The aim of this study was to investigate trends in suicide rates (SRs) among the elderly in China. Annual data on SRs among Chinese people ≥ the age of 65 were collected from China\'s Health Statistics Yearbook from 2002 to 2020. Then, data were stratified by age, region, and sex. Standardized SRs were calculated and analyzed using a conventional joinpoint regression model. Results revealed that overall, SRs among the elderly in China tended to decline from 2002-2020. Fluctuations in SRs, including in 2004-2005 due to the SARS epidemic, in 2009-2010 due to the economic crisis, and in 2019-2020 due to the COVID-19 pandemic, were also observed. Data suggested a relatively greater crude SR among the elderly (vs. young people), in males (vs. females), and in people living in a rural area (vs. those living in an urban area). SRs tended to rise with age. Joinpoint regression analysis identified joinpoints only for males ages 65-69 and over the age of 85 living in a rural area, suggesting that individuals in these groups are more sensitive to negative stimuli and more likely to commit suicide, necessitating closer attention. The findings from this study should help to make policy and devise measures against suicide in the future.

UNASSIGNED: The aims of this study were to explore the incidence characteristics and trend prediction of lymphoma from 2005 to 2035, and to provide data basis for the prevention and control of lymphoma in China.
UNASSIGNED: The data on lymphoma incidence in China from 2005 to 2017 were obtained from the Chinese Cancer Registry Annual Report. The Joinpoint regression model was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to reflect time trends. Age-period-cohort models were conducted to estimate age, period, and cohort effects on the lymphoma incidence. A Bayesian age-period-cohort model was used to predict lymphoma incidence trends from 2018 to 2035.
UNASSIGNED: From 2005 to 2017, the incidence of lymphoma was 6.26/100,000, and the age-standardized incidence rate (ASIR) was 4.11/100,000, with an AAPC of 1.4% [95% confidence interval (CI): 0.3%, 2.5%]. The ASIR was higher in men and urban areas than in women and rural areas, respectively. The age effect showed that the incidence risk of lymphoma increased with age. In the period effect, the incidence risk of lymphoma in rural areas decreased first and then increased with 2010 as the cutoff point. The overall risk of lymphoma incidence was higher in the cohort before the 1970-1974 birth cohort than in the cohort after. From 2018 to 2035, the lymphoma incidence in men, women, and urban areas will show an upward trend.
UNASSIGNED: From 2005 to 2017, the incidence of lymphoma showed an increasing trend, and was different in regions, genders, and age groups in China. It will show an upward trend from 2018 to 2035. These results are helpful for the formulation and adjustment of lymphoma prevention, control, and management strategies, and have important reference significance for the treatment of lymphoma in China.

The long-term trends in maternal and child health (MCH) in China and the national-level factors that may be associated with these changes have been poorly explored. This study aimed to assess trends in MCH indicators nationally and separately in urban and rural areas and the impact of public policies over a 30‒year period. An ecological study was conducted using data on neonatal mortality rate (NMR), infant mortality rate (IMR), under-five mortality rate (U5MR), and maternal mortality ratio (MMR) nationally and separately in urban and rural areas in China from 1991 to 2020. Joinpoint regression models were used to estimate the annual percentage changes (APC), average annual percentage changes (AAPC) with 95% confidence intervals (CIs), and mortality differences between urban and rural areas. From 1991 to 2020, maternal and child mortalities in China gradually declined (national AAPC [95% CI]: NMRs - 7.7% [- 8.6%, - 6.8%], IMRs - 7.5% [- 8.4%, - 6.6%], U5MRs - 7.5% [- 8.5%, - 6.5%], MMRs - 5.0% [- 5.7%, - 4.4%]). However, the rate of decline nationally in child mortality slowed after 2005, and in maternal mortality after 2013. For all indicators, the decline in mortality was greater in rural areas than in urban areas. The AAPCs in rate differences between rural and urban areas were - 8.5% for NMRs, - 8.6% for IMRs, - 7.7% for U5MRs, and - 9.6% for MMRs. The AAPCs in rate ratios (rural vs. urban) were - 1.2 for NMRs, - 2.1 for IMRs, - 1.7 for U5MRs, and - 1.9 for MMRs. After 2010, urban‒rural disparity in MMR did not diminish and in NMR, IMR, and U5MR, it gradually narrowed but persisted. MCH indicators have declined at the national level as well as separately in urban and rural areas but may have reached a plateau. Urban‒rural disparities in MCH indicators have narrowed but still exist. Regular analyses of temporal trends in MCH are necessary to assess the effectiveness of measures for timely adjustments.

OBJECTIVE: To analyze the trends in Oncomelania hupensis distribution in Wuhan City, Hubei Province from 2003 to 2022, so as to provide insights into precision schistosomiasis control.
METHODS: Data pertaining to O. hupensis snail survey in Wuhan City from 2003 to 2022 were collected. The trends in the proportion of areas with snail habitats, actual area with snail habitats, mean density of living snails and prevalence of Schistosoma japonicum infection in snails were evaluated in schistosomiasis-endemic areas of Wuhan City from 2003 to 2022 with the slope of trend curve (β), annual percent change (APC) and average annual percent change (AAPC) using a Joinpoint regression model.
RESULTS: During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in Wuhan City in 2005 and 2015, with a rise during the period from 2003 to 2005 (β1 = 5.93, t = 1.280, P > 0.05), a decline from 2005 to 2015 (β2 = -0.88, t = -2.074, P > 0.05) and a rise from 2015 to 2022 (β3 = 1.46, t = -2.356, P < 0.05). During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in islet endemic areas of Wuhan City in 2006 and 2015, with no significant differences in the trends from 2003 to 2006 (β1 = 4.64, t = 1.888, P > 0.05) or from 2006 to 2015 (β2 = -1.45, t = -2.143, P > 0.05), and with a tendency towards a rise from 2015 to 2022 (β3 = 2.04, t = -3.100, P < 0.05). During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in inner embankment endemic areas of Wuhan City in 2012 and 2020, with a tendency towards a decline from 2003 to 2012 (β1 = -0.39, t = -4.608, P < 0.05) and with no significant differences in the trends from 2012 to 2020 (β2 = 0.03, t = 0.245, P > 0.05) and from 2020 to 2022 (β3 = 1.38, t = 1.479, P > 0.05). During the period from 2003 to 2022, the actual area with snail habitats all appeared a tendency towards a decline in Wuhan City, and in islet and inner embankment endemic areas of Wuhan City from 2003 to 2022 (AAPC = -2.39%, -5.75% and -2.35%, all P values < 0.05). The mean density of living snails reduced from 0.087 snails/0.1 m2 in 2003 to 0.027 snails/0.1 m2 in 2022 in Wuhan City, with a significant difference in the tendency towards the decline (APC = AAPC = -11.47%, P < 0.05). The annual mean decline rate of the mean density of living snails was 17.36% in outside embankment endemic areas of Wuhan City from 2003 to 2022 (APC = AAPC = -17.36%, P < 0.05), and there was no significant difference in the trends in the mean density of living snails in islet endemic areas of Wuhan City from 2003 to 2022 (APC = AAPC = -0.97%, P > 0.05). In addition, the prevalence of S. japonicum infection in snails appeared a tendency towards a decline in Wuhan City from 2003 to 2022 (APC = AAPC = -12.45%, P < 0.05).
CONCLUSIONS: The proportion of areas with snail habitats, actual area with snail habitats, mean density of living snails and prevalence of S. japonicum infection in snails all appeared a tendency towards a decline in Wuhan City from 2003 to 2022. Intensified snail control, modification of snail habitats, shrinking of areas with snails and implementation of grazing prohibition in snail-infested settings are required, in order to facilitate the progress towards schistosomiasis elimination in Wuhan City.
［摘要］ 目的 分析 2003—2022 年湖北省武汉市螺情变化趋势, 为制定血吸虫病精准防控措施提供参考。方法 收集 2003—2022 年武汉市钉螺调查资料, 以有螺面积查出比例、实有钉螺面积、活螺平均密度和钉螺血吸虫感染率等作为螺 情分析指标, 采用 Joinpoint 回归模型分析武汉市血吸虫病流行区各指标趋势变化, 计算趋势曲线斜率 (β)、年度变化百分 比 (annual percent change, APC) 和平均年度变化百分比 (average annual percent change, AAPC) 以评价 2003—2022 年武汉 市螺情数据变化趋势。结果 2003—2022 年, 武汉市有螺面积查出比例在 2005 年和 2015 年出现 2 个连接点, 2003—2005 年为上升阶段 (β1 = 5.93, t = 1.280, P > 0.05)、2005—2015 年为下降阶段 (β2 = −0.88, t = −2.074, P > 0.05), 变化趋势 均无统计学意义; 2015—2022 年为上升阶段 (β3 = 1.46, t = −2.356, P < 0.05)。2003—2022 年, 武汉市垸外洲滩亚型血吸 虫病流行区有螺面积查出比例于 2006 年和 2015 年出现 2 个连接点, 2003—2006 年 (β1 = 4.64, t = 1.888, P > 0.05) 和 2006—2015 年 (β2 = −1.45, t = −2.143, P > 0.05) 变化趋势均无统计学意义, 2015—2022 年呈上升趋势 (β3 = 2.04, t = −3.100, P < 0.05)。2003—2022 年, 武汉市垸内亚型血吸虫病流行区有螺面积查出比例在 2012 年和 2020 年出现 2 个连接点, 2003—2012 年呈下降趋势 (β1 = −0.39, t = −4.608, P < 0.05); 2012—2020 年 (β2 = 0.03, t = 0.245, P > 0.05) 和 2020—2022 年 (β3 = 1.38, t = 1.479, P > 0.05) 变化趋势均无统计学意义。2003—2022 年, 武汉市实有钉螺面积、垸内亚型和垸外洲滩亚 型血吸虫病流行区实有钉螺面积均呈下降趋势 (AAPC = −2.39%、−5.75%和−2.35%, P 均< 0.05)。2003—2022 年, 武汉市 活螺平均密度由 0.087只/0.1 m2 降至 0.027只/0.1 m2, 下降趋势有统计学意义 (APC = AAPC = −11.47%, P < 0.05)。2003—2022 年, 武汉市垸外洲滩亚型流行区活螺平均密度年均下降 17.36% (APC = AAPC = −17.36%, P < 0.05), 垸内亚型流行 区活螺平均密度变化趋势无统计学意义 (APC = AAPC = −0.97%, P > 0.05)。2003—2022 年, 武汉市钉螺血吸虫感染率呈 下降趋势 (APC = AAPC = −12.45%, P < 0.05)。结论 2003—2022 年, 武汉市有螺面积查出比例、实有钉螺面积、活螺平 均密度和钉螺血吸虫感染率均呈下降趋势。需进一步强化钉螺控制、改造钉螺孳生环境、压缩有螺面积、推进有螺地带 禁牧等措施, 以稳步推进武汉市血吸虫病消除工作。.

China faces challenges in meeting the World Health Organization (WHO)\'s target of reducing hepatitis B virus (HBV) infections by 95% using 2015 as the baseline. Using Global Burden of Disease (GBD) 2019 data, joinpoint regression models were used to analyse the temporal trends in the crude incidence rates (CIRs) and age-standardized incidence rates (ASIRs) of acute HBV (AHBV) infections in China from 1990 to 2019. The age-period-cohort model was used to estimate the effects of age, period, and birth cohort on AHBV infection risk, while the Bayesian age-period-cohort (BAPC) model was applied to predict the annual number and ASIRs of AHBV infections in China through 2030. The joinpoint regression model revealed that CIRs and ASIRs decreased from 1990 to 2019, with a faster decline occurring among males and females younger than 20 years. According to the age-period-cohort model, age effects showed a steep increase followed by a gradual decline, whereas period effects showed a linear decline, and cohort effects showed a gradual rise followed by a rapid decline. The number of cases of AHBV infections in China was predicted to decline until 2030, but it is unlikely to meet the WHO\'s target. These findings provide scientific support and guidance for hepatitis B prevention and control.

Ecosystem Services Value (ESV) are the various beneficial functions and products that natural ecosystems provide to humans, and are important indicators for evaluating ecosystem conditions and human well-being. Opencast mining is one of the human activities that severely damage the surface environment, but its long-term impact on ecosystem services lacks systematic assessment. This study takes the Ordos opencast mining area as an example, and calculates the value of ESV from 1990 to 2020 based on the Google Earth Engine platform. Mann-Kendall Tau-b with Sen\'s Method (Sen + mk test) and Joinpoint regression model were used to analyzes its spatiotemporal variation characteristics. Further revealed the impacts of opencast mining on ESV as well as the trend of ESV changes. The results show that: (1) The dynamic ESV levels in the study area fluctuated considerably from 1990 to 2020 with an overall decreasing trend of 89.45%. (2) Among nine types ecosystem services, most of them were significantly different (p < 0.001) between mining areas and control areas, with biodiversity protection (BP), climate regulation (CR), gas regulation (GR), soil formation and retention (SFR), water supply (WS) and waste treatment (WT) showed a significant decrease between 1990 and 2020. (3) In the past 30 years, the ESV of the study area showed an overall improvement trend, where the improved area accounted for 48.45% of the total area of the study area. However, the degraded area also accounted for 21.28, and 17.19% of the area belonged to severe degradation. With 67% of the significantly degraded areas distributed within mining concessions. (4) The trend of ESV changes in the mining impact areas and the control area showed significant differences. The ESV of the control area increased continuously, with an average annual percentage change (AAPC) of 0.7(95%CI:0.50 ~ 0.9, P < 0.001) from 1990 to 2020; while the ESV of the mining impact areas first stabilized and then decreased significantly, with an AAPC of - 0.2(95%CI:- 0.3 ~ - 0.1,P < 0.001) from 1990 to 2020. This study provides scientific support for formulating ecosystem management, restoration plans, and payment for ecosystem service policies, which is conducive to achieving regional sustainable development and improving human well-being.

UNASSIGNED: Smoking increases the risk of various cardiovascular diseases, including ischemic heart disease (IHD). This study aimed to assess the impact of age, period, and cohort on long-term trends in IHD mortality in China, India, Indonesia, the United States, and Russia, the five countries with the highest number of smokers, from 1990 to 2019.
UNASSIGNED: The data were obtained from the Global Burden of Disease (GBD) Study 2019, and the age-standardized mortality rate (ASMR) was calculated. Joinpoint regression analysis was used to assess the magnitude and direction of trends in smoking-attributable mortality from IHD. Age-period-cohort (APC) studies were used to estimate net drift (estimated annual percentage change (EAPC)s), local drift (age-specific EAPCs), and independent trends in age, period, and cohort effects.
UNASSIGNED: The analysis revealed a significant downward trend in ASMRs attributable to IHD as a result of smoking in the United States, India, and Russia. Indonesia and China showed an upward trend. Age effects were increasing for both country and sex, with China showing the most significant increase in the older age group; period effects were decreasing in all countries except Indonesia, and cohort effects were increasing only in Indonesia and China.
UNASSIGNED: From 1990 to 2019, mortality from IHD caused by smoking showed a downward trend in these five countries. However, the pattern of increased mortality from IHD in women caused by smoking warrants further study.

BACKGROUND: Anxiety disorders (ADs) are the most common mental illness with high prevalence, chronicity, and comorbidity. Despite rapid economic and cultural development, the global incidence of ADs continues to increase, with predominance in male individuals.
OBJECTIVE: To address the above issues, we analyzed the dynamic trends of the global incidence and disease burden of ADs from 1990 to 2019 and their different effects on age, period, and birth cohort and predicted the future trend of AD incidence.
METHODS: The data were obtained from the Global Burden of Disease study in 2019. A joinpoint regression model was used to calculate the annual percent change in AD incidence, and age-period-cohort analysis was used to estimate the independent effects of age, period, and cohort. Nordpred age-period-cohort analysis was used to predict the incidence of ADs from 2020 to 2044.
RESULTS: The age-standardized incidence rate of ADs increased by 1.06% for both sexes, and the age-standardized disability-adjusted life-year (DALY) rate (ASDR) decreased by 0.12%. Joinpoint regression indicated that increments in average annual percent changes in the age-standardized incidence rate (0.068 vs 0.012) and ASDR (0.035 vs -0.015) for ADs globally were higher among male individuals than female individuals. The age-period-cohort analyses revealed that the relative risk (RR) of the incidence and DALYs of ADs among people of different sexes increased with age in adolescence and middle age and then decreased. For the period effect, the RR of incidence decreased, whereas the RR of DALYs increased in both sexes. Moreover, the RR of the incidence gradually increased and DALYs slowly decreased with birth year for both male and female individuals. New cases of ADs in male individuals are predicted to increase in the coming 25 years.
CONCLUSIONS: This study provided the changing trend of the global incidence and disease burden of ADs in the past 3 decades, indicating that early prevention and effective control cannot be ignored. We analyzed the age-period-cohort effect of potential trends in ADs and predicted future incidence trends. The results suggest that we should take active intervention measures, focusing on high-risk groups and developing effective management and control policies to reduce the global burden of disease.

UNASSIGNED: We aimed to provide a timely, comprehensive, and reliable assessment of the burden of iron deficiency (ID) in children between 1990 and 2019 at the global, regional, and national levels to inform policymakers in developing locally appropriate health policies.
UNASSIGNED: Data related to ID among children younger than 15 years old were analyzed by sex, age, year, socio-demographic index (SDI), and location according to the Global Burden of Disease Study 2019 (GBD 2019). Age-standardized rates were used to compare the burden between different regions and countries. Furthermore, the Joinpoint regression model was used to assess temporal trends from 1990 to 2019.
UNASSIGNED: In 2019, the number of prevalent cases and disability-adjusted life years (DALYs) for ID in children were 391,491,699 and 13,620,231, respectively. The global age-standardized prevalence and DALY rates for childhood ID in 2019 were 20,146.35 (95% confidence interval: 19,407.85 to 20,888.54) and 698.90 (466.54 to 1015.31) per 100,000, respectively. Over the past 30 years, the global prevalence of ID among children has been highest in low-SDI regions, particularly in Western Sub-Saharan Africa, South Asia, and Eastern Sub-Saharan Africa. Since 1990, the prevalence and DALY of ID in children have been declining in most geographic regions. Nationally, Ecuador, China, and Chile have shown the most significant decreases in prevalence. The greatest decline in age-standardized DALY rate was observed in Ecuador, while Burkina Faso experienced the highest increase. Bhutan had the highest prevalence and DALY rates in 2019. On the age level, the prevalence was relatively higher among the <5 years age group. At the gender dimension, the prevalence of ID in children overall was more pronounced in girls than in boys, as was the case for DALY.
UNASSIGNED: Although the burden of ID in children has been declining, this disease remains a major public health problem, especially in countries with low SDI. Children younger than 5 years of age are an important group for whom targeted measures are needed to reduce the burden of ID.

BACKGROUND: Sexually transmitted and blood-borne infections (STBBIs) is a major public health concern in China. This study assessed the overall trends in STBBIs to improve the comprehensive understanding of the burden of STBBIs and provide evidence for their prevention and control.
METHODS: Data for the period from 2005 to 2021 were analyzed across China on infections with hepatitis B or C; syphilis; gonorrhea; and HIV infection. Trends, annual percent change (APC), and average annual percent change (AAPC) in diagnosis rate was analyzed using joinpoint regression models for the five STBBIs together or individually.
RESULTS: From 2005 to 2021, the overall diagnosis rate of all five STBBIs increased, with an AAPC of 1.3% [95% confidence interval (CI) -0.5% to 3.1%]. Diagnosis rates of HIV, syphilis and hepatitis C increased individually, but it decreased for infections of hepatitis B and gonorrhea. Joinpoint analysis identified four phases in diagnosis rate of hepatitis C; three phases in diagnosis rate of hepatitis B, HIV infection, and syphilis; two in diagnosis rate of gonorrhea infection.
CONCLUSIONS: Despite national efforts to prevent and control STBBIs, their overall diagnosis rate has continued to rise in China, and they remain an important public health challenge. Further efforts should be made to educate the general population about STBBIs, particularly HIV. Interventions targeting vulnerable groups should be adopted and their efficacy monitored through regular analysis of trends.