Assessing greenspace and cardiovascular health through deep-learning analysis of street-view imagery in a cohort of US children.

Accurately capturing individuals' experiences with greenspace at ground-level can provide valuable insights into their impact on children's health. However, most previous research has relied on coarse satellite-based measurements. We utilized CVH and residential address data from Project Viva, a US-based pre-birth cohort, tracking participants from mid-childhood to late adolescence (2007-21). A deep learning segmentation algorithm was applied to street-view images across the US to estimate % street-view trees, grass, and other greenspace (flowers, field, and plants). Exposure estimates were derived by linking street-view greenspace metrics to 500m of participants' residences during mid-childhood, early and late adolescence. CVH scores (range 0-100; higher indicate better CVH) were calculated using the American Heart Association's Life's Essential 8 algorithm at these three time points, incorporating four biomedical components (body weight, blood lipids, blood glucose, blood pressure) and four behavioral components (diet, physical activity, nicotine exposure, sleep). Linear regression models were used to examine cross-sectional and cumulative associations between street-view greenspace metrics and CVH scores. Generalized estimating equations models were used to examine associations between street-view greenspace metrics and changes in CVH scores across three timepoints. All models were adjusted for individual and neighborhood-level confounders. Adjusting for confounders, a one-SD increase in street-view trees within 500m of residence was cross-sectionally associated with a 1.92-point (95%CI: 0.50, 3.35) higher CVH score in late adolescence, but not mid-childhood or early adolescence. Longitudinally, street-view greenspace metrics at baseline (either mid-childhood or early adolescence) were not associated with changes in CVH scores at the same and all subsequent time points. Cumulative street-view greenspace metrics across the three time points were also not associated with CVH scores in late adolescence. In this US cohort of children, we observed few evidence of associations between street-level greenspace children's CVH, though the impact may vary with children's growth stage.

Yi L ，Rifas-Shiman S ，Pescador Jimenez M ，Lin PD ，Suel E ，Hystad P ，Larkin A ，Hankey S ，Zhang W ，Klompmaker J ，Oken E ，Hivert MF ，Aris I ，James P ... -  《-》

Satellite-Based and Street-View Green Space and Adiposity in US Children.

Yi L ，Harnois-Leblanc S ，Rifas-Shiman SL ，Suel E ，Pescador Jimenez M ，Lin PD ，Hystad P ，Hankey S ，Zhang W ，Hivert MF ，Oken E ，Aris IM ，James P ... -  《JAMA Network Open》

Erratum: Eyestalk Ablation to Increase Ovarian Maturation in Mud Crabs.

《Jove-Journal of Visualized Experiments》

Temporal Trends in Cardiovascular Health Status Among Chinese School-Aged Children From 1989 to 2018: Multiwave Cross-Sectional Analysis.

Despite the release of updated metrics for Life's Essential 8 (LE8), key indicators for assessing cardiovascular health (CVH) status, there is currently no report on their distribution among Chinese children. This study aimed to assess the nationwide distribution of CVH in Chinese school-aged children using LE8 scores and analyze temporal changes in these scores over time. Participants aged 7 to 19 years from 11 waves (between 1989 and 2018) of the China Health and Nutrition Survey were included in this study. LE8 components were grouped into 2 domains of health behaviors (diet, physical activity, nicotine exposure, sleep) and health factors (BMI, blood lipids, blood glucose, blood pressure). Scores of overall CVH and each LE8 metric were calculated individually. Temporal changes were assessed with joint point regression models by rural and urban living residence. The causal relationships between health behaviors and health factors that changed the most over time were built with cross-lagged panel models. A total of 21,921 participants, 52.6% (n=11,537) of whom were male, who had data for at least 4 CVH components were included in the analysis. The mean age was 13 (SD 3.6) years. The overall CVH score remained stable in most regions, with the lowest found in Shandong from East China, which had a mean between 67 (SD 10.9) and 67.2 (SD 12.4). In contrast, the highest score was found in Guizhou from Southwest China, with a mean between 71.4 (SD 10.8) and 74.3 (SD 10.3). In rural areas, the diet score decreased significantly from 1997 onward with a speed of 0.18 (95% CI: 0.15-0.21; P<.001) per year, and the BMI score decreased significantly from 2005 onward with a speed of 0.56 (95% CI 0.44-0.68; P<.001) per year. In urban areas, the diet score decreased from 1994 onward with a speed of 0.03 (95% CI: 0.001-0.07; P=.04) per year, and the BMI score decreased from 2002 onward with a speed of 0.63 (95% CI 0.47-0.79; P<.001) per year. The sleep score dropped constantly in both urban and rural areas, with a speed of 0.69 (95% CI 0.58-0.80; P<.001) and 0.69 (95% CI: 0.52-0.86; P<.001) per year, respectively. A decline in the diet score led to a decline in the BMI score with a coefficient of 0.190 (95% CI 0.030-0.351; P=.02), while a decline in the BMI score led to a decline in sleep health with a coefficient of 0.089 (95% CI 0.010-0.168; P=.03). Chinese school-aged children and adolescents were generally of moderate CVH status, but mutual influences existed between CVH metrics. Dietary interventions should be prioritized for promoting overall CVH in the future.

Wang X ，Dong B ，Huang F ，Zhang J ，He R ，Du S ，Zhang J ，Ma J ，Wang H ，Zhang B ，Liang W ... -  《JMIR Public Health and Surveillance》

Association between new Life's Essential 8 and the risk of all-cause and cardiovascular mortality in patients with hypertension: a cohort study.

The American Heart Association recently introduced a new model for cardiovascular health (CVH) known as Life's Essential 8 (LE8). The impact of LE8 on hypertensive individuals is currently unclear. In our study, we investigated the correlation between comprehensive and individual CVH indicators as defined by LE8, and the mortality rates in hypertension patients. We analyzed a total of 8,448 hypertensive individuals aged ≥ 20 years who participated in the National Health and Nutrition Examination Survey from 2007 to 2016. These participants were nonpregnant and noninstitutionalized. We identified their mortality by linking their data to the National Death Index until December 31, 2019. The overall cardiovascular health (CVH) was assessed using the LE8 score, which ranged from 0 to 100. Additionally, we evaluated the scores for each component of diet, physical activity, tobacco/nicotine exposure, sleep duration, body mass index, non-high-density lipoprotein cholesterol, blood glucose, and blood pressure. The CVH were categorized into low (0-49), moderate (50-79), and high (80-100) CVH. Over an average follow-up period of 7.41 years, 1,482 (17.54%) of the participants died, among which 472 deaths were attributed to CVD. When compared to adults with lower total CVH scores, those with elevated total CVH scores displayed a 37% reduced risk of mortality from all causes (adjusted hazard ratio [aHR] = 0.63, 95% confidence interval [CI] = 0.45-0.88). In relation to CVD-specific mortality, the corresponding aHRs for moderate and high total CVH scores were 0.76 (0.60-0.97) and 0.54 (0.31-0.94), respectively. Furthermore, after adjusting for potential confounders, it was observed that higher scores on the LE8 index were associated with a reduced risk of both all-cause mortality (aHR for every 10-score increase, 0.91; 95% CI = 0.86-0.96) and CVD-specific mortality (aHR for every 10-score increase, 0.82; 95% CI = 0.75-0.90). Notably, a linear dose-response relationship was observed in this association. Similar patterns were identified in the relationship between health behavior and both all-cause and CVD-specific mortality. Achieving a higher CVH score, as per the new LE8 guidelines, has been found to be associated with a reduced risk of mortality from all causes and specifically from CVD in patients with hypertension. Therefore, public health and healthcare initiatives that focus on promoting higher CVH scores could potentially yield significant benefits in terms of reducing mortality rates among individuals with hypertension.

He L ，Zhang M ，Zhao Y ，Li W ，Zhang Y ... -  《BMC PUBLIC HEALTH》