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AimThe aim of this study was to determine reference values for oxygen saturation (SpO2) in neonates at mild and moderate altitudes.MethodsOur study included 41 097 consecutively born, asymptomatic neonates from 35 hospitals, located in Yunnan, China, with altitudes ranging from 267 to 2202 m. Pre‐and post‐ductal SpO2 of each neonate was measured at 24 hours of age and before hospital discharge. All study participants, according to the altitude of birth, were categorised into three groups: low (0‐500 m), mild (500‐1500 m) and moderate altitude (1500‐2500 m).ResultsEvery 1000‐m increase in altitude was associated with a 1.54 per cent decrease in mean SpO2. The means of pre‐ductal SpO2 at low, mild and moderate groups were 97.9%, 96.4% and 95.5%, respectively. We used the 2.5th percentile of SpO2 distribution as the cut‐off for neonatal SpO2 screening and defined new cut‐off values of ≤93% for mild altitudes, ≤92% for moderate altitudes and no adjustment for low altitudes.ConclusionWe recommend revised cut‐off values for neonatal SpO2 at mild and moderate altitudes and provide new values for paediatricians to refer to when screening neonates for severe congenital heart or lung diseases.

Introduction People living in obesogenic environments, with limited access to healthful food outlets and exercise facilities, generally have poor health. Previous research suggests that behavioral risk factors and indicators of physiological functioning may mediate this link; however, no studies to date have had the requisite data to investigate multi-level behavioral and physiological risk factors simultaneously. The present study conducted serial and parallel mediation analyses to examine behavioral and physiological pathways explaining the association between environmental obesogenicity and cardiovascular disease (CVD). Methods This cross-sectional observational study used data from the 2012–2016 Health and Retirement Study, a representative survey of US older adults (n = 12,482, mean age 65.9). Environmental obesogenicity was operationalized as a combined score consisting of nine environmental measures of food and physical activity. CVD and health-compromising behaviors (diet, alcohol consumption, smoking, and exercise) were self-reported. Physiological dysregulation was assessed with measured blood pressure, heart rate, HbA1c, cholesterol levels, BMI, and C-reactive protein. The Hayes Process Macro was used to examine serial and parallel paths through health-compromising behaviors and physiological dysregulation in the environmental obesogenicity-CVD link. Results People living in more obesogenic environments had greater odds of self-reported CVD (odds ratio = 1.074, 95% confidence interval (CI): 1.028, 1.122), engaged in more health-compromising behaviors (β = 0.026, 95% CI: 0.008, 0.044), and had greater physiological dysregulation (β = 0.035, 95% CI: 0.017, 0.054). Combined, health-compromising behaviors and physiological dysregulation accounted for 7% of the total effects of environmental obesogenicity on CVD. Conclusion Behavioral and physiological pathways partially explain the environmental obesogenicity-CVD association. Obesogenic environments may stymie the success of cardiovascular health-promotion programs by reducing access to resources supporting healthy lifestyles.

Racial and ethnic health disparities are fundamentally connected to neighborhood quality. For example, as a result of historical systemic inequities, racial and ethnic minorities are more likely to live in neighborhoods with signs of physical disorder (e.g., graffiti, vandalism), and physically disordered environments have been noted to associate with increased risk for chronic illness. Degree of exposure to neighborhood disorder may alter peoples' perception of their neighborhoods, however, with those most exposed (e.g., historically marginalized racial/ethnic groups) perhaps perceiving less threat from signs of neighborhood disorder. The purpose of the present study was to examine the complex interrelationships between people and place by investigating whether exposure to neighborhood physical disorder relates to residents' (1) perceptions of neighborhood safety and (2) perceptions of their health, and (3) examining whether these links vary by race/ethnicity. Using 2016–2018 Health and Retirement Study (HRS) data, a representative sample of US adults aged 51 years and older (n = 9,080, mean age 68 years), we conducted a series of weighted linear regressions to examine the role of neighborhood disorder in relation to both perceived neighborhood safety and self-rated health. Results indicated that greater neighborhood physical disorder was statistically significantly related to feeling less safe among non-Hispanic Whites and Hispanics, but not non-Hispanic Blacks. Regarding self-rated health, neighborhood physical disorder was statistically significantly related to poorer health among all racial/ethnic groups. These findings suggest that, despite differential interpretation of neighborhood disorder as a threat to safety, this modifiable aspect of peoples' environment is related to poor health regardless of one's race/ethnicity.

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