Frontiers in Public Health最新文献

{"title":"Spatio-temporal evolution characteristics and influencing factors of environmental welfare performance in Chinese cities.","authors":"Yipeng Zhang, Meixia Wang","doi":"10.3389/fpubh.2025.1543745","DOIUrl":"10.3389/fpubh.2025.1543745","url":null,"abstract":"<p><strong>Background: </strong>In the process of China's urbanization, issues such as air pollution, water pollution, soil pollution, and noise pollution have become increasingly prominent, severely constraining the sustainable development of cities. The resultant decline in environmental welfare performance (EWP) not only affects residents' quality of life but may also lead to public health issues, increasing healthcare costs, and subsequently impacting social stability and economic development.</p><p><strong>Methods: </strong>This paper incorporates factors closely related to environmental pollution, such as residents' health and social welfare, into the analytical framework of environmental welfare performance. Using the Hybrid-Network-DEA model, we measure the EWP of 240 cities in China, and then investigate the spatial distribution characteristics and spatio-temporal evolution patterns of EWP. Finally, empirical testing of the factors influencing EWP is conducted using spatial econometric methods.</p><p><strong>Results: </strong>The overall level of EWP in 240 Chinese cities from 2004 to 2019 is relatively low, but it generally shows a wavy upward trend. Meanwhile, notable regional disparities exist in EWP, with the highest average performance in the east, followed by the west, and the lowest in the central. The main source of regional differences in EWP lies in inter-regional disparities. The greatest internal disparities are found in the east, while the largest inter-regional disparities are between the east and the west. A pronounced positive spatial autocorrelation is observed in the EWP among Chinese cities. Economic development, opening-up, financial development, digital infrastructure, and population density significantly promote the local EWP, whereas the industrial structure and transportation structure have exerted opposite effects. Additionally, the enhancement of EWP in neighboring regions is also notably facilitated by economic development, opening-up, financial development, and digital infrastructure. Within the three major regions, the direct and indirect effects of various influencing factors exhibit significant differences.</p><p><strong>Conclusion: </strong>Based on these insights, we suggest comprehensively improving environmental welfare efficiency, narrowing regional disparities, strengthening spatial agglomeration effects, optimizing industrial structure, and strengthening financial support and digital infrastructure construction.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1543745"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic status correlates with clinical outcomes in patients with acral melanoma.","authors":"Rong Huang, Jiayu Wang, Kelin Zheng, Mengke Zhao, Zhengyun Zou","doi":"10.3389/fpubh.2025.1496082","DOIUrl":"10.3389/fpubh.2025.1496082","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the impact of socioeconomic status on survival in Chinese patients with acral melanoma.</p><p><strong>Methods: </strong>We collected clinical and socioeconomic information of 298 primary acral melanoma patients and performed Kaplan-Meier curves, log-rank tests, Cox proportional hazards models, and Pearson's chi-squared tests to evaluate the relationships between clinical characteristics, socioeconomic factors, and survival outcomes.</p><p><strong>Results: </strong>Among the clinical characteristics, age, gender, stage, Breslow thickness, and primary tumor site significantly impacted survival in acral melanoma patients (<i>p</i> = 0.01, <i>p</i> = 0.05, <i>p</i> < 0.01, <i>p</i> < 0.01, <i>p</i> < 0.01, respectively). Compared to individual socioeconomic factors such as education, occupation, medical insurance, and marital status, the socioeconomic level derived from these four dimensions accurately predicted patient survival. Patients with higher socioeconomic status demonstrated significantly reduced mortality risk (HR = 0.60, 95% CI = 0.40-0.91, <i>p</i> = 0.02). However, socioeconomic level was not found to be an independent prognostic factor for acral melanoma patients after multivariable adjustment. Notably, a negative correlation was observed between socioeconomic level and Breslow thickness.</p><p><strong>Conclusion: </strong>Socioeconomic level is associated with survival in Chinese acral melanoma patients. However, this association may be attributable to Breslow thickness rather than socioeconomic status itself.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1496082"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of migrant workers' health capital on their returning home intentions: evidence from China.","authors":"Haitao Li, Haibo Li, Hao Xiang","doi":"10.3389/fpubh.2025.1473435","DOIUrl":"10.3389/fpubh.2025.1473435","url":null,"abstract":"<p><strong>Background: </strong>The health problems and migration problems of China's huge migrant workers are related to the implementation effect of new-type urbanization and rural revitalization strategy. A thorough examination of the effect of migrant workers' health on their returning home intentions and its mechanism is imperative.</p><p><strong>Objectives: </strong>This study aims to understand the influence of migrant workers' health capital (HC) in their returning home intentions (RHI). For this, using capital theory, this study developed an empirical model to probe the impact of Chinese migrant workers' health on their RHI and analyze the paths that this influence may follow to form the RHI of migrant workers.</p><p><strong>Methods: </strong>A theoretical model was established from the perspective of capital to study the relationship between health and migrant workers' migration. A probit model was used to probe the impact of Chinese migrant workers' HC on their RHI, and propensity score matching (PSM), replacing the explained variable (REV), and transforming the model (TM) were used for the robustness test. Stepwise coefficient test (SCT) and Sobel test (ST) were used to analyze the mediating effects of economic capital (EC) and social capital (SC) in the relationship of HC affecting RHI. Data were collected from a sample of 810 migrant workers from three provinces located in eastern, central, and western China using a survey questionnaire.</p><p><strong>Results: </strong>Migrant workers' HC had a significant and negative impact on their RHI, and mental health (MH) had a greater impact on migrant workers' RHI than physical health (PH). There is regional heterogeneity in the effect of HC on the RHI of migrant workers in China. In addition, economic capital (EC) mediated indirectly the relationship between HC and RHI, while the mediating role of social capital in the relationship between HC and RHI was not significant.</p><p><strong>Conclusion: </strong>Migrant workers' HC is an important factor affecting the formation of their RHI, in which EC plays an intermediary role. This study extends and deepens our understanding of HC and helps to understand the role of health in shaping RHI from the perspective of capital, and the finding confirms the validity of the \"salmon bias effect\" hypothesis in the Chinese context. These findings can also help local government pay more attention to returning migrant workers' HC.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1473435"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring urban-rural inequities in older adults life expectancy: a case study in Zhejiang, China for health equity.","authors":"Yongguo Chen, Xiaoting Fan, Shusheng Shen, Yong Chen, Zhiwei Pan, Zixuan Chen, Haoqiang Zhong, Menglong Li","doi":"10.3389/fpubh.2025.1439857","DOIUrl":"10.3389/fpubh.2025.1439857","url":null,"abstract":"<p><p>This study investigates the inequities in life expectancy among individuals aged 65 and above in urban and rural areas of Zhejiang Province, China, with a primary focus on promoting health equity among the older adults population. The objective is to analyze the trends and factors contributing to the urban-rural gap in life expectancy and to propose strategies for reducing this disparity. Data from the 2010 and 2020 statistical records and census data were analyzed using cohort life tables and gray correlation analysis. Results indicate an overall increase in life expectancy among the older adults, with a more pronounced improvement in rural areas, thereby narrowing the urban-rural gap from 1.53 years in 2010 to 1 year in 2020. Income inequality emerges as the primary factor influencing life expectancy, followed by educational attainment, with variations across different age groups and gender. This underscores the importance of tailored interventions that consider the specific needs of older adults individuals in diverse geographical areas and age brackets to extend life expectancy and promote health equity. By tackling these unfair differences, health equity can be ensured and the overall well-being of the older population in both urban and rural areas can be improved.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1439857"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and spatiotemporal analysis of acute hemorrhagic conjunctivitis in Zhejiang province, China (2004-2023).","authors":"Wanwan Sun, Yijuan Chen, Shuwen Qin, Ziping Miao","doi":"10.3389/fpubh.2025.1509495","DOIUrl":"https://doi.org/10.3389/fpubh.2025.1509495","url":null,"abstract":"<p><strong>Background: </strong>Acute hemorrhagic conjunctivitis (AHC) has become a significant public health issue in Zhejiang province. However, the analysis of epidemiological characteristics and spatio-temporal patterns of AHC in Zhejiang province has not been studied yet.</p><p><strong>Methods: </strong>Monthly cases of AHC from 2004 to 2023 reported at the county level in Zhejiang province were obtained from the China Information System for Disease Control and Prevention. Demographic features, yearly county incidence, global spatial autocorrelation, local spatial autocorrelation analyses, and temporal and space-time cluster analysis were performed to identify and visualize the spatiotemporal patterns of AHC cases in Zhejiang province. The epidemiological characteristics of AHC outbreaks in the same period in Zhejiang province were also compared.</p><p><strong>Results: </strong>A total of 52,119 AHC cases were reported in Zhejiang province, yielding an average incidence rate of 5.37 per 100,000. No fatalities were reported. The average age of those affected was 25.44 ± 4.37 years, with the highest incidence (16.70%) among individuals aged between 10 and 19 years. Seasonal peaks occur from August to October each year. Students and farmers experienced the highest incidence rates of infection. Significant positive spatial correlations for AHC were observed in Zhejiang province in the years 2007 (Moran's I = 0.095, <i>p</i> = 0.039), 2009 (Moran's I = 0.075, <i>p</i> = 0.031), and 2011 (Moran's I = 0.173, <i>p</i> = 0.034), indicating spatial clustering. Spatiotemporal scanning identified two distinct clusters: Cluster 1 and Cluster 2. Cluster 1, characterized by a relative risk of 21.44 (<i>p</i> < 0.001), was located in northeastern Zhejiang province, comprising 30 counties, with an active period from 1st September 2010 to 30th September 2010. Compared to low-risk regions, high-risk counties exhibited a different demographic profile with a higher proportion of men, older people, and farmers. Among the affected students during outbreaks, the predominant symptoms were conjunctival congestion, increased eye secretions, eye swelling, eye pain, photophobia and tearing, while the incidence of fever was relatively low.</p><p><strong>Conclusion: </strong>The results of this study demonstrate the spatiotemporal heterogeneity of AHC cases in Zhejiang province and underscore the necessity for targeted prevention and control measures in high-risk areas to mitigate transmission and occurrence.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1509495"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world cost-effectiveness of nirmatrelvir-ritonavir as treatment for SARS-CoV-2 infection in the Belgian setting with omicron variant.","authors":"Sophie Marbaix, Steven Simoens, Philippe Clevenbergh, Pascal Van Bleyenbergh, Keliane Liberman, Dimitri Dehenau","doi":"10.3389/fpubh.2024.1432821","DOIUrl":"10.3389/fpubh.2024.1432821","url":null,"abstract":"<p><strong>Background: </strong>Nirmatrelvir-ritonavir is an oral treatment for SARS-CoV-2 infection in patients who are at high risk of developing severe COVID-19 disease. This antiviral has proven to significantly reduce the risk of hospitalization and death compared to no anti-SARS-CoV-2 treatment in this target population. This paper aims to assess the cost-effectiveness of nirmatrelvir-ritonavir in Belgium using real-world evidence.</p><p><strong>Methods: </strong>A static decision tree model was developed to capture the health progression of patients infected with the SARS-CoV-2 virus. Outcomes were expressed in Quality Adjusted-Life Years (QALYs), hospitalizations, Intensive Care Unit (ICU) admissions, deaths and Long Covid cases, derived from epidemiological data over the first full year of the Omicron variant's circulation (2022). Costs were calculated for the year 2023 from the healthcare payer's perspective. Extensive sensitivity analyses were conducted to test the robustness of the cost-effectiveness results.</p><p><strong>Results: </strong>In a cohort of 1,000 patients, treatment with nirmatrelvir-ritonavir is projected to save 95 QALYs and €82,658 compared to no anti-SARS-CoV-2 treatment over a lifetime horizon. These savings primarily stem from the reduction in hospitalizations among vulnerable patients who typically require a longer recovery time. The analysis also indicates 5 fewer ICU admissions and 8 fewer premature deaths per 1,000 infected patients.</p><p><strong>Conclusion: </strong>In the context of Omicron SARS-CoV-2 infection, administering nirmatrelvir-ritonavir to patients at high risk of severe disease improves health outcomes and reduces costs. Nirmatrelvir-ritonavir is 100% likely to be cost-effective at a willingness to pay of €2,000 per QALY.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"12 ","pages":"1432821"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying hope: an EU perspective of rare disease therapeutic space and market dynamics.","authors":"Emmanuelle Cacoub, Nathalie Barreto Lefebvre, Dimitrije Milunov, Manish Sarkar, Soham Saha","doi":"10.3389/fpubh.2025.1520467","DOIUrl":"10.3389/fpubh.2025.1520467","url":null,"abstract":"<p><p>Rare diseases, affecting millions globally, pose a significant healthcare burden despite impacting a small population. While approximately 70% of all rare diseases are genetic and often begin in childhood, diagnosis remains slow and only 5% have approved treatments. The UN emphasizes improved access to primary care (diagnostic and potentially therapeutic) for these patients and their families. Next-generation sequencing (NGS) offers hope for earlier and more accurate diagnoses, potentially leading to preventative measures and targeted therapies. In here, we explore the therapeutic landscape for rare diseases, analyzing drugs in development and those already approved by the European Medicines Agency (EMA). We differentiate between orphan drugs with market exclusivity and repurposed existing drugs, both crucial for patients. By analyzing market size, segmentation, and publicly available data, this comprehensive study aims to pave the way for improved understanding of the treatment landscape and a wider knowledge accessibility for rare disease patients.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1520467"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic identification and quantification of factors and their interactions with age, sex, and panel wave influencing cognitive function in Korean older adults.","authors":"Eunmi Kim, Jinkyung Oh, Jungsoo Gim, Iksoo Huh","doi":"10.3389/fpubh.2025.1547575","DOIUrl":"10.3389/fpubh.2025.1547575","url":null,"abstract":"<p><strong>Background: </strong>Cognitive decline in older adults is influenced by diverse factors, and degrees of influence of these factors may vary depending on sex, age cohorts, and passage of time. Moreover, these factors differ in their responsiveness to general interventions. Thus, identifying these factors including their interactions with age, sex, and panel wave and conducting a systematic quantification of their influences on cognitive function are both necessary for developing efficient intervention strategies.</p><p><strong>Methods: </strong>To identify the influencing factors and their interactions, we applied a systematic stepwise variable selection using 2,535 community-dwelling older adults who participated in the Korean Longitudinal Study of Aging from Wave 5 (2014) to Wave 8 (2020). These factors were subsequently grouped based on their modifiability to investigate group-wise influences on cognitive function. For handling the longitudinal data, a generalized least squares method was used, and the degrees of influence of these factors were measured using the delta <i>R</i> ².</p><p><strong>Results: </strong>Twelve variables had significant main effects on cognitive function in older adults. Among these variables, age interacted with sex, regular exercise, and marital status. Sex interacted with regular exercise, education level, and depressive symptoms. Wave number interacted with depressive symptoms and social activity. In addition, the group-wise delta <i>R</i> ² values were found to be 10.9, 6.3, and 5.9% in the difficult-to-modify, modifiable, and non-modifiable factor groups, respectively. Afterwards, we provided the delta <i>R</i> ² for each sub-population divided by the levels of age, sex, and wave number to examine how these factors changed the influences.</p><p><strong>Conclusion: </strong>Based on the interaction and quantification results, we elucidated the characteristics of the influencing factors and their degrees of influence, and we suggest grouping factors based on their modifiability to systematically prevent cognitive decline in older adults.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1547575"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An extreme value analysis of daily new cases of COVID-19 in Africa.","authors":"Saralees Nadarajah, Adamu Abubakar Umar","doi":"10.3389/fpubh.2025.1546404","DOIUrl":"10.3389/fpubh.2025.1546404","url":null,"abstract":"<p><p>Modeling COVID-19 cases in Africa is crucial for developing effective public health strategies, allocating resources efficiently, and mitigating the impact of the pandemic on vulnerable populations. A recent paper by the first author provided an extreme value analysis of daily new cases of COVID-19 from sixteen countries in west Africa. In this paper, we broaden our analysis to encompass data spanning all fifty four African nations over a period of forty four months. We identified extreme values as the monthly maximums of daily new cases. Utilizing the generalized extreme value distribution, we fitted the data, allowing two of its three parameters to vary linearly or quadratically in relation to the month number. Twenty six countries demonstrated significant downward trends in monthly maximums. Two countries demonstrated significant upward trends in monthly maximums. Nineteen countries demonstrated significant quadratic trends where monthly maximums initially increased before decreasing. The sharpest and weakest of the downward trends with respect to location were for Mali and Liberia, respectively. The sharpest and weakest of the downward trends with respect to scale were for Egypt and Libya, respectively. Recommendations are given for each country. We evaluated the adequacy of fits through probability plots and the Kolmogorov-Smirnov test. Subsequently, the fitted models were employed to determine quantiles of the monthly maximum of new cases, as well as their limits extrapolated to infinite month numbers.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1546404"},"PeriodicalIF":3.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect and prediction of long-term weather and pollutant exposure on hemorrhagic fever with renal syndrome: based on statistical models.","authors":"Weiming Hou","doi":"10.3389/fpubh.2025.1393763","DOIUrl":"10.3389/fpubh.2025.1393763","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have typically explored daily lagged relationships between hemorrhagic fever with renal syndrome (HFRS) and meteorology, with a limited seasonal exploration of monthly lagged relationships, interactions, and the role of pollutants in multiple predictions of hemorrhagic fever.</p><p><strong>Methods: </strong>Our researchers collected data on HFRS cases from 2005 to 2018 and meteorological and contaminative factors from 2015 to 2018 for the northeastern region. First, we applied the moving epidemic method (MEM) to estimate the epidemic threshold and intensity level. Then, we used a distributed lag non-linear model (DLNM) and a generalized additive model (GAM) with a maximum lag of 6 months to evaluate the lagged and interaction effects of meteorological and pollution factors on the HFRS cases. Multiple machine learning models were then applied after Spearman's rank correlation coefficient analysis was performed to screen for environmental factors in the Northeastern region.</p><p><strong>Results: </strong>There was a yearly downward trend in the incidence of HFRS in the northeastern region. High prevalence threshold years occurred from 2005 to 2007 and from 2012 to 2014, and the epidemic months were mainly concentrated in November. During the low prevalence threshold period, the main lag factor was low wind direction. In addition, the meteorological lag effect was pronounced during the high prevalence threshold period, where the main lag factors were cold air and hot dew point. Low levels of the AQI and PM₁₀ and high levels of PM_2.5 showed a dangerous lag effect on the onset of HFRS, while extremely high levels of PM_2.5 appeared to have a protective effect. High levels of the AQI and PM₁₀, as well as low levels of PM_2.5, showed a protective lag effect. The model of PM_2.5 and the AQI interaction pollution is better. The support vector machine (SVM)-radial algorithm outperformed other algorithms when pollutants are used as predictor variables.</p><p><strong>Conclusion: </strong>This is the first mathematically based study of the seasonal threshold of HFRS in northeastern China, allowing for accurate estimation of the epidemic level. Our findings suggest that long-term exposure to air pollution is a risk factor for HFRS. Therefore, we should focus on monitoring pollutants in cold conditions and developing HFRS prediction models.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"13 ","pages":"1393763"},"PeriodicalIF":3.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}