1.Biological Aging Affects the Rate of Cognitive Decline in Middle-aged and Elderly Populations:A Cohort Study Based on CHARLS
Huiyu HE ; Mengling WEI ; Jiao ZHONG ; Juan WANG ; Lei HUANG ; Yajia LAN ; Yang ZHANG
Journal of Sichuan University (Medical Sciences) 2025;56(2):470-477
Objective To investigate the relationship between biological aging and the rate of cognitive decline in middle-aged and elderly populations.Methods Longitudinal tracking data of cognitive function were obtained from the China Health and Retirement Longitudinal Study(CHARLS).We employed the Klemera and Doubal method(KDM)to estimate biological age(BA),and calculate the biological aging index(BAI)and biological aging type(BAT).A multivariate linear regression model was employed to analyze the relationships between baseline BAI,BAT,and cognitive function scores.Based on the baseline analysis,a mixed-effects model was used to examine the longitudinal associations between baseline BAI,BAT,and cognitive function during follow-up.Results A total of 5 897 participants were included in the study.BAI was found to be negatively associated with baseline cognitive function scores,with the partial regression coefficient(β)(95%CI)being-0.185(—0.231,—0.139)(P<0.001).Compared with the lagged aging group,the premature aging group had lower cognitive function scores(β[95%CI]:—0.741[—0.966,—0.516]).For age and sex,for each additional year of baseline BAI,cognitive function scores declined by an average of 0.012(95%CI:—0.019,—0.005)points per year after adjusting for age and sex,and declined by 0.011(95%CI:—0.018,—0.004)points per year after adjusting for other covariates.Compared with participants with lagged aging,those with premature aging experienced,on average,an additional decline of 0.042(95%CI:—0.075,0.009)points per year in cognitive function scores after adjusting for age and sex alone,and by 0.039(95%CI:—0.072,—0.007)points per year after adjusting for other covariates.Conclusion Biological aging affects the rate of cognitive decline in middle-aged and elderly populations.A higher BAI is associated with a faster decline in cognitive function.Compared with those with lagged aging,individuals with premature aging exhibit a more rapid rate of cognitive decline.
2.Relationship between self-perceived noise intensity and sleep quality in noise-exposed workers—A mediating role of negative emotions
Li WANG ; Lei HUANG ; Jingxuan MA ; Kewei ZENG ; Juan WANG ; Yajia LAN
Journal of Environmental and Occupational Medicine 2024;41(5):519-525
Background Studies on the relationships of environmental noise exposure with negative emotions and sleep quality have long been reported. Self-perceived noise intensity is not only related to environmental noise exposure, but also reflects an individual's susceptibility to noise; however, few studies on self-perceived noise intensity, negative emotions, and sleep quality have been reported, and it is not clear whether negative emotions play a mediating role in the relationship between self-perceived noise intensity and sleep quality. Objective To analyze the mediating role of negative emotions (anxiety, depression, and stress) in the relationship between self-perceived noise intensity and sleep quality in noise-exposed workers, and to provide a scientific basis for addressing psychological problems and sleep quality induced by noise exposure. Methods Stratified cluster sampling was used to select noise-exposed workers from a large equipment manufacturing plant in Chengdu from May to June 2023, and demographic characteristics were investigated using a self-designed general information questionnaire; self-perceived noise intensity was reported by the study subjects as the noise intensity of their workplaces; sleep quality was synthesized from three indicators: night sleep duration, self-perceived sleep quality, and sleep-related symptoms; the Anxiety-Depression-Stress Scale (DASS-21 scale) was used to evaluate anxiety, depression, and stress of a worker. Structural equation modeling was used to analyze the pathways of negative emotions (anxiety, depression, and stress) between self-perceived noise intensity and sleep quality. Results The positive rates of negative emotions were 33.1% (anxiety symptoms, 215/649), 26.0% (depression symptoms, 169/649), and 14.0% (stress symptoms, 91/649), respectively in a total of 649 noise-exposed workers. Self-perceived noise intensity was positively correlated with sleep quality score (r=0.218, P<0.001) and negative emotions (anxiety, depression, and stress) (r=0.167, 0.145, 0.167, P<0.001); sleep quality score was positively correlated with negative emotions (anxiety, depression, and stress) (r=0.512, 0.447, 0.513, P<0.001). The results of path analysis showed that the negative emotions (anxiety, depression, and stress) partially mediated between self-perceived noise intensity and sleep quality (β=0.123,P<0.001). Self-perceived noise intensity was positively correlated with negative emotions and sleep quality, and there was a path of self-perceived noise intensity → negative emotion → sleep quality (P<0.001), and the mediating effect accounted for 42.71%. Conclusion The positive rates of anxiety, depression, and stress are high among the noise-receiving workers in this manufacturing industry, and negative emotions characterized by anxiety, depression, and stress partially mediate the relationship between self-perceived noise intensity and sleep quality.
3.Analysis of Risk Factors of Chronic Pulmonary Heart Disease in Patients With Pneumoconiosis
Qing CHEN ; Peng ZHANG ; Xuxi CHEN ; Yanqiu ZOU ; Jiaqiang LIAO ; Qin ZHANG ; Lijun PENG ; Yajia LAN ; Yuqin YAO ; Qiurong HE
Journal of Sichuan University (Medical Sciences) 2024;55(1):167-175
Objective To explore the risk factors for developing chronic pulmonary heart disease in patients with pneumoconiosis.Methods The medical records of pneumoconiosis patients admitted to an occupational disease hospital in Sichuan Province between January 2012 and November 2021 were collected.Kaplan-Meier(K-M)method,or product-limit method,was used to plot the incidence curves of pulmonary heart disease in the pneumoconiosis patients.Cox proportional hazard regression model was used to analyze the influencing factors associated with chronic pulmonary heart disease in patients with pneumoconiosis.Results A total of 885 pneumoconiosis patients were included in this study.The follow-up time was 12 to 115 months and the median follow-up time was 43 months.A total of 138 patients developed chronic pulmonary heart disease and the incidence density of pulmonary heart disease was 38.50/1000 person-years.Multivariate Cox proportional hazard regression analysis showed that the influencing factors of pneumoconiosis inpatients developing chronic pulmonary heart disease included the following,being 50 and older(hazard ratio[HR]=1.85,95%confidence interval[CI]:1.25-2.74),stage Ⅲ pneumoconiosis(HR=2.43,95%CI:1.48-4.01),resting heart rate≥100 beats/min(HR=2.62,95%CI:1.63-4.21),the complication of chronic obstructive pulmonary disease(COPD)(HR=4.52,95%CI:2.12-9.63),underweight(HR=2.40,95%CI:1.48-3.87),overweight and obesity(HR=0.54,95%CI:0.34-0.86),and triacylglycerol(TG)(HR=0.69,95%CI:0.49-0.99).Conclusion Old age,stage Ⅲ pneumoconiosis,high resting heart rate,low BMI,and the complication of COPD are risk factors for chronic pulmonary heart disease in pneumoconiosis patients,while overweight and obesity and TG are protective factors.Early identification of the risk factors and the adoption of the corresponding prevention measures are the key to preventing chronic pulmonary heart disease in patients with pneumoconiosis.
4.Path analysis on relationship among tested hearing thresholds, conscious hearing, and negative emotions in noise-exposed workers
Xiaofang CHEN ; Lei HUANG ; Juan WANG ; Yajia LAN
Journal of Environmental and Occupational Medicine 2023;40(6):667-672
Background The correlation between noise exposure and negative emotions of noise-exposed workers has received increasing attention and related studies have been reported. However, there is a lack of research on the path and effect analysis of the relationship between noise exposure and negative emotions, which will contribute to a more comprehensive understanding of the health damage characteristics of noise in addition to hearing loss. Objective To explore the path and effects of cumulative noise exposure, tested hearing thresholds, and conscious hearing level of noise-exposed workers on negative emotions. Methods Using stratified random sampling, 312 noise-exposed workers from a machinery and equipment manufacturing enterprise were selected. Occupational history, negative emotions (including the feelings of stress, anxiety, and depression), and conscious hearing level of the workers were investigated using the Depression-Anxiety-Stress Scale (DASS-21) and a self-made questionnaire. The hearing threshold of the workers was measured by pure tone air conduction audiometry. Sound level meter was used to measure noise equivalent sound level at selected work sites. Individual cumulative noise exposure was estimated based on work site noise level and personal noise exposure history. Path analysis was used to analyze potential mediating effects of workers' hearing thresholds and conscious hearing levels on the relationship between noise exposure and negative emotions (including stress, anxiety, and depression). Results The positive rates of negative emotions among the 312 noise-exposed workers were 18.27% (57/312) for stress, 46.79% (146/312) for anxiety, and 28.53% (89/312) for depression; the cumulative noise exposure ranged from 101.0 to 136.1 dB(A)·d, with an average of 125.69 dB(A)·d. The distributions of tested hearing thresholds and conscious hearing levels among the workers exposed to noise were significantly inconsistent (P<0.001), with both unweighted and weighted Kappa values less than 0.4. The percentage of workers with conscious hearing levels higher than their hearing threshold levels was 16.0%, and the percentage of workers with conscious hearing levels lower than conscious hearing levels was 38.7%. The path analysis results showed that tested hearing thresholds had no mediating effect on the relationship between cumulative noise exposure and negative emotions. There was a partial mediating effect of conscious hearing level on the relationship between cumulative noise exposure and negative emotions, with a mediating effect value of 0.06 (95%CI: 0.03, 0.11) and a mediating effect ratio of 28.57%. Conclusion Conscious hearing plays a partial mediating role in the relationship between cumulative noise exposure and negative emotions of noise-exposed workers, while tested hearing thresholds do not.
5.Characteristics of blood test indexes in patients with pneumoconiosis complicated with tuberculosis
Na CAO ; Wen DU ; Yajia LAN ; Lijun PENG
Journal of Environmental and Occupational Medicine 2022;39(9):1026-1030
Background The positive rate of sputum bacteria in patients with pneumoconiosis complicated with pulmonary tuberculosis is lower than that in patients with simple tuberculosis, which makes the disease assessment more difficult. Objective To compare the differences of blood test indexes between patients with pneumoconiosis complicated with bacteriologically negative and bacteriologically positive pulmonary tuberculosis, so as to provide a basis for the assessment of lesions in patients with pneumoconiosis complicated with pulmonary tuberculosis. Methods The relevant information of 329 patients with pneumoconiosis complicated with tuberculosis diagnosed from 2010 to 2020 was retrospectively collected, including 260 cases of pneumoconiosis complicated with bacteriologically negative tuberculosis (B-TB) and 69 cases of pneumoconiosis complicated with bacteriologically positive tuberculosis (B+TB). The demographic characteristics and blood test indexes of the two groups of patients were analyzed and compared, and logistic regression analysis was conducted to identify factors associated with pneumoconiosis complicated with bacteriologically positive tuberculosis. Results Body mass index (BMI) was significantly different between the two groups (P<0.05), and the proportion of BMI≤18.5 kg·m−2 in the pneumoconiosis cases with B+TB was higher than those with B-TB. The levels of platelet count, fibrinogen, white blood cell count, neutrophil count, monocyte count, C-reactive protein, erythrocyte sedimentation rate, and D-dimer in the pneumoconiosis cases with B+TB were higher than those in the pneumoconiosis cases with B-TB (P<0.05); the levels of mean platelet volume, hemoglobin, albumin to globulin ratio, and high-density lipoprotein in the pneumoconiosis with B+TB group were lower than that in the pneumoconiosis with B-TB group (P<0.05). The abnormal rates of other indicators except mean platelet volume, fibrinogen, and high-density lipoprotein were higher in the pneumoconiosis with B+TB group than in the pneumoconiosis with B-TB group (P<0.05). The results of multiple logistic regression showed that C-reactive protein (OR=1.006, 95%CI: 1.001-1.010), platelet count (OR=1.004, 95%CI: 1.002-1.007), and monocyte count (OR=3.461, 95%CI: 1.370-8.745) were associated with positive sputum smear in patients with pneumoconiosis complicated with pulmonary tuberculosis (P<0.05). Conclusion Some blood test indexes show differences between pneumoconiosis complicated with bacteriologically positive patients and pneumoconiosis complicated with bacteriologically-negative tuberculosis patients. C-reactive protein, platelet count, and monocyte count are factors associated with sputum positivity in pneumoconiosis complicated with tuberculosis patients. Monitoring selected indicators of blood test have a certain reference value for the assessment of lesions in patients with pneumoconiosis complicated with tuberculosis.
6.The mediating role of worker-occupation fit between occupational stress and anxiety symptoms in medical staff
Ruican SUN ; Keyao LYU ; Guowen FENG ; Qiuyan XU ; Yajia LAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(7):495-500
Objective:To analyze the mediating effect of work-occupation fit between occupational stress and anxiety symptoms in medical staff.Methods:Convenience sampling method was adopted to select participants of one general hospital and three specialized hospitals as respondents for a questionnaire survey in Henan Province from October 2020 to January 2021. A total of 2050 medical staff were investigated, and 1988 valid questionnaires were collected, and the effective rate of the questionnaire was 97.0% (1988/2050) . The "Depression-Anxiety-Stress Scale" and "Worker-Occupation Fit Inventory" were used to evaluate the occupational stress, anxiety symptoms and worker-occupation fit level of medical staff, and the mediation effect of work-occupation fit on the relationship between occupational stress and anxiety symptoms was analyzed using a mediating effect model.Results:The average age of the 1988 medical staff was (32.7±7.8) years old, the positive detection rates of occupational stress and anxiety symptoms were 42.5% (845/1988) and 56.7% (1127/1988) , respectively. Anxiety symptoms of medical staff were positively correlated with occupational stress, negatively correlated with worker-occupation fit ( r=0.831, -0.364, P<0.001) , work-occupation fit was negatively correlated with occupational stress ( r=-0.259, P<0.001) . The results of the mediation effect analysis showed that occupational stress had a direct effect on anxiety symptoms ( β=0.677, BCa 95% CI: 0.648-0.707) , and worker-occupation fit ( β=0.047, BCa 95% CI: 0.039-0.056) , characteristic fit ( β=0.089, BCa 95% CI: 0.074-0.104) , need-supply fit ( β=0.075, BCa 95% CI: 0.062-0.089) , and ability-demand fit ( β=0.035, BCa 95% CI: 0.026-0.044) mediated the association between occupational stress and anxiety symptoms in medical staff, with the mediating effect as a percentage of 6.5%, 12.3%, 10.3%, and 4.8%, respectively. Conclusion:Worker-occupation fit has a mediating effect between occupational stress and anxiety symptoms in medical staff, but mainly direct effect.
7.The mediating role of worker-occupation fit between occupational stress and anxiety symptoms in medical staff
Ruican SUN ; Keyao LYU ; Guowen FENG ; Qiuyan XU ; Yajia LAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(7):495-500
Objective:To analyze the mediating effect of work-occupation fit between occupational stress and anxiety symptoms in medical staff.Methods:Convenience sampling method was adopted to select participants of one general hospital and three specialized hospitals as respondents for a questionnaire survey in Henan Province from October 2020 to January 2021. A total of 2050 medical staff were investigated, and 1988 valid questionnaires were collected, and the effective rate of the questionnaire was 97.0% (1988/2050) . The "Depression-Anxiety-Stress Scale" and "Worker-Occupation Fit Inventory" were used to evaluate the occupational stress, anxiety symptoms and worker-occupation fit level of medical staff, and the mediation effect of work-occupation fit on the relationship between occupational stress and anxiety symptoms was analyzed using a mediating effect model.Results:The average age of the 1988 medical staff was (32.7±7.8) years old, the positive detection rates of occupational stress and anxiety symptoms were 42.5% (845/1988) and 56.7% (1127/1988) , respectively. Anxiety symptoms of medical staff were positively correlated with occupational stress, negatively correlated with worker-occupation fit ( r=0.831, -0.364, P<0.001) , work-occupation fit was negatively correlated with occupational stress ( r=-0.259, P<0.001) . The results of the mediation effect analysis showed that occupational stress had a direct effect on anxiety symptoms ( β=0.677, BCa 95% CI: 0.648-0.707) , and worker-occupation fit ( β=0.047, BCa 95% CI: 0.039-0.056) , characteristic fit ( β=0.089, BCa 95% CI: 0.074-0.104) , need-supply fit ( β=0.075, BCa 95% CI: 0.062-0.089) , and ability-demand fit ( β=0.035, BCa 95% CI: 0.026-0.044) mediated the association between occupational stress and anxiety symptoms in medical staff, with the mediating effect as a percentage of 6.5%, 12.3%, 10.3%, and 4.8%, respectively. Conclusion:Worker-occupation fit has a mediating effect between occupational stress and anxiety symptoms in medical staff, but mainly direct effect.
8.Summary and prospect of early warning models and systems for infectious disease outbreaks
Shengjie LAI ; Luzhao FENG ; Zhiwei LENG ; Xin LYU ; Ruiyun LI ; Ling YIN ; Wei LUO ; Zhongjie LI ; Yajia LAN ; Weizhong YANG
Chinese Journal of Epidemiology 2021;42(8):1330-1335
This paper summarizes the basic principles and models of early warning for infectious disease outbreaks, introduces the early warning systems for infectious disease based on different data sources and their applications, and discusses the application potential of big data and their analysing techniques, which have been studied and used in the prevention and control of COVID-19 pandemic, including internet inquiry, social media, mobile positioning, in the early warning of infectious diseases in order to provide reference for the establishment of an intelligent early warning mechanism and platform for infectious diseases based on multi-source big data.
9.Establishment of multi-point trigger and multi-channel surveillance mechanism for intelligent early warning of infectious diseases in China
Weizhong YANG ; Yajia LAN ; Wei LYU ; Zhiwei LENG ; Luzhao FENG ; Shengjie LAI ; Chuchu YE ; Qing WANG
Chinese Journal of Epidemiology 2020;41(11):1753-1757
This paper reviews the limitations of current infectious disease surveillance and early warning system in China, analyzes the concepts and countermeasures of the establishment of an intelligent early warning platform of infectious diseases based on multi-point trigger mechanism and multi-channel surveillance mechanism and proposes the realization routes for the purpose of facilitating capacity building and improvement of surveillance and early warning of infectious diseases in China.
10.The correlation between worker-occupation fit and occupational stress in nurses
Chinese Journal of Preventive Medicine 2020;54(11):1197-1201
Objective:To explore the relationship between the worker-occupation fit and occupational stress in nurses.Methods:Convenience sampling method was used to collect 1 463 nurses from one general hospital and three specialized hospitals from July to October 2019. Depression-anxiety-stress scale (DASS-21) was used to assess the level of occupational stress. Pearson correlation and multivariate logistic regression model were used to analyze the relationship between the worker-occupation fit and occupational stress.Results:The average age of 1 463 nurses was (31.8±7.2) years, and 92.3% ( n=1 350) of nurses were female. 47.2% ( n=690) of nurses had occupational stress and the mean score of worker-occupation fit was (34.4±6.1). The worker-occupation fit and occupational stress had a significant negative correlation ( r=-0.472, P<0.001). The moderate and high level of the worker-occupation fit, characteristic fit, need supply fit, and demand ability fit had protective effects on occupational stress based on the outcome of multivariate logistic regression model [ OR(95% CI) were 0.40 (0.28-0.59), 0.16 (0.10-0.24); 0.32 (0.22-0.47), 0.18 (0.11-0.20); 0.33 (0.21-0.52), 0.18 (0.11-0.30); 0.59 (0.37-0.9), 0.54 (0.38-0.78), respectively]. Conclusion:The worker-occupation fit and different types of fit, including characteristic fit, need supply fit, and demand ability fit, could be associated with the occupational stress.

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