policy, altering the relationship between HFMD and meteorological factors. The modifying effects of vaccine interventions may be influenced by variables such as race, sex, and economic level. This provides valuable information for the prevention of the disease and policy decisions. [ABSTRACT FROM AUTHOR]