JMIR Public Health and Surveillance最新文献

{"title":"Characterizing US Spatial Connectivity and Implications for Geographical Disease Dynamics and Metapopulation Modeling: Longitudinal Observational Study.","authors":"Giulia Pullano, Lucila Gisele Alvarez-Zuzek, Vittoria Colizza, Shweta Bansal","doi":"10.2196/64914","DOIUrl":"10.2196/64914","url":null,"abstract":"<p><strong>Background: </strong>Human mobility is expected to be a critical factor in the geographic diffusion of infectious diseases, and this assumption led to the implementation of social distancing policies during the early fight against the COVID-19 emergency in the United States. Yet, because of substantial data gaps in the past, what still eludes our understanding are the following questions: (1) How does mobility contribute to the spread of infection within the United States at local, regional, and national scales? (2) How do seasonality and shifts in behavior affect mobility over time? (3) At what geographic level is mobility homogeneous across the United States?</p><p><strong>Objective: </strong>This study aimed to address the questions that are critical for developing accurate transmission models, predicting the spatial propagation of disease across scales, and understanding the optimal geographical and temporal scale for the implementation of control policies.</p><p><strong>Methods: </strong>We analyzed high-resolution mobility data from mobile app usage from SafeGraph Inc, mapping daily connectivity between the US counties to grasp spatial clustering and temporal stability. Integrating this into a spatially explicit transmission model, we replicated SARS-CoV-2's first wave invasion, assessing mobility's spatiotemporal impact on disease predictions.</p><p><strong>Results: </strong>Analysis from 2019 to 2021 showed that mobility patterns remained stable, except for a decline in April 2020 due to lockdowns, which reduced daily movements from 45 million to approximately 25 million nationwide. Despite this reduction, intercounty connectivity remained seasonally stable, largely unaffected during the early COVID-19 phase, with a median Spearman coefficient of 0.62 (SD 0.01) between daily connectivity and gravity networks., We identified 104 geographic clusters of US counties with strong internal mobility connectivity and weaker links to counties outside these clusters. These clusters were stable over time, largely overlapping state boundaries (normalized mutual information=0.82) and demonstrating high temporal stability (normalized mutual information=0.95). Our findings suggest that intercounty connectivity is relatively static and homogeneous at the substate level. Furthermore, while county-level, daily mobility data best captures disease invasion, static mobility data aggregated to the cluster level also effectively models spatial diffusion.</p><p><strong>Conclusions: </strong>Our work demonstrates that intercounty mobility was negligibly affected outside the lockdown period in April 2020, explaining the broad spatial distribution of COVID-19 outbreaks in the United States during the early phase of the pandemic. Such geographically dispersed outbreaks place a significant strain on national public health resources and necessitate complex metapopulation modeling approaches for predicting disease dynamics and control design. We thus inform t","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e64914"},"PeriodicalIF":3.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Trajectories of Poor Vision in Children and Adolescents in Wuhan, China From 2016 to 2019: Prospective Cohort Study.","authors":"Lijuan Xu, Hanjia Li, Fang Li, Tinghui Zhang, Jingyan Yan, Hong Yan, Lu He, Bin Yu","doi":"10.2196/53028","DOIUrl":"10.2196/53028","url":null,"abstract":"<p><strong>Background: </strong>Poor vision is a challenging public health problem among children and adolescents globally and in China. It is well-recognized that early onset of poor vision and progressing to moderate and severe poor vision will increase the risk of irreversible blinding complications. To achieve the national goal of poor vision control and prevention, it is essential to investigate and understand the development of poor vision among children and adolescents in China.</p><p><strong>Objective: </strong>This study aims to investigate the progression of poor vision among children and adolescents in Wuhan, China, based on a prospective cohort and to provide scientific evidence for the development and implementation of effective poor vision prevention and control programs.</p><p><strong>Methods: </strong>Data were derived from a 4-year prospective cohort (2016-2019) of primary and middle school students (N=108,585) in Wuhan, China. Vision condition was measured using the standard logarithmic visual acuity charts. A group-based trajectory model was used to identify trajectories of poor vision overall and by gender and region.</p><p><strong>Results: </strong>The mean age of the study subjects was 11.13 (SD 3.33) years, 200,110 (53.91%) were male and the majority (354404, 95.48%) were from urban areas. The prevalence of poor vision was 58.51% in 2016, 58.95% in 2017, 53.83% in 2018, and 54.79% in 2019. Group-based trajectory model identified 3 groups, including normal vision group (NVG) (27.4%), vision decline group (VDG) (17.8%), and moderate poor vision group (MPVG) (54.8%). A higher proportion of girls (57.8%) were in the MPV group compared to boys (50.5%), and the VDG showed greater changes in girls compared to boys. Furthermore, urban students (55.3%) had a higher proportion of MPV compared to rural students (47.5%), while urban students (17.2%) had a smaller proportion in the VDG compared to rural students (24%). Further analyses showed that as age increased, the likelihood of being categorized in the NVG decreased (β=-.417, P<.001), while the likelihood of being in the VDG (β=.058, P<.001) increased. Compared with boys, girls were more likely to be categorized in the VDG (β=.597, P<.001) and MPV group (β=.362, P<.001). Rural students were less likely than urban students to be categorized in the VDG (β=-.311, P<.001).</p><p><strong>Conclusions: </strong>The prevalence of poor vision among children and adolescents in Wuhan has remained high over the years, with a slight decrease in recent years. The study identified three groups: normal vision, vision decline, and moderate poor vision. Girls and students from urban areas were more likely to have moderate poor vision, while boys and rural students had a higher proportion of vision decline. These findings provide valuable information for implementing poor vision prevention and control policies in the region.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e53028"},"PeriodicalIF":3.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Early-Onset Colorectal Cancer in Singapore: Epidemiological Study of a Multiethnic Population.","authors":"Hui Lionel Raphael Chen, Qingqing Dawn Chong, Brenda Tay, Siqin Zhou, Evelyn Yi Ting Wong, Isaac Seow-En, Ker Kan Tan, Yi Wang, Adeline Seow, Kwong-Wei Emile Tan, Bee Huat Iain Tan, Sze Huey Tan","doi":"10.2196/62835","DOIUrl":"10.2196/62835","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Colorectal cancer (CRC) incidence and mortality in those aged 50 years and above have decreased over the past 2 decades. However, there is a rising incidence of CRC among individuals under 50 years of age, termed early-onset colorectal cancer (EOCRC). Patients with EOCRC are diagnosed at an advanced stage and may be in more psychosocial, emotional, and financial distress.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Our study examined the epidemiological shifts in CRC in Singapore, a multiethnic country.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;CRCs diagnosed at age 20 years and above were identified from the Singapore Cancer Registry (SCR) from 1968 to 2019. Patient characteristics included gender, ethnicity, and age of CRC diagnosis. Population information was obtained from the Department of Statistics Singapore (SingStat). Age-specific incidence rates (ASRs) and age-standardized incidence rates (ASIRs) were calculated. The cohort was divided into 3 age groups: 20-49, 50-64, and ≥65 years. Temporal trends in incidence rates were modeled with joinpoint regression. Birth cohort models were fitted using the National Cancer Institute (NCI) age-period-cohort analysis tool. Cancer-specific survival analysis was performed with the Cox proportional hazards model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 53,044 CRCs were included, and 6183 (11.7%) adults aged 20-49 years were diagnosed with EOCRC. The ASR of EOCRC rose from 5 per 100,000 population in 1968 to 9 per 100,000 population in 1996 at 2.1% annually and rose to 10 per 100,000 population in 2019 at 0.64% annually. The ASR for CRC among adults aged 50-64 years rose at 3% annually from 1968 to 1987 and plateaued from 1987, while the ASR for adults aged 65 years and above rose at 4.1% annually from 1968 to 1989 and 1.3% annually from 1989 to 2003 but decreased from 2003 onwards at 1% annually. The ASR of early-onset rectal cancer increased significantly at 1.5% annually. There was a continued rise in the ASR of EOCRC among males (annual percentage change [APC] 1.5%) compared to females (APC 0.41%). Compared to the 1950-1954 reference birth cohort, the 1970-1984 birth cohort had a significantly higher incidence rate ratio (IRR) of 1.17-1.36 for rectal cancer, while there was no significant change for colon cancer in later cohorts. There were differences in CRC trends across the 3 ethnic groups: Malays had a rapid and persistent rise in the ASR of CRC across all age groups (APC 1.4%-3%), while among young Chinese, only the ASR of rectal cancer was increasing (APC 1.5%). Patients with EOCRC had better survival compared to patients diagnosed at 65 years and above (hazard ratio [HR] 0.73, 95% CI 0.67-0.79, P&lt;.001) after adjusting for covariates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The rise in the incidence of rectal cancer among young adults, especially among Chinese and Malays, in Singapore highlights the need for further research to diagnose CRC earlier and reduce cancer-related morbidity","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":" ","pages":"e62835"},"PeriodicalIF":3.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Promise and Perils of Artificial Intelligence in Advancing Participatory Science and Health Equity in Public Health.","authors":"Abby C King, Zakaria N Doueiri, Ankita Kaulberg, Lisa Goldman Rosas","doi":"10.2196/65699","DOIUrl":"10.2196/65699","url":null,"abstract":"<p><strong>Unlabelled: </strong>Current societal trends reflect an increased mistrust in science and a lowered civic engagement that threaten to impair research that is foundational for ensuring public health and advancing health equity. One effective countermeasure to these trends lies in community-facing citizen science applications to increase public participation in scientific research, making this field an important target for artificial intelligence (AI) exploration. We highlight potentially promising citizen science AI applications that extend beyond individual use to the community level, including conversational large language models, text-to-image generative AI tools, descriptive analytics for analyzing integrated macro- and micro-level data, and predictive analytics. The novel adaptations of AI technologies for community-engaged participatory research also bring an array of potential risks. We highlight possible negative externalities and mitigations for some of the potential ethical and societal challenges in this field.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e65699"},"PeriodicalIF":3.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Net Reproduction Number as a Real-Time Metric of Population Reproducibility.","authors":"Chiara Achangwa, Changhee Han, Jun-Sik Lim, Seonghui Cho, Sangbum Choi, Sukhyun Ryu","doi":"10.2196/63603","DOIUrl":"10.2196/63603","url":null,"abstract":"<p><strong>Unlabelled: </strong>The total fertility rate (TFR) is a biased estimate of the population reproductive potential when there is a sex-ratio imbalance at birth, and it does not account for the mortality of women of childbearing age. This study aimed to estimate the reproduction rate (Rt), which adjusts for the sex-ratio imbalance and the mortality of women of childbearing age, and to assess the differences in the timing of when the population reached the replacement level of the TFR and Rt. We first estimated the Rt using the probability of survival in women and the number of female births. Then, using a time-series analysis, we compared the time series of the TFR and Rt in the Korean population between 1975 and 2022. We found the Rt showed a below replacement level of the population a year earlier than the TFR. However, the estimate of the time-series analysis of Rt was not significantly different from the estimates of the TFR. Our finding suggests that the Rt can provide timely information on the adjusted population reproductive potential and is easier for the public to interpret compared to TFR.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e63603"},"PeriodicalIF":3.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Call for Action: Lessons Learned From a Pilot to Share a Complex, Linked COVID-19 Cohort Dataset for Open Science.","authors":"Clara Amid, Martine Y van Roode, Gabriele Rinck, Janko van Beek, Rory D de Vries, Gijsbert P van Nierop, Eric C M van Gorp, Frank Tobian, Bas B Oude Munnink, Reina S Sikkema, Thomas Jaenisch, Guy Cochrane, Marion P G Koopmans","doi":"10.2196/63996","DOIUrl":"10.2196/63996","url":null,"abstract":"<p><strong>Unlabelled: </strong>The COVID-19 pandemic proved how sharing of genomic sequences in a timely manner, as well as early detection and surveillance of variants and characterization of their clinical impacts, helped to inform public health responses. However, the area of (re)emerging infectious diseases and our global connectivity require interdisciplinary collaborations to happen at local, national and international levels and connecting data to understand the linkages between all factors involved. Here, we describe experiences and lessons learned from a COVID-19 pilot study aimed at developing a model for storage and sharing linked laboratory data and clinical-epidemiological data using European open science infrastructure. We provide insights into the barriers and complexities of internationally sharing linked, complex cohort datasets from opportunistic studies for connected data analyses. An analytical timeline of events, describing key actions and delays in the execution of the pilot, and a critical path, defining steps in the process of internationally sharing a linked cohort dataset are included. The pilot showed how building on existing infrastructure that had previously been developed within the European Nucleotide Archive at the European Molecular Biology Laboratory-European Bioinformatics Institute for pathogen genomics data sharing, allowed the rapid development of connected \"data hubs.\" These data hubs were required to link human clinical-epidemiological data under controlled access with open high dimensional laboratory data, under FAIR (Findable, Accessible, Interoperable, Reusable) principles. Based on our own experiences, we call for action and make recommendations to support and to improve data sharing for outbreak preparedness and response.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e63996"},"PeriodicalIF":3.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting the Influence of Using Blood Donor Residual Samples for SARS-CoV-2 Seroprevalence Studies in Japan: Cross-Sectional Survey Study.","authors":"Ryo Kinoshita, Sho Miyamoto, Tadaki Suzuki, Motoi Suzuki, Daisuke Yoneoka","doi":"10.2196/60467","DOIUrl":"10.2196/60467","url":null,"abstract":"<p><strong>Unlabelled: </strong>Background: Residual blood donor samples are commonly used in SARS-CoV-2 seroepidemiological studies; however their use may introduce bias due to the healthy donor effect, wherein blood donors are generally healthier than the general population. This potential bias is critical for accurately interpreting seroepidemiological data, as blood donors might not fully represent broader population-level infection rates., Objective: This study aims to assess the potential bias in SARS-CoV-2 seroprevalence estimates derived from blood donor samples in Japan by examining the association between blood donation history and COVID-19 diagnosis. By quantifying the healthy donor effect, we seek to refine the interpretation of SARS-CoV-2 seroepidemiological studies using residual blood donor samples., Methods: We conducted a web-based survey from December 14 to 28, 2023, recruiting 10,781 Japanese residents aged 16-69, stratified by demographic factors to match national representation. Participants provided information on demographics, socioeconomic status, COVID-19 vaccination history, comorbidities, and blood donation experience. A logistic regression model adjusting for confounders such as age, sex, education, occupation, comorbidities, and vaccination status, was used to estimate the odds of COVID-19 diagnosis among blood donors compared to nondonors., Results: Of the 10,781 participants, 3583 (33.2%) reported a history of COVID-19 diagnosis, and 5015 (46.5%) indicated they had donated blood at least once in their lifetime, and 1128 (10.5%) donated within the last year. Blood donors had mean of 13.5 (SD 43.6) donations and were older, with a mean age of 46.4 (SD 13.9) years, compared to 38.5 (SD 14.1) years for nondonors. Among blood donors, 39.9% had comorbidities (95% CI 38.5-41.2) compared to 27.9% (95% CI 26.7-29.0) of nondonors. Blood donors had 1.62 (95% CI: 1.48-1.78) times higher odds of COVID-19 diagnosis compared to nondonors. The higher diagnosis rate among blood donors likely reflects increased social interactions and health-seeking behaviors, a phenomenon we refer to as the inverse healthy donor effect. This suggests that blood donor samples could overestimate SARS-CoV-2 seroprevalence when generalized to the broader Japanese population., Conclusions: Higher COVID-19 diagnosis rates among blood donors may reflect increased community involvement and health-seeking behaviors, suggesting an inverse healthy donor effect. This pattern indicates that in terms of SARS-CoV-2 infection, blood donors might not represent the healthiest segment of the population. Consequently, seroprevalence studies using blood donor samples could overestimate SARS-CoV-2 infection rates in the general Japanese population. For more accurate public health surveillance, the development of statistical methods to adjust for this bias is recommended.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e60467"},"PeriodicalIF":3.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Equity of Hypertension Management Between Local Residents and Internal Migrants in Shenzhen, China: Cross-Sectional Study.","authors":"Jinyu He, Yanjun Li, Huatang Zeng, Haoran Sun, Liqun Wu, Zhenzhen Zhu, Ning Zhang, Wannian Liang","doi":"10.2196/65548","DOIUrl":"10.2196/65548","url":null,"abstract":"<p><strong>Background: </strong>With hypertension emerging as a global public health concern, taking measures to alleviate its burden is urgently needed. The hypertension management program (HMP) in China is a standardized policy to help people with hypertension to improve their health levels and reduce health inequalities. However, studies focusing on details regarding participation in this program remain scarce.</p><p><strong>Objective: </strong>This study aims to investigate the participation rates in HMPs in China and examine the health disparities in hypertension management between local residents and internal migrants in Shenzhen.</p><p><strong>Methods: </strong>This study used the medical record of Shenzhen, Guangdong, China. We included adults with new-onset diagnosis of hypertension after 2017 and focused on patients who have a record in the community health center. We described the basic characteristics of people diagnosed with hypertension, including age, gender, marital status, occupation, education level, and health insurance type. Enrolled rate, follow-up rate, and adherence rate were used to measure the engagement with this program at the city, district, and community levels.</p><p><strong>Results: </strong>Of the 1,160,214 hypertensive patients, 29.70% (344,526/1,160,214) were local residents, while 70.3% (815,688/1,160,214) were internal migrants. In addition, 55.36% (642,250/1,160,214) were enrolled in the HMP. Of those, 57.52% (369,439/642,25) were followed up. In addition, 62.59% (231,217/369,439) of followed up individuals were adherents. Internal migrants demonstrated a significantly higher participation in the HMP, especially for the enrolled rate (local residents: 156,085/344,526, 45.30% vs internal migrants: 486,165/815,688, 59.60%) and adherence rate (local residents: 44,044/84,635, 52.04% vs internal migrants: 187,173/284,804, 65.72%). Apart from that, local, single, and younger individuals had lower rates compared to their counterparts. There also existed within-district and within-community variation among enrolled, follow-up, and adherence rates.</p><p><strong>Conclusions: </strong>Based on our research, individuals with different demographic and socioeconomic characteristics and in different regions had different enrolled, follow-up, and adherence rates. Internal migrants in Shenzhen showed a significantly higher participation in the HMP. Given these findings, there exists the potential to enhance the outreach and engagement of local, single, and younger populations through targeted promotional strategies.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e65548"},"PeriodicalIF":3.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Deliberate Self-Harm in Hong Kong Before and During the COVID-19 Pandemic: Population-Wide Retrospective Cohort Study.","authors":"Luke Y F Luk, Christie J Y Ching, Tsz Fung Yip, Sunny C L Chan, Catherine Y T Lam, Elizabeth T C Lam, Serena R B Yue, Hoi Ching Pang, Janet Y H Wong, Carlos K H Wong, Chak Kwan Tong, Tafu Yamamoto, Timothy H Rainer, Abraham K C Wai, Joshua W K Ho","doi":"10.2196/57500","DOIUrl":"10.2196/57500","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 ended on May 5, 2023, and since then Hong Kong reported increased mental distress, which was speculated to be from the policies implemented during the pandemic. Despite this, longitudinal surveillance of deliberate self-harm (DSH) incidences throughout the pandemic in Hong Kong remained insufficient.</p><p><strong>Objective: </strong>The objective of this study was to outline the changes in DSH incidences before and during the COVID-19 pandemic in Hong Kong, with respect to sex, age, and co-occurring mental health issues.</p><p><strong>Methods: </strong>A quasi-experiment was conducted using an interrupted time series design to estimate the impact of the pandemic on DSH-related emergency department (ED) visits. This design enabled the estimation of DSH-related ED visits based on prepandemic data from 2016 to 2019, assuming the pandemic had not occurred, and allowed for a comparison with observed DSH-related ED visits during the pandemic. The descriptive results were reported as the observed monthly DSH-related ED visits and observed incidence ratios during the pandemic. Afterwards, a negative binomial model was fitted to the prepandemic data (2016-2019) and adjusted for temporal trends, seasonality, and population variation to estimate the expected monthly DSH-related ED visits and adjusted incidence ratios (aIRs).</p><p><strong>Results: </strong>Between January 2016 and December 2022, a total of 31,893 DSH episodes were identified. Initial descriptive analysis showed a significant difference in demographic characteristics (sex) and clinical characteristics (death within 28 d, diagnoses of co-occurring mental health issues, public assistance pay code, and triage level). Subsequent interrupted time-series analysis demonstrated significantly increasing trends in comparison with the prepandemic period. As reported in the aIRs among young adult males (aIR in 2020=1.34, P=.002; 2021: aIR=1.94, P<.001; and 2022: aIR=2.53, P<.001), adult males (aIR in 2020=1.58, P<.001; 2021: aIR=2.64, P<.001; and 2022: aIR=3.13, P<.001), adult females (aIR in 2020=1.13, P=.01; 2021: aIR=1.52, P<.001; and 2022: aIR=1.64, P<.001), and older male adults (aIR in 2020=1.53, P<.001; 2021: aIR=2.37, P<.001; and 2022: aIR=3.01, P<.001).</p><p><strong>Conclusions: </strong>The average annual DSH-related ED visits increased during the pandemic period. Therefore, there is a need to raise awareness for such vulnerable groups in Hong Kong to prepare for postpandemic spillover.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e57500"},"PeriodicalIF":3.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Exposure to Fine Particulate Matter (PM_2.5) Components and Precocious Puberty Among School-Aged Children: Cross-Sectional Study.","authors":"Xuelian Zhou, Xiaochi Zhang, Guannan Bai, Guanping Dong, Xinyi Li, Ruimin Chen, Shaoke Chen, Rongxiu Zheng, Chunlin Wang, Haiyan Wei, Bingyan Cao, Yan Liang, Hui Yao, Zhe Su, Mireguli Maimaiti, Feihong Luo, Pin Li, Min Zhu, Hongwei Du, Yu Yang, Lanwei Cui, Jinling Wang, Jinna Yuan, Zhuang Liu, Wei Wu, Qi Zhao, Junfen Fu","doi":"10.2196/62861","DOIUrl":"10.2196/62861","url":null,"abstract":"<p><strong>Background: </strong>The increasing incidence of precocious puberty is a major health challenge for Chinese children, while related risk factors remain less well explored. Exposure to ambient fine particulate matter (PM2.5) is a leading environmental hazard in China. Although certain components of PM2.5 have been reported to be endocrine disruptors for sex hormones, population-based evidence is still lacking on the association between PM2.5 exposure and precocious puberty in China.</p><p><strong>Objective: </strong>Based on a cross-sectional survey covering 30 cities in 2017 to 2019, this study was designed to explore the association between long-term exposure to PM2.5 and its 5 major components with precocious puberty in China and to check the potential modifying effects of family-related and personal factors.</p><p><strong>Methods: </strong>We included 34,105 children aged 6 to 9 years. We collected the 5-year average concentrations of PM2.5 and its 5 major components (sulfate, nitrate, ammonium, organic matter, and black carbon) in the area (at a spatial resolution of 0.1° × 0.1°) where each school was located. We used mixed effect logistic regression to estimate the effect sizes of the total mass of PM2.5 and each of its components on precocious puberty, and we examined the modifying effects of family-related and personal factors using an additional interactive term. A weighted quantile sum (WQS) regression model was applied to identify the weights of each component in explaining the effect size of the total mass of PM2.5.</p><p><strong>Results: </strong>We found that the odds ratio (OR) for precocious puberty per IQR increase in the concentration of total PM2.5 mass was 1.27 (95% CI 0.92-1.75) for the whole population, 2.12 (95% CI 1.27-3.55) for girls, and 0.90 (95% CI 0.62-1.30) for boys. Similarly, the effect sizes of the 5 major components were all substantial for girls but minimal for boys. Results of the WQS analysis showed that organic matter could explain the highest proportion of the effect of PM2.5, with the weight of its contribution being 0.71. Modification effects of family income and dietary habits were only observed in certain population subgroups.</p><p><strong>Conclusions: </strong>Long-term exposure to total PM2.5 mass was significantly associated with precocious puberty in girls, with organic matter identified as the major effect contributor. The results add evidence on the detrimental effects of PM2.5 on children's development and growth.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e62861"},"PeriodicalIF":3.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}