Temporal trends

时间趋势
  • 文章类型: Journal Article
    全氟辛酸(PFOA),全氟辛烷磺酸(PFOS),全氟己烷磺酸盐(PFHxS),全氟壬酸(PFNA)是全球范围内检测到的人类血液中的持久性污染物,引发重大健康问题。作为回应,美国和澳大利亚等国家已经实施了限制其使用的监管措施。这项研究分析了这四种PFAS的血清浓度的时间趋势,以及这些趋势如何与监管措施相一致。使用NHANES(2003-2004至2017-2018)和澳大利亚人类生物监测计划(2002-2003至2020-2021)的数据。进行年龄和性别校正的多元回归分析以估计平均浓度变化,并评估每个数据集中的差异。结果表明全氟辛烷磺酸显著减少(p<0.001),PFOA,和PFHxS浓度在2002-2003年之后,而PFNA水平在2009-2010年之前一直上升,然后在澳大利亚和美国下降。根据NHANES数据,上一次监测期间与年龄相关的趋势显示,年龄最大的年龄组的PFAS浓度更高,在澳大利亚,这种趋势特别是在PFOS和PFHxS中观察到。在澳大利亚,0-5岁年龄组的PFOA和PFNA浓度与46岁以上的成年人相似,表明正在进行的暴露。性别差异也是一致的,6-15岁、31-45岁和46-60岁的女性血清浓度较低,特别是在31-45岁年龄组。这些发现支持澳大利亚和美国通过监管行动减少PFAS暴露的努力,强调需要解决幼儿持续暴露的问题,并考虑影响PFAS浓度的性别因素。
    Perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) are persistent contaminants detected in human blood worldwide, raising significant health concerns. In response, countries like the United States and Australia have implemented regulatory measures to limit their use. This study analysed temporal trends in serum concentrations of these four PFAS and how these trends align with regulatory measures, using data from NHANES (2003-2004 to 2017-2018) and the Australian Human Biomonitoring Program (2002-2003 to 2020-2021). Multiple regression analyses adjusted for age and gender were performed to estimate mean concentration changes, and differences within each dataset were assessed. Results indicate significant reductions (p<0.001) in PFOS, PFOA, and PFHxS concentrations post-2002-2003, while PFNA levels rose until 2009-2010 before declining in both Australia and the U.S. Age-related trends show in the last monitoring period showed higher PFAS concentrations in the oldest age groups according to NHANES data, while in Australia, this trend was observed specifically for PFOS and PFHxS. In Australia, the age group of 0-5 years had PFOA and PFNA concentrations similar to those of adults over 46 years, indicating ongoing exposure. Gender differences were also consistent, with females aged 6-15, 31-45, and 46-60 years exhibiting lower serum concentrations, particularly in the 31-45 years age group. These findings support Australian and U.S. efforts to reduce PFAS exposure through regulatory actions, highlight the need to address ongoing exposure in young children, and consider gender-specific factors affecting PFAS concentrations.
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  • 文章类型: Journal Article
    坚持生活方式建议对于管理高血压至关重要,独立于医疗。本研究旨在评估坚持生活方式建议的实施情况,并使用韩国国家健康和营养检查调查(KNHANES)分析2007年至2021年韩国高血压患者坚持生活方式建议的趋势。该研究包括年龄≥20岁的成年人。有规律的身体活动等因素,吸烟和酒精禁欲,体重和压力管理,和坚持健康的饮食进行了分析。2021年,与2007年相比,坚持限钠的高血压患者比例增加了一倍。然而,70%的高血压患者消耗的钠比建议的多。此外,自2014年以来钾摄入量稳步下降,只有23.8%的高血压患者达到推荐摄入量.高血压患者的体重指数(BMI)和腰围逐步增高,较少的患者保持适当的体重。在经历高压力水平的年轻高血压患者中,忽视饮食和体重控制给改变他们的生活方式带来了挑战。韩国的高血压患者仍然消耗大量的钠,而钾的摄入量逐渐减少。此外,肥胖率一直在增加,尤其是年轻的高血压患者。多学科方法对于改善高血压患者的生活习惯是必要的。
    Adherence to lifestyle recommendations is crucial in managing hypertension, independent of medical treatment. This study aimed to evaluate the implementation of adherence to lifestyle recommendations and analyze the trends in adherence to lifestyle recommendations among patients with hypertension in Korea from 2007 to 2021 using the Korea National Health and Nutrition Examination Survey (KNHANES). The study included adults aged ≥20 years. Factors such as regular physical activity, smoking and alcohol abstinence, weight and stress management, and adherence to a healthy diet were analyzed. In 2021, A doublefold increase was observed in the proportion of patients with hypertension who adhered to sodium restriction compared to 2007. However, 70% of patients with hypertension consume more sodium than recommended. Moreover, potassium intake has steadily decreased since 2014, with only 23.8% of patients with hypertension meeting the recommended intake. The body mass index (BMI) and waist circumference of patients with hypertension have gradually increased, with fewer patients maintaining an appropriate weight. The neglect of diet and weight control among young patients with hypertension who experience high stress levels poses challenges in modifying their lifestyles. Patients with hypertension in Korea still consume high amounts of sodium, whereas potassium intake is gradually decreasing. Additionally, obesity rates have been increasing, especially among young patients with hypertension. A multidisciplinary approach is necessary for improving the lifestyle habits of hypertensive patients.
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  • 文章类型: Journal Article
    背景:常规获得的参数的时间趋势可能为预测BSI提供有价值的信息,但LVAD患者尚未建立这种关联.
    方法:本回顾性分析包括来自3种旋转式LVAD类型的347名连续接受者的数据。研究终点包括BSI的发生率,常规获得的血液生物标志物的时间趋势与BSI的发展的关联,BSIs的发生率,在LVAD支持下生存。
    结果:随访期间,47.8%(n=166)的患者发生BSI。在多变量分析中,BSI的发展是死亡率的重要预测因子(HR5.78,95%CI4.08-8.19,p<0.0001)。在单变量分析中,在调整了潜在的混杂因素后,白蛋白(SHR0.94,95%CI0.91-0.97,p<0.00010),肌酐(SHR1.49,95%CI1.03-2.15,p=0.033),C反应蛋白(SHR1.19,95%CI1.08-1.32,p=0.0007)显着预测LVAD支持期间BSI的发展。值得注意的是,在白蛋白(p=0.045)和肌酐(p=0.003)的情况下,参数变化与BSI预测的相关性强度表明存在时间依赖性相关性.
    结论:血流感染在LVAD受者中非常普遍,并且是死亡率的独立预测因子。时间生物标志物趋势显着预测BSI的发展。这些发现表明了旨在减少BSI发生率的干预措施的机会。
    BACKGROUND: Temporal trends of routinely obtained parameters may provide valuable information for predicting BSIs, but this association has not yet been established in LVAD patients.
    METHODS: This retrospective analysis included data from 347 consecutive recipients of three rotary LVAD types. Study endpoints included the incidence of BSI, the association of temporal trends of routinely obtained blood biomarkers with the development of BSIs, the incidence of BSIs, and survival on LVAD support.
    RESULTS: During follow-up, 47.8% (n = 166) of the patients developed BSI. In multivariate analyses, the development of BSI was a significant predictor of mortality (HR 5.78, 95% CI 4.08-8.19, p < 0.0001). In univariate analyses, after adjusting for potential confounders, albumin (SHR 0.94, 95% CI 0.91-0.97, p < 0.00010), creatinine (SHR 1.49, 95% CI 1.03-2.15, p = 0.033), and C-reactive protein (SHR 1.19, 95% CI 1.08-1.32, p = 0.0007) significantly predicted the development of BSIs during LVAD support. Notably, the strength of the association of parameter changes with the prediction of BSIs demonstrated a time-dependent correlation in the cases of albumin (p = 0.045) and creatinine (p = 0.003).
    CONCLUSIONS: Bloodstream infections are highly prevalent among LVAD recipients and are independent predictors of mortality. Temporal biomarker trends significantly predict the development of BSIs. These findings suggest opportunities for interventions aiming to reduce the incidence of BSIs.
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  • 文章类型: Journal Article
    尿金属离子的长期生物监测是慢性暴露水平流行病学评估的重要工具。使我们能够跟踪金属暴露随时间的变化,并更好地了解其对健康的影响。在这项研究中,我们评估了1962年广州市居民尿金属离子的时间趋势,中国,从2018年到2022年。人群尿液中的总金属离子浓度在2018年至2019年之间没有显着变化。随着2020年COVID-19大流行的爆发,尿总金属离子浓度开始急剧下降,2021年达到最低水平。2022年观察到浓度反弹,恢复到2018年观察到的初始水平。尿铬和镉浓度在2020年达到峰值,而尿铅水平在2021年最高,尿镍浓度在2022年最高。在研究的每一年中,男性始终显示出更高的尿铅和砷浓度。此外,未成年人的尿镍水平始终高于成年人,而成年人的尿镉浓度始终高于未成年人。每年对尿中金属离子进行聚类分析,以检查其分布差异并评估金属暴露模式随时间的变化。蒙特卡洛模拟表明,整个人群表现出砷暴露的高非致癌风险和与镍暴露相关的显著致癌风险,砷,铬,还有镉.用灰色预测模型预测未来两年,并使用平均绝对百分比误差测试结果,证明准确性高。
    Long-term biomonitoring of urinary metal ions is an essential tool for the epidemiological assessment of chronic exposure levels, enabling us to track changes in metal exposure over time and better understand its health implications. In this study, we evaluated the temporal trends of urinary metal ions among 1962 residents of Guangzhou, China, from 2018 to 2022. The total metal ion concentrations in the urine of the population did not change significantly between 2018 and 2019. With the onset of the COVID-19 pandemic in 2020, urinary total metal ion concentrations began to decline dramatically, reaching their lowest level in 2021. A rebound in concentrations was observed in 2022, which returned to the initial levels observed in 2018. Urine chromium and cadmium concentrations peaked in 2020, while urinary lead levels were the highest in 2021, and urinary nickel concentrations were the highest in 2022. Males consistently displayed higher urinary concentrations of lead and arsenic throughout each year of the study. Furthermore, minors consistently had higher urinary nickel levels than adults, whereas adults consistently had higher urinary cadmium concentrations than minors. Cluster analyses were conducted annually on urinary metal ions to examine the differences in their distribution and to evaluate changes in metal exposure patterns over time. The Monte Carlo simulations indicate that the whole population exhibits a high non-carcinogenic risk from arsenic exposure and significant carcinogenic risks associated with exposure to nickel, arsenic, chromium, and cadmium. The next two years were predicted by a gray prediction model, and the results are tested using mean absolute percentage error which demonstrating high accuracy.
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  • 文章类型: Journal Article
    草甘膦,在美国使用最广泛的除草剂,用于控制阔叶杂草和草。公众越来越关注农药如何影响人类和环境健康。草甘膦对动物的毒性是已知的,但是人类的致癌性是有争议的,有限的流行病学证据表明暴露与呼吸系统疾病之间存在关联(例如,哮喘)和不良儿童神经发育。了解美国人口普遍暴露于草甘膦的程度很重要。为了检查草甘膦暴露的时间趋势,我们从2013-2018年国家健康和营养检查调查(NHANES)的三个周期中确定了美国儿童和成人的尿草甘膦浓度.大多数人口(70.0%-81.7%,取决于周期)被暴露,包括3岁的儿童。从2013年到2018年,浓度下降了38%;年轻年龄组的下降幅度较小。下降趋势可能反映了草甘膦使用的变化,至少在某种程度上,从农业实践的变化,监管行动,以及公众对草甘膦毒性认识的转变。继续进行草甘膦生物监测将有助于了解这种常见农药的使用变化和限制使用的行动如何影响人类暴露。
    Glyphosate, the most widely used herbicide in the United States, is applied to control broadleaf weeds and grasses. Public concern is mounting over how pesticides affect human and environmental health. Glyphosate toxicity in animals is known, but human carcinogenicity is controversial, and limited epidemiologic evidence suggests associations between exposure and respiratory diseases (e.g., asthma) and adverse child neurodevelopment. Understanding the extent of the general U.S. population exposure to glyphosate is important. To examine temporal trends in exposure to glyphosate, we determined urinary concentrations of glyphosate among U.S. children and adults from three cycles of the National Health and Nutrition Examination Survey (NHANES) conducted 2013-2018. Most of the population (70.0%-81.7%, depending on cycle) was exposed, including children as young as 3 years of age. Concentrations decreased from 2013 to 2018 by 38%; the decline was smaller in younger age groups. The downward trend likely reflects changes in glyphosate use resulting, at least in part, from changes in agricultural practices, regulatory actions, and shifts in public awareness regarding glyphosate toxicity. Continuing glyphosate biomonitoring will help understand how changes in use and actions to restrict applications of this common pesticide affect human exposures.
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  • 文章类型: Journal Article
    急性代偿性心力衰竭(ADHF)与频繁住院有关,在全球范围内构成重大的健康和经济负担。尽管在心力衰竭管理方面取得了进展,描述ADHF结局的时间趋势的研究很少。方法:在回顾性分析中,2007年至2017年在沙米尔医学中心住院的ADHF患者分为两个队列:早期(2007-2011年)和最近(2012-2017年)。临床特征,医院干预措施,并对结果进行了比较。使用具有对数秩检验的Kaplan-Meier方法进行生存分析。
    对8332名入院患者进行了分析,4366(52.4%)在早期,和3966(47.6%)在最近一段时间。在最近的队列中,缺血性心脏病显著减少(从45.2%降至34.7%),而高血压和吸烟率上升。此外,观察到出院后冠状动脉旁路移植术(从0.8%到3.5%)和β受体阻滞剂处方(从45.5%到63.4%)显著增加.然而,住院死亡率没有实质性改善(早期与早期的8.9%最近8.0%),30天(早期与早期的3.2%最近3.1%),1年(早期与早期的23.3%最近的23.8%),或5年生存率被记录在队列之间.对心内科住院患者的子集分析显示,在最近的队列中,住院死亡率显着降低(早期与早期相比为12.3%最近的6.3%),但没有相应的长期生存益处。
    在11年的研究期间,心力衰竭管理方面的进步并未显示ADHF患者的临床结局有所改善,强调将ADHF患者医疗护理的进步转化为长期生存获益的挑战。
    UNASSIGNED: Acute Decompensated Heart Failure (ADHF) is associated with frequent hospitalizations, posing a significant health and economic burden globally. Despite advancements in heart failure management, studies delineating temporal trends in ADHF outcomes are sparse.Methods: in this retrospective analysis, ADHF patients admitted to Shamir Medical Center from 2007 to 2017 were categorized into two cohorts: early (2007-2011) and recent (2012-2017). Clinical characteristics, in-hospital interventions, and outcomes were compared. Survival analysis was performed using Kaplan-Meier methods with log-rank tests.
    UNASSIGNED: 8332 admitted patients were analyzed, 4366 (52.4 %) in the early period, and 3966 (47.6 %) in the recent period. In the recent cohort, ischemic heart disease decreased significantly (from 45.2 % to 34.7 %), while hypertension and smoking rates increased. Additionally, a significant increase in coronary artery bypass grafting (from 0.8 % to 3.5 %) and beta-blockers prescription (from 45.5 % to 63.4 %) post-discharge was observed. However, no substantial improvement in in-hospital mortality (8.9 % in early vs. 8.0 % in recent), 30-day (3.2 % in early vs. 3.1 % in recent), 1-year (23.3 % in early vs. 23.8 % in recent), or 5-year survival rates was noted between cohorts. A subset analysis of patients admitted to cardiology departments showed a significant reduction in in-hospital mortality in the recent cohort (12.3 % in early vs. 6.3 % in recent), yet without a corresponding long-term survival benefit.
    UNASSIGNED: Advancements in heart failure management over the 11-year study period did not demonstrate an improvement in clinical outcomes for ADHF patients, highlighting the challenge of translating advancements in the medical care of ADHF patients into long-term survival benefits.
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  • 文章类型: Journal Article
    目的:医学文献中已很好地认识到干预措施的比较荟萃分析的时间趋势。对于诊断测试准确性(DTA)的研究,时间趋势的证据越来越多,评估和报告这些趋势的重要性在几个司法管辖区最近的上市后监督指南中得到了强调。在这项研究中,我们使用比以前检查的更大,更最新的DTA系统评价来评估时间趋势的患病率和模式。来自Cochrane系统评论数据库。
    方法:对双变量随机效应进行累积荟萃分析,在按出版日期对研究进行排名之后。所有研究的趋势都是通过研究排名的汇总估计图以图形方式进行评估的,并使用ROC图的灵敏度与特异性。还使用加权线性回归描述了线性趋势,其中汇总估计与研究等级的自相关误差。描述了非线性趋势的各种模式。
    结果:分析包括2017年至2022年进行的46条评论(92项荟萃分析)。所有评论中的研究总数为1,486,每个评论的中位数[IQR]为7,134[2,782,16,406]名参与者。评论的中位数[IQR]时间跨度为19[15,25]个出版年。在40条(87%)评论中观察到至少一项DTA测量的时间趋势,32篇(71%)评论中具有统计学意义的线性趋势。在16条(35%)评论中观察到非线性时间趋势。在27条(59%)评论中,没有证据表明任何一项DTA措施都有趋势。
    结论:该研究提供了关于线性和非线性时间DTA趋势模式变化的证据,这在以前没有被描述过。我们建议研究人员检查趋势分析方法的统计假设,例如使用图形方法。对时间趋势的潜在原因的进一步研究可能有助于未来荟萃分析的稳健性。
    OBJECTIVE: Temporal trends in comparative meta-analyses of interventions are well-recognised in the medical literature. For studies of diagnostic test accuracy (DTA), evidence of temporal trends is growing and the importance of assessing and reporting them has been highlighted in recent guidelines on post-market surveillance in several jurisdictions. In this study we evaluate the prevalence and patterns of time trends using a larger and more up-to-date set of DTA systematic reviews than has previously been examined, from the Cochrane Database of Systematic Reviews.
    METHODS: Cumulative meta-analysis was conducted on bivariate random effects meta-analysis estimates of sensitivity and specificity, after ranking studies by publication date. Trends for all studies were assessed graphically using plots of summary estimates by study rank, and using ROC plots of sensitivity vs. specificity. Linear trends were also described using weighted linear regression with autocorrelated errors of summary estimates against study rank. Various patterns of non-linear trends were characterised descriptively.
    RESULTS: The analysis included 46 reviews (92 meta-analyses) conducted between 2017 and 2022. The total number of studies within all reviews was 1,486, with a median [IQR] 7,134 [2,782, 16,406] participants per review. Reviews had a median [IQR] time span of 19 [15,25] publication years. Time trends in at least one DTA measure were observed in 40 (87%) reviews, and statistically significant linear trends in 32 (71%) reviews. Non-linear time trends were observed in 16 (35%) reviews. There was no evidence for a trend in either DTA measure in 27 (59%) reviews.
    CONCLUSIONS: The study contributes evidence on the variety in patterns of linear and non-linear temporal DTA trends which has not previously been described. We recommended researchers check statistical assumptions of trend analysis methods, for example using graphical methods. Further research into potential reasons for time trends could contribute to the robustness of future meta-analyses.
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  • 文章类型: Journal Article
    更新的肺癌系统统计数据是制定该疾病预防和控制策略的基础基石。估算了2016年中国肺癌的发病率和死亡率数据,并用于分析本研究从2000年到2016年肺癌的时间趋势。
    使用来自487个癌症登记处的数据估算了2016年中国肺癌的负担,从中国国家癌症中心(NCC)的数据库中提取。使用来自22个癌症登记处的2000年至2016年的数据估计了时间趋势。
    2016年中国估计有828,100例新肺癌病例和657,000例肺癌死亡。东部地区的粗发病率和死亡率是全国最高的。肺癌的发病率和死亡率随年龄增长而增加,大多数新病例发生在60岁以上的年龄组。在2000年至2016年期间,年龄标准化发病率每年增加约0.8%,特别是在女性中,年增长率达到2.1%。年龄标准化死亡率每年下降约0.6%,城市地区每年下降1.3%,农村地区每年增长2.3%。新增病例和死亡人数分别上升162.6%和123.6%,分别,在2000年至2016年期间,这主要可以用年龄结构的变化来解释。
    中国肺癌负担严重,农村地区妇女的增长尤其迅速。由于老龄化和人口增长等因素,预计该疾病将在未来威胁更多人的生命。未来,肺癌预防和控制策略和资源应用于妇女和农村地区。
    UNASSIGNED: Updated systematic statistics on lung cancer are the underpinning cornerstones for formulating prevention and control strategies for the disease. The incidence and mortality data of lung cancer in China in 2016 were estimated, and also used to analyze the temporal trends of lung cancer from 2000 up to 2016 in this study.
    UNASSIGNED: The burden of lung cancer in China in 2016 was estimated using data from 487 cancer registries, which were abstracted from the database of the National Cancer Center of China (NCC). The temporal trends were estimated with the data of 2000 to 2016 from 22 cancer registries.
    UNASSIGNED: About 828,100 new lung cancer cases and 657,000 lung cancer deaths were estimated in China in 2016. The crude incidence and mortality rates in the eastern region were the highest nationwide. The incidence and mortality of lung cancer increased with age, and most of the new cases occurred in the age group of over 60 years. The age-standardized incidence increased by about 0.8% per year during 2000 to 2016, especially in woman, whose annual increase rate reached 2.1%. The age-standardized mortality rate decreased by about 0.6% per year, with a decrease of 1.3% per year in urban areas and an increase of 2.3% per year in rural areas. The numbers of new cases and deaths increased by 162.6% and 123.6%, respectively, during 2000 to 2016, which can be explained mainly by the change of the age structure.
    UNASSIGNED: The burden of lung cancer is serious in China, and increased especially rapidly for women in rural areas. The disease is expected to threaten the lives of more people in the future due to factors such as aging and population growth. Lung cancer prevention and control strategies and resources should be leveraged toward women and rural areas in the future.
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  • 文章类型: Journal Article
    目的:这项研究的目的是分析1985年至2019年儿童和青少年的心肺适应性(CRF)和体重指数(BMI)的时间趋势。
    方法:从1985年至2019年,对1840212名7-18岁的儿童和青少年(921223名男孩)进行了CRF测试。CRF对7-12岁的男孩和女孩进行了50米×8的穿梭试验,13-18岁的男孩跑1000米,13-18岁的女孩跑800米。还调查了2000年至2019年BMI的趋势。
    结果:在整个34年中,所有性别和年龄类别的儿童和青少年的心肺健康下降,下降最快的是1995年至2005年。从2005年至2019年,在13-15岁的青少年和2014年至2019年16-18岁的女孩中观察到了CRF的一些积极趋势。CRF分布的变化不均匀,CRF水平高的参与者的Z分数变化很小或增加(CRF稳定或改善),而CRF水平低的参与者的Z分数继续降低(CRF降低)。所有年龄段的男孩和女孩的BMI随着时间的推移而增加,随着近年来青少年人数的增长加速。
    结论:这项研究表明,中国儿童和青少年的总体CRF水平在过去的三十年中有所下降,但在最近几年稳定或改善。BMI继续增加。我们的发现对于关注未来的家庭身体健康和公共卫生非常重要。
    OBJECTIVE: The aim of this study was to analyze the temporal trends in cardiorespiratory fitness (CRF) and body mass index (BMI) among children and adolescents from 1985 to 2019.
    METHODS: A total of 1 840 212 children and adolescents aged 7-18 years (921 223 boys) were tested for CRF from 1985 to 2019. CRF was tested by 50-m × 8 shuttle run for boys and girls aged 7-12 years, 1000-m run for boys aged 13-18 years, and 800-m run for girls aged 13-18 years. Trends in BMI from 2000 to 2019 were also investigated.
    RESULTS: Cardiorespiratory fitness decreased during the entire 34 years among children and adolescents in all sex and age categories, and the most rapid decline occurred from 1995 to 2005. Some positive trends in CRF were observed among adolescents aged 13-15 years from 2005 to 2019 and among girls aged 16-18 years from 2014 to 2019. The variation in the CRF distribution was not uniform, with Z-scores for participants with high CRF levels changing little or increasing (CRF stabilized or improved) and Z-scores for participants with low CRF levels continuing to decrease (CRF decreased). BMI increased over time for boys and girls in all age categories, with an acceleration of the increase for adolescents in recent years.
    CONCLUSIONS: This study revealed that the overall CRF levels of Chinese children and adolescents decreased over three decades but stabilized or improved in recent years. BMI continued to increase. Our findings are important for the focus on future domestic physical fitness and public health.
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  • 文章类型: Journal Article
    目的:本研究旨在分析时间趋势,空间异质性,以及在全球21个疾病负担(GBD)地区,由于对妇女的亲密伴侣暴力(IPV)而导致的重度抑郁症(MDD)负担的潜在改善,从1990年到2019年,共有204个国家和地区。
    方法:我们以每100,000人的残疾调整生命年(DALYs)来评估女性IPV引起的MDD负担,在20个年龄组和GBD地区,国家,和领土,使用2019年GBD研究的数据。DALY年龄标准化率(ASR)的平均年变化百分比(AAPC)用于反映一段时间的趋势。使用LOESS和分位数回归对五个GBD社会人口统计学指数(SDI)类别与DALYASR之间的关系进行建模。前沿分析确定了与发育状态相关的最小可实现DALYASR,以SDI衡量。
    结果:尽管全球整体下降(AAPC-0.08[95%UI-0.2,0.03]),某些GBD地区,特别是高收入的北美和拉丁美洲中部,经历了DALYASR的增加。SDI和MDD负荷之间的关系表现出U型变异性,低SDI区域始终表现出较高且稳定的DALY率。前沿分析显示,几个国家,不管他们的SDI,在观察到的和潜在可实现的DALY率之间有很大的差距,指出有针对性干预的领域,以减轻IPV引起的MDD负担。
    结论:从1990年到2019年,由于IPV导致的MDD在全球范围内发生了显着的时空异质性,突显了各国改善的巨大潜力。保护措施应定制以适应独特的文化背景,发展状态,以及每个国家的地区差异。
    OBJECTIVE: This study aimed to analyze the temporal trends, spatial heterogeneities, and potential improvements in the burden of major depressive disorders (MDD) attributable to intimate partner violence (IPV) against women across 21 global burden of disease (GBD) regions, and 204 countries and territories from 1990 to 2019.
    METHODS: We evaluated the burden of MDD attributable to IPV against women, as measured in disability-adjusted life years (DALYs) per 100,000 people across 21 GBD regions and 204 GBD countries and territories, using data from the 2019 GBD Study. The average annual percentage change (AAPC) of the DALY age-standardized rates (ASRs) was used to reflect trends over time. LOESS and quantile regression were used to model the relationship between the five GBD sociodemographic index (SDI) categories and DALY ASRs. Frontier analysis determined the minimum achievable DALY ASR associated with developmental status, as measured by the SDI.
    RESULTS: The overall AAPC in age-standardized DALY rates for MDD attributable to IPV declined globally between 1990 and 2019. Despite the overall global decline (AAPC -0.08 [95 % UI -0.2, 0.03]), certain GBD regions, particularly high-income North America and Central Latin America, have experienced increases in DALY ASRs. The relationship between SDI and MDD burden showed a U-shaped variability, with low-SDI regions consistently exhibiting higher and stable DALY rates. Frontier analysis revealed that several countries, regardless of their SDI, have substantial gaps between observed and potentially achievable DALY rates, indicating areas for targeted intervention to reduce the burden of MDD due to IPV.
    CONCLUSIONS: Significant spatial and temporal heterogeneity in MDD due to IPV was observed globally from 1990 to 2019, highlighting the substantial potential for improvement in various countries. Protective measures should be customized to suit the unique cultural contexts, developmental statuses, and regional disparities of each country.
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