Suboptimal health status (SHS) is the third state between good health and disease. SHS is the clinical or pre-disease status of psychosomatic disease and a major global public health challenge. Although its underlying causes remain unclear, lifestyle is one of the most important factors affecting health status. A cross-sectional survey was conducted at Renmin University of China in September of 2015. Data were collected from college freshmen using a questionnaire covering characteristics, lifestyle, nutrition status, and health status. A total of 6025 questionnaires were distributed during the study period, and 5344 completed responses were received. The prevalence rates for the “healthy,” “SHS,” and “disease” groups of college freshmen were 46.7% (2433), 51.2% (2667), and 2.1% (111), respectively. It is notable that health status was significantly positively correlated with lifestyle (Spearman’s r = 0.4435, p < 0.001). The multivariate Logistic regression results showed that students who were relatively younger and students from rural areas had a higher percentage of SHS. Good sleep quality (aOR = 0.650, 95%CI = 0.612–0.690), abundant physical exercise (aOR = 0.889, 95%CI = 0.845–0.933), and adequate nutrition intake (aOR = 0.868, 95%CI = 0.864–0.908) are negatively associated with SHS. Overuse of electronic devices (aOR = 1.066, 95%CI = 1.013–1.121), smoking (aOR = 1.824, 95%CI = 1.195–2.755), and weight loss (aOR = 1.255, 95%CI = 1.043–1.509) are positively associated with SHS. Poor lifestyle behaviors are associated with SHS. In particular, the overuse of electronic devices is one of underlying causes of SHS. By altering lifestyle behaviors for the better, the health statuses of these college freshmen can be effectively improved.

Summary: This paper is concerned with the problem of comparing the population means of two groups of independent observations. An approximate randomization test procedure based on the test statistic of Chen & Qin (2010) is proposed. The asymptotic behaviour of the test statistic, as well as the randomized statistic, is studied under weak conditions. In our theoretical framework, observations are not assumed to be identically distributed even within groups. No condition on the eigenstructure of the covariance matrices is imposed. Furthermore, the sample sizes of the two groups are allowed to be unbalanced. Under general conditions, all possible asymptotic distributions of the test statistic are obtained. We derive the asymptotic level and local power of the approximate randomization test procedure. Our theoretical results show that the proposed test procedure can adapt to all possible asymptotic distributions of the test statistic, always has the correct test level asymptotically and has good power behaviour. Our numerical experiments show that the proposed test procedure has favourable performance compared with several alternative test procedures.

Background It has been reported that strict non-pharmaceutical measures can significantly reduce the incidence and mortality of respiratory and intestinal infectious diseases during the COVID-19 pandemic, but there are limited reports on the impact in terms of the rates of zoonotic diseases. Methods We extracted the incidence and mortality data of eight notifiable infectious zoonotic diseases from the website of the National Health Commission of the People’s Republic of China for the period of January 2015 to April 2021. Results First, the overall incidence of zoonotic diseases decreased from 0.3714 per 100 000 in 2015–2019 to 0.2756 in 2020 (25.79% reduction, p<0.001); however, a dramatic increase in activity was seen in 2021 compared with 2020 (0.4478 per 100 000 in 2021, 62.47% increase, p<0.001). Anthrax, brucellosis, leptospirosis and hydatid disease exhibited significant upward trends in 2021. Second, analysed further by stages, the monthly incidence in the routine stage (from May to December 2020) was much higher than that in the emergency stage of the COVID-19 (from January to April 2020) (55.33% increase, p<0.001). We also found that the monthly observed incidence was significantly lower than the predicted incidence of a 10.29% reduction in the emergency stage. Third, no differences were seen in mortality between 2021 and 2020, while a significant decline was found in 2020 compared with the previous 5 years (72.70%, p<0.001). Conclusions Strict containment and feasible suppression strategies during the 2020 period of the COVID-19 pandemic had positive impacts on the overall incidence of zoonotic diseases in China. However, anthrax, brucellosis, leptospirosis and hydatid diseases might increase with the relaxation of non-pharmacological interventions in 2021.

Background: This study explored the effect of a continuous mitigation and containment strategy for coronavirus disease 2019 (COVID-19) on five vector-borne diseases (VBDs) in China from 2020 to 2021. Methods: Data on VBDs from 2015 to 2021 were obtained from the National Health Commission of the People’s Republic of China, and the actual trend in disease activity in 2020–2021 was compared with that in 2015–2019 using a two-ratio Z-test and two proportional tests. Similarly, the estimated trend in disease activity was compared with the actual trend in disease activity in 2020. Results: There were 13,456 and 3684 average yearly cases of VBDs in 2015–2019 and 2020, respectively. This represents a decrease in the average yearly incidence of total VBDs of 72.95% in 2020, from 0.9753 per 100,000 population in 2015–2019 to 0.2638 per 100,000 population in 2020 (t = 75.17, P < 0.001). The observed morbidity rates of the overall VBDs were significantly lower than the predicted rates (47.04% reduction; t = 31.72, P < 0.001). The greatest decline was found in dengue, with a 77.13% reduction (observed rate vs predicted rate: 0.0574 vs. 0.2510 per 100,000; t = 41.42, P < 0.001). Similarly, the average yearly mortality rate of total VBDs decreased by 77.60%, from 0.0064 per 100,000 population in 2015–2019 to 0.0014 per 100,000 population in 2020 (t = 6.58, P < 0.001). A decreasing trend was also seen in the monthly incidence of total VBDs in 2021 compared to 2020 by 43.14% (t = 5.48, P < 0.001). Conclusions: The results of this study verify that the mobility and mortality rates of VBDs significantly decreased from 2015–2019 to 2020–2021, and that they are possibly associated to the continuous COVID-19 mitigation and contamination strategy implemented in China in 2020–2021. Graphical

The public health interventions to mitigate coronavirus disease 2019 (COVID‐19) could also potentially reduce the global activity of influenza. However, this strategy's impact on other common infectious diseases is unknown. We collected data of 10 respiratory infectious (RI) diseases, influenza‐like illnesses (ILIs), and seven gastrointestinal infectious (GI) diseases during 2015–2020 in China and applied two proportional tests to check the differences in the yearly incidence and mortality, and case‐fatality rates (CFRs) over the years 2015–2020. The results showed that the overall RI activity decreased by 7.47%, from 181.64 in 2015–2019 to 168.08 per 100 000 in 2020 (p < 0.001); however, the incidence of influenza was seen to have a 16.08% escalation (p < 0.001). In contrast, the average weekly ILI percentage and positive influenza virus rate decreased by 6.25% and 61.94%, respectively, in 2020 compared to the previous 5 years (all p < 0.001). The overall incidence of GI decreased by 45.28%, from 253.73 in 2015–2019 to 138.84 in 2020 per 100 000 (p < 0.001), and with the greatest decline seen in hand, foot, and mouth disease (HFMD) (64.66%; p < 0.001). The mortality and CFRs from RI increased by 128.49% and 146.95%, respectively, in 2020, compared to 2015–2019 (p < 0.001). However, the mortality rates and CFRs of seven GI decreased by 70.56% and 46.12%, respectively (p < 0.001). In conclusion, China's COVID‐19 elimination/containment strategy is very effective in reducing the incidence rates of RI and GI, and ILI activity, as well as the mortality and CFRs of GI diseases.