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In recent years, the prevalence of allergic diseases has increased significantly, causing great concern, and wheat, as one of the top 8 food allergens, is a common allergy trigger. Nevertheless, reliable estimates of the positivity rate of wheat allergens in the allergic population in China are still lacking. The systematic review and meta-analysis aims to evaluate the positive detection rate of wheat allergens in the Chinese allergic population and further provide a reference for the prevention of allergy. CNKI, CQVIP, WAN-FANG DATA, Sino Med, PubMed, Web of Science, Cochrane Library, and Embase databases were retrieved. Related research and case reports about the positive rate of wheat allergen in the Chinese allergic population published from inception to June 30, 2022, were searched, and meta-analysis was performed using Stata software. The pooled positive rate of wheat allergens and 95% confidence interval were calculated by random effect models, and the publication bias was evaluated using Egger's test. A total of 13 articles were included for the final meta-analysis, in which wheat allergen detection methods involved only serum sIgE testing and SPT assessment. The results showed that the wheat allergen positivity detection rate in Chinese allergic patients was 7.30% (95% CI 5.68–8.92%). Subgroup analysis showed that the positivity rate of wheat allergens was influenced by region, but hardly by age and assessment method. The positive rates of wheat allergy in the population with allergic diseases were 2.74% (95% CI 0.90–4.58%) and 11.47% (95% CI 7.08–15.87%) in southern and northern China, respectively. In particular, the positive rates of wheat allergens were greater than 10% in Shaanxi, Henan and Nei Mongol, all of which belong to the northern region. These results suggest that wheat allergens are an important cause of sensitization in allergic populations from northern China, and therefore attention should be paid to early prevention in high-risk populations. [ABSTRACT FROM AUTHOR]

Background: Carpal tunnel syndrome (CTS), as the most common compression neuropathy in the upper limb, can lead to upper limb dysfunction in patients. The effectiveness of acupuncture in treating CTS has been validated based on numerous clinical trials and meta-analyses, but questions remain, such as how to select the best acupoints. Our purpose is to conduct the first data mining analysis to identify the most effective acupoint selection and combinations for treating CTS. Methods: We will search 7 electronic bibliographic databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database and Chongqing VIP Database) from inception to March 2023. Clinical trials assessing the effectiveness of acupuncture therapy on the management of CTS will be selected. Reviews, protocols, animal trials, case reports, systematic reviews, and meta-analyses will be excluded. The primary outcome measure will be clinical result associated with CTS. Descriptive statistics will be performed in Excel 2019. Association rule analysis will be performed in SPSS Modeler 18.0. Exploratory factor analysis and cluster analysis will be performed in SPSS Statistics 26.0. Results: This study will investigate the most effective acupoint selection and combinations for patients with CTS. Conclusion: Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupoint application for patients with CTS, helping clinicians and patients make a more informed decision together. [ABSTRACT FROM AUTHOR]

Based on the precipitation records of 2474 meteorological stations, this study investigated precipitation characteristics and trends in China from 1961 to 2010, including spatiotemporal distribution and changes in average annual precipitation amount, number of days when daily precipitation > = 1, 5, 10, 25, 50 mm, and extreme precipitation indices. The results showed that: (1) in terms of annual average precipitation amount, both dry to wet, wet to wetter, and shifting between wet and dry showed decadal and climatical fluctuations in annual precipitation totals in space and time, with a clear shift in space from the 0 to 200 mm and above 400 mm precipitation levels to the 200 to 400 mm precipitation level. (2) In terms of graded precipitation days, three kinds of trend changes were observed: (a) enhancement, manifested as an increase in precipitation events, mainly in the northwest and northeast of China; (b) reduction, manifested as a decrease in precipitation events, mainly in the central parts of China; and (c) polarization, which is manifested as a decrease in gentle and light precipitation events but an increase in dry days, heavy, and rainstorm precipitation events, primarily along coastal area in southeast China. (3) In terms of extreme precipitation events, precipitation persistence showed a decreasing trend, but an increasing trend in precipitation intensity and magnitude in most regions of China. This paper also presents the relationship between certain atmospheric circulation indices and the seasonal precipitation of summer and winter. The distribution characteristics and changes in minor precipitation events were highlighted, including gentle and light rain events. Relevant findings can provide scientific guidance for water resource management and conservation. [ABSTRACT FROM AUTHOR]

Few studies have linked social factors to air pollution exposure in China. Unlike the race or minority concepts in western countries, the Hukou system (residential registration system) is a fundamental reason for the existence of social deprivation in China. To assess the differences in ozone (O 3 ) exposure among social groups, especially groups divided by Hukou status, we assigned estimates of O 3 exposure to the latest census data of the Beijing urban area using a kriging interpolation model. We developed simultaneous autoregressive (SAR) models that account for spatial autocorrelation to identify the associations between O 3 exposure and social factors. Principal component regression was used to control the multicollinearity bias as well as explore the spatial structure of the social data. The census tracts (CTs) with higher proportions of persons living alone and migrants with non-local Hukou were characterized by greater exposure to ambient O 3 . The areas with greater proportions of seniors had lower O 3 exposure. The spatial distribution patterns were similar among variables including migrants, agricultural population and household separation (population status with separation between Hukou and actual residences), which fit the demographic characteristics of the majority of migrants. Migrants bore a double burden of social deprivation and O 3 pollution exposure due to city development planning and the Hukou system. [ABSTRACT FROM AUTHOR]

Exposure to long-term ambient air pollution is believed to have adverse effects on human health. However, the mechanisms underlying these impacts are poorly understood. DNA methylation, a crucial epigenetic modification, is susceptible to environmental factors and likely involved in these processes. We conducted a whole-genome bisulfite sequencing study on 120 participants from a highly polluted region (HPR) and a less polluted region (LPR) in China, where the HPR had much higher concentrations of five air pollutants (PM 2.5 , PM 10 , SO 2 , NO 2 , and CO) (fold difference 1.6 to 6.6 times; P value 1.80E-07 to 3.19E-23). Genome-wide methylation analysis revealed 371 DMRs in subjects from the two areas and these DMRs were located primarily in gene regulatory elements such as promoters and enhancers. Gene enrichment analysis showed that DMR-related genes were significantly enriched in diseases related to pulmonary disorders and cancers and in biological processes related to mitochondrial assembly and cytokine production. Further, HPR participants showed a higher mtDNA copy number. Of those identified DMRs, 15 were significantly correlated with mtDNA copy number. Finally, cytokine assay indicated that an increased plasma interleukin-5 level was associated with greater air pollution. Taken together, our findings suggest that exposure to long-term ambient air pollution can lead to alterations in DNA methylation whose functions relate to mitochondria and immune responses. Image 1 • We used whole-genome bisulfite sequencing to study the influence of air pollution on DNA methylation in blood leukocyte. • DNA methylation levels were compared between residents from two areas with distinct air quality in China. • Differentially methylated regions were enriched in gene regulatory elements. • Genes involved in mitochondrial function and immune response are preferentially impacted by air pollution. Summary: By comparing DNA methylation of subjects from two areas with distinct air quality in China, we identified differential methylation regions whose functions are mostly related to mitochondria and immune responses. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify long-term distinct trajectories of multimorbidity with ageing from 50 to 85 years among Chinese older adults and examine the relationship between exposure to early-life adversity (ELA; including specific types of adversity and accumulation of different adversities) and these long-term multimorbidity trajectories., Design: The group-based trajectory models identified long-term multimorbidity trajectories. Multinomial logistic regression models were used to examine the relationship between ELA and the identified multimorbidity trajectories., Setting: This study used data from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018) and the 2014 Life History Survey., Participants: We used data from 9112 respondents (aged 60 and above) of the 2018 wave of CHARLS., Outcome Measures: Each respondent's history of chronic conditions and experiences of ELA were collected from the 2011-2018 waves of CHARLS and the 2014 Life History Survey., Results: Four heterogeneous long-term trajectories of multimorbidity development were identified: 'maintaining-low' (19.1%), 'low onset-rapidly increasing' (23.3%), 'middle onset-moderately increasing' (41.5%) and 'chronically-high' (16.2%). Our findings indicated that the heterogeneity can be explained by ELA experiences. Across various types of different ELA experiences, exposure to food insufficiency (relative risk ratios from 1.372 (95% CI 1.190 to 1.582) to 1.780 (95% CI 1.472 to 2.152)) and parental quarrel/divorce (relative risk ratios from 1.181 (95% CI 1.000 to 1.394) to 1.262 (95% CI 1.038 to 1.536)) had the most prominent associations with health deterioration. The accumulation of more different ELA experiences was associated with a higher relative risk of developing more severe multimorbidity trajectories (relative risk ratio for five to seven ELAs and chronically high trajectory: 7.555, 95% CI 4.993 to 11.431)., Conclusions: There are heterogeneous long-term trajectories of multimorbidity in Chinese older adults, and the risk of multimorbidity associated with ELA accumulates over the lifespan. Our findings highlight the role of a supportive early-life family environment in promoting health development across the lifespan, advocating for the integration of life-course approaches to implementing health disparity interventions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Recent studies suggest air pollution as an underlying factor to kidney disease. However, there is still limited knowledge about the short-term correlation between glomerulonephritis (GN) and air pollution. Thus, we aim to fill this research gap by investigating the short-term correlation between GN clinical visits and air pollution exposure., Methods: Between 2015 and 2019, daily GN visit data from two grade A tertiary hospitals in Hefei City were collected, along with corresponding air pollution and meteorological data. A generalized linear model integrated with a distributed lag nonlinear model was employed to analyze the relationship between GN visits and air pollutants. Moreover, we incorporated a dual pollutant model to account for the combined effects of multiple pollutants. Furthermore, subgroup analyses were performed to identify vulnerable populations based on gender, age, and season., Results: The association between 23,475 GN visits and air pollutants was assessed, and significant positive associations were found between CO and NO 2 exposure and GN visit risk. The single-day lagged effect model for CO showed increased risks for GN visits from lag0 (RR: 1.129, 95% CI: 1.031-1.236) to lag2 (RR: 1.034, 95% CI: 1.011-1.022), with the highest risk at lag0. In contrast, NO 2 displayed a more persistent impact (lag1-lag4) on GN visit risk, peaking at lag2 (RR: 1.017, 95% CI: 1.011-1.022). Within the dual-pollutant model, the significance persisted for both CO and NO 2 after adjusting for each other. Subgroup analyses showed that the cumulative harm of CO was greater in the cold-season and older adult groups. Meanwhile, the female group was more vulnerable to the harmful effects of cumulative exposure to NO 2 ., Conclusion: Our study indicated that CO and NO 2 exposure can raise the risk of GN visits, and female and older adult populations exhibited greater susceptibility., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher., (Copyright © 2023 Chen, Duan, Zhu, Wan, Zhao, Ye and Fang.)

Although considerable progress toward gender equality in science has been made in recent decades, female researchers continue to face significant barriers in the academic labor market. International mobility has been increasingly recognized as a strategy for scientists to expand their professional networks, and that could help narrow the gender gap in academic careers. Using bibliometric data on over 33 million Scopus publications, we provide a global and dynamic view of gendered patterns of transnational scholarly mobility, as measured by volume, distance, diversity, and distribution, from 1998 to 2017. We find that, while female researchers continued to be underrepresented among internationally mobile researchers and migrate over shorter distances, this gender gap was narrowing at a faster rate than the gender gap in the population of general active researchers. Globally, the origin and destination countries of both female and male mobile researchers became increasingly diversified, which suggests that scholarly migration has become less skewed and more globalized. However, the range of origin and destination countries continued to be narrower for women than for men. While the United States remained the leading academic destination worldwide, the shares of both female and male scholarly inflows to that country declined from around 25% to 20% over the study period, partially due to the growing relevance of China. This study offers a cross-national measurement of gender inequality in global scholarly migration that is essential for promoting gender-equitable science policies and for monitoring the impact of such interventions.

Background: This study aimed to investigate multimorbidity patterns and their associated factors among elderly population in China., Methods: A total of 10,479 participants aged at least 60 years were drawn from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). Latent class analysis (LCA) was performed to identify distinct multimorbidity classes based on 14 self-reported chronic conditions. The multinomial logit model was used to analyze the associated factors of multimorbidity patterns, focusing on individuals' demographic characteristics, socioeconomic status (SES), and health behaviors., Results: Among the 10,479 participants (mean age [SD]: 69.1 [7.1]), 65.6% were identified with multimorbidity. Five multimorbidity clusters were identified by LCA: relatively healthy class (49.8%), vascular class (24.7%), respiratory class (5.6%), stomach-arthritis class (14.5%), and multisystem morbidity class (5.4%). Multinomial logit analysis with the relatively healthy class as the reference showed that participants of older age and female sex were more likely to be in the vascular class and multisystem morbidity class. The probability of being in the vascular class was significantly higher for those with high SES. Ever smoking was associated with a higher probability of being in the respiratory class and multisystem morbidity class. Physical activity was associated with lower odds of being assigned to the vascular class, respiratory class, and multisystem class., Conclusion: The distinct multimorbidity patterns imply that the prevention and care strategy should target a group of diseases instead of a single condition. Prevention interventions should be paid attention to for individuals with risk factors., (© 2022. The Author(s).)

(1) Background: The heavy workload and understaffed personnel of village doctors is a challenge to the rural healthcare system in China. Previous studies have documented the predictors of doctors' burnout; however, little attention has been paid to village doctors. This study aims to investigate the prevalence and influential factors of burnout among village doctors. (2) Methods: Data was collected by a self-administered questionnaire from 1248 village doctors who had worked at rural clinics for more than a year. Burnout was measured using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) with three dimensions-emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). A logistic regression model was applied to estimate the influential factors of burnout. (3) Results: The prevalence of overall burnout was 23.6%. Being male (OR = 0.58, 95%CI: 0.41-0.82), poor health status (OR = 0.80, 95%CI: 0.67-0.94), low income (OR = 0.62, 95%CI: 0.40-0.95), and a poor doctor-patient relationship (OR = 0.57, 95%CI: 0.48-0.67) were significantly related to burnout. Conclusion: Burnout is prevalent among Chinese village doctors. Policies such as increasing village doctors' income and investing more resources in rural healthcare system should be carried out to mitigate and prevent burnout.

Background: Frailty, which is defined as aging-related multisystem impairments, can lead to adverse health outcomes. However, evidence for such a connection in Chinese older adults remains lacking. This study examined the association between frailty and future falls and disability among community-dwelling Chinese older adults., Methods: Data were obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were aged 60 years and above at baseline in 2011 and completed the follow-up survey in 2015. Outcome measures were future falls, incident disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and worsening performance of ADLs and IADLs. A multivariate logistic regression was conducted to examine the association between frailty phenotype and falls, incident disability, and worsening disability during a four-year period., Results: We found that frail participants were at increased risk at follow-up for: falls (OR 1.54, 95% CI, 1.14-2.08); developing new ADL difficulties (OR 4.10, 95% CI, 2.79-6.03) and IADL difficulties (OR 3.06, 95% CI, 2.03-4.61); and worsening ADLs performance (OR 2.27, 95% CI, 1.27-4.06), after adjusting for potential confounders. Prefrailty was also significantly associated with future falls, incident disability in ADLs and IADLs, but with a lower magnitude of effect., Conclusions: Frailty phenotype is an independent predictor of future falls, incident disability, and worsening performance in ADLs among Chinese older adults. The association suggests the need to pay special attention in caring for frail and prefrail elders and improving individuals' frailty status.

Background: Since 2000, a series of national policies have been released to tackle mental health problems in China; however, their promotion and implementation at local level are under-evaluated. This study will evaluate the case of Liuyang Municipality, to present a deeper understanding of China's problems and lessons on implementation of mental health policy in developing countries., Methods: A rapid appraisal was conducted on Liuyang's mental health policy and plan, under two evaluation frameworks: (1) the WHO checklists for mental health policy and plan, (2) activities and time frames stated in Liuyang's mental health policy and plan. Documentation review, semi-structured interviews with nine key informants, and surveys on 32 front-line implementers were performed. Descriptive statistics and framework analysis were employed respectively to analyze quantitative and qualitative data., Results: As a local-level promotion of national mental health policies, Liuyang's mental health policy and plan had evidence base and received highest-level approval within local health system, but without stakeholders' consultation. The vision, principles and objectives were consistent with national policies. Twelve WHO-suggested areas for actions were unequally covered. Policy content had operational defects of lacking necessary details on evaluation, funding and activity. For implementation, health departments generally outperformed non-health ones. Discrepancies between planning and practices, and uneven regional implementation compromised implementation quality. Insufficient and poorly trained human resources, unguaranteed funding and low client acceptability were identified as implementation barriers., Conclusions: The case of Liuyang is an active attempt to promote and implement national mental health policies at local level. As a reflection of mental health policy in China and developing countries, its highlights and problems demonstrate that evidence base, high-level approval, multi-sector involvement, operational content, and clear focuses promote policy implementation.