Objective: To explore the prospective association between multidimensional sleep indicators and the risk of newlyonset dental caries, providing a reference for childrens oral healthrelated sleep intervention. Methods: In October 2021, 1 417 students in grades 1 to 4 (aged 6 to 11) from two elementary schools in Bengbu, Anhui Province, were selected by cluster sampling method. Surveys and followup visits were conducted at baseline (T1), November 2022 (T2), May 2023 (T3), and November 2023 (T4), respectively, including parental questionnaires, oral health and physical examination. Bedtime, sleep duration, sleep midpoint, social jet lag, weekend catchup sleep, and sleep habits were collected and calculated. A multifactorial Cox proportional risk regression model was used to analyze the association between multidimensional sleep indicators and newlyonset caries in schoolaged children after 2 years. Results: The prevalence of dental caries in children was 65.1% at baseline, and the prevalence was 59.0% at the end of the 2year followup. Cox proportional risk regression model showed that for every 1point increase in the childrens bedtime resistance, nocturnal awakenings, parasomnias, and daytime sleepiness scores, the risk of newlyonset caries increased by 12% (HR=1.12, 95%CI=1.08-1.15), 22% (HR=1.22, 95%CI=1.15-1.29), 12% (HR=1.12, 95%CI=1.08-1.17), and 15% (HR=1.15, 95%CI=1.12-1.19), respectively; the risk of newlyonset caries increased by 23% for each 1 h increase in the length of weekend catchup sleep (HR=1.23, 95%CI=1.14 -1.33); compared with children who went to bed before 21:00 on school days, those who went to bed later than 22:00 had a 57% higher risk of newlyonset caries (HR=1.57, 95%CI=1.22-2.03). Compared to children who slept adequately (≥9 h/d), those with insufficient sleep had a 67% higher risk of new caries (HR=1.67, 95%CI=1.43-1.95) (P<0.01). Conclusions These findings suggest a significant association between sleep patterns/sleep disorders and the development of childhood dental caries. Incorporating sleep behavior optimization and sleep quality improvement into comprehensive caries prevention and oral health management protocols may represent a promising intervention strategy to enhance childrens oral health outcomes.

Objective: To investigate the impact of temperature changes between neighboring days (TCN) on the mortality risk of respiratory diseases, so as to provide the evidence for the study of deaths from respiratory diseases caused by climate change. Methods: The monitoring data of deaths from respiratory diseases in Zibo City from 2015 to 2019 were collected from Shandong Provincial Management Information System for Chronic Diseases and Cause of Death Surveillance. The meteorological and air pollutant data of the same period were collected from China Meteorological Data Website and ChinaHighAirPollutants dataset. The effect of TCN on the risk of deaths from respiratory diseases was examined using a generalized additive model combined with a distributed lag non-linear model, and subgroup analyses for gender and age were conducted. The disease burden attributed to TCN at different intervals was assessed by calculating attributable fraction. Results: Totally 11 767 deaths from respiratory diseases were reported in Zibo City from 2015 to 2019, including 6 648 males (56.50%) and 5 119 females (43.50%). There were 1 307 deaths aged <65 years (11.11%), and 10 460 deaths aged 65 years and older (88.89%). A monotonically increasing exposure-response relationship was observed between TCN and deaths from respiratory diseases in the general population, females, and the population aged 65 years and older. The 95th percentile of TCN (P95, 3.84 ℃) reached the peak at a cumulative lagged of day 11 (RR=2.063, 95%CI: 1.261-3.376). The results of subgroup analyses showed greater impacts on females and the population aged 65 years and older, with cumulative lagged effects peaking at day 12 (RR=3.119, 95%CI: 1.476-6.589) and day 11 (RR=2.107, 95%CI: 1.260-3.523). The results of attributional risk analysis showed that next-day warming might increase the attributable risk of deaths from respiratory diseases, and next-day cooling might decrease the attributable risk. Conclusion Next-day warming may increase the mortality risk of respiratory diseases, and has greater impacts on females and the population aged 65 years and older.

Objective To construct a model for predicting recidivism in violence in community-based schizophrenia spectrum disorder patients(SSDP)by adopting a joint modeling method.Methods Based on the basic data on severe mental illness in Southwest China between January 2017 and June 2018,4565 community-based SSDP with baseline violent behaviors were selected as the research subjects.We used a growth mixture model(GMM)to identify patterns of medication adherence and social functioning.We then fitted the joint model using a zero-inflated negative binomial regression model and compared it with traditional static models.Finally,we used a 10-fold training-test cross validation framework to evaluate the models'fitting and predictive performance.Results A total of 157 patients(3.44%)experienced recidivism in violence.Medication compliance and social functioning were fitted into four patterns.In the counting model,age,marital status,educational attainment,economic status,historical types of violence,and medication compliance patterns were predictive factors for the frequency of recidivism of violence(P＜0.05).In the zero-inflated model,age,adverse drug reactions,historical types of violence,medication compliance patterns,and social functioning patterns were predictive factors for the recidivism in violence(P＜0.05).For the joint model,the average value of Akaike information criterion(AIC)for the train set was 776.5±9.4,the average value of root mean squared error(RMSE)for the testing set was 0.168±0.013,and the average value of mean absolute error(MAE)for the testing set was 0.131±0.018,which were all lower than those of the traditional static models.Conclusion Joint modeling is an effective statistical strategy for identifying and processing dynamic variables,exhibiting better predictive performance than that of the traditional static models.It can provide new ideas for promoting the construction of comprehensive intervention systems.

Objective To investigate the status of medication adherence and various types of risky behaviors of schizophrenia patients in a certain area of western China and to explore accordingly the correlation between the two.Methods A total of 292 667 patients with schizophrenia were enrolled in a follow-up survey between 2006 and 2018.In addition,based on the outcome-wide analysis strategy,a multivariate Cox proportional risk regression model was used to estimate and compare the impact of medication adherence on different types of risky behaviors in schizophrenia patients.Results In this 13-year prospective cohort,65 175 patients(31.4％)showed good medication adherence,while 142 394 patients(68.6％)showed poor medication adherence.The incidence rates of various risky behaviors during the follow-up period were as follows,minor nuisances,12.25％,violation of the Law of the People's Republic of China on Penalties for Administration of Public Security(APS law),3.82％,violation of criminal law,0.94％,suicide completed,0.28％,self-harm,1.42％,and attempted suicide,0.82％.Schizophrenia patients who had poor medication adherence had higher risks of committing violence against others and self-inflicted injury compared to patients with good medication adherence did,with the associated effects being minor nuisances(hazard ratio[HR]=1.31,95％confidence interval[CI]:1.27-1.35),violation of APS law(HR=1.47,95％CI:1.38-1.56),violation of criminal law(HR=1.17,95％CI:1.05-1.31),and self-harm(HR=1.43,95％CI:1.32-1.56),respectively,while the risk of suicide completed is lower in schizophrenia patients with poor medication adherence than that in patients with good medication adherence(HR=0.56,95％CI:0.47-0.66).There was no statistically significant association between attempted suicide and medication adherence.Conclusion There are variations in the direction and strength of the association between medication adherence and different types of risky behaviors and further research is needed to elucidate the mechanisms of the association.