{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:24:38Z","timestamp":1793057078110,"version":"4.5.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"BYHEALTH Nutrition and Health Research Foundation","award":["TY202001017"],"award-info":[{"award-number":["TY202001017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study aimed to assess the association between outdoor activity and myopia among children and adolescents and investigate whether sleep time could mediate this relationship.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This cross-sectional study was performed on students aged 4\u201316\u00a0years in China, from August 2021 to January 2022. Outdoor activity was assessed by the Assessment Questionnaire of Exposure to Sunlight Activities for Students (AQESAS). Binary logistic regression combined with the mediation analysis was used to analyze the association of AQESAS with myopia and the mediating effect of sleep time on this relationship.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The prevalence of myopia was 53.51% (N\u00a0=\u00a01609). Multivariate logistic regression analysis showed that more sleep time (OR\u00a0=\u00a00.794, 95%CI: 0.707\u20130.893) and a higher score of AQESAS (OR\u00a0=\u00a00.989, 95%CI: 0.981\u20130.996) were significantly associated with a decreased risk of myopia. Mediation analysis revealed that sleep time plays a mediating role in the association between outdoor activity and myopia (ACME\u00a0=\u00a0\u22120.0006, P\u00a0&amp;lt;\u00a00.001), and the mediation proportion was 19.7%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Outdoor activity affects myopia directly and indirectly through sleep time. The result suggested that children may be able to reduce the risk of myopia by promoting sleep through increased awareness of outdoor activity and exposure to sunlight.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pubmed\/fdae104","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T05:57:17Z","timestamp":1718690237000},"page":"376-382","source":"Crossref","is-referenced-by-count":9,"title":["Mediation effect of sleep time on the association between outdoor activity and myopia in Chinese children and adolescents: a cross-sectional study"],"prefix":"10.1093","volume":"46","author":[{"given":"Tongtong","family":"Li","sequence":"first","affiliation":[{"name":"School of Public Health, Tianjin Medical University , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoming","family":"Deng","sequence":"additional","affiliation":[{"name":"Health Science Research Department, BYHEALTH Institute of Nutrition & Health , No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Huangpu District, Guangzhou 510663 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health, Tianjin Medical University , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"},{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases , Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, , No. 251. Fukang Road, Tianjin 300384 , China"},{"name":"Tianjin Medical University Eye Hospital , Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, , No. 251. Fukang Road, Tianjin 300384 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Public Health, Tianjin Medical University , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xukun","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Public Health, Tianjin Medical University , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naijian","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, Tianjin Medical University , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongxia","family":"Li","sequence":"additional","affiliation":[{"name":"Health Science Research Department, BYHEALTH Institute of Nutrition & Health , No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Huangpu District, Guangzhou 510663 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The People Hospital of Feicheng , No. 108 Xincheng Road, Feicheng 271600 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Qin","sequence":"additional","affiliation":[{"name":"Medical Laboratory, The People Hospital of Feicheng , No. 108 Xincheng Road, Feicheng 271600 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengtong","family":"Yang","sequence":"additional","affiliation":[{"name":"Health Science Research Department, BYHEALTH Institute of Nutrition & Health , No. 3 Kehui 3rd Street, No. 99 Kexue Avenue Central, Huangpu District, Guangzhou 510663 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyun","family":"Li","sequence":"additional","affiliation":[{"name":"Outpatient Department, The People Hospital of Feicheng , No. 108 Xincheng Road, Feicheng 271600 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Laboratory, The People Hospital of Feicheng , No. 108 Xincheng Road, Feicheng 271600 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Wang","sequence":"additional","affiliation":[{"name":"ENT Department, The People Hospital of Feicheng , No. 108 Xincheng Road, Feicheng 271600 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjun","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Optometry, Tianjin Medical University , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Lu","sequence":"additional","affiliation":[{"name":"School of Public Health, Tianjin Medical University , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"},{"name":"Tianjin Key Laboratory of Environment, Nutrition and Public Health , 22 Qixiangtai Road, Heping District, Tianjin 300070 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuehan","family":"Qian","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases , Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, , No. 251. 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