Background: The arrival of the big-data era provides us with a chance to elaborate the spectrum and epidemiological characteristics of infectious diseases in children and adolescents aged 0–18 years in the pre-COVID-19 pandemic era. Methods: We collected data on infectious diseases in 891,981 participants from the Cheeloo Lifespan Electronic Health Research Data-library. The incidence density of each infection was calculated and stratified by age and region. The annual percentage change (APC) in incidence was estimated by logarithmic linear regression. Results: A total of 18,183 cases of 78 infections were diagnosed, with an overall incidence density of 626.33 per 100,000 person-years (PY). Of these, 6825 cases of 50 non-notifiable infectious diseases were identified. Children aged 1–3 years had the highest incidence of infections. The overall incidence revealed a significant increasing trend from 2013 to 2017 (APC = 36.9%, p < 0.05). Hand, foot, and mouth disease, pneumonia, and influenza were the three most common diseases. The incidence of pneumonia, rubella, scarlet fever, zoster, molluscum contagiosum, and syphilis increased significantly during the study period (all p < 0.05). Taian, Binzhou, and Weihai had the highest incidence of all other cities. The incidence of gastrointestinal infections increased markedly in the eastern coastal regions. Conclusions: More stress should be placed on a number of non-notifiable infectious diseases with a high burden and a significant increasing trend. Age-based and regional targeting efforts are needed to prevent and contain infectious diseases among children and adolescents.

Although the relationship between urbanization and influenza has received increasing attention, previous studies have often examined this relationship based on single indicators, neglecting the multi-dimensions of urban development and their integrated impact on influenza incidence in neighboring cities. A multidimensional urbanization evaluation framework was developed based on social, economic, and ecological dimensions to comprehensively assess urbanization. Then, we analyzed the impact of urbanization development on influenza incidence within and across cities using Bayesian spatiotemporal models and spatial Durbin models. Regional heterogeneity analysis was performed to investigate the impact of urbanization on influenza incidence within cities. From 2014 to 2019, there were 5,062,254 influenza cases in 283 prefecture-level cities in China. Each standard deviation increment in comprehensive, social, and economic indexes of urbanization was associated with a 14.9% (95% CI: 6.1%, 24.3%), 9.9% (95% CI: 3.5%, 16.3%), and 13.4% (95% CI: 4.5%, 23.7%) increase in influenza incidence, respectively. The effects of urban development on influenza incidence varied significantly across regions, with the greatest impact found in southern China. Additionally, a significant positive spatial spillover effect of urbanization was observed on influenza incidence in surrounding cities. Urbanization and its various dimensions were linked to increased risk of local influenza incidence, which also showed substantial positive spatial spillover effect to surrounding areas. During the rapid urbanization process in China, local governments should prioritize equity and accessibility in healthcare services and strengthen the coordinated prevention and control of influenza epidemics across cities.

Although studies have reported the modification effect of air pollutants on heat-related health risk, little is known on the modification effect among various particulate matter with different particle size on mortality. We aimed to investigate whether the associations of hot temperatures with daily mortality were modified by different air pollutant levels in Shandong Province, China. Daily data of air pollutants, meteorological factors, and mortality of 1,822 subdistricts in Shandong province from 2013 to 2018 were collected. We used a time-stratified case-crossover model with an interaction term between the cross-basis term for ambient temperature and the linear function of particulate matter ≤1 µm (PM₁), PM_2.5, nitrogen dioxide (NO₂), and ozone to obtain heat-mortality associations during the hot season. Results showed that the cumulative odds ratio of extreme heat on mortality over 0 to 10 days was 3.66 (95% CI: 3.10–4.31). The mortality risk during hot seasons was stronger at high air pollutant levels. The modification effect of particulate matters on heat-related mortality decreased by its aerodynamic diameter. Females and older adults over 75 years were more vulnerable to the modification effect of air pollutants, and significant differences were detected in the association between temperatures and mortality stratified by PM₁ and PM_2.5. Higher heat-related mortality risks were observed at high NO₂ levels, especially for cardiorespiratory disease. The findings suggest that more consideration should be given to the combined effect of very fine particles and NO₂ with ambient heat when developing healthcare strategies, and women and older adults should be given priority in health-related settings.

Purpose The study aimed to assess the interconnection of quality of life (QoL) variables and identify key areas for which interventions could improve QoL among men who have sex with men (MSM) living with HIV on antiretroviral therapy (ART). Methods A cross-sectional study was conducted in Jinan of Shandong Province, between October to December 2020. Undirected network analyses were conducted to examine and visualize the interconnections between QoL variables among MSM living with HIV. Centrality indices, including strength, betweenness, closeness, and expected influence (EI), were calculated to quantify the importance of each variable in the network. A network comparison test was used to assess differences between networks of individuals who initiated ART before and after the introduction of “Treat-All” strategy, comparing network structure, edge strength, and global strength. Results A total of 584 participants were included, with an average overall QoL score of 87.80±12.75. At the domain level, psychology (EI=1.04) emerged as the most central domain within the QoL network. At the item level, satisfaction with the ability to perform activities of daily living showed the highest EI (1.25), followed by access to information (EI=1.12). No significant differences were observed in network structure (Test statistic M=0.21, P=0.317) and global strength (Test statistic S=0.64, P=0.056) between the networks for men who initiated ART before and after the introduction of “Treat-All” strategy. Conclusion Psychological well-being emerged as the most central QoL domain for MSM with HIV on ART, with daily living abilities and information access being key aspects. Thus, HIV care should incorporate interventions improving these and mental health.

Background: The occurrence of compound hot extreme (CHE) events in China is increasingly frequent. This study aimed to investigate the association between CHEs and all-cause mortality in Shandong Province and to estimate the attributable excess deaths. Methods: We collected daily data on weather, air pollution, and all-cause mortality at the subdistrict level in Shandong Province from 2013 to 2018. A CHE was defined as both daily maximum and minimum temperatures being higher than their historical 90th percentiles during 2013–2018 hot seasons. A case time-series analysis with a distributed lagged non-linear model was applied to analyze the subdistrict-specific association between different hot extremes and mortality risk, which were then pooled at the province level using meta-analysis. Results: Hot nights (RR = 1.44, 95%CI: 1.35–1.53) and CHEs (RR = 1.77, 95%CI: 1.64–1.90) were significantly associated with an increased mortality risk. CHEs had a greater effect for females (RR = 1.99, 95%CI: 1.81–2.19) and the elderly (>74 years) (RR = 2.14, 95%CI: 1.93–2.38) than their counterparts, respectively. Cardiovascular and respiratory deaths were more susceptible to CHEs than other deaths. Each year, 4888 (95%CI: 4133–5811) excess deaths in Shandong Province were attributable to CHEs, accounting for 2.60% (95%CI: 2.20–3.10%) of all-cause deaths and equating to 50 (95%CI: 42–58) deaths per 1,000,000 residents. The CHE-related mortality burden varied across subdistricts, with the highest occurring in the southeastern area and the lowest occurring in the northeastern and southwestern regions. Conclusion: CHEs and hot nights were substantially associated with excess deaths in Shandong Province, especially for females, the elderly, and residents living in the southeastern area. Our findings may facilitate the development of a heat alert warning system and preventive measures for vulnerable populations.