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Background Depression imposes immense public health burden, demonstrating an urgent need of the identification of modifiable risk factors. Only a few cohort studies have analyzed the association between Mediterranean dietary pattern (MDP) and depression but with mixed results. We examined the impact of MDP on clinically ascertained depression in a large population-based dataset. Methods In 1991/92, detailed information on diet, using a food frequency questionnaire, and potential confounding factors (body weight, height, educational attainment, smoking, previous diabetes and hypertension, and physical activity) was collected, in a random sample of 49,261 Swedish women aged 29-49. Adherence to MDP was calculated. Clinical depression was extracted from the National Patient Register. Study participants were followed up through 2012. Results During an average follow-up of 20.4 years, 1677 incident cases of depression were diagnosed. We observed a lower risk of depression for medium (score 4-5) and high (6-9) adherence to MDP, compared with low (0-3) adherence (Medium: hazard ratio (HR) = 0.90, 95% confidence interval (CI) = 0.81-1.00; High: HR = 0.82, 95%CI = 0.71-0.94). Per unit increase of adherence, the risk of depression was reduced by 5% (HR = 0.95, 95%CI = 0.92-0.98). The association became stronger when restricting to severe form of depression (HR = 0.51, 95%CI = 0.33-0.76). The HRs were higher from age 50 onward both over the first and the second 10-year follow-up period, compared with before age 50, indicating stronger association with increasing age. Results remained after extensive sensitivity analyses. Conclusion Higher adherence to a Mediterranean diet at middle age was associated with a lower risk of depression later in life among Swedish women.

Children born small for gestational age have a higher risk of intellectual disability. We investigated associations of birth weight for gestational age percentile and gestational age with risk of intellectual disability in appropriate-for-gestational-age (AGA) children. We included 828,948 non-malformed term or post-term AGA singleton children (including 429,379 full siblings) born between 1998 and 2009 based on data from the Swedish Medical Birth Register. Diagnosis of intellectual disability after 3 years of age was identified through the Patient Register. Using Cox regression models, we calculated hazard ratios (HRs) with 95% confidence intervals (CIs) of intellectual disability among children with different birth weight percentiles and gestational age in the whole population and in a subpopulation of full siblings. A total of 1688 children were diagnosed with intellectual disability during follow-up. HRs (95% CIs) of intellectual disability for the low birth weight percentile groups (10th–24th and 25th–39th percentiles, respectively) versus the reference group (40th–59th percentiles) were 1.43 (1.22–1.67) and 1.28 (1.10–1.50) in population analysis and 1.52 (1.00–2.31) and 1.44 (1.00–2.09) in sibling comparison analysis. The increased risk for low birth weight percentiles in population analysis was stable irrespective of gestational age. A weak U-shaped association between gestational age and intellectual disability was observed in population analysis, although not in sibling comparison analysis. These findings suggest that among AGA children born at term or post-term, lower birth weight percentiles within the normal range are associated with increased risk of intellectual disability, regardless of gestational age.

China ranks third in estimated TB incidence in 2023, accounting for 6.8% of the global cases. TB in children and adolescents is a public health issue that today warrants priority attention in China. The purpose of this study was to investigate the burden of TB among Chinese children and adolescents aged 0-19 years from 1990 to 2021 and to estimate the incidence rate, mortality rate, and disability-adjusted life years (DALYs) rate from 2022 to 2031. The Joinpoint regression analysis was used to identify periods of significant change and autoregressive Integrated Moving Average (ARIMA) modeling was employed to predict the TB burden for 2022-2031. The study indicated that China has significantly reduced the TB burden among children and adolescents over the past 32 years, the most pronounced reductions in incidence occurred during the periods 2010-2015 (APC = -8.64%, P < 0.05) and 2019-2021 (APC = -6.09%, P < 0.05). Meanwhile, death and DALYs rates showed a consistently rapid decline across the entire 32-year span. Adolescents aged 15-19 years have the highest incidence rates, and children under 5 continue to face high mortality and DALYs rates. Additionally, females experienced a more significant decline compared to males across all age groups. Despite minor fluctuations in some age groups, a downward trend in incidence, death, and DALYs rates was anticipated to continue until 2031, with persistent gender differences in future projections. Our findings demonstrate a persistent downward trajectory in TB burden among Chinese children and adolescents from 1990 to 2021, with significant gender disparities favoring females across all age groups. Notably, children younger than 5 years and adolescents aged 15-19 years are at higher risk, which emphasizes the importance of tailored interventions to ensure continued progress towards comprehensive TB control goals.

•Successfully clustered the white matter functional networks of 10 neonates.•Identified significant differences in connectivity between preterm and full-term neonates.•Analyzed white matter connectivity and the effects of gender, age, and hemispheric differences.•Evaluated spontaneous activity of white matter networks with gender, age, and hemispheric effects. In recent years, the development of neonatal brain networks has become a research focus, with traditional studies primarily emphasizing gray matter (GM) functional networks. This study systematically explores the developmental characteristics of white matter (WM) functional networks in neonates. Utilizing data from the third release of the Developing Human Connectome Project (dHCP), we analyzed resting-state functional magnetic resonance imaging (rs-fMRI) data from 730 full-term and 157 preterm neonates. We successfully identified ten large-scale WM functional networks and validated their correspondence with established WM fiber tracts using diffusion tensor imaging (DTI). We examined WM functional networks from two dimensions: network functional connectivity and spontaneous activity, incorporating four factors: preterm birth status, age, sex, and hemispheric differences. The results indicate that WM network functional connectivity significantly increases with age, with preterm infants exhibiting lower connectivity than full-term infants, whereas no significant differences were observed between sexes or hemispheres. Regarding spontaneous activity, preterm infants showed lower amplitude in the low-frequency range, whereas in the high-frequency range, their amplitude distribution was more unstable and dispersed. Additionally, certain differences in spontaneous activity were observed between hemispheres and sexes. These findings provide novel insights into the early development of neonatal brain networks and hold significant implications for clinical interventions and treatment strategies for preterm infants.

While recent studies have indicated a potential link between incense burning and respiratory diseases, there is a lack of data specifically focused on diabetic patients. To explore the relationship between indoor incense burning and impaired lung function among Chinese individuals with diabetes, a comprehensive cross-sectional study was undertaken, enrolling 431 adults diagnosed with diabetes. Information on incense burning and characteristics was collected using a structured questionnaire. The outcome of the study, impaired lung function, was assessed using spirometry. Multivariable logistic regression models were employed. In the fully adjusted model, participants exposed to indoor incense burning exhibited 130% higher odds of impaired lung function compared to those not exposed, as indicated by an odds ratio (OR) of 2.3 (95% confidence interval [CI]: 0.97, 5.16; P  = 0.05). Notably, this association was statistically significant only in men (OR = 3.39; 95%CI: 1.07, 9.82; P  = 0.03). Our study has elucidated an association between exposure to indoor incense burning and impaired lung function in individuals with diabetes, independently of demographic factors. These findings underscore the importance of considering indoor environmental factors, such as incense burning, in the comprehensive management and care of diabetic individuals.

In this study, we aimed to examine whether parental major life events before or during pregnancy were associated with autistic behaviors in preschoolers, and whether alcohol use or smoking modified these associations. This study included 18,664 children aged 3–6 years in southern China. Parents reported seven types of major life events before or during pregnancy. Autistic behaviors were assessed by the Clancy Autism Behavior Scale. Logistic regression was applied to evaluate the associations of parental major life events with the risk of autistic behaviors, along with the modifying effects of alcohol consumption and smoking. This study found that paternal exposure to major life events before or during pregnancy was associated with an increased risk of autistic behaviors. Maternal exposure to major life events during pregnancy was associated with a higher risk of autistic behaviors. The associations between paternal pre-pregnancy major life events and autistic behaviors were stronger when either parent consumed alcohol before pregnancy. No modifying effect was shown for smoking. Findings from this study highlighted the importance of monitoring parental stress and alcohol use before and during pregnancy to improve children’s neurodevelopmental outcomes.

BackgroundWhile compromised stress resilience constitutes a recognised risk factor for somatic and psychiatric disease development in general, the knowledge about how individual variation in vulnerability to stress may specifically influence the long-term risks of disadvantageous health behaviours is limited.MethodsIn this Swedish cohort study, we aimed to investigate the association between stress resilience in late adolescence and adult use of addictive substances. We included 9381 men with information on psychological stress resilience measured during military conscription examinations, who later responded to an extensive health survey (mean age 34.0±7.2 years) including detailed information on substance use. We modelled continuous outcomes using linear regression, binary outcomes with logistic regression and other categorical outcomes with multinomial logistic regression.ResultsWe found that low stress resilience in adolescence conferred increased risks of all studied measures of addictive behaviour. After adjusting for childhood socioeconomic information, low stress resilience was associated with adult current regular smoking (relative risk ratio: 5.85, 95% CI 4.32 to 7.93), higher nicotine dependence scores (beta: 0.76, 95% CI 0.29 to 1.23), hazardous use of alcohol (>14 alcoholic drink-equivalents per week, OR: 1.72, 95% CI 1.37 to 2.16), DSM-IV criteria for alcohol dependence (OR: 1.74, 95% CI 1.35 to 2.25), and drug use (OR: 1.77, 95% CI 1.51 to 2.08). The results remained largely unchanged after further adjustments for adult educational attainment and occupation as well as for additional conscription covariates.ConclusionLow stress resilience in late adolescence appears to be associated with an increased risk of disadvantageous and addictive health behaviours in adulthood.

Background Individual socioeconomic status (SES) has been found to be associated with cardiovascular diseases in developed countries, but the association between individual SES and metabolic syndrome (MetS) is still unclear in China. The objective of this study was to investigate the association between individual SES and MetS in China. Methods A cross-sectional study of 10054 community residents was performed from May to August 2007 using multistage stratified random sampling. SES was assessed in terms of education, personal monthly income, and household monthly income. The association between SES and MetS was determined by logistic regression models. Results After the adjustments regarding age, marital status, smoking, drinking, physical activity, body mass index (BMI), and community type, odds ratios (ORs) for MetS of individuals with education level of 7~12 years and >12 years were 0.87 (95% confidence interval [CI]: 0.75 to 0.99) and 0.83 (95% CI: 0.62 to 0.91) respectively compared with those with education level of <7 years in women. Following the adjustments as above, ORs for MetS of individuals with household monthly income level of middle and higher were 0.94 (95% CI: 0.86 to 0.97), and 0.72 (95% CI: 0.65 to 0.88) respectively compared with those with lower household monthly income level in women. The association between SES and MetS was not significant in men. Conclusions Gender had an influence on the association between individual SES and MetS. Lower education and household monthly income level were associated with higher risk of MetS among community residents in women, while such association was not significant in men.

PurposePreoperative chemotherapy is underused in conjunction with radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) due to concerns for complications and delay of surgery. Prospective data on short-term complications from population-based settings with frequent use of preoperative chemotherapy and standardised reporting of complications is lacking.MethodsWe identified 1,340 patients who underwent RC between 2011 and 2015 in Sweden due to MIBC according to the Swedish Cystectomy Register. These individuals were followed through linkages to several national registers. Propensity score adjusted logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for complications and death within 90 days of surgery, comparing patients receiving preoperative chemotherapy or not.ResultsMinimum two cycles of preoperative chemotherapy were given to 519 (39%) of the patients, who on average tended to be younger, have higher education, better physical status, and more advanced bladder cancer than patients not receiving chemotherapy. After adjusting for these and other parameters, there was no association between treatment with preoperative chemotherapy and short-term complications (OR 1.06 95% CI 0.82–1.39) or mortality (OR 0.75 95% CI 0.36–1.55). We observed a risk reduction for gastrointestinal complications among patients who received preoperative chemotherapy compared with those who did not (OR 0.49 95% CI 0.30–0.81).ConclusionThis nation-wide population-based observational study does not suggest that preoperative chemotherapy, in a setting with high utilisation of such treatment, is associated with an increased risk of short-term complications in MIBC patients treated with radical cystectomy.

Background Pediatric Tuina has been widely used in children with acute diarrhea in China. However, due to the lack of high-quality clinical evidence, the benefit of Tuina as a therapy is not clear. We aimed to assess the effect of pediatric Tuina compared with sham Tuina as an add-on therapy in addition to usual care for 0–6-year-old children with acute diarrhea. Methods Eighty-six participants aged 0–6 years with acute diarrhea were randomized to receive pediatric Tuina plus usual care ( n  = 43) or sham Tuina plus usual care ( n  = 43). The primary outcomes were days of diarrhea from baseline and times of diarrhea on day 3. Secondary outcomes included a global change rating (GCR) and the number of days when the stool characteristics returned to normal. Adverse events were assessed. Results Pediatric Tuina was associated with a reduction in times of diarrhea on day 3 compared with sham Tuina in both ITT (crude RR, 0.73 [95% CI, 0.59–0.91]) and PP analyses (crude RR, 0.66 [95% CI, 0.53–0.83]). However, the results were not significant when we adjusted for social demographic and clinical characteristics. No significant difference was found between groups in days of diarrhea, global change rating, or number of days when the stool characteristics returned to normal. Conclusions In children aged 0–6 years with acute diarrhea, pediatric Tuina showed significant effects in terms of reducing times of diarrhea compared with sham Tuina . Studies with larger sample sizes and adjusted trial designs are warranted to further evaluate the effect of pediatric Tuina therapy. Trial registration Clinicaltrials.gov, Identifier: NCT03005821 , Data of registration: 2016-12-29.