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We conducted a community-based cohort study to predict the 3-year occurrence of chronic kidney disease (CKD) among population aged ≥60 years. Participants were selected from two communities through randomized cluster sampling in Jiading District of Shanghai, China. The two communities were randomly divided into a development cohort (n = 12012) and a validation cohort (n = 6248) with a 3-year follow-up. Logistic regression analysis was used to determine the independent predictors. A nomogram was established to predict the occurrence of CKD within 3 years. The area under the curve (AUC), the calibration curve and decision curve analysis (DCA) curve were used to evaluate the model. At baseline, participants in development cohort and validation cohort were with the mean age of 68.24 ± 5.87 and 67.68 ± 5.26 years old, respectively. During 3 years, 1516 (12.6%) and 544 (8.9%) new cases developed CKD in the development and validation cohorts, respectively. Nine variables (age, systolic blood pressure, body mass index, exercise, previous hypertension, triglycerides, fasting plasma glucose, glycated hemoglobin and serum creatinine) were included in the prediction model. The AUC value was 0.742 [95% confidence interval (CI), 0.728–0.756] in the development cohort and 0.881(95%CI, 0.867–0.895) in the validation cohort, respectively. The calibration curves and DCA curves demonstrate an effective predictive model. Our nomogram model is a simple, reasonable and reliable tool for predicting the risk of 3-year CKD in community-dwelling elderly people, which is helpful for timely intervention and reducing the incidence of CKD. [ABSTRACT FROM AUTHOR]

OBJECTIVES Despite excellent 5-year survival, there are limited data on the long-term prognostic characteristics of clinical stage IA part-solid lung adenocarcinoma. The objective was to elucidate the dynamics of prognostic characteristics through conditional survival analysis. METHODS Consecutive patients who underwent complete resection for clinical stage IA part-solid lung adenocarcinoma between 2011 and 2015 were retrospectively reviewed. Conditional survival is defined as the probability of surviving further y years, conditional on the patient has already survived x years. The conditional recurrence-free survival (CRFS) and conditional overall survival (COS) were analysed to evaluate prognosis over time, with conditional Cox regression analysis performed to identify time-dependent prognostic factors. RESULTS A total of 1539 patients were included with a median follow-up duration of 98.4 months, and 80 (5.2%) patients experienced recurrence. Among them, 20 (1.3%) recurrence cases occurred after 5 years of follow-up with 100% intrathoracic recurrence. The 5-year CRFS increased from 95.8% to 97.4%, while the 5-year COS maintained stable. Multivariable Cox analysis revealed that histologic subtype was always an independent prognostic factor for CRFS even after 5 years of follow-up, while the independent prognostic value of consolidation-to-tumour ratio, visceral pleural invasion and lymph node metastasis was observed only within 5 years. Besides, age, pathologic size and lymph node metastasis maintained independent predictive value for COS during long-term follow-up, while consolidation-to-tumour ratio was predictive for COS only within 5 years of follow-up. CONCLUSIONS The independent prognostic factors for clinical stage IA part-solid lung adenocarcinoma changed over time, along with gradually increasing 5-year CRFS and stable 5-year COS. [ABSTRACT FROM AUTHOR]

Objective. Capillary glycated hemoglobin (HbA1c) may enhance screening for childhood prediabetes and diabetes, but variations in this parameter remain unclear. We aimed to develop percentiles of HbA1c and explore the influence of various variables on HbA1c level among Chinese children. Study Design and Methods. The data were derived from the Shanghai Children's Health and Nutrition Community‐based Epidemiologic Survey (CHANCE). A total of 4,615 children aged 3–12 years were included. The capillary HbA1c level was measured using point‐of‐care (POC) testing analyzers. Abnormal HbA1c level was identified as HbA1c (%) value equal to or above the 95th percentile of the nomograms. Results. The mean HbA1c value was 5.30% (SD = 0.50%). The age‐specific 95th percentile thresholds of HbA1c (%) ranged from 5.9 to 6.2 among all children. In the whole participants, body mass index (BMI), total cholesterol (TC), outdoor activity frequency, and daily sleep duration were positively associated with high HbA1c. Among preschool‐aged children, TC and sleep duration ≥10 hr per day were associated with increased risk of being in the higher HbA1c (both P < 0.05). Among the school‐aged group, positive associations with HbA1c levels were identified for TC, living with grandparents, frequency of outdoor activity, and sleep duration (all P < 0.05). Conclusions. The present study established capillary HbA1c percentiles based on a large sample of Chinese children among aged 3–12 years. Daily sleep duration and frequency of outdoor activity, BMI, and TC were found to be associated with high HbA1c. Actions of successful public strategies that focus on promoting a healthy lifestyle, including regular physical exercise to reduce weight among children, are needed. Key Points. We used POC testing for capillary HbA1c with a finger‐stick sample which may offer an opportunity to enhance screening and early diagnosis for childhood and adolescent diabetes, which was suggested as an essential premise to determine the subject's glycemic status by the American Diabetes Association (ADA). Capillary HbA1c levels fluctuate during childhood, while there has been no population‐based study on HbA1c reference values in Chinese youths. [ABSTRACT FROM AUTHOR]

Background: Health literacy is one of the important determinants of healthy aging, yet few studies have focused on the association between health literacy and falls. Aims: This study aims to explore the relationship between health literacy and falls, with a focus on sex differences among older people in China. Methods: This cross-sectional study enrolled 2,144 older people aged ≥ 60 years from Shandong Province, China in 2021. We used general health literacy screening scale to assess health literacy, and collected the incidence of falls in the past year. Logistic regression models were employed to analyze the relationship between health literacy and falls. We investigated the sex differences by subgroup analyses. Results: The prevalence of adequate health literacy and falls was 21.7% (95% CI: 20.0–23.5%) and 25.4% (95% CI: 23.6–27.3%), respectively. In a fully-adjusted model, adequate health literacy was associated with a lower prevalence of falls in older adults (OR = 0.71, 95%CI: 0.52–0.96). Subgroup analysis revealed sex differences in this relationship (Pfor interaction <0.05). Specifically, the female group showed no significant relationship between health literacy and falls (OR = 0.92, 95% CI: 0.59–1.44); however, the male group demonstrated a robust and significant relationship (OR = 0.58, 95% CI: 0.37–0.90). Conclusions: Older people with adequate health literacy have lower prevalence of falls, which appears to differ by sex. This relationship was significant among men but not among women. These findings emphasize the need for policymakers and healthcare providers to consider sex differences when designing and implementing programs aimed at improving health literacy and preventing falls in the older population. Improving health literacy among older women could be a strategic component in bridging sex inequality in falls. [ABSTRACT FROM AUTHOR]