Background: During the outbreak of COVID-19, numerous rumors emerged on the internet in China and caused confusion among the public. However, the characteristics of these rumors in different phases of the epidemic have not been studied in depth, and the official responses to the rumors have not been systematically evaluated. Objective: The aims of this study were to evaluate the rumor epidemic and official responses during the COVID-19 outbreak in China and to provide a scientific basis for effective information communication in future public health crises. Methods: Data on internet rumors related to COVID-19 were collected via the Sina Weibo Official Account to Refute Rumors between January 20 and April 8, 2020, extracted, and analyzed. The data were divided into five periods according to the key events and disease epidemic. Different classifications of rumors were described and compared over the five periods. The trends of the epidemic and the focus of the public at different stages were plotted, and correlation analysis between the number of rumors and the number of COVID-19 cases was performed. The geographic distributions of the sources and refuters of the rumors were graphed, and analyses of the most frequently appearing words in the rumors were applied to reveal hotspots of the rumors. Results: A total of 1943 rumors were retrieved. The median of the response interval between publication and debunking of the rumors was 1 day (IQR 1-2). Rumors in text format accounted for the majority of the 1943 rumors (n=1241, 63.9%); chat tools, particularly WeChat (n=1386, 71.3%), were the most common platform for initial publishing of the rumors (n=1412, 72.7%). In addition to text rumors, Weibo and web pages were more likely to be platforms for rumors released in multimedia formats or in a combination of formats, respectively. Local agencies played a large role in dispelling rumors among social media platforms (1537/1943, 79.1%). There were significant differences in the formats and origins of rumors over the five periods (P<.001). Hubei Province accounted for most of the country’s confirmed rumors. Beijing and Wuhan City were the main centers for debunking of disinformation. The words most frequently included in the core messages of the rumors varied by period, indicating shifting in the public’s concern. Conclusions: Chat tools, particularly WeChat, became the major sources of rumors during the COVID-19 outbreak in China, indicating a requirement to establish rumor monitoring and refuting mechanisms on these platforms. Moreover, targeted policy adjustments and timely release of official information are needed in different phases of the outbreak.

Evidence of associations between type-specific bullying victimization and suicidal ideation and suicide attempt among adolescents is scant. This study examined these associations among middle and high school students in China. A cross-sectional study of 27,030 students with mean age of 15.7 ± 1.7 years, including 13,946 boys and 13,084 girls, was carried out between April and June 2022. The prevalence of suicidal ideation and attempt was 19.7 % and 2.9 %, respectively. 30.0 % (95%CI: 28.8-31.1) of students reported being bullied (i.e., bullying victimization) in the past 30 days, and the corresponding figs. (95%CI) for verbal bullying, relational bullying, property-related bullying, physical bullying, and cyberbullying were 11.0 % (10.4-11.7), 2.8 % (2.5-3.0), 1.9 % (1.7-2.2), and 5.7 % (5.3-6.0), respectively. After adjustment for socio-demographic status, lifestyle factors, academic performance, self-reported health and mental health, compared to those who reported not being bullied in the past 30 days, the odds ratios (95%CI) for suicidal ideation and suicide attempt among students who reported being bullied were 1.75 (1.60-1.90) and 2.01 (1.63-2.52), respectively. The corresponding odds ratios (95%CI) for verbal bullying were 1.77 (1.61-1.93) and 2.09 (1.67-2.61), respectively, for relational bullying were 1.77 (1.57-2.00) and 2.31 (1.79-2.98), respectively, for property-related bullying were 1.88 (1.48-2.37) and 2.44 (1.60-3.70), respectively, for physical bullying were 1.79 (1.30-2.47) and 2.86 (1.67-4.90), respectively, and for cyberbullying were 2.02 (1.71-2.39) and 2.83 (2.08-3.84), respectively. All types of bullying victimization are strongly associated with both suicidal ideation and suicide attempt among middle and high school students.

Objective: This study aimed to explore the relationship between breakfast consumption frequency and both depression and anxiety symptoms among middle and high school students in Eastern China. Methods: In this school-based cross-sectional study, 27,001 middle and high school students were investigated in 2022. Multivariable logistic regression models were used to examine the relationship between breakfast consumption frequency and both depression and anxiety symptoms. Results: The percentages of students who consumed breakfast daily, 6 days/week, 4–5 days/week, and ≤3 days/week were 71.0% (95%CI: 69.9–72.2), 8.3% (95%CI: 7.8–8.6), 11.9% (95%CI: 11.2–12.6), and 8.8% (95%CI: 8.2–9.5), respectively. After adjusting for socio-demographic and lifestyle factors, academic performance, self-reported health, and bullying victimization, compared to those consuming breakfast daily, the odds ratios (95%CI) for depression symptoms were 1.32 (1.15–1.52) for those consuming breakfast 6 days/week, 1.66 (1.49–1.84) for those consuming breakfast 4–5 days/week, and 1.74 (1.54–1.97) for those consuming breakfast ≤3 days/week, respectively (p < 0.001). The corresponding figures for anxiety symptoms were 1.31 (1.14–1.51), 1.35 (1.20–1.52), and 1.43 (1.23–1.66), respectively (p < 0.001). Conclusions: Breakfast skipping is common among middle and high school students in Eastern China. The frequency of breakfast consumption is inversely associated with both depression symptoms and anxiety symptoms among adolescents.

Background: Existing literature on the association between the frequency of muscle-strengthening exercise (MSE) and depression among adolescents is limited and contradictory. Objective: This study aimed to elucidate the association of MSE frequency with depression symptoms among middle and high school students in China. Methods: A total of 27,070 students in grades 7-12 from 376 middle and high schools were surveyed using an anonymous self-administered questionnaire between April and June 2022. Information on engaging in MSE was self-reported, and depression symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Poisson regression was used to examine the association between MSE frequency and depression symptoms. Results: Among the 27,006 eligible students, 51.6% (n=13,933) were boys, and the mean age was 15.6 (SD 1.7) years. The overall prevalence of meeting MSE recommendations (ie, engaging in MSE ≥3 days/week) was 34.6% (95% CI 32.6%-36.6%; n=9145); the prevalence was higher in boys (43.8%, 95% CI 41.8%-45.8%; 6067/13,933) than in girls (24.3%, 95% CI 22%-26.6%; 3078/13,073; P<.001). A total of 5882 (21.8%) students reported having depression symptoms. After adjustment for sociodemographic status, lifestyle factors, academic performance, and experience of physical fighting, compared to students who did not engage in MSE, the prevalence ratios (PRs) for depression symptoms were 0.98 (95% CI 0.97-0.99) for those engaging in MSE once a week, 0.95 (95% CI 0.93-0.97) for 2 days/week, 0.93 (95% CI 0.90-0.96) for 3 days/week, 0.90 (95% CI 0.87-0.94) for 4 days/week, 0.88 (95% CI 0.84-0.93) for 5 days/week, 0.86 (95% CI 0.81-0.92) for 6 days/week, and 0.84 (95% CI 0.78-0.90) for 7 days/week, respectively. Conclusions: The overall prevalence of meeting MSE recommendations among Chinese adolescents is low. The frequency of MSE was inversely associated with depression symptoms.

Objective: Evidence of spatial disparity in dementia mortality in China has been found to have higher dementia mortality in eastern and rural China. Regional factors of physical and social features may be influencing this spatial disparity. However, the extent of spatial difference in dementia mortality across small regional localities is unclear. This study aims to investigate the geographic variations in mortality and risk of all dementia subtypes and identify the effect of the associated environmental risk factors.Methods: We used surveillance data on death reports from Alzheimer’s disease and other forms of dementia in Zhejiang province from 2015 to 2019. We estimated the relative risk of dementia mortality using a Bayesian spatial model. We mapped predicted relative risk to visualize the risk of death from different types of dementia and to identify risk factors associated with dementia.Results: Thirty thousand three hundred and ninety-eight deaths attributable to dementia as the underlying or related cause (multiple causes) were reported during 2015–2019. Counties and districts in the southeast and west of Zhejiang province had significantly higher standardized mortality ratios than others. Counties and districts with a smaller proportion of residents aged 60 years or older, poorer economic status, insufficient health resources, and worse pollution had a higher risk of deaths due to dementia.Conclusion: Higher risks of dementia mortality were found in counties and districts with poorer economic status, insufficient health resources, and worse pollution in Zhejiang. Our study adds new evidence on the association between socioeconomic and environmental factors and the mortality risk due to dementia.

Introduction: The Global Burden of Diseases Study systematically updates the dementia burden attributable to high fasting plasma glucose (HFPG) to investigate the temporal trends of dementia burden and promote comparisons between countries, sexes, and age groups. In this study, we aimed to estimate the disease burden of dementia attributable to HFPG using an age-period-cohort model in adults aged >60 years from 1990 to 2021 and forecast the mortality and disability-adjusted life-years (DALYs) rates in China and globally in 2040.Method: Data on the mortality and DALYs rates of dementia attributable to HFPG in China and globally were extracted from the Global Burden of Disease Study 2021. An age-period-cohort model was used to estimate the net drift, local drift, fitted longitudinal age-specific rates, and period/cohort relative risks from 1990 to 2021. The Bayesian age-period-cohort model was used to predict future mortality and DALYs rates from 2022 to 2040.Results: The net drifts showed an overall upward trend in the dementia burden attributable to HFPG in China and globally from 1990 to 2021, with a much slower trend in China. A constantly rising risk for age and birth cohort effects was observed, while period effects presented a globally constantly increasing risk and two inflection points in China, probably due to healthcare reform. The forecasted disease burden by 2040 demonstrated an increasing trend globally and a declining trend in China.Conclusion: The burden of dementia attributable to HFPG has consistently increased globally over the past 30 years but has gradually declined in China in recent years. China’s strategies for preventing and managing diabetes and dementia may provide valuable insights for other regions. Further targeted policies are required to reduce the burden on females and older adults, particularly to improve their quality of life.