Research on the Path and Process of Changing from Rural Family Supporting to Social Pensions under the Background of Aging Population in China

Traditional family supporting model is the main form in the rural old-age security system at the present stage.In the context of an aging population,the family supporting function gradually weakening,the rural social old-aging pensions shift to become the inevitable choice.Based on the changing trend of development of the family supporting and dynamic adjustment of rural social pensions mechanism,the article makes the quantitative analysis on the changing path of the mode of China’s rural old-age security and finds that urbanization and rapid increase in the proportion of elderly population in rural areas are the important driving factors of changing family supporting to social pensions,meanwhile finds a turning point and three phases:according to substitution rate,family support is priority and gradually weakening phase between 2012 and 2021;2022 is the turning point of changing rural old-age security mode,family supporting and social pensions pay same role in rural old-age security;social pensions is priority and will be gradually rising between 2023and 2050.We put forward the corresponding countermeasures and suggestions on the changing path of the rural old-age security.

Temporal trends and cohort variations of gender-specific major depressive disorders incidence in China:analysis based on the age-period-cohortinteraction model

Background Major depressive disorders(MDDs)impose substantial burdens on individuals and society;however,further detailed analysis is still needed for its long-term trends.Aims This study aimed to analyse the gender-specific temporal trends and cohort variations of MDD incidence among Chinese residents over the past three decades.Methods Employing the age-period-cohort-interaction model and leveraging data from the Global Burden of Disease Study 2019,this research identified and analysed incidence trends of MDD among Chinese males and females aged 5-94 years from 1990 to 2019 across three dimensions,encompassing age,period and birth cohort.Results The analysis reveals age-related effects,indicating heightened MDD risk among adolescents and older adults.Specifically,individuals entering the older adulthood at the age of 65-69 significantly increased the risk of MDD by 64.9%.People aged 90-94 years witnesseda 105.4%increase in MDD risk for the overall population,with females and males in this age group experiencing a 75.1%and 103.4%increase,respectively.In terms of period effects,the risk of MDD displayed a decline from 1990 to 1994,followed by a rebound in 2008.Cohort effects demonstrated diverse generational patterns,with generationⅠand generationⅢmanifesting opposing‘age-as-level'trends.GenerationⅡand generationⅣexhibited'cumulative disadvantage'and'cumulative advantage'patterns,respectively.Age effects indicated an overall higher risk of MDD incidence in females,while cohort effects showed greater variations of MDD incidence among females.Conclusions The study underscores the substantial effects of age,period and cohort on MDD across genders in China.Priority interventions targeting vulnerable populations,including children,adolescents,older adults,females and the post-millennium birth cohort,are crucial to mitigate the impact of MDD.

Impact of Periconceptional Multi-micronutrient Supplementation on Gestation:A Population-based Study

Objective To examine the effect of periconceptional multi‐micronutrient supplementation on gestation and birth outcomes.Methods A population‐based community intervention program was conducted in 18 counties in China.Participants were divided into an intervention group,who received multi‐micronutrient supplementation from at least 3 months before pregnancy throughout the first trimester,and a control group.Pregnant women were followed up to record information about birth outcomes.Maternal socio‐economic characteristics and main birth outcomes were evaluated.Gestational age was further analyzed using survival analysis,to determine the time distribution of delivery.Results Periconceptional multi‐micronutrient supplementation was associated with higher birth weight,birth length and occipitofrontal head circumference,and with lower incidence rates for stillbirth,low birth weight,and preterm birth.Moreover,periconceptional multi‐micronutrient supplementation changed the time distribution of delivery,making the deliveries more clustered in the period between day 275 and day 295 of gestation.Conclusion Our study shows that periconceptional multi‐micronutrient supplementation is beneficial for fetal development and optimizes all measured aspects of health in neonates in socioeconomically disadvantaged areas in China.The change in time distribution of deliveries caused by multi‐micronutrient supplementation needs further clarification.

Geographical Patterns of Chinese Ethnic Minority Population Composition and Ethnic Diversity

Ethnicity is a carrier of language and culture.Spatial distribution of ethnic diversity is fundamental for identifying and reconstructing the migration patterns and evolution histories of cultures and languages.Utilizing the Chinese 4th National Census (1990) data,we investigated the specific time geographical patterns of population and diversity of Chinese ethnicminorities.As anticipated,results show that Chineseminorities are chiefly concentrated in dis-tant plateaus and mountains in the southwest,northwest and northeast of China.Further,population density centers of the 10 majorminorities are rather scattered,alternatively dominating at different parts of the country.This study pro-vides a first comprehensive quantitative test on a prevailing notion of 'six plates and three corridors' on the empirical clustering patterns of Chinese ethnicminorities.There are more consistent evidences supporting this notion in the north of China,with the central and southern regions showing more complex patterns,potentially transformed by processes such as migration,fragmentation,and percolation.The results of this study suggest that a geographical ap-proach can provide heuristic and complementary information for better understanding of historical social processes.

The Localization, Practice and Innovation of Time Banking——On a New Approach to China's Aging Population

In the context of an aging population, the promotion of time banking as a new model of voluntary service can help alleviate the ever–increasing pressures for elderly care and services in China. The development of time banking in China has successively undergone the stage of traditional practice, the stage of infancy and exploration, as well as the stage of accelerated growth. Meanwhile, this process has also witnessed the formation of many localized innovations. To further the localization and innovation of time banking, this paper analyzes its basis in traditional culture, summarizes its process of practice and explores new directions of future innovation. Based on the summary of existing problems, this paper proposes to enhance the recognition of time banking among the public, facilitate localized innovation of time banking, promote its informatization, and involve the participation of young people, particularly college students.

Polymorphisms of the maternal Slug gene in fetal neural tube defects in a Chinese population

Several studies have demonstrated that Slug,which encodes a zinc finger of the Snail family of transcription factors,is a potential risk factor for neural tube defects.Neural tube defects tend to occur with a high rate in Shanxi province,China.The present case-control study investigated genotypic distributions and allele frequencies of Slug C1548A polymorphisms in DNA samples from59 women with a history of neural tube defect pregnancies and 73 controls during the same period from Shanxi Province,China.Results demonstrated that women with a history of neural tube defect pregnancies had significantly greater genotypic distributions of Slug AA genotypes and A allele frequencies compared with controls,and A allele Slug C1548A was a risk factor for neural tube defects（odds ratio = 3.444;95% confidence interval;2.021-5.868,P 〈 0.05）.Three-dimensional structure prediction revealed that Slug C1548A resulted in transition of aspartic acid into glutamate at position 119.This indicated that these mutations could lead to damaged protein structure and function.These findings suggest that Slug C1548A gene polymorphism is closely related to neural tube defects in a population of Han Chinese origin from Shanxi Province,China

Progress in Research of Nutrition and Life Expectancy

Life expectancy is an important indicator to evaluate the social development of a country. Health and longevity can not only improve people＇s life quality but also ensure them to have more time to pursue their life goal. A one-year increase in life expectancy during ＇China＇s Twelfth Five-Year Economic and Social Development Plan＇ period has been used as an indicator to evaluate whether the goal of improving people＇s living standards continuously is met. Nutrition is one of the important factors affecting people＇s health. Both malnutrition and overnutrition are risk factors for disease and death. Many studies of the relationship between nutrition and life expectancy have been conducted in the world, and the results of them are quite valuable for China to improve people＇s life expectancy by targeted nutrition intervention strategy. This paper summarizes the progress in research of nutrition and life expectancy in the world.

An Adaptive Parameter-Free Optimal Number of Market Segments Estimation Algorithm Based on a New Internal Validity Index

An appropriate optimal number of market segments(ONS)estimation is essential for an enterprise to achieve successful market segmentation,but at present,there is a serious lack of attention to this issue in market segmentation.In our study,an independent adaptive ONS estimation method BWCON-NSDK-means++is proposed by integrating a newinternal validity index(IVI)Between-Within-Connectivity(BWCON)and a newstable clustering algorithmNatural-SDK-means++(NSDK-means++)in a novel way.First,to complete the evaluation dimensions of the existing IVIs,we designed a connectivity formula based on the neighbor relationship and proposed the BWCON by integrating the connectivity with other two commonly considered measures of compactness and separation.Then,considering the stability,number of parameters and clustering performance,we proposed the NSDK-means++to participate in the integrationwhere the natural neighbor was used to optimize the initial cluster centers(ICCs)determination strategy in the SDK-means++.At last,to ensure the objectivity of the estimatedONS,we designed a BWCON-based ONS estimation framework that does not require the user to set any parameters in advance and integrated the NSDK-means++into this framework forming a practical ONS estimation tool BWCON-NSDK-means++.The final experimental results showthat the proposed BWCONand NSDK-means++are significantlymore suitable than their respective existing models to participate in the integration for determining theONS,and the proposed BWCON-NSDK-means++is demonstrably superior to the BWCON-KMA,BWCONMBK,BWCON-KM++,BWCON-RKM++,BWCON-SDKM++,BWCON-Single linkage,BWCON-Complete linkage,BWCON-Average linkage and BWCON-Ward linkage in terms of the ONS estimation.Moreover,as an independentmarket segmentation tool,the BWCON-NSDK-means++also outperforms the existing models with respect to the inter-market differentiation and sub-market size.

Effect of Exposure to Trace Elements in the Soil on the Prevalence of Neural Tube Defects in a High-Risk Area of China

Objective Our objective is to build a model that explains the association between the exposure to trace elements in the soil and the risk of neural tube defects. Methods We built a function with different parameters to describe the effects of trace elements on neural tube defects. The association between neural tube defects and trace element levels was transformed into an optimization problem using the maximum likelihood method. Results Tin, lead, nickel, iron, copper, and aluminum had typical layered effects （dosage effects） on the prevalence of neural tube defects. Arsenic, selenium, zinc, strontium, and vanadium had no effect, and molybdenum had one threshold value that affected the prevalence of birth defects. Conclusion As an exploratory research work, our model can be used to determine the direction of the effect of the trace element content of cultivated soil on the risk of neural tube defects, which shows the clues by the dosage effect of their toxicological characteristics. Based on our findings, future biogeochemical research should focus on the direct effects of trace elements on human health.

Spatiotemporal Property Analysis of Birth Defects in Wuxi,China

Objective To describe the temporal trends and spatial patterns of birth defects occurring in Wuxi, a developed region of China. Methods Wavelet analysis was used to decompose the temporal trends of birth defect prevalence based on the birth defect rates over the past 16 years. Birth defect cases with detailed personal and family information were geo-coded and the relative risk in each village was calculated. General G statistic was used to test the spatial property with different scales. Results Wavelet analysis showed an increasing temporal trend of birth defects in this region. Clustering analysis revealed that changes continued in the spatial patterns with different scales. Conclusion Wuxi is confronted with severe challenges to reduce birth defect prevalence. The risk factors are stable and show no change with spatial scale but an increasing temporal trend. Interventions should be focused on villages with a higher prevalence of birth defects.

Relationship Between Polymorphism of Cystathionine beta Synthase Gene and Congenital Heart Disease in Chinese Nuclear Families

Objective To study the relationship between polymorphism of cystathionine beta synthase （CBS） gene and development of congenital heart disease （CHD）. Methods One hundred and twenty-seven CHD case-parent triads were recruited from Liaoning Province as patient group, and 129 healthy subjects without family history of birth defect were simultaneously recruited as control group together with their biological parents. For all subjects the polymorphism of CBS gene G919A locus was examined by PCR-ARMS method, Results The frequencies of three genotypes （w/w, w/m, and m/m） in control group were 27.2%, 58,4%, and 14.4%, respectively, with no significant difference in gender. A significant difference in the allele frequency was found between CHD patients and controls, the wild allele frequency was 67,9% in patients and 55.7% in controls CHD parents＇ genotype distribution was significantly different from that in controls. Further comparison of each type of CHD showed that genotype frequencies in several CHD subtypes were significantly different from those in their corresponding controls. The results of TDT analysis showed that no allele transmission disequilibrium existed in CHD nuclear families. Conclusions CBS gene G919A mutation is associated with the development of CHD, and the mutated allele may decrease the risk of CHD.

An Evaluation of the Investment for Child Development in China

Objective This study estimated the investment in child development from three aspects-public health, public education, and family investment to establish the level of investment, to provide reference information for government decision making and to provide international comparisons. Methods Public investment in health was measured with macro data related to public health spending and child development in government expenditure. Public education investment was based on basic education data. Family investment evaluation was based on per capita family consumer spending data in different age groups to estimate the input for child development. Results Both public health investment level and the proportion of GDP rose for all age groups over time, but the overall investment level was still insufficient. Public investment in children＇s education has increased year by year, but the trends in all age groups are unbalanced with much lower investment in early childhood education. Private investment in children has increased over the period, but has declined as a percentage of GDP. International comparisons show that China＇s investment in child development is much lower than OECD countries. Conclusion The private investment in child development was the main way in China, with public finance contributing only a small proportion. Given the poor international comparisons, the government needs to review the balance of public investment to redirect more towards the development of children under the age of six to their health and education.

Unusual Patterns of Neural Tube Defects in a High Risk Region of Northern China

Objective To study the prevalence of different types of neural tube defects （NTDs） in Luliang Prefecture, Shanxi province, where the prevalence of NTDs is unusually high and the correlation between NTDs prevalence and patterns. Methods A surveillance population-based birth defects was performed in Luliang Prefecture, Shanxi province. Results The results of our study showed that the prevalence of NTDs was 2-fold higher in Luliang Prefecture than in other areas of Shanxi province. Unusual patterns of NTDs were found, however, multiple NTDs were relatively common in Luliang Prefecture, accounting for over 13% of all NTDs cases in China. Conclusion The prevalence of NTDs is associated with its patterns.

Two-year outcomes of ab interno trabeculectomy with the Trabectome for Chinese primary open angle glaucoma： a retrospective multicenter study

AIM： To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open angle glaucoma （POAG） patients. METHODS： This was a multicenter, retrospective, observational study and included POAG patients with or without visually-significant cataracts. The Chinese patients were enrolled from three glaucoma centers and a group of comparable Japanese POAG patients was analyzed from our international Trabectome database. The patients received Trabectome or a combined surgery with phacoemulsification and intraocular lens implantation. The primary outcome was intraocular pressure （IOP） reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2y. Success was defined as： 1） IOP≤21 mm Hg and at least 20% IOP reduction from baseline after 3mo at any two consecutive visits; 2） no additional glaucoma surgery required. RESULTS： A total of 42 Chinese POAG patients from three glaucoma centers were enrolled. Twelve patients underwent Trabectome surgery combined with phacoemulsification and intraocular lens implantation while the remainder underwent Trabectome surgery alone. Thirteen patients had a history of failed glaucoma surgery and were considered as complicated cases. In China data, the mean preoperative IOP was 21.4±1.23 mm Hg. The Trabectome lowered IOP to 17.9±1.8 mm Hg at 2y （P=0.05）. The number of glaucoma medications also decreased significantly from a baseline of 2.0±0.9 to 1.1±0.8 at 2y post-surgery （P=0.04）. The overall 2-year success rate was 78%, with patients undergoing combined surgery having a higher success rate compared with those undergoing Trabectome surgery alone （100% vs 76%）. In Japan data, the mean preoperative IOP was 20.8±7.7 mm Hg. The Trabectome lowered IOP to 12.20±2.0 mm Hg at 2y. The number of glaucoma medications also decreased significantly from a baseline of 2.1±0.9 to 3.4±0.6 at 2y post-surgery. In all patients, no major complications were seen. CONCLUSION： Surgery with the Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.

Association of β3 Adrenergic Receptor and Peroxisome Proliferator-activated Receptor Gamma 2 Polymorphisms With Insulin Sensitivity:A Twin Study

Objective To study the effect of β3 adrenergic receptor （β3AR） Trp64Arg and peroxisome proliferator activated receptor gamma 2 （PPAR72） Prol2Ala polymorphisms on insulin resistance. Methods One hundred and eight dizygotic twin pairs were enrolled in this study. Microsatellite polymorphism was used to diagnose zygosity of twins. Insulin sensitivity was estimated with logarithm transformed homeostasis model assessment （HOMA）. PCR-RFLP analysis was performed to detect the variants. As a supplement to the sib-pair method, identity by state （IBS） was used to analyze the association of polymorphisms with insulin sensitivity. Results The genotype frequencies of Trp64Trg, Trp64Arg, and Arg64Arg were 72.3%, 23.8%, and 3.9%, respectively, while the genotype frequencies of Pro12Pro, Pro12Ala, and Ala12Ala were 89.9%, 9.6%, and 0.5%, respectively. For β3AR Trp64Arg the interclass co-twin correlations of Waist-to-hip ratio （WHR）, blood glucose （GLU）, and insulin （INS）, homeostasis model assessment insulin resistance index （HOMA-IR） of the twin pairs sharing 2 alleles of IBS were greater than those sharing 0-1 allele of IBS, and HOMA4R had statistic significance. For PPAR3t2 Prol2Ala most traits of twin pairs sharing 2 alleles of IBS had greater correlations and statistic significance in body mass index （BMI）, WHR, percent of body fat （PBF） and GLU, but there were low correlations of either insulin or HOMA-IR of twin pairs sharing 1 or 2 alleles of IBS. The combined effects of the two variations showed less squared significant twin-pair differences of INS and HOMA-IR among twins sharing 4 alleles of IBS. Condusions β3AR Trp64Arg and PPAR）,2 Pro 12Ala polymorphisms might be associated with insulin resistance and obesity, and there might be slight synergistic effects between this two gene loci, and further studies are necessary to confirm this finding.

Health Inequalities during 20 Years of Rapid Economic Development in China (1980-2000):A Mortality Analysis

Objective To examine the influence of China＇s economic reforms on population health and regional mortality rates.Methods Longitudinal study measuring the mortality trends and their regional variations.Using data from the three most recent national censuses,we used the model life table to adjust the mortality levels within the population for each census,and to calculate life expectancy.We then examined the variation in patterns of mortality and population health by economic status,region and gender from 1980-2000.Results Life expectancy varied with economic status,province,and gender.Results showed that,although life expectancy in China had increased overall since the early 1980s,regional differences became more pronounced.Life expectancy for populations who live in the eastern coastal provinces are greater than those in the western regions.Conclusion Differences in life expectancy are primarily related to differences in regional economic development,which in turn exacerbate regional health inequalities.Therefore,it is necessary to improve economic development in less developed regions and to improve health policies and the public health system that address the needs of everyone.

Bayesian mapping of neural tube defects prevalence in Heshun County, Shanxi Province, China during 1998～2001

Objective: To estimate the prevalence rates of neural tube defects (NTDs) in Heshun County, Shanxi Province, China by Bayesian smoothing technique. Methods: A total of 80 infants in the study area who were diagnosed with NTDs were analyzed. Two mapping techniques were then used. Firstly, the GIS software ArcGIS was used to map the crude prevalence rates. Secondly, the data were smoothed by the method of empirical Bayes estimation. Results: The classical statistical approach produced an extremely dishomogeneous map, while the Bayesian map was much smoother and more interpretable. The maps produced by the Bayesian technique indicate the tendency of villages in the southeastern region to produce higher prevalence or risk values. Conclusions: The Bayesian smoothing technique addresses the issue of heterogeneity in the population at risk and it is therefore recommended for use in explorative mapping of birth defects. This approach provides procedures to identify spatial health risk levels and assists in generating hypothesis that will be investigated in further detail.

Application of GIS-Based Spatial Filtering Method for Neural Tube Defects Disease Mapping

This study is to assess the prevalence rates spatial pattern of neural tube defects with geographic information system and spatial filtering technique. A total of 80 infants who diagnosed from neural tube defects in the area being studied between 1998 and 2001 were analyzed. Firstly, the geographic information system （GIS） software ArcGIS was used to map the crude prevalence rates. Secondly, the data were smoothed by the method of spatial filtering. We evaluated that the effect of changes in spatial filtering radius size was assessed by creating maps based on various filtering radius sizes. The 3 miles or larger filtering radius gives better section variability than the 2 and 2.5 miles or smaller ones. The maps produced by the spatial filtering technique indicate that prevalence rates in the villages in the southeastern region are to produce higher prevalence than that in the other regions. The smoothed maps based on Heshun County display a more adequate data representation than the raw prevalence rate map.

Rural migrants' participation in old-age insurance: a case study of the inter-provincial migrant workers from Sichuan, China

Old-age pension, a fundamental part of the Chinese social security system, is perceived by the Chinese government as the last support for rural-to-urban migrant workers upon retreating from the labor market. Using survey data collected by the authors, this paper examines a host of factors which influence migrant workers' participation in the old-age scheme. The result shows that individual characteristics, employment status, attitudes toward old-age support and perception of the old-age pension system significantly differentiate two groups of migrant workers between those that have participated in and their counterparts who have not participated in the old-age pension schemes. Among a number of factors, age, educational attainment, holding labor contract, etc. are found to be significant factors influencing migrants' behavior participating(or not participating) the available age-pension schemes. Policy implications for how to improve the rate of participation in existing old-age pension schemes among migrant workers are drawn from the findings.

Effect of Pathoanatomic Diagnosis on the Quality of Birth Defects Surveillance in China

Objective To provide evidence for more accurate diagnosis of birth defects based on the pathoauatomy of congenital malformations. Methods Data used in this study were obtained fi＇om Luliang City Hospital and three county hospitals of Shanxi province between February 2004 and March 2006. Autopsy and pathological examination of 160 dead fetuses and stillbirths were performed. Photos of dead fetuses and stillbirths were taken, tissues were cut into sections for pathological examination under microscope, all pathological information was recorded, and percentage of birth defects was calculated. Results The proportion of dead fetuses and stillbirths with or without congenital malformations was 84.4% （135/160） and 15.6% （25/160）, respectively. There were 16 categories of major external and internal birth defects in 135 cases of such defects. Congenital heart defects, anencephaly and spina bifida had a higher prevalence rate in the study period. The prevalence rate of non-malformation death and birth defects 〈 28 gestational weeks and internal anomalies ≥ 28 gestational weeks was 14.61% （61/4175） and 17.25% （72/4175）, respectively. A total of 413 in situ anomalies were found in 135 cases of autopsy. Spina bifida, anencephaly, congenital heart defects, aplasia or accessory lobe of lung, renal agenesis and dysplasis and congenital hydrocephaly were more closely associated with severe malformations than with mitis malformations. The cases of dead fetuses and stillbirths with multiple malformations （/〉 2 in situ anomalies） had a higher proportion （74.1%）, whereas those with isolated malformations had a lower proportion （25.93%）. Conclusion The occurrence of congenital malformations in different embryonic developmental stages affects multiple organs. Postmortem examination of internal and multiple malformations of fetal deaths and stillbirths can provide more accurate diagnostic information for birth defects.