Intertwined depressive and cognitive trajectories and the risk of dementia and death in older adults:a competing risk analysis

Background Depressive symptoms and cognitive impairment often interact,rendering their associations controversial.To date,their joint trajectories and associations with dementia and death remain underexplored.Aims To explore the interactions between depressive symptoms and cognitive function,their developmental trajectories and the associations with all-cause dementia,Alzheimer’s disease(AD)and all-cause death in older adults.Methods Data were from the Health and Retirement Study.Depressive symptoms and cognitive function were measured using the 8-item Centre for Epidemiologic Studies Depression Scale and the Telephone Interview of Cognitive Status,respectively.All-cause dementia and AD were defined by self-reported or proxy-reported physician diagnoses.All-cause death was determined by interviews.The restricted cubic spline,group-based trajectory modelling and subdistribution hazard regression were used.Results Significant interactions between depressive symptoms and cognitive function in 2010 in their association with new-onset all-cause dementia and AD from 2010 to 2020 were found,especially in women(p for interaction<0.05).Independent trajectory analysis showed that emerging or high(vs no)depressive trajectories and poor or rapidly decreased cognitive trajectories(vs very good)from 1996 to 2010 were at significantly higher risk of subsequent all-cause dementia,AD and all-cause death.15 joint trajectories of depressive symptoms and cognitive function from 1996 to 2010 were determined,where rapidly decreased cognitive function was more common in those with no depressive symptoms.Compared with older adults with the trajectory of no depressive symptoms and very good cognitive function,those with the trajectory of no depressive symptoms but rapidly decreased cognitive function were much more likely to develop new-onset all-cause dementia and death,with subdistribution hazard ratios(95%confidence intervals)of 4.47(2.99 to 6.67)and 1.84(1.43 to 2.36),especially in women.Conclusions To effectively mitigate the risk of dementia and death,it is crucial to acknowledge the importance of preventing cognitive decline in older adults without depressive symptoms,particularly in women.

Adverse childhood experiences from family and society contribute to increased risk of depressive symptoms and cognitive impairment:a cross-sectional study

Background Family environments can shape children’s personalities and social networks,rendering distinguishing adverse childhood experiences(ACEs)from family and society essential,but related evidence remains limited.Aims This cross-sectional study aimed to investigate the correlations between intrafamilial and social ACEs,their associations with depressive symptoms and cognitive impairment and the(education-moderated)mediating role of social ACEs.Methods Data for this cross-sectional study were from the China Health and Retirement Longitudinal Study.Nine intrafamilial(0,1,2,3,and 4 or more)and three social(0,1,and 2 or more)ACEs were identified.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale.Global cognition,including episodic memory and mental intactness,was calculated as z scores.Binary and ordered logistic regressions,generalised linear models with Gaussian family and identity link,and mediation analysis were used.Results 13435 participants aged 59.0(51.0–66.0)were included.Compared with participants with no intrafamilial ACEs,those with 1,2,3,and 4 or more intrafamilial ACEs tended to develop more social ACEs,with odds ratios(ORs)of 1.55(95%confidence interval(CI):1.36 to 1.76),2.36(95%CI:2.08 to 2.68),3.46(95%CI:3.02 to 3.96)and 6.10(95%CI:5.30 to 7.02),respectively.Both intrafamilial and social ACEs were associated with depressive symptoms(OR>3 for four or more intrafamilial ACEs and two or more social ACEs)and global cognition(β=−0.26 for four or more intrafamilial ACEs andβ=−0.29 for two or more social ACEs).Social ACEs mediated the associations of intrafamilial ACEs with depressive symptoms and global cognition by 12.3%and 13.1%,respectively.Furthermore,as education levels increased,the impact of intrafamilial ACEs on depressive symptoms was increasingly mediated through social ACEs,while the mediating role of social ACEs between intrafamilial ACEs and cognitive impairment gradually diminished.Conclusions Improving children’s social environments and elevating general education can prevent later-life depressive symptoms and cognitive impairment attributed to ACEs in China.

Effect modifications of BMI transition and trajectory in the associations of adverse childhood experiences with new-onset dementia and its subtypes in older US adults

Background Adverse childhood experiences(ACEs)and dementia are associated and comorbid with obesity.However,according to emerging research,the role of obesity in the association between ACEs and dementia seems controversial.Aims This analysis aimed to explore the associations between ACEs and different dementia subtypes and the effect modification of long-term body mass index(BMI).Methods Data were obtained from the US Health and Retirement Study.Six ACEs were categorised as 0,1 and 2 or more.All-cause dementia,Alzheimer’s disease(AD)and other dementias were defined by self-reported or proxy-reported physician diagnosis.Cox proportional hazards regression was used to explore the associations of ACEs with new-onset all-cause dementia,AD and other dementias from 2010 to 2020.Effect modification of BMI in 2010 and BMI transition and trajectory(fitted by group-based trajectory modelling)from 2004 to 2010 were assessed.Results 15282 participants with a mean age of 67.0 years(58.0–75.0)were included in the 2010 data analysis.Significant interactions of ACEs with baseline BMI,BMI transition and BMI trajectory in their associations with new-onset all-cause dementia and AD were observed(all p<0.05).For instance,positive associations of two or more ACEs(vs none)with all-cause dementia and AD were found in those with a BMI trajectory of maintaining≥30 kg/m2(maintain obesity)rather than a decline to or maintaining<25 kg/m2(decline to or maintain normal weight),with hazard ratios(HRs)of 1.87(95%confidence interval(CI):1.45 to 2.42)and 1.85(95%CI:1.22 to 2.80),respectively.Conclusions ACEs were associated with dementia and AD in US adults with long-term abnormally elevated BMI but not with long-term normal or decreasing BMI.Integrated weight management throughout life could prevent dementia among those with childhood adversity.

Ambient Fine Particulate Matter Exposure and Blood Pressure:Evidence from a Large Chinese Multiple Follow-Up Study

Objective This study aimed to investigate the association of ambient PM_(2.5)exposure with blood pressure(BP)at the population level in China.Methods A total of 14,080 participants who had at least two valid blood pressure records were selected from the China Health and Retirement Longitudinal Survey during 2011–2015.Their long-term PM_(2.5)exposure was assessed at the geographical level,on the basis of a regular 0.1°×0.1°grid over China.A mixed-effects regression model was used to assess associations.Results Each decrease of 10μg/m^(3)in the 1 year-mean PM_(2.5)concentration(FPM1Y)was associated with a decrease of 1.24[95%confidence interval(CI):0.84–1.64]mmHg systolic BP(SBP)and 0.50(95%CI:0.25–0.75)mmHg diastolic BP(DBP),respectively.A robust association was observed between the long-term decrease in PM_(2.5)and decreased BP in the middle-aged and older population.Using a generalized additive mixed model,we further found that SBP increased nonlinearly overall with FPM1Y but in an approximately linear range when the FPM1Y concentration was<70μg/m^(3);In contrast,DBP increased approximately linearly without a clear threshold.Conclusion Efficient control of PM_(2.5)air pollution may promote vascular health in China.Our study provides robust scientific support for making the related air pollution control policies.

Status of Equities in Prenatal Care Utilization and Changing Patterns among Women in China

Objective To assess the extent and relative changes of the equities in prenatal care utilization among women with different educational attainment in some areas of China. Methods Data were collected in 13 counties/cities covered by Perinatal Health Care Surveillance System established by Institute of Reproductive and Child Health, Peking University. The study population consisted of 103 704 women who delivered single live births in 1994 and 2000. Chi-square and multiple Logistic regression were employed to compare the administrative rates and relative risks. Concentration index was used to assess the relative changes of equities in prenatal care utilization. SPSS 11.5 and Microsoft Excel 2003 were used for analysis. Results The total systematic management rate was 22.1% in 1994 and 57.4% in 2000. The concentration index was -0.046 in 1994 and 0.066 in 2000. In northern areas, the concentration index increased from 0.015 in 1994 to 0.295 in 2000, while it increased from -0.015 in 1994 to 0.062 in 2000 in southern areas. In rural areas, the concentration index increased from O. 002 in 1994 to 0.026 in 2000, while it decreased from 0.042 in 1994 to 0.019 in 2000 in urban areas. Conclusion Inequities in prenatal care utilization in 2000 become more obvious than in 1994, especially in northern areas. More attention should be paid to solve the inequities.

Secular trends in incidence of lung cancer by histological type in Beijing, China, 2000-2016

Objective: The objective of this study was to characterize secular trends in the sex-specific, age-standardized incidence of lung cancer by histological type in Beijing, China, from 2000 to 2016 based on data from a populationbased cancer registry.Methods: Data on the incidence of cancer from 2000 to 2016 were obtained from the Beijing Cancer Registry.We examined trends in the sex-specific, age-standardized incidence of lung cancer by histological type using a Joinpoint regression model.Results: A total of 117,409 cases of lung cancer were diagnosed from 2000 to 2016. Overall, 73,062(62.23%)patients were males. The most common histological type among both sexes was adenocarcinoma; however, the proportion of adenocarcinoma differed significantly between males and females(45.36% vs. 77.14%, respectively,P<0.0001). The age-standardized incidence of total lung cancer increased from 2000 to 2010 with an annual percent change(APC) of 2.2% [95% confidence interval(95% CI), 1.5% to 2.9%] and stabilized thereafter. Among males, the incidence of total lung cancer peaked in 2008 and then decreased slightly, with an APC of-1.1%(95%CI,-2.1% to-0.1%). Among females, the incidence increased continuously during the study period, with an APC of 1.4%(95% CI, 0.9% to 1.9%). The incidence of squamous cell carcinoma decreased significantly in recent years among both sexes, with APCs of-2.6%(95% CI,-4.5% to-0.6%) from 2007 to 2016 for males and-5.4%(95%CI,-7.2% to-3.6%) from 2004 to 2016 for females. In contrast, the incidence of adenocarcinoma increased continuously throughout the study period, by APCs of 4.0%(95% CI, 2.6% to 5.4%) for males and 6.2%(95% CI,4.8% to 7.6%) for females. The incidence of small cell carcinoma peaked in 2007 and stabilized thereafter among males, whereas it peaked in 2012 and then decreased with an APC of-14.7%(95% CI,-25.3% to-2.6%) among females. The incidence of large cell carcinoma and other specified malignant neoplasm did not change much,whereas the incidence of unspecified type decreased among both sexes during the study period.Conclusions: Although the incidence of squamous cell carcinoma decreased significantly among both sexes in recent years in Beijing, China, adenocarcinoma increased continuously throughout the study period among both sexes. Knowledge of differences in trends is useful for surveillance and control of lung cancer. However, the reason for the increase in adenocarcinoma remains unclear and warrants investigation.

Prevention of neural tube defects with folic acid: The Chinese experience

Neural tube defects(NTDs) are a group of congenital malformations of the central nervous system that are caused by the closure failure of the embryonic neural tube by the 28 th day of conception. Anencephaly and spina bifida are the two major subtypes. Fetuses with anencephaly are often stillborn or electively aborted due to prenatal diagnosis, or they die shortly after birth. Most infants with spina bifida are live-born and, with proper surgical treatment, can survive into adulthood. However, these children often have life-long physical disabilities. China has one of the highest prevalence of NTDs in the world. Inadequate dietary folate intake is believed to be the main cause of the cluster. Unlike many other countries that use staple fortification with folic acid as the public health strategy to prevent NTDs, the Chinese government provides all women who have a rural household registration and who plan to become pregnant with folic acid supplements, free of charge, through a nation-wide program started in 2009. Two to three years after the initiation of the program, the folic acid supplementation rate increased to 85% in the areas of the highest NTD prevalence. The mean plasma folate level of women during early and mid-pregnancy doubled the level before the program was introduced. However, most women began taking folic acid supplements when they knew that they were pregnant. This is too late for the protection of the embryonic neural tube. In a postprogram survey of the women who reported folic acid supplementation, less than a quarter of the women began taking supplements prior to pregnancy, indicating that the remaining three quarters of the fetuses remained unprotected during the time of neural tube formation. Therefore, staple food fortification with folic acid should be considered as a priority in the prevention of NTDs.

The main and added effects of heat on mortality in 33 Chinese cities from 2007 to 2013

Increases in ambient temperatures and the frequency of extreme heat events constitute important burdens on global public health.However,evidence on their effects on public health is limited and inconclusive in China.In this study,data on daily deaths recorded in 33 Chinese cities from 2007 to 2013 was used to evaluate the effect of heat on mortality in China.In addition to the definition of a heatwave established by the China Meteorological Administration,we combined four city-specific relative thresholds(90th,92.5th,95th,and 97.5th percentiles)of the daily mean temperature during the study period and three durations of≽2,≽3,and≽4 days,from which 13 heatwave definitions were developed.Then,we estimated the main and added effects of heat at the city level using a quasi-Poisson generalized additive model combined with a distributed lag nonlinear model.Next,the estimates for the effects were pooled at the national level using a multivariable meta-analysis.Subgroup analysis was performed according to sex,age,educational attainment,and spatially stratified heterogeneity.The results showed that the mortality risk increased from 22.3%to 37.1%due to the effects of the different heatwave definitions.The added effects were much lower,with the highest increase of 3.9%(95%CI:1.7%–6.1%)in mortality risk.Females,the elderly,populations with low educational levels,and populations living inland in China were found to be the most vulnerable to the detrimental effects of heat.These findings have important implications for the improvement of early warning systems for heatwaves.

Prevalence and Trends of Birth Defects—Five Counties,Shanxi Province,China,2003–2022

Summary What is already known about this topic?The Shanxi Province,located in northern China,holds the highest prevalence of birth defects(BDs)across the country.Following the implementation of a nationwide folic acid supplementation program in 2009,a significant reduction of 53.89%in the prevalence of neural tube defects(NTDs)was observed in Shanxi from 2012 to 2017.

Temporal Trends of Clinical Characteristics and Treatments in People Living with HIV at the Initiation of Antiretroviral Therapy — Beijing Municipality, China, 2010–2020

Summary What is already known about this topic?Antiretroviral therapy(ART)eligibility criteria and treatment regimens were updated in national guidelines.However,whether treatment was timely and followed guidelines was under-assessed.

Healthy Lifestyles and Chronic Pain with New-Onset Metabolic-Related Multimorbidity among Older Adults—China,2011–2018

Summary What is already known about this topic?Chronic pain has been identified as a risk factor for cardiovascular diseases.Evidence shows that adopting a healthy lifestyle can help reduce the cardiometabolic risks associated with chronic pain.What is added by this report?Results from this cohort study suggest a positive association between chronic pain and the development of new-onset metabolic-related multimorbidity,specifically metabolic multimorbidity and cardiometabolic comorbidity,within middle-aged and older Chinese adults.Furthermore,adopting healthy lifestyles can potentially mitigate or even reverse these associations.What are the implications for public health practice?The results of our study emphasize the importance of promoting healthy lifestyles among older Chinese adults as a preventative measure against the medical burdens and cardiometabolic risks associated with chronic pain.

Synergetic roadmap of carbon neutrality and clean air for China

It is well recognized that carbon dioxide and air pollutants share similar emission sources so that synergetic policies on climate change mitigation and air pollution control can lead to remarkable co-benefits on greenhouse gas reduction,air quality improvement,and improved health.In the context of carbon peak,carbon neutrality,and clean air policies,this perspective tracks and analyzes the process of the synergetic governance of air pollution and climate change in China by developing and monitoring 18 indicators.The 18 indicators cover the following five aspects:air pollution and associated weather-climate conditions,progress in structural transition,sources,inks,and mitigation pathway of atmospheric composition,health impacts and benefits of coordinated control,and synergetic governance system and practices.By tracking the progress in each indicator,this perspective presents the major accomplishment of coordinated control,identifies the emerging challenges toward the synergetic governance,and provides policy recommendations for designing a synergetic roadmap of Carbon Neutrality and Clean Air for China.

Cesarean delivery on maternal request and childhood intelligence： a cohort study

Background Cesarean section births have been steadily increasing over the past decade and have become an epidemic in China. Cesarean delivery on maternal request is a major contributor to this upward trend, and there has been of much concern about its impact on maternal and child health. Most of mothers believe that cesarean delivery on maternal request can improve the child＇s intelligence, but direct evidence is sparse. In this cohort study, we aimed to directly assess the impact of cesarean delivery on maternal request on childhood intelligence. Methods Intelligence quotient （IQ） of 4144 preschool children from 21 cities/counties of Zhejiang and Jiangsu province whose mothers were registered in a population-based perinatal surveillance program during 1993-1996 was assessed with Chinese Wechsler Young Children Scale of Intelligence （C-WYCSI） in 2000. The outcomes were full-scale IQ, verbal IQ, and performance IQ of C-WYCSI. Mode of delivery and covariates were obtained from the surveillance program. We estimated unadjusted and adjusted effects of cesarean delivery on maternal request and assisted vaginal delivery on IQ scores compared with spontaneous vaginal delivery using regression analysis. Results The mean full-scale, verbal, and performance IQ for all children was 99.3_＋16.1,93.6_＋17.7, and 105.3_＋14.3. In crude analysis, cesarean delivery on maternal request versus spontaneous vaginal delivery was associated with an increase of 3.9 （95% confidence interval, 0.6 to 7.2） points in full-scale IQ, 4.8 （1.2 to 8.4） points in verbal IQ, and 2.4 （-0.6 to 5.3） points in performance IQ. After adjusting for maternal education, occupation, and IQ, the advantage was reduced to 1.6 （-1.3 to 4.5）, 2.3 （-0.8 to 5.5）, and 0.6 （-2.0 to 3.3） points for full-scale, verbal, and performance IQ, respectively. Assisted vaginal delivery versus spontaneous vaginal delivery was not associated with IQ scores in any analysis. Conclusion Neither cesarean delivery on maternal request nor assisted vaginal delivery affected children＇s IQ.

Maternal periconceptional consumption of pickled vegetables and risk of neural tube defects in offspring

Background Maternal exposure to nitrate, nitrite, and N-nitroso compounds from drinking water or diet has been associated with an increased risk of neural tube defects （NTDs） in some studies. Pickled vegetables contain relatively large amounts of nitrite and N-nitroso compounds. We examined the association between maternal periconceptional consumption of pickled vegetables and NTDs in Shanxi Province of northern China. Methods Data were derived from a population based case-control study of major external birth defects in four counties of $hanxi Province. Participants included 519 NTDs cases identified between 2003 and 2007 and 694 healthy controls. Exposure information was collected within 1 week after delivery. Multivariable non-conditioanal Logistic regression model was used to estimate the adjusted odds ratio （OR） controlling for potential confounding variables.

Prevalence of Metabolic Syndrome and Risk Factors Among Chinese Adults:Results from a Population-Based Study—Beijing,China,2017–2018

Summary What is already known about this topic?Metabolic syndrome(MetS)is one of the most easily available health indicative markers for cardiovascular diseases,and it has become a major public health problem worldwide due to increasing urbanization and aging populations.The prevalence of MetS increased dramatically in China,however,there are no records of MetS defined by the 2017 Chinese Diabetes Society for Beijing by far.What is added by this report?In this study,the data of 24,412 participants aged 18–74 years from a large population-based study in Beijing was collected.The overall prevalence of MetS among Beijing residents was 24.5%.The prevalence was 35.2%in males and 15.4%in females.What are the implications for public health practice?Effective public health strategies should target males,people with older age,lower education,higher body mass index,smokers,those who drink alcohol,those who are unemployed or retired,and those who live in rural areas on MetS prevention and control.

Melamine Nephrotoxicity is Mediated by Hyperuricemia

Objective We tested whether melamine nephrotoxicity was exacerbated by urate(a typical component of renal stones in humans)in rats with hyperuricemiainduced by the uricase inhibitor,potassium oxonate(Oxo).Methods Rats were exposed to melamine or Oxo alone or combinations of melamine(200-400 mg/kg)and Oxo(200-600 mg/kg)for 3 consecutive days.Kidney injury was evaluated by renal biochemical functions,histomorphology,and lipid peroxidation.Kidney crystals were analyzed for their composition.Results Nephrotoxicity was minimal in animals administered melamine or Oxo alone,but it was demonstrable in animals administered at least 800 mg/kg of the two compounds combined.All rats in the 400+600(melamine+Oxo)and 400+400 mg/kg groups and 4 out of 6 in the 200+600 mg/kg group died within 3 days;no rat died in the 200+400 or 200+200 mg/kg group.Dose-dependent renal damage resembling clinical findings in affected patients was observed in rats administered the two compounds.Crystal composition determination revealed the existence of melamine and uric acid in the affected kidneys,resembling human stones.Conclusion Our findings suggest that uric acid plays a key role in melamine-related kidney injury in humans.Future studies should consider uric acid together with melamine when examining adverse effects in humans.

Risk Factors and Pregnancy Outcome in Women with a History of Cesarean Section Complicated by Placenta Accreta

Objective:To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta(PA).Methods:This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017.According to the intraoperative findings after delivery,the study population was divided into PA and non-PA groups.We compared the pregnancy outcomes between the two groups,used multivariate logistic regression to analyze the risk factors for placental accreta.Results:For this study we included 11,074 pregnant women with a history of cesarean section;and of these,869 cases were in the PA group and 10,205 cases were in the non-PA group.Compared with the non-PA group,the probability of postpartum hemorrhage(236/10,205,2.31%vs.283/869,32.57%),severe postpartum hemorrhage(89/10,205,0.87%vs.186/869,21.75%),diffuse intravascular coagulation(3/10,205,0.03%vs.4/869,0.46%),puerperal infection(33/10,205,0.32%vs.12/869,1.38%),intraoperative bladder injury(1/10,205,0.01%vs.16/869,1.84%),hysterectomy(130/10,205,1.27%vs.59/869,6.79%),and blood transfusion(328/10,205,3.21%vs.231/869,26.58%)was significantly increased in the PA group(P<0.05).At the same time,the neonatal birth weight 3250.00(2950.00–3520.00)g vs.2920.00(2530.00–3250.00)g),the probability of neonatal comorbidities(245/10,205,2.40%vs.61/869,7.02%),and the rate of neonatal intensive care unit admission(817/10,205,8.01%vs.210/869,24.17%)also increased significantly(P<0.05).Weight(odds ratio)(OR)=1.03,95%confidence interval(CI):1.01–1.05)),parity(OR=1.18,95%CI:1.03–1.34),number of miscarriages(OR=1.31,95%CI:1.17–1.47),number of previous cesarean sections(OR=2.57,95%CI:2.02–3.26),history of premature rupture of membrane(OR=1.61,95%CI:1.32–1.96),previous cesarean-section transverse incisions(OR=1.38,95%CI:1.12–1.69),history of placenta previa(OR=2.44,95%CI:1.50–3.96),and the combination of prenatal hemorrhage(OR=9.95,95%CI:8.42–11.75)and placenta previa(OR=91.74,95%CI:74.11–113.56)were all independent risk factors for PA.Conclusion:There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section,and this required close clinical attention.Weight before pregnancy,parity,number of miscarriages,number of previous cesarean sections,history of premature rupture of membranes,past transverse incisions in cesarean sections,a history of placenta previa,prenatal hemorrhage,and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section.These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section.

Modeling the Prevalence of Asymptomatic COVID-19 Infections in the Chinese Mainland

Recently,considerable efforts have been focused on intensifying the screening process for asymptomatic COVID-19 cases in the ChineseMainland,especially for up to 10 million citizens living in Wuhan City by nucleic acid testing.However,a high percentage of domestic asymptomatic cases did not develop into symptomatic ones,which is abnormal and has drawn considerable public attention.Here,we aimed to investigate the prevalence of COVID-19 infections in the Chinese Mainland from a statistical perspective,as it is of referential significance for other regions.By conservatively assuming a development time lag from pre-symptomatic(i.e.,referring to the infected cases that were screened before the COVID-19 symptom onset)to symptomatic as an incubation time of 5.2 days,our results indicated that 92.5%of those tested in Wuhan City,China,and 95.1%of those tested in the Chinese Mainland should have COVID-19 syndrome onset,which was extremely higher than their corresponding practical percentages of 0.8%and 3.3%,respectively.We propose that a certain false positive rate may exist if large-scale nucleic acid screening tests for asymptomatic cases are conducted in common communities with a low incidence rate.Despite adopting relatively high-sensitivity,high-specificity detection kits,we estimated a very low prevalence of COVID-19 infections,ranging from 10
6 to 10
4 in both Wuhan City and the Chinese Mainland.Thus,the prevalence rate of asymptomatic infections in China had been at a very low level.Furthermore,given the lower prevalence of the infection,close examination of the data for false positive results is necessary to minimize social and economic impacts.

Developmental Gerontology and Active Population Aging in China

Population aging is an irreversible process in the development of modern society,which brings challenges to comprehensive modernized social governance.Population aging is a“dualistic”development issue that not only leads to aging of the labor force structure but also creates new demographic dividends.This study describes the core thoughts of developmental gerontology(DG),which provides new insight into the relationship between active aging and comprehensive governance for modernized society.The development of DG will provide a feasible and sustainable path to integrate and coordinate the relationship between population aging,society,and economy.

Preventing Birth Defects:Implications and Prospects

Efforts to lower maternal and neonatal mortality rates and enhance the quality of maternal and child care are pivotal,particularly in low-and middle-income countries(LMICs).These initiatives are critical for the realization of the Sustainable Development Goals by 2030.In 2019,congenital anomalies ranked as the tenth leading cause of global health loss(1).These conditions,also known as birth defects(BDs).