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COVID and animals
The COVID-19 pandemic changed human behaviors — at least for a while. It also affected animal behavior. Using data from more than 5,000 camera traps during the pandemic, researchers found that in urban landscapes where animals are habituated to humans, all species seemed to get out into nature more often. For example, sightings of raccoons and deer increased, even with more people about. In more rural areas, however, animals more wary of humans became more skittish and reduced their activity significantly — a sort of asocial distancing.
The causes of dementia are many, and most are not well-understood. One that is getting more attention these days is viral infections, the idea that pathogens can trigger a cascade of events that results in progressive neurodegeneration. Indeed, some recent evidence found that the vaccine for shingles, caused by varicella-zoster virus, helps protect people’s brains from dementia. Part of this shift is due to COVID-19 and concerns about long-term cognitive decline. “I’ve always been a vaccine believer, but the COVID vaccine reinforced to me that there may be long-term benefits to vaccination beyond simply stopping short-term effects,” Paul Harrison, a psychiatry professor at Oxford University, told STAT. Drifting smoke from wildfires in 2019 through 2021 reached almost every lake in North America for at least one day per year, according to UC Davis report. More significantly, 89 percent of the lakes experienced smoke exposure for more than 30 days. The research is part of an effort to examine how smoke affects lake environments, such has how much solar radiation penetrates the water or alters its composition. “We just don’t know yet how smoke affects food webs, lake ecology, or what the future of these systems will be if there’s an increase in lake-smoke days,” said study author Mary Jade Farruggia. “I think quantifying the scope of the problem is really the first step. We’re pointing out that this is something we need to manage for across the globe, and not just areas affected by wildfire.”
Singultus — a hiccup or an attack of hiccups. Multiple attacks are singultases. Macromania — a delusion that things are actually larger than their natural size Botanically speaking, bananas are a berry. Blackberries and strawberries are members of the rose family, as are cherries, apricots, plums, pears, apples, quinces and peaches. Blueberries and cranberries are part of the heath family.
“Laziness is nothing more than the habit of resting before you get tired.” — French author Jules Renard (1864-1910) This week in 1750, Benjamin Franklin was severely shocked while electrocuting a turkey. Two days later, he wrote to his brother that an experiment in electricity had gone wrong when, distracted by talk from observers around him, he inadvertently contacted the “electrical fire,” leaving a small swelling where he was shocked. “I am ashamed to have been guilty of so notorious a blunder,” he wrote his brother. The electrocuted turkey wasn’t too happy either. Many, if not most, published research papers have titles that defy comprehension. They use specialized jargon, complex words and opaque phrases like “nonlinear dynamics.” Sometimes they don’t, and yet they’re still hard to figure out. Here’s an actual title of actual published research study: “On the Effectiveness of Aluminium Foil Helmets: An Empirical Study.” Published in 2008, the study investigators sought to determine which styles of helmet made with aluminum (or aluminium, both are correct) foil are most effective at fending off invasive radio signals. They found that some radio frequences were attenuated, but others were amplified, most notably frequencies reserved for government use. Very suspicious.
In today’s world of widespread poverty and unprecedented wealth, how about raising the wages of the most poorly-paid workers? This October, the World Bank reported that “8.5 percent of the global population―almost 700 million people―live today on less than $2.15 per day,” while “44 percent of the global population―around 3.5 billion people―live today on less than $6.85 per day.” Meanwhile, “global poverty reduction has slowed to a near standstill.” In early 2024, the charity group Oxfam International noted that, since 2020, “148 top corporations made $1.8 trillion in profit, 52 percent up on 3-year average, and dished out huge payouts to rich shareholders.” During this same period, the world’s five wealthiest men “more than doubled their fortunes from $405 billion to $869 billion,” an increase of $14 million per hour. As corporate elites gathered in Davos for a chat about the world economy, 10 corporations alone were worth $10.2 trillion, more than the GDPs of all the countries in Africa and Latin America combined. The world’s vast economic inequality “is no accident,” concluded a top Oxfam official. “The billionaire class is ensuring corporations deliver more wealth to them at the expense of everyone else.” Although inequalities in income and wealth have existed throughout much of human history, they have been softened somewhat by a variety of factors, including labor unions and―in modern times―minimum wage laws. Designed to provide workers with a basic standard of living, these laws create a floor below which wages are not allowed to sink. In 1894, New Zealand became the first nation to enact a minimum wage law, and―pressured by the labor movement and public opinion―other countries (including the United States in 1938) followed its lead. Today, more than 90 percent of the world’s nations have some kind of minimum wage law in effect. These minimum wage laws have had very positive effects upon the lives of workers. Most notably, they lifted large numbers of wage earners out of poverty. In addition, they undermined the business practice of slashing wages (and thus reducing production costs) to increase profit margins or to cut prices and grab a larger share of the market. Even so, the growth of multinational corporations provided businesses with opportunities to slip past these national laws and dramatically reduce their labor costs by moving production of goods and services to low-wage nations. This corporate offshoring of jobs and infrastructure gathered steam in the mid-twentieth century. Initially, multinational corporations focused on outsourcing low-skilled or unskilled manufacturing jobs, which had a negative impact on employment and wages in advanced industrial nations. In the twenty-first century, however, the outsourcing of skilled jobs, particularly in financial management and IT operations, rose dramatically. After all, from the standpoint of enhancing corporate profits, it made good sense to replace an American IT worker with an Indian IT worker at 13 percent the cost. The result was an accelerating race to the bottom. In the United States, this export of formerly good-paying jobs to low-wage, impoverished countries―combined with “free trade” agreements, a corporate and government assault on unions, and conservative obstruction of any raise in the pathetically low federal minimum wage ($7.25 per hour)―produced a disaster. The share of private-sector goods-producing jobs at high wages shrank, since the 1960s, from 42 to 17 percent. Increasingly, U.S. jobs were located in the low-paid service sector. Not surprisingly, by 2023 an estimated 43 million Americans lived in poverty, while another 49 million lived just above the official poverty line. Little wonder that, in this nation and many others caught up in corporate globalization, there was an alarming rise of right-wing demagogues playing on economic grievances, popular hatreds, and fears. If, therefore, wages in underdeveloped nations and in advanced industrial nations are not keeping pace with the vast accumulation of capital by the world’s wealthiest people and their corporations, one way to counter this situation is to move beyond the disintegrating patchwork of wage-floor efforts by individual nations and develop a global minimum wage. Such a wage could take a variety of forms. The most egalitarian involves a minimum-wage level that would be the same in all nations. Unfortunately, though, given the vast variation among countries in wealth and current wages, this does not seem practical. In Luxembourg, for example, the average yearly per capita purchasing power is 316 times that of South Sudan. But other options are more viable, including basing the minimum wage on a percentage of the national median wage or on a more complex measurement accounting for the cost of living and national living standards. Over the past decade and more, prominent economists and other specialists have made the case for a global minimum wage, as have a variety of organizations. For an appropriate entity to establish it, they have usually pointed to the International Labor Organization, a UN agency that has long worked to set international labor standards. The advantages of a global minimum wage are clear. Of course, higher labor costs at home and abroad would reduce corporate profits and limit the growth of billionaires’ wealth and power. But wouldn’t these also be positive developments? Lawrence S. Wittner (https://www.lawrenceswittner.com/ ) is Professor of History Emeritus at SUNY/Albany and the author of Confronting the Bomb (Stanford University Press). Get the latest from FPIF in your inbox. 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This story was updated with new information Bill Belichick seems to have made his first major coaching staff hire at North Carolina. And it’s a familiar face. REQUIRED READING:North Carolina hiring Bill Belichick is gamble not that difficult to see ending in disaster According to 247Sports’ Matt Zenitz, the Tar Heels‘ coaches oldest son, Washington defensive coordinator Steve Belichick, is expected to make the cross country move to Chapel Hill after the Huskies‘ bowl game against Louisville on Dec. 31. Steve Belichick will serve in the same role as he did at Washington, per Zenitz. NFL STATS CENTRAL:The latest NFL scores, schedules, odds, stats and more. The hiring of Steve Belichick at UNC has long been expected within those college football, including before the Tar Heels and Bill Belichick came to an agreement on a five-year, $50 million contract to be Mack Brown’s successor. According to a report from Oliver Connelly at The Guardian on Dec. 6, part of Bill Belichick’s negotiations with North Carolina included Steve Belichick becoming the program’s next-in-line coach after Belichick retires or leaves the program. Steve Belichick is currently in his first season coaching at the college ranks as Jedd Fisch’s defensive coordinator at Washington. Under Steve Belichick, the Huskies’ defense improved significantly compared to the year prior, when Kalen DeBoer served as Washington’s head coach. Washington ranked 27th in the nation in total defense this year compared to 99th in 2023 per ESPN. Washington’s defense also ranked 46th in scoring defense (22.83 points per game) and tied for 52nd in red zone defense (81%) in the regular season. He will now be tasked with replicating that success in Chapel Hill with the Tar Heels defense, which ranked 12th in the ACC this past year in scoring defense. The news of Steve Belichick coming to UNC also comes a day after Washington linebacker transfer Khmori House committed to Bill Belichick and North Carolina. Prior to joining Fisch’s staff, he spent 11 seasons on Bill Belichick’s staff in New England in various defensive coaching roles from 2012-2023. For his last four seasons in Foxborough, Steve Belichick served as the Patriots defensive play caller, though he did not formally hold the title of the team’s defensive coordinator.
Bangkok – Psoriasis has become a significant health concern in Thailand, with more than 20,000 outpatient cases recorded in 2024. It is now the third most common dermatological condition in the country. Approximately 1.7 million Thais suffer from psoriasis, with 30% experiencing severe symptoms that often require advanced treatments beyond standard medications. The average cost of treatment per visit is estimated at 3,100 THB. Karom Polpornklang, Deputy Spokesperson for the Prime Minister’s Office, shared these statistics while highlighting a breakthrough in alternative treatments. The Department of Thai Traditional and Alternative Medicine (DTAM) has collaborated with Thai researchers to develop an innovative herbal patch for psoriasis patients. This herbal patch, inspired by the traditional formula “Karun Osot,” incorporates cannabidiol (CBD) extracts. Using transdermal delivery, the patch targets symptoms such as thickened skin patches and is particularly effective for mild to moderate cases. It offers a promising alternative for patients seeking Thai traditional medical solutions. The patch recently earned international recognition, winning a silver medal at the iENA 2024 International Trade Fair in Nuremberg, Germany. It also received a special award from the China Association of Inventions. Psoriasis patients are encouraged to consult Thai traditional medicine practitioners at hospitals and clinics nationwide. For more information, contact the Department of Thai Traditional and Alternative Medicine at 02-149-5678 or via their official Facebook page or LINE account: @DTAM. Thantawan Industry Public Co., Ltd., a Thai manufacturer of premium plastic packaging, signed a landmark 30-year lease for a factory in Phuoc Dong Industrial Park, Tay Ninh province, in October. BCPG Public Co., Ltd., a leading renewable energy company in Thailand, announced it had invested $130 million in wind power plants in Gia Lai on November 25. By VNA
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WWE Hall of Famer Kevin Nash took to an episode of his Kliq This podcast, where he talked about a number of topics including how he found religion prior to his recent surgery for his torn bicep and how his diet has changed. Nash said, “I’ve lost more weight, but it’s on purpose because I pretty much went carnivore. I’m just not eating carbs. I know that I’m gonna have a pretty, especially at 65, without being able to do any progressive resistance training, I’m going to lose a s**t load of muscle over the next three months. But the beauty of training for 50-plus years is the muscle memory is there, and it’ll come right back. So I got out of the shower today, and I looked at myself, I said, ‘Woah, dude. You look 65.’ Usually I look pretty f***ing…I mean, I look at myself, I’m like, ‘F**k, you look….’ Today, I’m just like, man. I’m doing the pulleys, I’m already doing some mobility. I’m supposed to have my sling on right now. It’s great I guess if you got a 14-inch f***ing arm, but I still got Thanksgiving turkey for an arm, and you have a f***ing thing wrapped around your neck, and the f***ing weight of that arm is pulling into your neck, next thing you know, your right hand is going numb because [the pressure]. F**k that. The thing is, they always say, ‘You need to keep your sling on so you don’t f**k up.’ Hey, I promise you, I’m not going to forget and get up in the morning and go, ‘You know what I need to do is go hit a bucket of balls.’ It’s like, f**k, I know. Sleep in a recliner. Tonight will be day 15. This time, before I went in, I found God, man. I found my religion. I said the Lord’s Prayer, I said, I’m going in, and please don’t take me from Tamara, don’t put this on her lap. I went in, and I came out, and it was rough coming out, it was hard coming out of that anesthesia.” You can check out the complete podcast in the video below. (H/T to Fightful for transcribing the above quotes)
White Abarrio wins his return allowance race at Gulfstream Park Following an impressive 10 1/4-length allowance romp in his return to the races, 2023 Breeders' Cup Classic (G1) winner White Abarrio jumps back into graded company as he faces 11 rivals in the $165,000 Mr. Prospector Stakes (G3) at Gulfstream Park Dec. 28. The Nov. 22 victory at the same course and seven-furlong distance that he'll face Saturday came on the heels of a 5 1/2-month layoff since a soundly beaten fifth in the June 8 Metropolitan Handicap (G1). It was also his first start back in the Florida-based barn of his original trainer Saffie Joseph Jr., who trained the horse for his first 12 starts that included a victory in the 2022 Florida Derby (G1). PRESS RELEASE: White Abarrio Resumes Racing Nov. 22 at Gulfstream Park A return to the Florida sun was just what the doctor ordered for the 5-year-old son of Race Day as he improved his record at Gulfstream to 6-for-7. Despite being known for his success at longer routes, White Abarrio holds a perfect 2-for-2 record over seven furlongs, both contested at Gulfstream. Owned by C 2 Racing Stable, Prince Faisal Bin Khaled Bin Abdulaziz Al-Saud and Antonio Pagnano, White Abarrio has won eight of 18 starts for earnings of $5,213,350. Sign up for BloodHorse Daily One of his prinicipal rivals comes in the form of Carlos Saavedra and Stud Vendaval's Mufasa, who exits a disappointing run in the Nov. 2 Breeders' Cup Dirt Mile (G1).
Photo: Coglianese Photos/Walter Wlodarczyk
Mufasa wins the Vosburgh Stakes at Aqueduct Racetrack
Prior to that 11th-place finish around two turns at Del Mar, the Chilean group 3 winner introduced himself to American audiences with a pair of open-length victories over seven furlongs. The latter of the two came Sept. 28 at Aqueduct Racetrack when he won the Vosburgh Stakes (G3) over a sloppy track by 4 1/4 lengths. The Ignacio Correas trainee makes his fifth start in the United States at a fifth different track, but holds a perfect 4-for-4 record at the distance. Lea Farms' Super Chow is aiming to end the year the way he began it, rallying off three grade 3 wins in a four-race span at Aqueduct and Pimlico Race Course. However, he's failed to hit the board in his last three starts, finishing fourth in each. Like White Abarrio, the 4-year-old son of Lord Nelson has shown an affinity for Gulfstream, hitting the board in all six starts and visiting the winner's circle three times.
Photo: Mathea Kelley
Super Chow wins the Maryland Sprint Stakes at Pimlico Race Course
Half the field has won multiple starts at the Hallandale Beach, Fla. track, with the second-most victories belonging to Bianco Stable's Caramel Chip, who exits a third in the Nov. 16 Claiming Crown at Churchill Downs for trainer Carlos David. The 6-year-old son of Midshipman has won five of 15 starts at Gulfstream, hitting the board eight times. Stakes winner Shaq Diesel has won four times at Gulfstream, Real Macho three times, and Mr Skylight twice. Joseph Imbesi's Pennylvania homebred Gordian Knot, a five-time stakes winner and grade 3 placed in his home state, makes his first start for Hall of Fame trainer Todd Pletcher.
Advertisement BMC Psychiatryvolume 24, Article number: 947 (2024) Cite this article Metrics details This study explored the relationship between Adverse Childhood Experiences (ACE), physical pain, and depressive symptoms, and examined the mediating role of pain in the correlation between ACE and depressive symptoms among middle-aged and elderly Chinese (over the age of 45). Cox proportional hazards regression models were used to analysis the association between ACE, physical pain, and depressive symptoms. To assess the mediating role of physical pain in the relationship between ACE and depressive symptoms, mediation analysis was conducted. Indirect, direct, and total effects were estimated by combining mediation and outcome models, adjusting for relevant covariates. Bayesian network models were used to visually demonstrate the interrelations between factors influencing depressive symptoms, further verifying the association between ACE, physical pain, and depressive symptoms. In the fully adjusted model, middle-aged and elderly individuals reporting ACE had a higher risk of developing depressive symptoms (hazard ratios [HR] and 95% confidence intervals [95% CI], 1.379 [1.266–1.503]). Compared to those without physical pain, individuals reporting severe physical pain were at an increased risk of depressive symptoms (HR [95% CI], 1.438 [1.235–1.673]). The risk was even higher for those with both ACE and severe physical pain compared to those with neither (HR [95% CI], 2.020 [1.630–2.505]). The intensity of pain explained 7.48% of the association between ACE and depressive symptoms, while the number of pain sites accounted for 7.86%. Physical pain partially mediated the association between ACE and depressive symptoms. The study findings highlighted the importance of early screening and intervention for physical pain in middle-aged and older adults with ACE. Not applicable. Peer Review reports With the intensification of social competition and the acceleration of life pace, the number of individuals suffering from depression is rapidly increasing. It is reported that globally, around 322 million people are affected by depression [1]. Studies in the Chinese population indicate that the prevalence of depression ranges from 1.5 to 7.9%, while the prevalence of significant depressive symptoms varies from 1.5–60.3%.2–5 Depression not only severely impacts the quality of life of middle-aged and elderly individuals but also serves as a significant risk factor for cardiovascular diseases, disability, and mortality [6,7,8,9]. Presently, the identification and control of risk factors are crucial for the primary and secondary prevention of depressive symptoms. Previous studies have shown that ACE are associated with a range of social disadvantages in adulthood, and individuals with higher ACE scores are more likely to engage in risky health behaviors [10,11,12]. People with ACE undergo physical and psychological abnormalities, with adult physical pain and depressive symptoms potentially being long-term health consequences of ACE. Chronic physical pain is characterized by high prevalence and substantial social burden, and it is also a leading cause of disability [13, 14]. Previous studies have shown that ACE is an important predictor of increased depressive symptoms during the pandemic, and that there is a combined effect between ACE and polygenic susceptibility to major depressive disorder [15, 16]. In addition, physical pain often occurs at the same time as depressive symptoms, suggesting that there may be a two-way association between the two [17]. Existing research [18,19,20,21] indicates that both ACE and physical pain are associated with depressive symptoms, but the role of physical pain in mediating the impact of ACE on depressive symptoms in middle-aged and elderly periods lacks verification from long-term cohort studies. Current evidence overlooks the potential roles of pain intensity and the number of pain sites, and there is a lack of exploration into the underlying mechanisms, particularly the interactions among influencing factors. Considering the potential long-term harm of ACE on mental health, understanding its relationship with depressive symptoms in middle-aged and elderly individuals, and the mediating role of physical pain, could provide a basis for promoting their physical and mental health. Therefore, this study aims to utilize data from the China Longitudinal Study of Health and Retirement (CHARLS) to explore the associations of ACE and physical pain with depressive symptoms among middle-aged and elderly Chinese, and further analyze the mediating roles of the number of pain sites and the intensity of physical pain in the relationship between ACE and depression. In terms of content, this study verified the association between ACE, physical pain, and depressive symptoms through a cohort study design, and also explored the mediating role of physical pain between ACE and depressive symptoms in the middle-aged and elderly population in China for the first time. In terms of methodology, this study not only uses traditional statistical models to analyze correlations, but also innovatively uses Bayesian network models to visually demonstrate complex correlations. CHARLS is a nationally representative longitudinal survey of adults over the age of 45. More details about CHARLS have been reported in previous studies [22]. In the 2011 baseline survey of this study, face-to-face interviews were conducted with individuals from 10,257 households across 28 provinces, utilizing the probability ratio sampling method. Subsequent follow-up surveys have been carried out in 2013, 2015, 2018, and 2020, following the initial survey in 2011. The life course survey was conducted in 2014. This study included a total of 3,840 participants (Fig. 1), excluding those who, at baseline, had depression, other affective psychiatric issues, or memory-related diseases (confirmed cases of Alzheimer’s disease, cerebral atrophy, Parkinson’s disease). Flow-chart of the selection of study participants. Abbreviations: ACE, adverse childhood experiences In the CHARLS, ACE before the age of 17 were assessed using the 2014 life history questionnaire. 14 ACE, including 11 intra-familial ACE (emotional neglect, family violence, parental separation or divorce, parental substance abuse, parents incarcerated, parental mental illness, parental disability, parental death, sibling death, physical abuse, and economic adversity) and 3 extra-familial ACE (bullying, loneliness, and community violence) were identified based on our previous research. Utilizing dichotomous items, we further constructed a composite variable (≥ 4 ACE vs. <4 ACE). This threshold was chosen because previous studies have reported that having four or more ACE increases the risk of various adverse health outcomes, making it a widely accepted benchmark [23, 24]. Additionally, this study also considered the relationship between continuous ACE scores and depressive symptoms. Depressive symptoms were measured using the CES-D scale, whose reliability in Chinese adults has been widely validated [25, 26]. Participants were asked about their mood and behavior over the past week, including eight negative and two positive questions. Each question was scored from 0 to 3, with a total score ranging from 0 to 30. Higher depressive scores refer to more depressive symptoms. The cutoff score for depressive symptoms was 10. During the baseline survey, participants were asked about the frequency of physical pain, the locations of the pain, and its intensity. The listed pain locations included the head, shoulders, arms, wrists, fingers, chest, stomach, back, waist, hips, legs, knees, ankles, toes, and neck. If participants experienced more than one type of pain, they were instructed to report the severity of the most severe pain. At baseline, sociodemographic factors, personal lifestyle, and health status were collected through questionnaire surveys, physical examinations, and blood tests. Potential confounding factors considered included sociodemographic factors (age, sex, urban/rural residence, education level, marital status, body mass index), personal lifestyle factors (smoking, alcohol consumption, social participation, exercise habits), relevant blood test indicators, and health status. The latter encompasses self-reported histories of 12 chronic diseases: hypertension, dyslipidemia, diabetes, cancer and other malignancies, chronic lung diseases, liver diseases, heart diseases, stroke, kidney diseases, stomach diseases, arthritis or rheumatism, and asthma, defined based on whether a doctor had informed the participants of having these diseases. Baseline characteristics of participants were described by mean values for continuous variables and proportions for categorical variables. Data are presented as frequency (%) and mean (SD). T tests were used for continuous variables, and Chi-square tests for categorical variables. Considering missing data, variables with a missing proportion over 5% were assigned NA dummy variables, while those with less than 5% missing data underwent multiple imputation. Details of missing data are shown in supplementary material (see Table S1 published as supplementary material online). Cox proportional hazards regression models were used to calculate HR [95% CI] for the association between ACE, physical pain, and depressive symptoms. Three models progressively revealed the correlations between ACE, physical pain, and depressive symptoms, comparing HR before and after adjusting for confounding factors. The effects of combinations of ACE and physical pain on depressive symptoms were further stratified. To assess the mediating role of physical pain in the relationship between ACE and depressive symptoms, mediation analysis was conducted. Indirect, direct, and total effects were estimated by combining mediation and outcome models, adjusting for relevant covariates. Several sensitivity analyses were performed to test the robustness of the results. Firstly, participants who developed depression within two years of recruitment were excluded to reduce the possibility of reverse causation. Secondly, continuous ACE scores and the number of pain sites were used instead of categorical ACE and pain intensity in the primary analysis. Thirdly, based on the results of the Cox regression models, variables with statistical significance were included, and those with over 5% missing data were excluded. Bayesian network models were used to visually demonstrate the interrelations between factors influencing depressive symptoms, further verifying the association between ACE, physical pain, and depressive symptoms. A two-sided P-value of < 0.05 was considered statistically significant. Analyses were conducted using R statistical software version 9.4 (R Foundation for Statistical Computing) and SPSS version 26.0 (IBM SPSS Statistics). Data analysis was carried out from November 2023 to January 2024. The main sample included 3840 middle-aged and elderly individuals, with an average age of 58.03 (SD = 8.32) years, of whom 1935 (50.39%) were female. During the 9-year follow-up period, 2095 (54.56%) reported new onset of depressive symptoms, with the cumulative incidence shown in supplementary material (see Table S2 published as supplementary material online). As indicated in Table 1, compared to those without depressive symptoms, participants who reported new onset of depressive symptoms were more likely to be older, male, from rural areas, have lower education levels, be in a single status, have unhealthier lifestyles, more chronic diseases, higher ACE scores, and experience more intense physical pain. Table 2 displays the associations between ACE, physical pain, and depressive symptoms in the Cox regression model. Compared to individuals with ACE scores less than 4, those with scores of 4 or higher had a significantly increased risk of developing depressive symptoms. The HR (95% CI) before and after adjusting for confounders were 1.439 (1.319–1.570) and 1.379 (1.266–1.503), respectively. Compared to those without physical pain, individuals with mild, moderate, and severe physical pain had progressively higher risks of developing depressive symptoms, with adjusted HR (95% CI) of 1.275 (1.094–1.486), 1.418 (1.209–1.665), and 1.438 (1.235–1.673), respectively. Compared to individuals with low ACE scores and no physical pain, those with high ACE scores and severe physical pain had a significantly increased risk of developing depressive symptoms, with an adjusted HR (95% CI) of 2.020 (1.630–2.505). Considering the potential for reverse causality, this study excluded participants who developed depressive symptoms within two years of recruitment and then reanalyzed using Cox regression. As illustrated in Fig. 2, the associations between ACE, physical pain, and depressive symptoms remained. To address collinearity issues, continuous ACE scores, the presence or absence of physical pain, and the number of pain sites were used instead of categorical ACE and pain intensity in the primary analysis. After adjusting for confounders, the results remained unchanged, consistent with previous conclusions (see Table S3 published as supplementary material online). Bayesian networks visually demonstrated the interrelations among factors influencing depressive symptoms, further verifying the association between ACE, physical pain, and depressive symptoms (see Figure S1 published as supplementary material online). When both ACE and physical pain scores were high, the probability of middle-aged and elderly individuals suffering from depressive symptoms was 76.70% (see Figure S2 published as supplementary material online). Relationship between adverse childhood experiences, physical pain and new-onset depressive symptoms during the period 2013–2020. Abbreviations: HR, hazard ratio; CI, confidence interval; ACE, adverse childhood experiences a adjusted for age, sex, residents, education, marital status, BMI, smoking, drinking, ADL, IADL, social activity, exercise, number of chronic diseases, Cystatin C, high density lipoprotein cholesterol The results of the mediation analysis are shown in Fig. 3. We found that physical pain partially mediated the association between ACE and depressive symptoms. The intensity of pain explained 7.48% of the association between ACE and depressive symptoms, while the number of pain sites accounted for 7.86%. Subgroup analyses by type of residence revealed that this mediating effect persisted in both urban and rural middle-aged and elderly populations (see Figure S3 and Figure S4 published as supplementary material online). However, the mediation effect was relatively increased in urban populations and decreased in rural populations. Effect of physical pain on the Association between ACE and the Aew-onset of Aepressive Aymptoms. Abbreviations: ACE, adverse childhood experiences. *p < 0.001. Adjusted for age, sex, residents, education, marital status, BMI, smoking, drinking, ADL, IADL, social activity, exercise, number of chronic diseases, Cystatin C, high density lipoprotein cholesterol. This study explored the association between ACE, physical pain, and depressive symptoms in middle-aged and older adults in China. It further analyzed the mediating role of the number of pain locations and the intensity of physical pain in the relationship between ACE and depression. The results indicated that both ACE and physical pain were significantly associated with a higher risk of depressive symptoms, with the risk positively correlated with the intensity of physical pain. Examination of the mediating effects revealed that both the intensity and the number of pain sites mediated the association between ACE and depressive symptoms to some extent, with this mediating effect being more pronounced in urban middle-aged and elderly populations. ACE and physical pain were identified as risk factors for depressive symptoms in middle-aged and older adults, aligning with findings from previous studies. A study in Germany during the Covid-19 pandemic identified ACE as a significant predictor of increased depressive symptoms, suggesting that individuals with ACE might be at risk for mental health issues during the current and potential future pandemics [15]. The UK’s aging longitudinal study confirmed that both ACE and polygenic susceptibility to major depression are associated with higher depressive symptoms, and the combined effect of ACE and polygenic susceptibility further increases the risk of depression [16]. Previous research has shown that physical pain often co-occurs with depressive symptoms, suggesting a bidirectional association [17, 27,28,29,30]. Building on these studies, our research further determined that in the Chinese middle-aged and elderly population, the intensity of physical pain and the number of pain sites explained 7.48% and 7.86%, respectively, of the association between ACE and depressive symptoms. Therefore, timely attention by Chinese health service personnel to the comprehensive assessment of physical pain in middle-aged and elderly people is more conducive to the prevention and control of depressive symptoms. Additionally, the Bayesian network showed that gender is a common influencing factor for both ACE and the intensity of physical pain, with physical pain not only directly affecting depressive symptoms but also influencing depressive symptoms through pathways including chronic diseases and social participation. The internal mechanisms linking ACE and physical pain with depressive symptoms remain unclear. Compared to normal individuals, those with high ACE scores experience more physical and psychological abnormalities during childhood, which may lead to physical pain in adulthood and a more closed and vulnerable psychological state. Biologically, chronic physical pain and depressive symptoms may share common neural circuits and brain modulators [31, 32]. Furthermore, research suggests that chronic inflammation is a risk factor for depression, and both ACE and physical pain are associated with some level of inflammation [33,34,35,36,37]. Longitudinal studies and meta-analyses evaluating evidence suggest that stress and immune system dysregulation due to ACE exposure are significantly associated with elevated inflammatory biomarkers, with a mechanophysiological response to trauma [38]. Long-term inflammation can cause peripheral sensitization, leading to hyperalgesia and chronic generalized pain [39]. Therefore, it is crucial to pay attention to the mental health of individuals with ACE who suffer from physical pain. China’s aging population is deepening, and the development of community health service centers is becoming more and more comprehensive, the results of this study provide guidance for the prevention and control of physical and mental health in the elderly. Measures should be taken to prevent and control the risk of depressive symptoms in potentially susceptible individuals, including regular screening and timely care for chronic physical pain in middle-aged and elderly people by community health centers [40]. This study has several significant strengths. Firstly, this cohort study integrates the intensity of physical pain and the number of pain sites to examine the association between ACE and depressive symptoms, which helps in better understanding the potential mechanisms. Secondly, the extended period of follow-up and the application of multiple imputation methods further ensure the accuracy of the causal relationships. Finally, multiple different sensitivity analyses enhance the reliability of our results. The study also has limitations. Firstly, ACE was measured by asking about experiences prior to age 18, and due to the relatively older age of the study subjects, there may be bias in recalling childhood trauma, and a certain amount of recall bias may not be eliminated. Secondly, although we adjusted for as many confounding factors as possible, the impact of residual confounders, such as genetic factors, cannot be entirely eliminated. Finally, pain in this study was self-rated by the subjects, so there may be information bias in the evaluation of pain degree. In this cohort study, we found that both ACE and physical pain were associated with a higher risk of developing depressive symptoms, particularly when both were present. Physical pain partially mediated the association between ACE and depressive symptoms in middle-aged and elderly individuals, indicating that adverse experiences in childhood can have long-term negative effects on mental health. Focusing on physical pain as a phenotypic factor may help mitigate these effects. Importantly, the development and promotion of physical pain screening and intervention measures within communities may enhance the physical and mental health of the middle-aged and elderly population with ACE. All data and materials are available from the corresponding author on reasonable request. Steel Z, Marnane C, Iranpour C, et al. 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School of Public Health, Southeast University, Nanjing, Jiangsu, China Min Bao Department of Medical Affairs, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China Rongji Ma You can also search for this author in PubMedGoogle Scholar You can also search for this author in PubMedGoogle Scholar Min Bao was in charge of study conceptualization, drafting of manuscript, carrying out statistical analyses, and interpretation of results. Rongji Ma revised the manuscript and offered constructive feedback. Correspondence to Rongji Ma. The study was approved by the Ethics Review Committee of Peking University, and all CHARLS participants provided written informed consent. All methods were carried out by the principle embodied in the Declaration of Helsinki. Not applicable. The authors declare no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 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