The Lancet Regional Health: Western Pacific最新文献

{"title":"Birth cohort-specific smoking patterns in Japan (1906–2004): a population-based study from the NC-CCAPH consortium","authors":"Shiori Tanaka ,&nbsp;Hikaru Ihira ,&nbsp;Tetsuya Tajima ,&nbsp;Rieko Kanehara ,&nbsp;Yosuke Inoue ,&nbsp;Takehiko Doi ,&nbsp;Nozomu Kobayashi ,&nbsp;Yuka Kato ,&nbsp;Yukiko Nishita ,&nbsp;Maki Konishi ,&nbsp;Yoko M. Nakao ,&nbsp;Isamu Kabe ,&nbsp;Chihiro Morioka ,&nbsp;Seitaro Dohi ,&nbsp;Paramita Khairan ,&nbsp;Ahmed Arafa ,&nbsp;Zui C. Narita ,&nbsp;Naho Morisaki ,&nbsp;Yukai Lu ,&nbsp;Rei Otsuka ,&nbsp;Manami Inoue","doi":"10.1016/j.lanwpc.2025.101562","DOIUrl":"10.1016/j.lanwpc.2025.101562","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to estimate Japan’s age-specific history of smoking prevalence, initiation, cessation, and intensity by birth cohort, using data from multiple cohort studies.</div></div><div><h3>Methods</h3><div>We pooled data from eight eligible cohorts surveyed between 1989 and 2020 as part of the National Center Cohort Collaborative for Advancing Population Health (NC-CCAPH). An Age-Period-Cohort model was employed to estimate birth cohort- and sex-specific smoking patterns for individuals born between 1920 and 1999.</div></div><div><h3>Findings</h3><div>Among 393,023 participants (40.9% female, mean age 51.8 years), smoking prevalence peaked in early adulthood (20s–30s) and declined with increasing age. Recent birth cohorts showed lower prevalence and smoking initiation in both sexes, albeit with increases in mid-female cohorts (1960s–1980s). Smoking cessation surged in the late 1990s and peaked around 2010, coinciding with tax-driven cigarette price hikes. Peak cigarette consumption occurred in 1990, followed by a steady decline. However, all birth cohorts maintained a mean consumption above 10 cigarettes smoked per day for both sexes.</div></div><div><h3>Interpretation</h3><div>This study highlights a generational shift in smoking behavior, in which younger birth cohorts smoked less and quit earlier than older birth cohorts. The study also reveals that smoking behaviors in males were strongly influenced by cigarette accessibility, such as price increases, while smoking initiation in females was more likely affected by societal changes, especially in the evolving roles of women. Smoking intensity remained stable across cohorts and sexes, emphasizing the need for stronger health policies, including higher tobacco taxes, to further reduce smoking and its health impact.</div></div><div><h3>Funding</h3><div>This study was conducted within the National Center Cohort Collaborative for Advancing Population Health (NC-CCAPH) and supported by grants from the <span>Japan Health Research Promotion Bureau</span> (JH) (<span><span>2019-(1)-1, 2024-B-05</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101562"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of care in the management of high-risk COPD in Australia (2015–2019): an observational study for the CONQUEST quality improvement program","authors":"Christine Jenkins ,&nbsp;Andrew P. Dickens ,&nbsp;Alexander Evans ,&nbsp;Porsche Le Cheng ,&nbsp;Florian Heraud ,&nbsp;Kerry Hancock ,&nbsp;Anita Sharma ,&nbsp;Belinda Cochrane ,&nbsp;Alexander Roussos ,&nbsp;Chantal Le Lievre ,&nbsp;John Blakey ,&nbsp;Sinthia Bosnic-Anticevich ,&nbsp;Victoria Carter ,&nbsp;Angelina Catanzariti ,&nbsp;Clare Ghisla ,&nbsp;Mark Hew ,&nbsp;Brian Ko ,&nbsp;Thao Le ,&nbsp;Paul Leong ,&nbsp;Vanessa M. McDonald ,&nbsp;David Price","doi":"10.1016/j.lanwpc.2025.101555","DOIUrl":"10.1016/j.lanwpc.2025.101555","url":null,"abstract":"<div><h3>Background</h3><div>We compared the management of patients with ‘high-risk’ COPD in Australia to national/international guidelines and quality standards, including the COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST).</div></div><div><h3>Methods</h3><div>Eligible patients in the Optimum Patient Care Research Database Australia were categorized as newly diagnosed (≤12 months after diagnosis), already diagnosed, or patients with potential undiagnosed COPD, in each year from 2015 to 2019. ‘High-risk’ patients had ≥2 COPD exacerbations/exacerbation-like events in the last 24 months. Descriptive statistics for 2019 are reported, along with annual trends.</div></div><div><h3>Findings</h3><div>In 2019, 11.3% (2608/22,985) of eligible patients met high-risk criteria. Most newly diagnosed high-risk COPD patients (71.3%) had no recorded lung function testing within 12 months of diagnosis. 63.6% of new COPD diagnoses had no evidence of supporting spirometry or chest CT, with the remainder having recorded chest CT only. 44.3% of already diagnosed high-risk patients had no recorded inhaled maintenance therapy, although this was recorded for 11.2% of potential undiagnosed patients. Smoking cessation support and pulmonary rehabilitation were recorded for &lt;40% and ≤2% of diagnosed COPD patients respectively.</div></div><div><h3>Interpretation</h3><div>There is substantial opportunity to improve diagnosis, assessment and treatment of patients with COPD in Australia by identifying, reviewing and managing high-risk patients in accordance with evidence-based guidelines and CONQUEST standards.</div></div><div><h3>Funding</h3><div>This study was conducted by <span>Optimum Patient Care Australia Pty Ltd</span> (OPCA) and was partially funded by <span>OPCA and AstraZeneca Pty Ltd</span>. No funding was received by the <span>Observational &amp; Pragmatic Research Institute Pte Ltd</span> (OPRI) for its contribution.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101555"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities and challenges of conducting vaccine research in low and middle-income countries in the Asia–Pacific region: perspectives from the Asia–Pacific Vaccine Research Network","authors":"Jarir At Thobari ,&nbsp;Eggi Arguni ,&nbsp;Janis Asuncion Bunoan-Macazo ,&nbsp;Stephanie Clark ,&nbsp;Narangerel Dorj ,&nbsp;Vannida Douangboupha ,&nbsp;Pawinee Doungngern ,&nbsp;Ha Hai Vu ,&nbsp;Lukman Ade Chandra ,&nbsp;Jonathan Hasian Haposan ,&nbsp;Isireli Koroituku ,&nbsp;Phonethipsavanh Nouanthong ,&nbsp;Anna Lisa Ong-Lim ,&nbsp;Dashpagam Otgonbayar ,&nbsp;Linh Phuong Tran ,&nbsp;Ilisapeci Tuibeqa ,&nbsp;Claire von Mollendorf ,&nbsp;Fiona M. Russell ,&nbsp;Asia–Pacific Vaccine Research Network","doi":"10.1016/j.lanwpc.2025.101559","DOIUrl":"10.1016/j.lanwpc.2025.101559","url":null,"abstract":"<div><div>During the COVID-19 pandemic, vaccine technology and development advanced substantially in high-income countries, but this progress was not followed by the equitable knowledge transfer and accessibility and uptake of vaccines, particularly among low-and middle-income countries (LMICs). The Asia–Pacific Vaccine Research Network is a collaborative platform that aims to address common challenges faced by Asia–Pacific LMICs in undertaking vaccine research and barriers to evidence-based immunisation policy and practice. A network workshop was held in 2023 that aimed to identify critical challenges and opportunities to advance vaccine research to inform immunisation policy in LMICs in the Asia–Pacific. We found common themes to be challenges and opportunities in vaccine research capacity and infrastructure, workforce availability, financing and regulatory issues. To help to address some of these common challenges across the region, the Asia–Pacific Vaccine Research Network aims to facilitate the upskilling of vaccine research capability and knowledge exchange by bringing together experts and stakeholders from diverse backgrounds and through collaboration.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101559"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the ABC (atrial fibrillation better care) pathway and risk of adverse outcomes in patients with chronic kidney disease: a report from the prospective APHRS-AF registry","authors":"Tommaso Bucci ,&nbsp;Katarzyna Nabradalik ,&nbsp;Krysztof Irlik ,&nbsp;Alena Shantsila ,&nbsp;Giulio Francesco Romiti ,&nbsp;Marco Proietti ,&nbsp;Wee-Siong Teo ,&nbsp;Hyung-Wook Park ,&nbsp;Wataru Shimizu ,&nbsp;Hung-Fat Tse ,&nbsp;Tze-Fan Chao ,&nbsp;Gregory Y.H. Lip","doi":"10.1016/j.lanwpc.2025.101570","DOIUrl":"10.1016/j.lanwpc.2025.101570","url":null,"abstract":"<div><h3>Background</h3><div>Limited data exist on the effectiveness of the ABC (Atrial Fibrillation Better Care) pathway in reducing adverse events in Asian patients with atrial fibrillation (AF) and chronic kidney disease (CKD).</div></div><div><h3>Methods</h3><div>A post-hoc analysis of the prospective APHRS AF Registry. Patients were divided into CKD (eGFR &lt; 60 ml/min) and non-CKD (eGFR ≥ 60 ml/min) groups. Logistic regression assessed factors associated with CKD, oral anticoagulant (OAC) use, and rhythm control strategies. Cox regression estimated hazard ratios (HRs) for a composite outcome of all-cause mortality and major adverse cardiovascular events. Subgroup analyses evaluated outcomes by CKD severity and ABC adherence.</div></div><div><h3>Findings</h3><div>Of 3550 patients, 1029 had CKD (mean age 75.3 ± 10.3 years, 40.3% female), and 2521 did not (66.4 ± 11.3 years, 32.3% female). CKD patients were older, more often female, had lower ABC adherence (29.5% vs. 42.1%, p &lt; 0.001) and anticoagulation use (Odds Ratio [OR] 0.77, 95% CI 0.61–0.96), but higher warfarin use, and were less likely to receive rhythm control (OR 0.79, 95% CI 0.66–0.94) comparing to those without CKD. CKD and adherence to the ABC pathway were independently associated with higher (HR 1.90, 95% CI 1.46–2.48) and lower (HR 0.64, 95% CI 0.48–0.87) risks of the composite outcome, respectively. Adverse event risks increased with CKD severity, and ABC pathway benefits were observed irrespective of CKD.</div></div><div><h3>Interpretation</h3><div>AF patients with CKD show lower ABC pathway adherence and high risk of adverse events. Improving adherence to integrated care approaches may improve prognosis in this patient group.</div></div><div><h3>Funding</h3><div>This study was an independent research grant by <span>Pfizer</span> and <span>Bristol Myers Squibb</span> (BMS) to APHRS.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101570"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment and recalibration of seventeen lung cancer risk prediction models in approximately one million Chinese population utilising healthcare big data: a retrospective cohort analysis","authors":"Ziqing Ye ,&nbsp;Yexiang Sun ,&nbsp;Yueqi Yin ,&nbsp;Liya Liu ,&nbsp;Miao Cui ,&nbsp;Longyao Zhang ,&nbsp;Yuantao Hao ,&nbsp;David C. Christiani ,&nbsp;Hongbo Lin ,&nbsp;Peng Shen ,&nbsp;Yongyue Wei","doi":"10.1016/j.lanwpc.2025.101575","DOIUrl":"10.1016/j.lanwpc.2025.101575","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;A number of lung cancer prediction models have been developed worldwide. However, there have been limited validation studies conducted specifically on Chinese populations. The objective of this study is to evaluate the feasibility and performance of 17 global lung cancer risk prediction models when applied to Chinese healthcare big data.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The study encompassed individuals whose information was recorded in the Yinzhou Regional Health Care Database (YRHCD) between January 1, 2010 and December 31, 2021. The 17 lung cancer risk prediction models, which comprised the Bach, the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial 2012 model (PLCO&lt;sub&gt;m2012&lt;/sub&gt;), the Korean Men, the PLCO&lt;sub&gt;all2014&lt;/sub&gt;, the Pittsburgh Predictor, Liverpool Lung Project Risk Prediction Model for Lung Cancer Incidence (LLPi), the Lung Cancer Risk Assessment Tool (LCRAT), Constrained LCRAT, the Nord-Trøndelag Health Study (HUNT), the Japan Public Health Center-based study (JPHC), Reduced HUNT, the PLCO&lt;sub&gt;m2012&lt;/sub&gt; without information of race (PLCO&lt;sub&gt;m2012-norace&lt;/sub&gt;), the Liverpool Lung Project version 3 (LLPv3), Lung Cancer Risk Score (LCRS), the Optimized Early Warning Model for Lung Cancer Risk (OWL), the University College London-Incidence (UCL-I), the Shanghai Lung Cancer incidence Model (Shanghai-LCM), were evaluated for their performance in overall population and subgroups stratified by age and sex. The discrimination of the 17 models was assessed using Harrell's C-index and time-dependent area under the curve (AUC). The calibration of the models was evaluated using the expected-to-observed ratio (EOR) and calibration curves. Moreover, the models were recalibrated in the Yinzhou population, and the calibration of the recalibrated models was evaluated. For each model before and after recalibration, we redefined risk thresholds that would select the same number of individuals as the China National Lung Cancer Screening Guideline with Low-dose Computed Tomography 2023 Version (CNLCS 2023) could screen out. The Kaplan–Meier method was used to estimate the incidence and number of cases of lung cancer in individuals screened according to different criteria or models over a five-year follow-up period, and Kaplan–Meier survival curves were plotted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 904,667 study participants were included in the analysis, comprising 66,730 ever smokers and 837,937 never smokers. Among the 17 models initially considered, only six (Bach, Pittsburgh Predictor, JPHC, Reduced HUNT, Constrained LCRAT, UCL-I) had complete information of predictive variables available in the YRHCD. Most models showed similar levels of discrimination, with C-indices ranging from 0.78 (95% CI 0.74–0.82) to 0.88 (0.87–0.89) and time-dependent AUCs ranging from 0.74 (95% CI 0.73–0.75) to 0.88 (0.87–0.89). The majority of models showed an overestimation of incidence risk among ever smok","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101575"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperuricemia, gout and the associated comorbidities in China: findings from a prospective study of 0.5 million adults","authors":"Pek Kei Im ,&nbsp;Christiana Kartsonaki ,&nbsp;Maria G. Kakkoura ,&nbsp;Olaa Mohamed-Ahmed ,&nbsp;Ling Yang ,&nbsp;Yiping Chen ,&nbsp;Huaidong Du ,&nbsp;Xiaoming Yang ,&nbsp;Hua Zhang ,&nbsp;Dianjianyi Sun ,&nbsp;Canqing Yu ,&nbsp;Jun Lv ,&nbsp;Liming Li ,&nbsp;Zhengming Chen ,&nbsp;Iona Y. Millwood","doi":"10.1016/j.lanwpc.2025.101572","DOIUrl":"10.1016/j.lanwpc.2025.101572","url":null,"abstract":"<div><h3>Background</h3><div>Despite the growing prevalence of hyperuricemia and gout, their epidemiology and associated comorbidity burden remains poorly studied in many populations, including China. We aimed to examine the patterns of plasma urate level, prevalence of hyperuricemia, and incidence of gout, and investigate the associations of gout with a range of comorbidities and all-cause mortality in Chinese adults.</div></div><div><h3>Methods</h3><div>The prospective China Kadoorie Biobank recruited 512,724 adults aged 30–79 years from ten diverse areas in 2004–2008 and measured plasma urate level among 16,817 participants. The incidence of gout and other diseases and deaths were monitored by electronic linkages with registries and hospital records. Cox and logistic regression yielded adjusted HRs and ORs for risks of mortality and comorbidities associated with gout, hyperuricemia, and urate level.</div></div><div><h3>Findings</h3><div>The gout incidence rate was 23.4 per 100,000 person-years, and was higher in men and older participants, and varied substantially by region. Gout was associated with higher risks of all-cause mortality (HR = 1.58, 95% CI 1.37–1.82), CVD (1.87, 1.64–2.14), CKD (5.61, 4.45–7.07), urolithiasis (2.50, 1.85–3.38), diabetes (1.99, 1.51–2.62), diseases of the oesophagus, stomach, and duodenum (2.14, 1.72–2.66), infectious and parasitic diseases (1.91, 1.47–2.48), arthropathies (6.06, 4.98–7.38), and other musculoskeletal disorders (2.10, 1.77–2.51). Most of these associations were bi-directional, sustained over time and little affected by adjustment for cardiometabolic risk factors. Moreover, participants who developed gout were more likely to have multiple major diseases and more hospitalisations. Among the subset with plasma urate measured, 15% had hyperuricemia, which was more common in men, older women, and urban residents, and was associated with increased risks of gout, all-cause mortality, and several cardiometabolic, renal, digestive, and musculoskeletal diseases.</div></div><div><h3>Interpretation</h3><div>In Chinese adults, gout was associated with several comorbidities and a poor health trajectory. Our findings reinforce the need for prevention and management of gout and associated comorbidities.</div></div><div><h3>Funding</h3><div><span>Kadoorie Charitable Foundation</span>, <span>National Natural Science Foundation of China</span>, <span>Noncommunicable Chronic Diseases-National Science and Technology Major Project</span>, <span>British Heart Foundation</span>, <span>Cancer Research UK</span>, <span>Wellcome Trust</span>, <span>UK Medical Research Council</span>, <span>Nuffield Department of Population Health at the University of Oxford</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101572"},"PeriodicalIF":7.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined effects of hydrological conditions and socioeconomic factors on the seasonal dynamics of severe fever with thrombocytopenia syndrome in China, 2011–2022: a modelling study","authors":"Hong-Han Ge ,&nbsp;Kun Liu ,&nbsp;Fang-Yu Ding ,&nbsp;Peng Huang ,&nbsp;Yan-Qun Sun ,&nbsp;Ming Yue ,&nbsp;Hong Su ,&nbsp;Qian Wang ,&nbsp;Nicholas Philip John Day ,&nbsp;Richard James Maude ,&nbsp;Dong Jiang ,&nbsp;Li-Qun Fang ,&nbsp;Wei Liu","doi":"10.1016/j.lanwpc.2025.101564","DOIUrl":"10.1016/j.lanwpc.2025.101564","url":null,"abstract":"<div><h3>Background</h3><div>Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral hemorrhagic fever with expanding geographical range. The determinants of the seasonal dynamics of SFTS remain poorly understood.</div></div><div><h3>Methods</h3><div>Monthly SFTS cases from 604 counties in five provinces with high-notification rate in China (2011–2022) were analyzed using hierarchical Bayesian spatiotemporal and distributed lag nonlinear models. Cumulative and month-specific effects of meteorological factors were assessed, with socioeconomic factors as modifiers.</div></div><div><h3>Findings</h3><div>The cumulative effect peaked at 21.97 °C (<em>RR</em> = 1.24, 95% CI: 1.10–1.40) and the month-specific effect peaked at 25.67 °C (<em>RR</em> = 1.38, 95% CI: 1.26–1.51) without time lag. Increased precipitation significantly amplified the risk of SFTS with a notable lag effect observed. Both drought and wet conditions heightened the risk of SFTS occurrence substantially, with cumulative <em>RR</em> peaking at 3.13 (95% CI: 1.58–6.23) for Standardized Precipitation Evapotranspiration Index (SPEI-1) of −2.5, indicating drought conditions, and peaking at 1.51 (95% CI: 1.00–2.27) for SPEI-1 of 2.16, indicating wet conditions. The highest month-specific <em>RR</em> was observed at an SPEI-1 of −2.5 with a 2-month lag and at 1.81 with a 1-month lag, respectively. The risk of SFTS was higher in low-urbanization areas during drought, while was higher in high-urbanization areas with wet conditions.</div></div><div><h3>Interpretation</h3><div>Climatic factors significantly influence SFTS dynamics, with socioeconomic conditions modifying these effects. Integrating climate factors into surveillance and early warning systems is essential for targeted prevention and control.</div></div><div><h3>Funding</h3><div><span>National Natural Science Foundation of China</span> (No. <span><span>82330103</span></span> and No. <span><span>42201497</span></span>), <span>Youth Innovation Promotion Association</span> (No. <span><span>2023000117</span></span>), and the <span>Wellcome Trust</span> [<span><span>220211</span></span>].</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101564"},"PeriodicalIF":7.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underestimating heat-related mortality—a comparison of excess mortality and death record studies for Australia","authors":"Thomas Longden","doi":"10.1016/j.lanwpc.2025.101557","DOIUrl":"10.1016/j.lanwpc.2025.101557","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101557"},"PeriodicalIF":7.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive systematic review and meta-analysis of risk factors for childhood obesity in China and future intervention strategies","authors":"Yanfen Jiang ,&nbsp;Jiajin Hu ,&nbsp;Fengyan Chen ,&nbsp;Borui Liu ,&nbsp;Mengna Wei ,&nbsp;Wenqi Xia ,&nbsp;Yinkun Yan ,&nbsp;Jinchen Xie ,&nbsp;Shufa Du ,&nbsp;Xiangyang Tian ,&nbsp;Izzuddin M. Aris ,&nbsp;Youfa Wang ,&nbsp;Jianduan Zhang","doi":"10.1016/j.lanwpc.2025.101553","DOIUrl":"10.1016/j.lanwpc.2025.101553","url":null,"abstract":"<div><h3>Background</h3><div>Childhood obesity is a critical public health concern in China. This study identified the key determinants of childhood obesity in China and provided recommendations for future intervention strategies.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive systematic review and meta-analysis to identify multiple-level determinants of childhood obesity in China and calculated the population-attributable risk percentage (PAR%) for each modifiable determinant. We also conducted expert consultations using the Socio-ecological Model to gain insights into the causes of obesity. Additionally, we reviewed current Chinese policies on childhood obesity intervention and compared them with the priorities identified in the meta-analysis and expert consultation to pinpoint policy gaps.</div></div><div><h3>Findings</h3><div>Our meta-analysis, incorporating 419 studies, identified 33 risk factors for childhood obesity. At the individual-level, we identified 11 key contributors including early-life risk factors such as maternal pre-pregnancy overweight/obesity (PAR%: 16.7%), breastfeeding duration of less than six months (14.1%), cesarean section delivery (11.1%), excessive gestational weight gain (10.5%), high birth weight (4.2%), and gestational diabetes mellitus (3.6%), and 13 behavioral factors during childhood such as sugar sweetened beverage consumption (16.4%), insufficient sleep (15.0%), rapid eating speed (14.7%), less than 2 h of physical activity per day (6.3%), and over 2 h of daily screen time (5.6%). We also identified six prominent family-level factors such as maternal overweight/obesity (24.3%) and paternal overweight/obesity (23.5%). Expert consultation highlighted genetic factors, and prioritized actionable risk factors, particularly dietary, expanding on the meta-analysis findings. Finally, policy review revealed that existing Chinese policies inadequately addressed these determinants, especially at the macro and structural levels.</div></div><div><h3>Interpretation</h3><div>This study highlights the importance of targeting high-risk populations and addressing detrimental behavioral factors, especially on early-life influences. However, real-world impacts require a comprehensive approach that goes beyond individual factors. More future effective intervention efforts are needed.</div></div><div><h3>Funding</h3><div>This study was funded by the <span>National Natural Science Foundation of China</span> (NSFC <span><span>82073567</span></span>; NSFC <span><span>82273641</span></span>) and the <span>National Science and Technology Innovation</span> 2030, <span>Noncommunicable Chronic Diseases-National Science and Technology Major Project</span> (Grant No. <span><span>2023ZD0508500</span></span>, <span><span>2023ZD0508504</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101553"},"PeriodicalIF":7.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secular trends in physical fitness and cardiovascular risks among Chinese college students: an analysis of five successive national surveys between 2000 and 2019","authors":"Shan Cai ,&nbsp;Yihang Zhang ,&nbsp;Ziyue Chen ,&nbsp;Yunfei Liu ,&nbsp;Jiajia Dang ,&nbsp;Jiaxin Li ,&nbsp;Tianyu Huang ,&nbsp;Ziyue Sun ,&nbsp;Yanhui Dong ,&nbsp;Jun Ma ,&nbsp;Yi Song","doi":"10.1016/j.lanwpc.2025.101560","DOIUrl":"10.1016/j.lanwpc.2025.101560","url":null,"abstract":"<div><h3>Background</h3><div>With increasing concerns about early-onset cardiovascular diseases, it is essential to understand the distribution of cardiovascular health among young adults. This study aimed to characterize trends in physical fitness and the prevalence of overweight/obesity (OWOB), elevated blood pressure (EBP), and their comorbidity among Chinese college students from 2000 to 2019 and to analyze the changes in their associations and subgroup differences.</div></div><div><h3>Methods</h3><div>Data were extracted from five cycles of the Chinese National Survey on Students' Constitution and Health (2000–2019), including 241,710 college students aged 19–22. Physical fitness indicator (PFI) was computed using standardized z-scores of forced vital capacity, sit-and-reach, 50-m dash, standing long jump, muscle strength, and endurance running. OWOB was defined as a body mass index ≥25 kg/m², and EBP as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Comorbidity was defined as the co-occurrence of OWOB and EBP. Mixed-effects logistic regression was used to analyze associations, and generalized linear mixed-effects models were applied to examine dose-response relationships.</div></div><div><h3>Findings</h3><div>The median of college students' PFI deteriorated continuously from −0.16 in 2000 to −1.99 in 2019, with boys experiencing a faster decline than girls. The prevalence of OWOB, EBP, and comorbidity increased significantly from 3.7%, 2.2%, and 0.3% in 2000 to 14.0%, 5.2%, and 1.8% in 2019, respectively, with boys exhibiting higher prevalence than girls. Decreasing PFI levels were significantly associated with the increasing prevalence of OWOB, EBP, and comorbidity, and such associations were strongest in 2019. L-shaped curves were observed for the relationships between PFI and the prevalence of OWOB, EBP, and comorbidity, with stronger associations in boys. Provincial population attributable fraction showed that when improving the PFI levels from low to middle-low or above, college students in Guizhou, Sichuan, and Yunnan provinces exhibited the most reductions in OWOB, EBP, and comorbidity.</div></div><div><h3>Interpretation</h3><div>Physical fitness among Chinese college students has significantly declined over the past two decades, accompanied by marked increases in the burden of cardiovascular risks. There is an urgent need to increase the focus on college students’ health and establish a college-based physical examination system to assess their long-term cardiovascular function.</div></div><div><h3>Funding</h3><div>The present study was funded by National Key R&amp;D Program of China (Grant No. 2024YFC2707901 to Yi Song), <span>National Natural Science Foundation of China</span> (Grant No. <span><span>82273654</span></span> to Yi Song), and <span>Beijing Office for Education Sciences Planning</span> (Grant No. <span><span>BBAA22027</span></span> to Yi Song).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"58 ","pages":"Article 101560"},"PeriodicalIF":7.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}