Objective To compare six existing Chinese standards related to visual disability,including Disability Assessment and Code for Life Insurance(Insurance Standard),Specification for Ability Assessment of Older Adults(Elderly Stan-dard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disability Classification Standard).Methods Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF)and International Classification of Diseases,the 11th Revision(ICD-11),and with reference to World Report on Vision(WRV),this study analyzed and compared five key dimensions of visual disability across the six stan-dards:definition,classification,grading,assessment methods and coding systems.Results In terms of definition,the insurance,work injury,military,and disability classification standards emphasized vi-sual structure and function,focusing on visual acuity and visual field;the insurance and elderly standards incor-porated activities and participation,reflecting the concept of functional vision;the judicial standard lacked a dedi-cated definition of visual disability.In terms of grading,each standard graded visual disability into different lev-els acoording to different functional indicators.In terms of coding,only the insurance standard adopted the ICF framework,while others used non-ICF numeric codes or lacked standardized coding.In terms of assessment tools,the elderly standard employed a customized perceptual and participation scoring system,while others re-lied primarily on vision charts.Conclusion Most current Chinese standards focus on impairments in visual function,with limited attention to activity limitations and participation restrictions.It is needed for incorporating the concept of functional vision,aligned with ICF and WRV,to establish a unified conceptual framework,terminology,coding system for visual disability,and comprehensive assessments that reflect not only impairments but also the impact on daily functioning and en-vironmental interaction.

Objective Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF),this paper compared the classification and grading methods of disability standards in four areas in China,focusing on definition,classification,grading,coding systems and assessment tools.Methods Four disability standards including Disability Assessment and Code for Life Insurance(insurance standard),Classification of Disability Degrees for Human Body Injury(judicial standard),Grading of Disability for Work-Related Injuries and Occupational Diseases(work-related injury standard),and Classification and Grading of Dis-abilities for Persons with Disabilities(disability eligibility standard)were systematically analyzed.Each standard was reviewed to identify core elements of disability definitions,classification,and grading methods.Content analysis was used to extract and compare the definitions,classification,grading,coding systems,and assessment tools.The strengths,weaknesses,and practical limitations of each standard were analyzed using the ICF frame-work.Results There were different in disability definitions,classification and grading,coding systems,and assessment tools across the standards.In terms of definitions,the insurance standard emphasized ICF's body structure and function impairments;the judicial standard defined disability as limitations in life and work capacity due to bodily injury,covering ICF's body structure and function,activity and participation;the work-related injury standard focused on loss of labor capacity due to work-related injuries,involving body structure and function,activity and partici-pation;the disability eligibility standard refered to the ICF model,defining disability as impairments in body function and structure,and activity limitations and participation restriction.Regarding classification and grading,the insurance standard divided disabilities into eight categories based on body structure and function,with ten grades of disability severity;the judicial standard first graded disabilities into ten levels and then classified as in-jury site;the work-related injury standard divided disabilities into five categories based on clinical disciplines,grading from one to ten;the disability eligibility standard divided disabilities into seven categories,each with four grades.For coding systems and assessment tools,the insurance standard used ICF coding system,while the disability standard for persons with disabilities used a numerical coding system other from ICF,and the other standards did not use coding systems.Assessment tools varied significantly.The use of World Health Organiza-tion Disability Assessment Schedule(WHODAS 2.0)was proposed but not applying it in grading.Conclusion This study has systematically compared and analyzed four typical disability-related standards in China using the ICF framework.Personal Insurance Disability Assessment and Coding,Grading of Disability Caused by Bodily Injury,and Classification and Grading of Disabilities for Persons with Disabilities are all promulgated af-ter 2011,and adopt ICF concepts and methods to define and classify disabilities,considering body function and structure,activity and participation,and environmental factors.However,due to different purposes,their grading methods and levels vary:except for Classification and Grading of Disabilities for Persons with Disabilities,which uses a four-level grading system,the other standards use a ten-level system,primarily based on body func-tion and structure.In disability assessment,the recommended methods differ by category,showing significant variability.Due to differing classification and grading methods,disability data from various standards are lack in comparability.The international trend advocates for a unified disability standard framework based on ICF and ICD-11 to enhance the comparability and exchangeability of disability data.

Objective Utilizing the International Classification of Functioning,Disability and Health(ICF)framework and Interna-tional Classification of Diseases,the 11th Revision(ICD-11)system,alongside evidence from World Health Or-ganization(WHO)global reports and technical reports from relevant countries,this study systematically exam-ines the definitions,classifications,grading,and assessment methods for visual,hearing,speech,physical,intel-lectual,and mental(psychiatric)disabilities.Methods Employing the ICF's biopsychosocial model,classification,and coding system and ICD-11,and referencing WHO global reports and national technical reports,this study systematically investigated the definitions,classifi-cations,grading and assessment approaches for six prevalent disabilities:visual,hearing,speech,physical,intel-lectual and mental.Results The ICF and ICD-11model and classification system offered a robust framework for defining,classifying,grad-ing and assessing disabilities.Disability definitions should address body function impairments,activity limita-tions,participation restrictions and environmental factors.The definitions,classifications and grading of visual,hearing,speech,physical,intellectual and mental disabilities aligned with ICF categories for body functions and structures,activities and participation and categories of ICD-11.Standardized tools like the WHO Disability As-sessment Schedule(WHODAS 2.0)effectively measured overall activity and participation levels.Conclusion Anchored in the ICF and ICD-11 framework,disabilities are defined,classified,graded and assessed across body functions and structure,activities and participation,and environmental factors.WHODAS 2.0 serves as a universal tool for assessing activities and participation,enabling both comprehensive functional evaluations and the conversion of results from other assessment tools.By analyzing WHO global reports and technical documents in some countries within the ICF and ICD-11 classifications framework,this study highlights global advance-ments in disability definitions,classifications,grading and assessments.Variations in disability statistics stem from differing definitions,diagnostic criteria and assessments.Disability service eligibility criteria should be tai-lored to the needs of recipients and the capacity of providers.

Objective To compare six existing Chinese standards related to visual disability,including Disability Assessment and Code for Life Insurance(Insurance Standard),Specification for Ability Assessment of Older Adults(Elderly Stan-dard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disability Classification Standard).Methods Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF)and International Classification of Diseases,the 11th Revision(ICD-11),and with reference to World Report on Vision(WRV),this study analyzed and compared five key dimensions of visual disability across the six stan-dards:definition,classification,grading,assessment methods and coding systems.Results In terms of definition,the insurance,work injury,military,and disability classification standards emphasized vi-sual structure and function,focusing on visual acuity and visual field;the insurance and elderly standards incor-porated activities and participation,reflecting the concept of functional vision;the judicial standard lacked a dedi-cated definition of visual disability.In terms of grading,each standard graded visual disability into different lev-els acoording to different functional indicators.In terms of coding,only the insurance standard adopted the ICF framework,while others used non-ICF numeric codes or lacked standardized coding.In terms of assessment tools,the elderly standard employed a customized perceptual and participation scoring system,while others re-lied primarily on vision charts.Conclusion Most current Chinese standards focus on impairments in visual function,with limited attention to activity limitations and participation restrictions.It is needed for incorporating the concept of functional vision,aligned with ICF and WRV,to establish a unified conceptual framework,terminology,coding system for visual disability,and comprehensive assessments that reflect not only impairments but also the impact on daily functioning and en-vironmental interaction.

Objective Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF),this paper compared the classification and grading methods of disability standards in four areas in China,focusing on definition,classification,grading,coding systems and assessment tools.Methods Four disability standards including Disability Assessment and Code for Life Insurance(insurance standard),Classification of Disability Degrees for Human Body Injury(judicial standard),Grading of Disability for Work-Related Injuries and Occupational Diseases(work-related injury standard),and Classification and Grading of Dis-abilities for Persons with Disabilities(disability eligibility standard)were systematically analyzed.Each standard was reviewed to identify core elements of disability definitions,classification,and grading methods.Content analysis was used to extract and compare the definitions,classification,grading,coding systems,and assessment tools.The strengths,weaknesses,and practical limitations of each standard were analyzed using the ICF frame-work.Results There were different in disability definitions,classification and grading,coding systems,and assessment tools across the standards.In terms of definitions,the insurance standard emphasized ICF's body structure and function impairments;the judicial standard defined disability as limitations in life and work capacity due to bodily injury,covering ICF's body structure and function,activity and participation;the work-related injury standard focused on loss of labor capacity due to work-related injuries,involving body structure and function,activity and partici-pation;the disability eligibility standard refered to the ICF model,defining disability as impairments in body function and structure,and activity limitations and participation restriction.Regarding classification and grading,the insurance standard divided disabilities into eight categories based on body structure and function,with ten grades of disability severity;the judicial standard first graded disabilities into ten levels and then classified as in-jury site;the work-related injury standard divided disabilities into five categories based on clinical disciplines,grading from one to ten;the disability eligibility standard divided disabilities into seven categories,each with four grades.For coding systems and assessment tools,the insurance standard used ICF coding system,while the disability standard for persons with disabilities used a numerical coding system other from ICF,and the other standards did not use coding systems.Assessment tools varied significantly.The use of World Health Organiza-tion Disability Assessment Schedule(WHODAS 2.0)was proposed but not applying it in grading.Conclusion This study has systematically compared and analyzed four typical disability-related standards in China using the ICF framework.Personal Insurance Disability Assessment and Coding,Grading of Disability Caused by Bodily Injury,and Classification and Grading of Disabilities for Persons with Disabilities are all promulgated af-ter 2011,and adopt ICF concepts and methods to define and classify disabilities,considering body function and structure,activity and participation,and environmental factors.However,due to different purposes,their grading methods and levels vary:except for Classification and Grading of Disabilities for Persons with Disabilities,which uses a four-level grading system,the other standards use a ten-level system,primarily based on body func-tion and structure.In disability assessment,the recommended methods differ by category,showing significant variability.Due to differing classification and grading methods,disability data from various standards are lack in comparability.The international trend advocates for a unified disability standard framework based on ICF and ICD-11 to enhance the comparability and exchangeability of disability data.

Objective Utilizing the International Classification of Functioning,Disability and Health(ICF)framework and Interna-tional Classification of Diseases,the 11th Revision(ICD-11)system,alongside evidence from World Health Or-ganization(WHO)global reports and technical reports from relevant countries,this study systematically exam-ines the definitions,classifications,grading,and assessment methods for visual,hearing,speech,physical,intel-lectual,and mental(psychiatric)disabilities.Methods Employing the ICF's biopsychosocial model,classification,and coding system and ICD-11,and referencing WHO global reports and national technical reports,this study systematically investigated the definitions,classifi-cations,grading and assessment approaches for six prevalent disabilities:visual,hearing,speech,physical,intel-lectual and mental.Results The ICF and ICD-11model and classification system offered a robust framework for defining,classifying,grad-ing and assessing disabilities.Disability definitions should address body function impairments,activity limita-tions,participation restrictions and environmental factors.The definitions,classifications and grading of visual,hearing,speech,physical,intellectual and mental disabilities aligned with ICF categories for body functions and structures,activities and participation and categories of ICD-11.Standardized tools like the WHO Disability As-sessment Schedule(WHODAS 2.0)effectively measured overall activity and participation levels.Conclusion Anchored in the ICF and ICD-11 framework,disabilities are defined,classified,graded and assessed across body functions and structure,activities and participation,and environmental factors.WHODAS 2.0 serves as a universal tool for assessing activities and participation,enabling both comprehensive functional evaluations and the conversion of results from other assessment tools.By analyzing WHO global reports and technical documents in some countries within the ICF and ICD-11 classifications framework,this study highlights global advance-ments in disability definitions,classifications,grading and assessments.Variations in disability statistics stem from differing definitions,diagnostic criteria and assessments.Disability service eligibility criteria should be tai-lored to the needs of recipients and the capacity of providers.

AIM:Bone morphogenetic protein 7(BMP7)reduces the expression of Yes-related protein 1(YAP1)by down-regulating Ajuba level and decreasing extracellular matrix(ECM)deposition.This study aimed to inves-tigate the influence of these factors on modifying the degree of renal fibrosis in rats with diabetic nephropathy.METH-ODS:Eighteen Sprague-Dawley(SD)rats were randomly divided into three groups:the normal control(NC)group,the diabetes mellitus(DM)group,and the DM group treated with BMP7 overexpressing adeno-associated virus(DM+rAAV-BMP7).Each group consisted of six rats.Diabetic kidney disease(DKD)was established in the DM and DM+rAAV-BMP7 groups by injecting 55 mg/kg streptozotocin(STZ)via the tail vein.NRK-52E cells were divided into three groups:the normal glucose(NG)group,the high glucose(HG)group,and the high glucose group treated with recombinant hu-man BMP7(HG+rhBMP7)group.Pathological changes in renal tissues were observed using hematoxylin and eosin(HE)and Sirius red staining.Immunohistochemical staining was performed to examine the expression sites of Ajuba and YAP1 in the renal cortex.Western blot analysis was conducted to determine the expression levels of BMP7,Ajuba,YAP1,colla-gen type Ⅲ(Col-Ⅲ),and fibronectin(FN)in the rat renal cortex and NRK-52E cells.RT-qPCR was used to measure the mRNA levels of Ajuba and YAP1 in the rat renal cortex.RESULTS:Biochemical indices revealed significantly ele-vated levels of blood glucose,serum creatinine,triglycerides,total cholesterol,and 24-hour urinary protein in the DM group compared to the NC group(P<0.05).In the DM+rAAV-BMP7 group,the levels of serum creatinine,24-hour uri-nary protein,triglycerides,and total cholesterol were lower than those in the DM group(P<0.05).Pathological staining demonstrated that the renal interstitium of the DM group exhibited inflammatory cell infiltration,fibrous tissue,collagen fi-ber deposition,disordered renal tubule arrangement,atrophy,and vacuolar degeneration,which were ameliorated in the DM+rAAV-BMP7 group.Immunohistochemistry revealed that Ajuba and YAP1 were mainly expressed in the cytoplasm and nucleus,with high expression in the cytoplasm of the DM group,which was significantly decreased in the DM+rAAV-BMP7 group.Western blot results indicated that the protein levels of FN,Col-Ⅲ,Ajuba,and YAP1 were up-regulated in the DM and the HG groups(P<0.05),but significantly down-regulated in the DM+rAAV-BMP7 group(P<0.05).RT-qP-CR results demonstrated that the mRNA levels of Ajuba and YAP1 were higher in the DM group and significantly lower in the DM+rAAV-BMP7 group(P<0.05).CONCLUSION:The overexpression of BMP7 can ameliorate renal fibrosis in rats with DKD.This effect is likely mediated by the down-regulation of Ajuba,reduction of YAP1 expression,and subse-quent inhibition of ECM deposition.

Objective To construct the theoretical framework of rehabilitation big data based on International Classification of Func-tioning,Disability and Health(ICF). Methods Drawing upon international rehabilitation policy documents,such as the World Health Organization's Rehabili-tation in health systems;Rehabilitation in health systems:guide for action;Rehabilitation indicator menu:a tool accompanying the Framework for Rehabilitation Monitoring and Evaluation(FRAME);Template for Rehabilita-tion Information Collection(TRIC):a tool accompanying the Systematic Assessment of Rehabilitation Situation(STARS);and Framework and Standards for Country Health Information Systems;this study examined the com-position and function of rehabilitation big data.The content structure of the rehabilitation big data domain was an-alyzed using the World Health Organization Family of International Classifications(WHO-FICs).Furthermore,the generation patterns of rehabilitation big data was constructed drawing on the Health Metrics Network and big data hierarchical classification. Results Within the six primary elements of the health service system,the information system element was particularly significant,encompassing a substantial branch known as rehabilitation big data.There were three components of rehabilitation big data:health condition,health-related factors and health services.The content framework for this data was derived from the WHO-FICs framework,which covered three dimensions:health and function,dis-ease and function,and disease,function and intervention.A comprehensive model for generating and applying re-habilitation big data in rehabilitation services was developed in line with the requirements for constructing big da-ta architectures.The sources of this data included population censuses,social registration information,population surveys,resources,services and personal records.The result chain of rehabilitation big data encompassed five major processes:input,process,output,outcome and impact.The processing and utilization of this data involved collection,storage,management,analysis and application. Conclusion A theoretical framework for rehabilitation big data has been constructed based on the ICF theory.

Objective To explore and organize the standards of rehabilitation big data. Methods The connotation and extension of rehabilitation big data were discussed based on International Classification of Functioning,Disability and Health(ICF)framework.Referring to the documents of Guidance on the analysis and use of routine health information systems rehabilitation module,Rehabilitation in health systems:guide for action,Rehabilitation indicator menu:a tool accompanying the Framework for Rehabilitation Monitoring and Evaluation(FRAME),and Data quality assurance.Module 1.Framework and metrics,the sources,patterns,clas-sification systems and coding standards were discussed under the ICF theory,and the metadata standards were ex-plored.The application and management of rehabilitation big data standards were discussed according to Nation-al Health Medical Big Data Standards,Security and Service Management Measures(Trial). Results The rehabilitation big data included rehabilitation service data and personal health data,coming from population-based and institution-based data,covering macro,meso and micro levels.The pattern of rehabilitation data flow corresponded to the interaction and source of the entire process of rehabilitation service,to organize and manage rehabilitation big data.The classification system included object classes,object feature classes,participant role classes,relationship classes,and activity and event classes,each of which was further subdivided into subcatego-ries to cover the entities,features,roles,relationships and activities involved in the rehabilitation process.The metadata standards included three levels:core,general and specialized metadata,ensuring standardized manage-ment,sharing and interoperability of rehabilitation data. Conclusion This study delves into the standardization of rehabilitation big data based on the ICF framework,encompass-ing multiple dimensions such as the connotation and extension of rehabilitation big data,data sources,data mod-els,classification systems,coding standards,and metadata standards.The construction of a rehabilitation big data standard system involves standardization efforts in various aspects,including data content,data structure,data coding,and metadata.These standards not only adhere to the norms of data flow,but also take into account the complexity of data composition.This system aligns with health big data standards,ensuring data consistency,ac-curacy,and interoperability,thus providing a foundation for effective exchange and comparison between different data sources.The establishment of a rehabilitation big data standard system not only ensures the standardized pro-cessing of rehabilitation big data,but also lays a solid foundation for effective exchange between rehabilitation big data and other health data,as well as for the widespread application of rehabilitation big data.This provides crucial support for improving the quality and efficiency of rehabilitation services,ensuring that patients receive appropriate care,rehabilitation and support.It holds significant theoretical and practical implications for promot-ing the development of the rehabilitation field.

ObjectiveTo systematically analyze international disability data policies and standards, as well as the application of disability data in policymaking, service optimization and inclusive social development, and to clarify the importance of international disability data policies, standard systems and disability data application for the development of disability-related services. MethodsThrough the analysis of policy content and research on the data standard system, this study explored the disability data policy framework, standard system and technical path of data interoperability and integration of international organizations including the United Nations (United Nations Statistics Division and United Nations Children's Fund), World Health Orgnization, United Nations Educational Scientific and Cultural Organization, and International Labour Organization. ResultsInternational organizations established disability data policy frameworks based on their respective mandates, involving data and service development, data standards, data governance, and data application. The international community established a disability data standard system for disability data collection, coding, exchange, interoperability, statistical analysis, data fusion and application. Building a standardized disability data standard system based on the framework of international health classification standards such as International Classification of Functioning, Disability and Health, and International Classification of Diseases, Eleventh Revision would ensure the consistency of cross-national disability data policies, and the interoperability and comparability of disability data, promoting the development of data-driven disability-related services, accurately identifying the service needs of people with disabilities, and optimizing service provision, thereby improving the quality of life and social participation of people with disabilities. ConclusionThe construction and implementation of international disability data policies and data standards have promoted the standardization and interoperability of disability data. With the application of big data, artificial intelligence and blockchain technologies in disability data, international cooperation and cross-industry data fusion in the field of disability data have been promoted, further promoting the development of data-driven disability services, ensuring equal opportunities for people with disabilities to enjoy service resources, and improving the coverage and quality of disability services.