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Prognostic prediction models for patients with comorbidity of chronic diseases: a scoping review
JIA Ming, ZHAO Hua, PENG Juyi, LIU Xingyu, LIU Yudan, HOU Jianing, YANG Jiale
Preventive Medicine    2024, 36 (6): 491-495.   DOI: 10.19485/j.cnki.issn2096-5087.2024.06.008
Abstract   PDF (791KB)  
Objective To conduct a scoping review on prognostic prediction models for patients with comorbidity of chronic diseases, and understand modeling methods, predictive factors and predictive effect of the models, so as to provide the reference for prognostic evaluation on patients with comorbidity of chronic diseases. Methods Literature on prognostic prediction models for patients with comorbidity of chronic diseases was collected through SinoMed, CNKI, Wanfang Data, VIP, PubMed, Embase, Cochrane Library and Web of Science published from the time of their establishment to November 1, 2023. The quality of literature was assessed using prediction model risk of bias assessment tool (PROBAST), then modeling methods, predictive factors and predictive effects were reviewed. Results Totally 2 130 publications were retrieved, and nine publications were finally enrolled, with an overall high risk of bias. Thirteen models were involved, with three established using machine learning methods and ten established using logistic regression. The prediction results of four models were death, with main predictive factors being age, gender, body mass index (BMI), Barthel index and pressure ulcers; the prediction results of nine models were rehospitalization, with main predictive factors being age, BMI, hospitalization frequency, duration of hospital stay and hospitalization costs. Eleven models reported the area under the receiver operating characteristic curve (AUC), ranging from 0.663 to 0.991 6; two models reported the C-index, ranging from 0.64 to 0.70. Eight models performed internal validation, one model performed external validation, and four models did not reported verification methods. Conclusions The prognostic prediction models for patients with comorbidity of chronic diseases are established by logistic regression and machine learning methods with common nursing evaluation indicators, and perform well. Laboratory indicators should be considered to add in the models to further improve the predictive effects.
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Construction of a prediction model for preterm birth risk
WANG Qiong, CHEN Danqing, WEI Yili, QIAN Fangfang
Preventive Medicine    2024, 36 (8): 663-668.   DOI: 10.19485/j.cnki.issn2096-5087.2024.08.005
Abstract   PDF (841KB)  
Objective To construct a prediction model for preterm birth risk among pregnant women, so as to provide the reference for screening high-risk population and preventing preterm birth. Methods Pregnant women who received antenatal examination and delivered at the Women's Hospital, School of Medicine, Zhejiang University from January 1 to December 31, 2019 were selected as the study subjects, among them, 80% were included in the modeling group, and 20% were included in the validation group. Demographic and clinical information were collected. A multivariable logistic regression model was used to analyze the predictive factors of preterm birth risk in the modeling group, and a preterm birth risk prediction model was established based on the OR values of predictive factors. The model was validated with the data from the validation group. The Youden index was used to determine the critical score for predicting preterm birth risk. The prediction performance of the model was evaluated using the receiver operating characteristic (ROC) curve. Results A total of 15 197 pregnant women were surveyed, including 12 131 pregnant women in the observation group and 3 066 pregnant women in the validation group. There was no statistically significant difference in age, education level and gravidity between the two groups of pregnant women (all P<0.05). Multivariable logistic regression analysis identified the number of pregnancies, education level, place of residence, hypertension, diabetes, history of preterm birth, twin-pregnancy, placenta praevia, and gestational hypertension as risk prediction factors for preterm birth risk among pregnant women. The risk score system for preterm birth was established as follows: >2 pregnancies (2 points), high school education or below (4 points), college degree or above (-4 points), rural residence (5 points), hypertension (7 points), diabetes (11 points), history of preterm birth (11 points), twin-pregnancy (28 points), placenta previa (19 points), and gestational hypertension (12 points). The total score of the preterm birth risk scoring system ranged from -4 to 99 points. When the critical score was 8 points, the Youden index was the highest at 0.480, with an area under the ROC curve of 0.749 (95%CI: 0.732-0.767), a sensitivity of 0.610, and a specificity of 0.886, indicating good prediction performance of the model. Conclusion The preterm birth risk prediction model established in this study based on demographic and clinical characteristics of pregnant women can effectively predict the risk of preterm birth among pregnant women.
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Epidemiological studies of falls among the elderly: a review
WU Shujun, ZHU Siyi, ZOU Zuquan, GAO Yuan, FANG Ting
Preventive Medicine    2024, 36 (7): 590-594,597.   DOI: 10.19485/j.cnki.issn2096-5087.2024.07.009
Abstract   PDF (890KB)  
Falls are the leading cause of accidental injury deaths among the elderly. Currently, the incidence and disease burden of falls among the elderly remain high. By understanding the influencing factors of falls among the elderly and formulating targeted preventive measures, the risk of falls can be effectively reduced. Studies have found that falls among the elderly are results of the interaction of multiple factors. When formulating fall prevention strategies, attention should be paid to fall risk assessment and stratification, fall prevention exercise support and health education, living environment improvement, and primary healthcare service enhancement. Reviewing publications pertaining to the epidemiological studies of falls from January 2004 to January 2024, this article summarizes the epidemiological characteristics, risk factors, prevention and control strategies of falls among the elderly, aiming to provide the reference for prevention and control.
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Effectiveness of recombinant Mycobacterium tuberculosis fusion protein skin test in screening for latent tuberculosis infection among HIV/AIDS patients
WANG Hui, LI Jincheng, LU Xing, WANG Jinfu, ZHU Limei, LIU Qiao
Preventive Medicine    2024, 36 (7): 639-643.   DOI: 10.19485/j.cnki.issn2096-5087.2024.07.021
Abstract   PDF (853KB)  
Objective To evaluate the effectiveness of recombinant Mycobacterium tuberculosis fusion protein skin test (EC-ST) in screening for latent tuberculosis infection (LTBI) among HIV/AIDS patients, so as to provide insights into the applicability of EC-ST in LTBI screening among HIV/AIDS patients. Methods From April to June 2023, HIV/AIDS patients under management and treatment in Yangzhou City, Jiangsu Province, were selected as study subjects. Basic information was collected through questionnaire surveys. LTBI was screened by EC-ST and interferon-gamma release assay (IGRA). Taking IGRA results as the diagnostic standard, the positive rate, sensitivity, specificity and consistency rate of EC-ST, and the impact of CD4+T lymphocyte (CD4) counts on the screening effect of EC-ST were analyzed. Results A total of 523 HIV/AIDS patients were screened, including 458 males (87.57%) and 65 females (12.43%). The median age was 48.00 (interquartile range, 21.00) years. The positive rate of EC-ST was 7.27% and the positive rate of IGRA was 7.46%, with no statistically significant difference (P>0.05). The consistency rate of the two methods was 94.84%, and the Kappa value of 0.621 (95%CI: 0.489-0.752, P<0.05). The sensitivity of EC-ST was 64.10% and the specificity was 97.31%. Comparing the groups with CD4 counts <500 and ≥500 cells/μL, the consistency rates of the two methods were 95.32% and 94.44%, and the Kappa values were 0.568 and 0.650, respectively (both P<0.05). There were no statistically significant differences in the positive rates, sensitivity, and specificity of EC-ST (all P>0.05). Comparing the groups with CD4 counts <200 and ≥200 cells/μL, the consistency rates of the two methods were 96.55% and 94.62%, and the Kappa values were 0.648 and 0.619, respectively (both P<0.05). There were no statistically significant differences in the positive rates, sensitivity, and specificity of EC-ST (all P>0.05). Conclusion The effectiveness of EC-ST in screening for LTBI among HIV/AIDS patients is consistent with that of IGRA and is not affected by CD4 counts.
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Household solid fuel use and risk of diabetes and hypertension: a review
JIN Dan, ZHANG Kaiyue, WANG Jing
Preventive Medicine    2024, 36 (8): 679-682.   DOI: 10.19485/j.cnki.issn2096-5087.2024.08.008
Abstract   PDF (836KB)  
Incomplete combustion of solid fuels produces a large amount of pollutants, which are associated with the incidence and mortality risks of various chronic diseases, making it one of the significant environmental and public health issues in China. Studies have shown that air pollutants generated by the use of solid fuels in households may increase the risk of diabetes by interfering with glucose metabolism and altering insulin resistance, and may also increase the risk of hypertension by inducing vascular oxidative stress and inflammatory responses. This article reviews relevant literature published domestically and internationally from 2001 to 2024, focusing on the impacts of household solid fuel use on diabetes and hypertension, as well as suggestions for reducing household solid fuel use, providing the reference for the prevention of related chronic diseases.
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Mediating effect of parental hostile attribution bias on depression and anxiety between parents and children
SHEN Lianxiang, MAO Wenjuan, WANG Yongguang, SHEN Zhihua, GAN Junyi
Preventive Medicine    2024, 36 (6): 479-482.   DOI: 10.19485/j.cnki.issn2096-5087.2024.06.005
Abstract   PDF (812KB)  
Objective To explore the mediating effect of parental hostile attribution bias on depression and anxiety between parents and children, so as to provide the reference for the promotion of children's mental health. Methods Students of grades 2-6 in two public primary schools in Linping District, Hangzhou City and their parents were investigated using stratified sampling method in November 2022. Emotions of children were surveyed using Depression Self-Rating Scale for Child (DSRSC) and Screen for Child Anxiety Related Emotional Disorders (SCARED), while emotions and hostile attribution bias of parents were surveyed using Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS) and Social Cognitive Screening Questionnaire (SCSQ). Mediating effect of parental hostile attribution bias on depression and anxiety between parents and children was analyzed using a structural equation model. Results Totally 300 questionnaires were allocated, and 263 valid questionnaires were recovered, with an effective rate of 87.67%. There were 137 boys (52.09%), and 126 girls (47.91%), with a mean age of (9.95±1.44) years. There were 69 fathers and 194 mothers investigated. The prevalence of depression among parents was 27.00%, the prevalence of anxiety among parents was 4.18%, and the median score of hostile attribution bias was 1.00 (interquartile range, 2.00). The prevalence of depression among children was 11.03%, and the prevalence of anxiety among children was 29.66%. Parents' depression and anxiety affected children's depression and anxiety directly (effect value=0.270, 95%CI: 0.131-0.436), and also indirectly affected children's depression and anxiety by increasing their hostile attribution bias (effect value=0.028, 95%CI: 0.004-0.082), with the mediating effect contributed 9.40% of the total effect. Conclusion Parents' depression and anxiety affect children's depression and anxiety directly or indirectly through hostile attribution bias.
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Influencing factors for depressive symptoms in adolescents
WANG Ningyu, ZHANG Zhongmin, CHEN Ting
Preventive Medicine    2024, 36 (7): 562-566,570.   DOI: 10.19485/j.cnki.issn2096-5087.2024.07.003
Abstract   PDF (859KB)  
Objective To explore the influencing factors for depressive symptoms in adolescents in China, so as to provide insights into promoting mental health of adolescents. Methods The 2020 follow-up survey data of China Family Panel Studies were collected, including demographic information, lifestyle, family factors and academic factors of adolescents aged 10-19 years. Depressive symptoms were evaluated using the 8-item Center for Epidemiological Studies Depression Scale. The influencing factors for depressive symptoms in adolescents were analyzed using a multivariable logistic regression model. Results A total of 2 777 adolescents were analyzed, including 1 470 males (52.93%) and 1 307 females (47.07%). There were 1 186 adolescents (42.71%) from urban areas and 1 591 adolescents (57.29%) from rural areas, 106 smokers (3.82%), and 459 adolescents (16.53%) with depressive symptoms. Multivariable logistic regression analysis showed that academic stress (OR=1.268, 95%CI: 1.151-1.396), poor self-rated health (OR=1.255, 95%CI: 1.116-1.411), smoking (OR=1.901, 95%CI: 1.127-3.207), low trust in parents (OR=0.780, 95%CI: 0.729-0.835) and large family size (OR=1.095, 95%CI: 1.035-1.158) were associated with an increased risk of depressive symptoms in adolescents. Conclusion The influencing factors for depressive symptoms in adolescents were academic stress, self-rated health, smoking, trust in parents and family size.
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Protective effects of nicotinamide mononucleotide on ethanol-induced DNA damage in L02 cells
DI Chunhong, YIN Jie, ZHONG Wenying, ZHANG Yingying, CAO Yuejia, TAN Xiaohua
Preventive Medicine    2024, 36 (6): 548-552.   DOI: 10.19485/j.cnki.issn2096-5087.2024.06.021
Abstract   PDF (779KB)  
Objective To investigate protective effects of nicotinamide mononucleotide (NMN) on ethanol-induced DNA damage in L02 cells, so as to provide the evidence for adjuvant therapy of NMN on alcoholic liver diseases. Methods L02 cells were pretreated with different concentrations of NMN (0, 1, 2, 4 and 8 mmol/L) for 6 h, and then were exposed to 0.4% ethanol for 12 h. The treated cells were divided into the control group, 0.4% ethanol group and different concentrations of NMN groups. Cell viability was analyzed using trypan blue staining for determining the concentration of NMN as a protective agent. The effects of NMN on ethanol-induced DNA damage in L02 cells were evaluated using immunofluorescence detection and reactive oxygen species (ROS) assay. L02 cells were exposed to 0.4% ethanol for 12 h, cultured in a medium containing a protective concentration of NMN, and divided into PBS group and NMN group. Cell viability was detected at 0, 2, 4, 8, 16 and 32 h, and the effects of NMN on repairing ethanol-induced DNA damage were evaluated by alkaline comet assay. Results The cell viability was lower in 0.4% ethanol group than than in the control group, and was higher in different concentrations of NMN groups than in 0.4% ethanol group (all P<0.05), with no significant difference in the cells viability between 4 mmol/L and higher concentrations of NMN groups and the control group (all P>0.05). Therefore, 4 mmol/L NMN was selected as a protective agent. The cell tail moments, relative immunofluorescence intensities of γH2AX and relative levels of ROS were higher in 0.4% ethanol group than in the control group, and lower in 4 mmol/L and higher concentrations of NMN groups than in 0.4% ethanol group (all P<0.05). The cell viability was increased and the cell tail moment was shortened with the increase of 4 mmol/L NMN intervention time; and the cell viability in 4 h and more of NMN groups were higher, and the cell tail moment were lower than that in PBS group (all P<0.05). Conclusions NMN attenuates DNA damage in a dose-dependent manner and promotes the repair of DNA damage in a time-dependent manner. NMN has a protective effect on ethanol-induced DNA damage in hepatocytes.
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Association between latent class of health-risk behaviors and depressive symptoms among middle school students
SUN Qiang, LI Xiaoyong, GONG Qinghai, PAN Wenjie, HUANG Yan
Preventive Medicine    2024, 36 (6): 474-478.   DOI: 10.19485/j.cnki.issn2096-5087.2024.06.004
Abstract   PDF (773KB)  
Objective To analyze the association between latent class of health-risk behaviors and depressive symptoms among middle school students, so as to provide the evidence for the prevention and intervention of depressive symptoms among middle school students. Methods Students in two junior high schools, two senior high schools and one vocational high school in Yinzhou District, Ningbo City, Zhejiang Province, were selected using a stratified multi-stage cluster sampling method. Demography and health-risk behaviors were collected using questionnaire surveys, depressive symptoms were investigated using the Center for Epidemiological Studies Depression-10 Scale, and latent class analysis was conducted for health-risk behaviors. The association between different latent classes and depressive symptoms was analyzed using a multivariable logistic regression model. Results A total of 1 247 students were surveyed, including 641 boys (51.40%) and 606 girls (48.60%). There were 452 junior high school students (36.25%), 532 high school students (42.66%) and 263 vocational high school students (21.09%). Latent class analysis showed that health-risk behaviors in students were classified into three groups, namely healthy behavior group (52.93%), poor diet group (39.94%) and high-risk behavior group (7.14%), and the detection rates of depressive symptoms were 7.12%, 18.88% and 52.81%, respectively, with a statistically significant difference between groups (P<0.05). Multivariable logistic regression analysis showed that after adjusting for age, gender, native place, only child and living on campus, the poor diet group (OR=3.107, 95%CI: 2.086-4.627) and high-risk behavior group (OR=15.401, 95%CI: 9.031-26.262) had higher risks of depressive symptoms compared with the healthy behavior group. Conclusion Having high-risk behaviors and poor diet may increase the risk of developing depressive symptoms among middle school students.
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Effects of broken window effect and narrative nursing intervention on adolescent non-suicidal self-injury
ZHANG Yuanyuan, WANG Wen, TANG Xinlong, JIANG Aiguo
Preventive Medicine    2024, 36 (7): 553-557.   DOI: 10.19485/j.cnki.issn2096-5087.2024.07.001
Abstract   PDF (838KB)  
Objective To evaluate the intervention effectiveness of broken window effect combined with narrative nursing on non-suicidal self-injury (NSSI) in adolescents, so as to provide the basis for NSSI prevention in adolescents. Methods Totally 134 adolescents with NSSI admitted to Mental Health Center of the Affiliated Hospital of Anhui West Health Vocational College from January 2022 to December 2023 were enrolled and randomly assigned into the control and treatment group. All were given narrative nursing and routine care, and the adolescents in the treatment group were given additional intervention based on broken window effect. The effects were evaluated using Self-Rating Depression Scale (SDS), Hamilton Depression Scale (HAMD), Self-Rating Idea of Suicide Scale (SIOSS), Ottawa Self-injury Inventory-Functions (OSI-F) and Nursing Satisfaction Scale, and the two groups were compared before and after intervention. Results The treatment and control groups comprised 67 cases each, had a median age of 14.12 (interquartile range, 2.01) years and 14.10 (interquartile range, 1.52) years, included 71.64% and 68.66% girls, and 79.10% and 74.63% junior high school students, respectively. There were no statistically significant differences between the treatment and control groups in terms of gender, age or educational level (all P>0.05). The results of analysis of variance for repeated measures showed that there were interactions between time and group for SDS, HAMD and SIOSS scores (all P<0.05), and the decrease in scores before and after intervention was greater in the treatment group than in the control group. After intervention, the SDS, HAMD, SIOSS score and incidence of suicidal behaviors in the treatment group were all lower than the control group [SDS: (32.54±1.27) vs. (44.25±2.23); HAMD: (10.54±1.83) vs. (18.73±1.89); SIOSS: (10.37±2.20) vs. (15.76±1.62); incidence of suicidal behavior: 14.93% vs. 32.84%; all P<0.05]. The nursing satisfaction rate was significantly higher in the treatment group than in the control group (98.51% vs. 88.06%, P<0.05). Conclusion The broken window effect combined with narrative nursing would improve the depressive symptoms in adolescents with NSSI, and reduce the suicidal ideation and self injury.
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