To evaluate the efficacy and safety of five live attenuated dengue vaccines and one inactivated dengue vaccine using Bayesian network meta-analysis, providing a scientific basis for dengue epidemic prevention and control as well as vaccine development.

A systematic search was conducted in various Chinese and English databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan fang Database, based on predefined inclusion and exclusion criteria. Randomized controlled trials (RCTs) assessing the efficacy and safety of six dengue vaccines were selected. The quality of the literature was evaluated using RevMan 5.4 software, and Bayesian network meta-analysis of relevant outcome indicators from the included RCTs was performed using R 4.3.1 software.

A total of 20 studies involving 120 909 participants were included. The results of the Bayesian network meta-analysis indicated that the efficacy of three live attenuated vaccines was notable and the ranking from highest to lowest efficacy was as follows: Butantan-DV > TAK-003 > CYD-TDV. Among these, the dengue vaccine combining serotype 4 non-structural genes and serotype 2 structural genes (Butantan-DV) showed the best preventive effect, with a risk probability of dengue infection post-vaccination lower than that of other vaccines (OR=0.22, 95%CI: 0.09-0.45). In terms of safety, the six vaccines showed varying risks of adverse events and ranked as follows: V180 > CYD-TDV > TV003 > TV005 > Butantan-DV > TAK-003. Notably, the inactivated vaccine (V180) presented a higher risk of adverse events (OR=2.28, 95%CI: 1.02-5.15).

Based on the quantity and quality of the included studies, Butantan-DV exhibited the best efficacy among the three live attenuated vaccines, while CYD-TDV demonstrated the weakest efficacy. TAK-003 showed relatively better safety. The literature on the efficacy of the V180,TV003, and TV005 vaccines is quite limited, suggesting potential directions for future research.

To understand the current state of social isolation among the elderly and its relationship with health-related quality of life, as well as to explore the mediating role of loneliness in this relationship.

A face-to-face questionnaire survey was conducted among 1 349 elderly individuals in Yangzhou using cluster random sampling. Social isolation was measured through three questions regarding social contact, loneliness was assessed using the UCLA Loneliness Scale (short version), and health-related quality of life was evaluated using the EuroQol five-dimensional questionnaire. Propensity score matching (PSM) was employed to match elderly individuals with and without social isolation in a 1:1 ratio without replacement.The mediating effect of loneliness was tested using Monte Carlo simulation analysis.

A total of 718 elderly individuals were included in the study after matching. Social isolation was negatively correlated with health-related quality of life (β=-0.016, 95%CI: -0.030 to -0.002, P<0.05) and positively correlated with loneliness (β=0.142, 95%CI: 0.047 to 0.237, P<0.01). Loneliness acted as a complete mediator in the pathway between social isolation and health-related quality of life among the elderly (β=-0.005, 95%CI: -0.008 to -0.001, P<0.01), with the indirect effect accounting for 31.25% of the total effect.

Social isolation indirectly affects the health-related quality of life of the elderly by increasing their feelings of loneliness. More opportunities for social participation should be provided to the elderly to reduce their loneliness and, consequently, improve their overall quality of life.

To investigate the current status of radiation protection in medical institutions in Sichuan Province, providing a reference for the scientific management and resource optimization of radiation diagnosis and treatment protection within the province.

A questionnaire survey was conducted to analyze medical institutions engaged in radiation diagnosis and treatment activities (excluding dental clinics) across 21 cities (prefectures) in Sichuan Province.

By the end of 2023, there were 3 424 medical institutions in Sichuan Province conducting radiation diagnosis and treatment, including 280 tertiary institutions (8.18%), 647 secondary institutions (18.90%), 1 104 primary institutions (32.24%), and 1 393 unclassified institutions (40.68%). A total of 31 763 radiation workers were employed. The province had 9 056 radiation diagnosis and treatment devices, with 3 346 in tertiary institutions (36.95%), 2 057 in secondary institutions (22.71%), 1 510 in primary institutions (16.67%), and 2 143 in unclassified institutions (23.67%). The pass rate for initial inspections of sentinel hospital equipment was 96.00%, while the re-inspection pass rate was 97.41%. Devices over 10 years old accounted for 24.70%, those between 5 to 10 years for 62.10%, and those under 5 years for 13.20%. The annual total of radiation diagnosis and treatment visits reached 49.8 897 million. The province had 48 877 pieces of personal protective equipment for radiation, with an average of more than 13 protective items per device in nuclear medicine and interventional radiology. Compared to 2014, the number of institutions conducting radiation diagnosis and treatment increased by 27%, the number of radiation workers grew by 251%, and the frequency of radiation diagnosis and treatment activities rose by 215%.

The update of radiation equipment is slow, with most devices in use for 5 to 10 years, indicating a need for improved maintenance and monitoring awareness among medical institutions. All levels of medical institutions meet the requirements for the quantity of radiation protection supplies, and there is sufficient provision of protective items in interventional radiology and nuclear medicine projects. Given the increasing frequency of radiation diagnosis and treatment, it is recommended that relevant departments strengthen monitoring of radiation equipment protection to enhance the level of radiation diagnosis and treatment in medical institutions and ensure safe practices in these activities.

To analyze the physical exercise habits of urban and rural residents in Henan Province and their association with depression, anxiety disorders, and insomnia.

A stratified multi-stage random sampling method was employed to survey residents aged 18 and older in urban and rural areas of Henan Province. Data on demographic characteristics, physical exercise, and mental health status were collected using questionnaires and screening scales. Subsequent diagnosis of mental disorders was performed on individuals screened out by the scales, and analyses were conducted using χ² tests and logistic regression.

(1) Among 10 057 urban and rural residents, the proportions of individuals engaging in minimal, low, moderate, and high levels of exercise were 46.8%, 21.1%, 26.1%, and 6.0%, respectively. Statistically significant differences in exercise levels were observed across various demographics, including region, gender, age, education level, occupation, marital status, monthly income, smoking habits, drinking habits, health status, and mental health literacy (P<0.05). (2) Multivariate logistic regression analysis indicated that, after adjusting for demographic characteristics, lifestyle habits, and health status, participants engaging in moderate exercise had a lower risk of depression (OR=0.670, 95%CI: 0.470-0.954) and insomnia (OR=0.758, 95%CI: 0.651-0.883) compared to those who did not exercise. (3) Logistic regression results among different demographic groups showed that participants engaging in moderate exercise had a lower risk of insomnia in urban (OR=0.674,95%CI: 0.446-0.987), rural (OR=0.664, 95%CI: 0.547-0.805), male (OR=0.744, 95%CI: 0.592-0.935), and 18-35 age groups (OR=0.514, 95%CI: 0.313-0.842). In the female population, those engaging in moderate exercise had a lower risk of depression (OR=0.296, 95%CI: 0.171-0.512) and anxiety disorders (OR=0.613, 95%CI: 0.432-0.870) compared to non-exercisers. Additionally, compared to non-exercisers, participants with small (OR=0.774, 95%CI: 0.627-0.955), moderate (OR=0.682, 95%CI:0.56-0.827), and high levels of exercise (OR=0.542, 95%CI: 0.367-0.800) had lower risks of insomnia. Among the 36-59 and ≥60 age groups, participants engaging in moderate exercise had a lower risk of depression (OR=0.621, 95%CI: 0.374-0.932; OR=0.502, 95%CI: 0.284-0.887), anxiety disorders (OR=0.665, 95%CI: 0.460-0.960; OR=0.737, 95%CI: 0.582-0.925), and insomnia (OR=0.674, 95%CI: 0.545-0.833; OR=0.625, 95%CI: 0.482-0.812).

There are significant differences in physical exercise levels among different demographic groups. Participants engaging in moderate exercise have a lower risk of depression and insomnia, with a more pronounced correlation between physical exercise and mental disorders observed in females and older adults.

To explore the causal relationship between serum micronutrients and hypertension using Mendelian randomization, thereby promoting the prevention and health management of hypertension.

Fourteen serum micronutrients were selected as exposure factors, with hypertension as the outcome. Two-sample Mendelian randomization analyses were conducted based on genome-wide association study data from European populations, followed by multivariable Mendelian randomization analyses to identify variables that may have a causal relationship with the outcome, determining the independent effects of each exposure factor on the outcome.

Univariate Mendelian randomization analysis indicated a positive causal effect of elevated copper levels on the incidence of hypertension (P<0.05). Multivariable Mendelian randomization showed that the causal relationship between copper and hypertension remained significant after controlling for potassium and vitamin B6 (OR=1.028, 95%CI: 1.009-1.047, P<0.05).

There is a causal relationship between elevated copper levels and hypertension. However, the findings of this study require validation through randomized controlled trials.

To analyze the epidemiological characteristics of Hepatitis A virus (HAV) in Xinjiang from 2005 to 2023,providing a scientific basis for its prevention and control.

Descriptive epidemiological methods were employed to analyze the epidemiological characteristics of HAV reported in Xinjiang from 2005 to 2023 using data from the Chinese Disease Prevention and Control Information System.

A total of 55 586 cases of HAV were reported in Xinjiang from 2005 to 2023, with an average annual incidence rate of 14.54 per 100 000. The incidence rate decreased from 31.19 per 100 000 in 2005 to 0.75 per 100 000 in 2023. The regions with the highest incidence rates were Kizilsu (31.45 per 100 000) and Hotan (24.55 per 100 000). The majority of cases were among scattered children (39.70%). The age group with the highest incidence was 0 to 15 years (36.08%). The gender ratio decreased to 1.00 by 2023.

Between 2005 and 2023, the prevention and control measures for HAV in Xinjiang were significantly effective. Continued efforts in vaccination and enhanced comprehensive prevention measures for children are necessary.

To analyze the application of the ARIMA and LSTM models in predicting pertussis incidence in Urumqi, providing a basis for assessing the epidemic trend of pertussis.

Monthly reported incidence data of pertussis in Urumqi from 2011 to 2021 were used to establish ARIMA and LSTM models. The incidence data from 2022 to 2023 were utilized to validate the predictive performance of the two models. The models’ performance was evaluated using Root Mean Square Error (RMSE) and Mean Absolute Error (MAE), and the incidence of pertussis in 2024 was predicted.

The incidence of pertussis in Urumqi from 2011 to 2023 showed an upward trend with seasonal variations. Additionally, a high incidence state of pertussis began in August 2023. Both the ARIMA and LSTM models demonstrated good fitting, although there were discrepancies in their predictions for July to December 2023. The overall predictive performance of the LSTM model (RMSE=32.34, MAE=11.41) was superior to that of the ARIMA model (RMSE=42.81, MAE=14.34). The LSTM model, which showed better validation results, predicted a continued increase in pertussis incidence for 2024.

The LSTM model provides a more accurate prediction of the pertussis incidence trend in Urumqi, offering valuable insights for monitoring and controlling the epidemic of pertussis.

To investigate the potential categories of health literacy in elderly patients with type 2 diabetes and their relationship with glycemic control.

A convenience sampling method was employed to select 1 113 elderly patients with type 2 diabetes from the Affiliated Hospital of North China University of Science and Technology between September 2021 and August 2022. General demographic data and diabetes health literacy were assessed using questionnaires, including a diabetes health literacy scale. A latent profile analysis was conducted on the health literacy of elderly patients with type 2 diabetes, and glycated hemoglobin levels were measured. The relationship between the latent categories of health literacy and glycemic control was analyzed using χ² tests and binary logistic regression.

The health literacy levels of patients could be categorized into three latent categories: low willingness to improve (31.72%), moderate balanced type (31.35%), and high confidence coping type (36.93%). Propensity score matching successfully matched 283 pairs of subjects. Low willingness to improve health literacy was identified as a risk factor for poor glycemic control in elderly patients with type 2 diabetes (OR=2.238, 95%CI:1.355-3.696), while high confidence coping health literacy served as a promoting factor for glycemic control (OR=0.318,95%CI: 0.196-0.516).

High health literacy can facilitate glycemic control in elderly patients with type 2 diabetes, suggesting that targeted interventions should be developed for different health literacy populations.

To explore the association between social activities and hypertension in individuals aged ≥ 45 in China, providing new intervention strategies for the prevention and treatment of hypertension.

A cross-sectional study was conducted using data from the fifth national survey of the China Health and Retirement Longitudinal Study (CHARLS) 2020.Demographic characteristics, lifestyle factors, and indicators of social activities of the study subjects were included. The association between seven types of social activities and hypertension among middle-aged and elderly individuals was analyzed using χ² tests and multivariate logistic regression.

A total of 19 213 middle-aged and elderly individuals were included, comprising 10 159 men and 9 054 women, with a median age of 63 years (ranging from 55 to 70 years). The prevalence of hypertension was 40.08% (7 702/19 213). Logistic regression analysis indicated that after adjusting for all confounding factors, visiting neighbors and socializing with friends (OR=1.08, 95%CI: 1.01-1.15, P=0.022) and participating in volunteer or charity activities (OR=1.23, 95%CI: 1.04-1.46, P=0.016) were positively associated with the risk of hypertension. Conversely, activities such as dancing, exercising, or practicing Qigong in parks or other venues were negatively associated with the risk of hypertension (OR=0.88, 95%CI: 0.78-1.00, P=0.044).

Participation in different social activities is associated with hypertension. It is recommended to encourage middle-aged and elderly individuals to actively engage in health-promoting social activities to reduce the risk of hypertension, thereby providing scientific guidance for achieving “Healthy China 2030”.

To analyze the impact of breastfeeding on life expectancy (LE) and healthy life expectancy (HLE) among rural women.

A cohort study was conducted involving women aged 40 and above from rural Henan. Data on demographic characteristics, personal medical history, and breastfeeding history were collected through questionnaires. The European five-dimensional health scale (EQ-5D-5L) was used to assess the quality-of-life utility index and visual analog scale (VAS) scores. Multi-state life table method was employed to calculate LE and HLE from three dimensions: common chronic diseases, health status utility index, and VAS scores.

Women with breastfeeding history had a lower prevalence of common chronic diseases (21.85% vs 23.46%). The average health status utility index and VAS scores were 0.94±0.12 and 76.85±15.26 for those with a breastfeeding history, compared to 0.93±0.15 and 76.09±17.97 for those without. In terms of common chronic diseases, women with breastfeeding history had HLE and LE at age 40 of 24.10 years and 44.36 years, respectively, which were 3.48 years and 3.23 years longer than those without breastfeeding history. In the utility index dimension, women with breastfeeding history had HLE and LE at age 40 of 35.96 years and 44.58 years, respectively, which were 4.08 years and 4.40 years longer than those without. In the VAS score dimension, HLE and LE at age 40 for women with breastfeeding history were 32.31 years and 46.36 years, respectively, which were 3.39 years and 3.75 years longer than those without. Among the three dimensions, in the utility index dimension, the highest HLE at age 40 was observed based on cumulative breastfeeding duration: ≤36 months (35.34 years), 37-60 months (35.87 years), and ≥61 months (36.34 years).

Breastfeeding is associated with longer HLE and LE among rural women, with those having a breastfeeding history enjoying greater HLE and LE. Increased cumulativebreastfeeding duration correlates with longer LE.

To develop a Knowledge, Attitude, and Behavior Scale for Adolescent Sexual and Reproductive Health and to conduct reliability and validity testing, providing a measurement tool for assessing adolescents’ knowledge, attitudes, and behaviors regarding sexual and reproductive health.

Based on the Knowledge, Attitude, and Behavior theoretical framework, an initial scale was formed through literature review, expert meetings, and preliminary surveys. A convenience cluster sampling method was employed to include 347 middle school students who met the criteria for item analysis and reliability and validity testing, resulting in the formal version of the scale.

The formal scale consists of three dimensions: knowledge, attitude, and behavior, with a total of 33 items. The expert authority coefficient score was 0.89, and Kendall’s W coefficient was 0.478. The content validity at the item level ranged from 0.82 to 1.00, while the content validity at the scale level was 0.93. Confirmatory factor analysis using Amos 24.0 yielded a model χ²/v of 1.831, RMSEA of 0.049, GFI of 0.842, CFI of 0.91,and PGFI of 0.739, indicating good model fit and structural validity. The overall Cronbach’s α was 0.914, with dimensionspecific Cronbach’s α values of 0.924, 0.767, and 0.741; the splithalf reliability of the total scale was 0.76. The testretest reliability correlation coefficient (r) for the total scale was 0.717 (P<0.001).

The Knowledge, Attitude, and Behavior Scale for Adolescent Sexual and Reproductive Health demonstrates good reliability and validity and can be used to assess adolescents’ knowledge, attitudes, and behaviors regarding sexual and reproductive health.

To analyze the influencing factors of myopia in children and adolescents, providing references for precise myopia prevention.

A stratified cluster random sampling method was employed to select 1 660 students aged 9 to 18 from six schools in Jiading District, Shanghai, for vision testing and questionnaire surveys from September to October of 2021.The random forest model was utilized to rank the importance of myopia influencing factors, and the sliding window sequential forward selection method was applied for dimensionality reduction. The factors with the highest importance scores and the lowest average out-of-bag estimation error rates were included in a multifactorial logistic regression analysis model to estimate the direction and effect values of the influencing factors.

The myopia rate among the 1 660 children and adolescents was 71.99%. The random forest model indicated that the average out-of-bag estimation error rate was minimized when the number of variables was six. When incorporated into the multifactorial logistic regression analysis model, the results showed that advancing educational stage (junior high: OR=5.191, 95%CI: 3.738-7.209; senior high: OR=6.989, 95%CI: 4.309-11.338), parental myopia (one parent myopic: OR=3.669, 95%CI: 2.723-4.943; both parents myopic: OR=5.231, 95%CI: 3.510-7.795), increased reading and writing duration (<1h: OR=12.192, 95%CI: 3.373-44.066; 1-2h: OR=11.985, 95%CI: 3.364-42.704; ≥2h:OR=10.547, 95%CI: 2.957-37.622), participation in extracurricular classes (<6 years: OR=3.114, 95%CI: 2.046-4.740; ≥6 years: OR=1.817, 95%CI: 1.351-2.444), and using only ceiling lights for reading and writing at home after dark (OR=2.921,95%CI: 2.009-4.248) were identified as risk factors for myopia. In contrast, a sleep duration of ≥8 hours (OR=0.383, 95%CI:0.264-0.557) was identified as a protective factor against myopia.

The prevalence of myopia among children and adolescents is high, and targeted measures should be implemented based on the identified influencing factors for myopia prevention and control.

To understand the epidemiological characteristics of chickenpox-related absenteeism among primary and secondary school students in Huai’an city, providing reference for further improving chickenpox prevention and control in schools.

Descriptive epidemiological methods were employed to analyze data on chickenpox-related absenteeism collected from the Jiangsu Provincial Student Health Monitoring System for the 2018 to 2022 academic years. The circular distribution method was used to analyze the seasonal characteristics of absenteeism due to chickenpox.

The average annual rate of chickenpox-related absenteeism among primary and secondary school students in Huai’an city from 2018 to 2022 was 26.23 per 100 000. The absenteeism rates varied between 11.96 (2021 academic year) and 70.84 (2020 academic year) (χ²=101 240.39, P < 0.01), with an average of 3.98 days absent per student. The absenteeism rate for boys was higher than that for girls (27.06 vs. 25.26, χ²=166.19, P < 0.01). Among different school types, the average absenteeism rate ranged from 4.30 (vocational high schools) to 39.97 (primary schools), with urban students exhibiting a higher average absenteeism rate compared to those in suburban areas (30.84 vs. 17.10, χ²=9 519.78, P < 0.01). A primary peak in absenteeism occurred from October to December in the first semester, while a secondary peak was observed from April to June in the second semester. Circular distribution method analysis revealed a significant seasonal concentration trend, with peak days occurring on November 26 and May 18, and peak periods spanning from October 29 to December 25 and from April 9 to June 26, respectively (Z values of 48 673.79 and 217.29, with P values < 0.01).

The rate of chickenpox-related absenteeism among primary and secondary school students in Huai’an city is relatively high. Monitoring should focus on boys, primary schools, urban areas, and the two peak periods (October-December and April-June). The circular distribution method for analyzing seasonal characteristics of absenteeism due to chickenpox demonstrates good practicality and can provide data support for chickenpox prevention and control in schools.

To investigate the relationship between physical and cognitive activities and cognitive function in different socioeconomic status (SES) populations, providing a basis for interventions targeting cognitive impairment in elderly individuals of varying SES.

Data were sourced from the Hubei Memory and Aging Cohort Study (HMACS), including physical examinations and cognitive assessments. SES was categorized into low, medium, and high groups based on education level, occupation, and income. Physical Activity (PA) and Cognitive Leisure Activity (CLA) were standardized through a comprehensive scoring system based on the type, duration, and frequency of activities. Chi-square tests or t-tests were used to analyze group differences, while multivariate logistic regression examined the association between SES and overall cognitive impairment as well as specific cognitive domains. General linear regression models analyzed the relationship between activity scores and cognitive function in elderly individuals across different SES groups.

A total of 8 597 eligible participants aged ≥65 years were included in HMACS, with a mean age of 72.2 (±6.0) years, an average education level of 7.9 (±5.2) years, including 4 735 females (55.1%), 3 008 from rural areas (35.0%), and 2 155 currently unmarried individuals (25.2%). Among them, 1 553(18.1%) were classified as low SES, and 2 677 (31.1%) had cognitive impairment. The prevalence of cognitive impairment was 1.88 times (95%CI: 1.62-2.18) higher in the medium SES group and 3.61 times (95%CI: 2.92-4.46) higher in the low SESgroup compared to the high SES group. In the medium SES group, PA showed the strongest association with memory and attention functions (β=0.06, 95%CI: 0.02-0.11; β=0.08, 95%CI: 0.04-0.12, respectively). In the low SES group, CLA demonstrated the strongest associations with overall cognitive function, memory, language, attention, and processing speed compared to the high SES group, with respective β values of 0.20 (95%CI: 0.12-0.28) vs. 0.03 (95%CI: 0.01-0.05), 0.15 (95%CI: 0.06-0.24) vs.0.04 (95%CI: -0.01-0.10), 0.07 (95%CI: -0.03-0.16) vs. 0.02 (95%CI: -0.02-0.07), 0.15 (95%CI: 0.07-0.24) vs. 0.06(95%CI: 0.00-0.11), and 0.22 (95%CI: 0.08-0.36) vs. 0.04 (95%CI: -0.02-0.09). Additionally, the combination of PA and CLA in the low SES group showed the strongest associations with overall cognitive function, memory, language, attention, and processing speed compared to the high SES group, with β values of 0.29 (95%CI: 0.19 to 0.40) vs. 0.04 (95%CI: 0.00 to 0.07),0.14 (95%CI: 0.02 to 0.26) vs. 0.05 (95%CI: -0.03 to 0.13), 0.11 (95%CI: -0.01 to 0.23) vs. 0.05 (95%CI: -0.01 to 0.11), 0.17(95%CI: 0.07 to 0.28) vs. 0.09 (95%CI: 0.01 to 0.17), and 0.23 (95%CI: 0.04 to 0.41) vs. -0.02 (95%CI: -0.09 to 0.05).

Physical and cognitive activities have a more significant impact on improving cognitive function among elderly individuals with low socioeconomic status. Implementing CLA and combined PA with CLA in low SES populations shows promising cognitive improvement effects.

To analyze the financing and utilization of preventive service costs in Guizhou Province from 2016 to 2022, providing reference for improving the resilience and sustainability of preventive funding structures and optimizing the functional structure of preventive services.

Based on the System of Health Accounts 2011 (SHA2011), this study analyzes the preventive service costs in Guizhou Province from the dimensions of total preventive service costs, financing schemes, service functions, and institutional flows.

The preventive service costs in Guizhou Province were 3.72 billion yuan in 2016, increasing to 10.056 billion yuan by 2022, with the proportion of these costs in recurrent health expenditures rising from 5.07% to 8.49%. In 2020, the proportion of expenditures on infectious disease prevention and control increased to 14.71%,while the shares for chronic disease management, child health services, and maternal health care decreased. Over the seven years, government programs and household health expenditures declined, while corporate financing significantly increased. The proportion of preventive service costs attributed to hospitals and grassroots medical institutions rose annually from 48.59% to 67.29%.

From 2016 to 2022, the preventive service costs and their share of recurrent health expenditures in Guizhou Province increased; however, the phenomenon of “less attention on prevention and much attention on treatment” remains evident. Hospitals, grassroots medical institutions, and public health agencies are the primary providers of various preventive services, reflecting a trend of “medical care supporting prevention”. The proportion of personal cash expenditures in preventive service costs gradually decreased, but government and social health funding remains insufficient, and the financing structure is vulnerable to short-term and long-term external factors.

To analyze the pilot policies for long-term care insurance and provide recommendations for optimizing these policies.

Utilizing the PMC index model, we constructed nine primary variable indicators and 45 secondary variable indicators to evaluate long-term care insurance policies.

Common issues across various regions included insufficient policy levels, unclear policy timelines, and inadequate incentive and constraint mechanisms.

It is necessary to elevate policy levels and further enhance the government’s coordination and collaboration, clarify policy timelines to achieve an organic integration of short, medium, and long-term planning, and improve incentive and constraint measures to effectively increase participation in insurance.

To analyze the coupling coordination relationship between the construction achievements of the 39 tight-knit county medical community pilot counties in Guangxi and the regional economic development levels in 2022.

The coupling coordination degree model was used to analyze the coupling coordination degree of the two systems. Moran I index was employed to conduct spatial correlation analysis of the coupling coordination degree.

Among the pilot counties, five counties (12.82%) exhibited a moderate coordination type between the construction achievements and regional economic development levels; 21 counties (53.85%) were in a barely coordinated state; and 13 counties (33.33%) showed moderate disorder.The global Moran I index was 0.542.

The coupling coordination degree of the two systems needs improvement; the achievements of the medical community construction are generally ahead of the regional economic development levels; there are regional disparities in coupling coordination degree, and mutual cooperation among the pilot counties in advancing the medical community construction is weak. It is recommended to strengthen cooperation and communication, promote high-quality regional economic development, and facilitate the rational allocation of quality medical and health resources.

To provide a reference for the expansion and balanced distribution of quality medical resources, thereby promoting maternal and child health.

This study utilized panel data from 31 provinces, cities, and autonomous regions from 2012 to 2021. The Moran I index and Getas-Ord G* index were employed to analyze the spatiotemporal characteristics and hotspot distributions of quality medical resources. The Grossman health production function was used to explore the effects of quality medical resources on maternal and child health.

From 2012 to 2021, the overall quality of medical resources in China showed an upward trend, with the number of tertiary hospitals increasing from 1 624 to 3 275, increasing by 101.66%.The Moran I indices for the years 2012, 2017, and 2021 were 0.292, 0.286, and 0.264, respectively, indicating a declining trend in the spatial autocorrelation of quality medical resources. For every additional tertiary hospital per 10 000 square kilometers, the infant mortality rate decreased by approximately 2.73‰, and the maternal mortality rate decreased by about 0.25 per 100 000.

The overall trend of quality medical resources in China is upward, with the eastern region experiencing the highest increase in quality medical resources, while the western region shows the greatest percentage increase. A significant“East-Central-West” hierarchical differentiation pattern exists, characterized by a spatial clustering distribution, where the eastern region is high, the central region is relatively high, and the western region is low. The effects of quality medical resources on maternal and child health are significant, negatively impacting both infant and maternal mortality rates.

To explore the factors related to cognitive impairment in elderly individuals aged 60 and above in China from the perspective of social determinants of health, providing a reference for the prevention and treatment of cognitive impairment in the elderly.

Utilizing data from the fourth wave of the 2018 China Health and Retirement Longitudinal Study, we conducted a statistical description of the cognitive status of 5 721 elderly individuals aged ≥60. A multifactor logistic regression model was employed to analyze factors affecting cognitive status in the elderly, investigating the impact of the interaction between depression symptoms and disability on cognitive impairment.

Among the participants, 2 277 individuals (39.80%) were identified with cognitive impairment. Risk factors for cognitive impairment included being female (OR=1.702, 95%CI: 1.491 to 1.943), aged ≥80 years (OR=1.862, 95%CI: 1.467 to 2.364), experiencing depression (OR=1.333,95%CI: 1.173 to 1.514), having a disability (OR=2.082, 95%CI: 1.687 to 2.569), sleeping more than 8 hours (OR=1.582,95%CI: 1.288 to 1.944), and residing in central and western regions (OR=1.275, 1.538; 95%CI: 1.109-1.467, 1.337-1.771). There was a multiplicative interaction between depression and disability affecting cognitive status in the elderly (P _interaction=0.005), with no additive interaction observed (RERI=-1.217, 95%CI: -2.480 to 0.046; AP=-0.522, 95%CI: -1.112 to 0.069;S = 0.523, 95%CI: 0.291 to 0.938).

The detection rate of cognitive impairment among elderly individuals in China is concerning. The multiplicative interaction of depression and disability on cognitive status suggests that the government should intervene from the perspective of social determinants of health, implementing multidimensional strategies to achieve an integrated approach to prevention and treatment.

To analyze the multiple mediating effects of different types of social activities on the relationship between health status and cognitive function, providing insights for mitigating cognitive impairment in older adults.

Using data from the 2018 China Health and Retirement Longitudinal Study, 7 991 individuals aged 65 and older were selected to construct a multiple mediation model examining the mediating effects of physical exercise, cultural and recreational activities, interpersonal interactions, and family life on the relationship between self-rated health and cognitive function.

Self-rated health and the four types of social activities were significantly correlated with cognitive function (P < 0.01). Physical exercise, cultural and recreational activities, interpersonal interactions, and family life exhibited partial mediating effects between self-rated health and cognitive function. Specifically, self-rated health directly influenced cognitive function with an effect size of 0.591 (95%CI: 0.471-0.710). Furthermore, self-rated health mediated cognitive function through the four types of social activities. The mediating effect size was 0.010 (95%CI: 0.002-0.018) for physical exercise, 0.083 (95%CI: 0.055-0.113) for recreational activities, 0.061 (95%CI: 0.042-0.080) for interpersonal interactions, and 0.078 (95%CI: 0.054-0.104) for family life.

Self-rated health can delay cognitive decline in older adults by promoting their participation in social activities.

To explore the parallel mediating effects of life satisfaction and parent-child relationship satisfaction on the relationship between daily living activity ability and depression in elderly patients with chronic respiratory diseases, providing references for improving their quality of life.

Data from the China Health and Retirement Longitudinal Study (CHARLS) 2020 were used, involving patients aged 60 and older with chronic respiratory diseases. The PROCESS 4.1 macro was employed to analyze the mediating effects between daily living activity ability and depression, and the bias-corrected nonparametric percentile Bootstrap method was used to validate the mediating variables.

Impaired daily living activity ability was negatively correlated with parent-child relationship satisfaction (r=-0.08, P < 0.01) and life satisfaction (r=-0.16, P <0.001), while positively correlated with depression (r=0.35, P < 0.001). The mediating effect analysis indicated that the total effect value of daily living activity ability on depression was 0.231 (95%CI: 0.600-0.944), with a direct effect value of 0.183(95%CI: 0.451-0.773). Life satisfaction and parent-child relationship satisfaction played parallel mediating roles between daily living activity ability and depression, with mediating effect values of 0.040 (95%CI: 0.018-0.062) and 0.009 (95%CI: 0.002-0.017), respectively. The total mediating effect accounted for 20.78% (95%CI: 0.023-0.074) of the overall effect.

There is a relationship between daily living activity ability and depression in elderly patients with chronic respiratory diseases.Life satisfaction and parent-child relationship satisfaction serve as parallel mediators in this relationship. Focusing on improving daily living activity ability and enhancing life satisfaction and parent-child relationship satisfaction may help alleviate depression in older patients with chronic respiratory diseases.

To verify the relationship between social participation and cognitive decline in the elderly, and to explore the effects of different types of social participation on cognitive decline based on data from the China Health and Retirement Longitudinal Study.

A total of 3 016 individuals aged 60 and above, who were followed across all five waves and did not have Alzheimer’s disease, was selected from the database to construct a balanced panel dataset. A fixed-effects Logit model controlling for individual-level characteristics was established.

The prevalence of cognitive decline among the elderly at baseline was 6.4%, which increased to 30.7% by the fifth wave. The proportion of cognitively declined elderly individuals engaging in social participation was 3.2% to 10.5% lower than those not participating. In the fixed-effects Logit analysis, the odds ratio (OR) was 0.575 (95%CI: 0.502-0.658), indicating an impact magnitude of approximately 40%. Among different types of social participation, social engagement significantly affected cognitive decline, with an OR of 0.640 (95%CI: 0.494-0.828).

The government should implement the concept of active aging, improve participation mechanisms, effectively ensure the rights of the elderly to engage in social participation, and encourage their involvement in social activities.

To assess the association between mood swings and pancreatic cancer using two-sample Mendelian randomization (TSMR) and to identify potential mediators between mood swings and pancreatic cancer through multivariable Mendelian randomization (MVMR).

Summary statistics for mood swings were obtained from genome-wide association studies (GWAS). Summary data for pancreatic cancer were derived from a cross-population atlas of 220 human phenotypic genetic associations. Single nucleotide polymorphism (SNP) associated with body mass index (BMI) and several common risk factors for pancreatic cancer, including smoking, alcohol consumption, triglycerides, and total cholesterol, were sourced from the UK Biobank and the IEU database. Causal relationships between mood swings and pancreatic cancer were explored using inverse variance weighting (IVW), MR-Egger, weighted median, simple mode, and weighted mode methods. A series of sensitivity analyses were conducted to evaluate the stability of the results.

Genetically predicted mood swings were positively associated with pancreatic cancer risk, with the IVW method indicating that individuals with genetically determined mood swings had an increased risk of developing pancreatic cancer (OR=2.05, 95%CI: 1.21-3.48). After adjusting for BMI using MVMR, the association between mood swings and pancreatic cancer was attenuated (OR=1.45, 95%CI: 0.94-2.23). Mediation analysis estimated that BMI partially mediated the causal relationship between mood swings and pancreatic cancer risk, with a mediation proportion of 48.2%.

The findings of this study indicate a positive correlation between mood swings and the risk of pancreatic cancer, potentially mediated by effects on BMI.

Self-perceptions of aging (SPA) are a critical issue in the mental health of middle-aged and older adults, yet the complex relationship with obesity remains insufficiently explored. This study analyzes the impact of obesity on SPA among this demographic.

Utilizing longitudinal follow-up data from the Health and Retirement Study (HRS) in the United States, logistic regression was employed to examine the relationship between Body Mass Index (BMI) and SPA, while restricted cubic splines (RCS) were used to reveal potential nonlinear associations.

After adjusting for baseline age, gender, race, education level, marital status, number of chronic diseases, depressive symptoms, functional limitations, and baseline SPA levels, grade 2/3 obesity was associated with negative SPA (OR=1.50, 95%CI: 1.08-2.07), and a significant nonlinear relationship between BMI and SPA was observed (P-overall < 0.001, P-nonlinear = 0.042). Subgroup analysis indicated that among individuals under 80 years old, females, those with a high school education or lower, Caucasians, individuals with depressive symptoms, and those without functional limitations, grade 2/3 obesity was positively correlated with negative SPA.

Obesity in middle-aged and older adults is related to negative SPA. Healthcare professionals should pay attention to the potential psychological impacts of obesity during the aging process and develop more targeted prevention and intervention strategies to assist obese individuals in improving their mental health as they age.

To establish a QuEChERS-UHPLC-MS/MS method for the determination of residues of 45 antibiotics in eggs.

Samples were extracted using a 90% acetonitrile aqueous solution (containing 0.1% formic acid), and the supernatant was transferred to a QuEChERS tube (150 mg HLB-P + 50 mg PSA) for purification. The purified extract was concentrated to near dryness under nitrogen, and then reconstituted with 10% methanol aqueous solution (containing 0.1% formic acid). Target compounds were separated using a BEH C18 column (2.1×100 mm, 1.7 μm) with a gradient elution of 0.1% formic acid in water and 0.1% formic acid in methanol as the mobile phase. Detection was performed in positive ion multiple reaction monitoring mode, and quantification was achieved using matrix-matched calibration curves.

Over the concentration range of 1.0 to 200 μg/L, all 45 target analytes exhibited good linear relationships in their regression equations. The method’s limit of detection was 1.0 μg/kg, with spiked recoveries ranging from 69.2% to 109.6% and relative standard deviations (RSD) between 1.2% and 15.8%.

This method is simple, rapid, and exhibits high accuracy and precision, making it suitable for the simultaneous detection of 45 antibiotics in eggs.

To explore a method for monitoring the concentration of SARS-CoV-2 in sewage in Shenzhen using digital PCR, enabling real-time detection of viral nucleic acids in sewage and reflecting the epidemiological status of COVID-19 infections in the population through nucleic acid concentration.

A digital PCR detection system for SARS-CoV-2 in sewage was established, and its minimum detection limit was determined. From April to July 2023, 24-hour composite sewage samples were collected twice weekly from the inflow of six sewage treatment plants in Nanshan and Futian districts of Shenzhen. The modified polyethylene glycol precipitation method was used for viral concentration enrichment, followed by quantitative detection of SARS-CoV-2 nucleic acids using the established reverse transcription digital PCR (RT-dPCR) method. Concurrently, data on COVID-19 infection cases in the monitored sewage areas were collected for correlation analysis with the nucleic acid concentrations in the sewage.

The RT-dPCR method for SARS-CoV-2 nucleic acid detection was successfully established, with a minimum detection limit of 1.00 copies/μl. A total of 162 sewage samples were collected from April to July 2023, with a positive detection rate of 96.3% for SARS-CoV-2 nucleic acids. The concentration of SARS-CoV-2 nucleic acids in Nanshan district ranged from 1.00×10³ to 1.08×10⁶ copies/L, while in Futian district it ranged from 1.44×10³ to 1.40×10⁶ copies/L, with peak concentrations observed on May 16. Correlation analysis indicated a significant association between sewage SARS-CoV-2 nucleic acid concentrations and the number of COVID-19 infection cases in the population (Nanshan district r=0.77, P<0.001; Futian district r=0.80, P<0.001).

The digital PCR method is suitable for the quantitative detection of low concentrations of SARS-CoV-2 nucleic acids in sewage, allowing for real-time monitoring of the COVID-19 epidemic, thus providing a scientific basis for public health management and intervention.

To analyze suspected adverse events following immunization (AEFI) of poliomyelitis vaccination (PV) in Anhui Province from 2020 to 2023.

Data on adverse events following immunization (AEFI) were collected through the AEFI monitoring module of the Chinese Disease Prevention and Control Information System. These included cases related to the bivalent oral poliovirus vaccine (bOPV), inactivated poliomyelitis vaccine made from Sabin strains (sIPV), inactivated poliovirus vaccine (IPV), and the combined diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and Haemophiles influenza type b vaccine (DTaP-IPV-Hib). The number of vaccine doses administered was obtained from the Anhui Immunization Program Information Management System. Descriptive epidemiological methods were used to analyze the incidence and characteristics of AEFI reports.

A total of 3 036 cases of AEFI related to poliomyelitis vaccination were reported in Anhui Province from 2020 to 2023, with an overall incidence rate of 38.37 per 100 000 doses. The incidence rates for bOPV, IPV-Sabin, IPV-Salk, and DTaP-IPV-Hib were 17.47, 47.86, 33.29, and 82.11 per 100 000 doses, respectively. General reactions accounted for 94.57% of cases, while abnormal reactions constituted 4.97%. The male-to-female ratio was 1.31:1. Among general reactions, the incidence rates for high fever (axillary temperature ≥ 38.6°C), local swelling (diameter > 2.5 cm), and local induration (diameter > 2.5 cm) were 8.67, 7.22, and 4.41 per 100 000 doses, respectively. For abnormal reactions, the incidence rates for allergic rashes and other diseases were 1.43 and 0.48 per 100 000 doses, respectively.

From 2020 to 2023,AEFI related to poliomyelitis vaccination in Anhui Province were predominantly general reactions, with abnormal reactions being rare.

To analyze the epidemiological characteristics of public health emergencies in Yunnan Province’s border areas in recent years, providing a scientific basis for effective prevention and control measures.

Data on public health emergencies reported in 25 border counties (cities) of Yunnan Province from 2012 to 2022 were collected through the “China Disease Prevention and Control Information System-Public Health Emergency Reporting Management System”. Descriptive epidemiological methods were employed to analyze the epidemiological characteristics.

From 2012 to 2022, a total of 452 public health emergencies were reported in Yunnan Province’s border areas, with 31 020 cases and 110 deaths, resulting in an overall incidence rate of 0.94% and a case fatality rate of 0.35%. The primary types of events were infectious disease outbreaks (75.2%) and food poisoning (22.1%). The peak periods for infectious disease outbreaks were June and November, while food poisoning peaked from May to July. The leading causes of events were chickenpox (21.0%), COVID-19 (17.7%), and wild mushroom poisoning (9.5%), with wild mushroom poisoning accounting for the most deaths (53 cases, 48.2%). Schools (47.7%) and communities/villages (27.7%) were the main locations for infectious disease outbreaks. Dehong Prefecture reported 192 events, constituting 42.7% of the total, with 13 644 cases, representing 44.0% of the total cases. Twelve (48.0%) border counties (cities) reported 16 public health emergencies caused by imported infectious diseases, primarily from Myanmar (93.7%) and Laos (6.3%). Main diseases included dengue fever (31.3%), COVID-19 (31.3%), and chikungunya (18.8%), with a peak period for imported infectious disease-related events from July to September.

The reported public health emergencies in Yunnan Province’s border areas are mainly due to infectious disease outbreaks and food poisoning, with peak seasons in summer and winter. Major causes include chickenpox, COVID-19, and dengue fever, while the leading cause of death is wild mushroom poisoning. Schools and communities are critical locations for the prevention and control of infectious disease outbreaks. It is recommended that border areas strengthen monitoring, early warning, and risk assessment for key diseases and vectors, with particular attention to cross-border disease prevention and control in regions adjacent to Myanmar.

To explore the latent profile categories of economic toxicity in lung cancer patients and their differential characteristics, analyze the relationship between economic toxicity and health-related quality of life, and propose nursing interventions.

A survey was conducted among 218 lung cancer patients receiving treatment at two tertiary hospitals in Luzhou, Sichuan, using a general information questionnaire, the financial toxicity scale for cancer outcomes, the multidimensional social support scale, and the quality-of-life measurement scale for lung cancer patients. Latent profile analysis of economic toxicity was performed, and influencing factors were examined using univariate analysis and logistic regression. The correlation between economic toxicity and health-related quality of life was analyzed using Pearson correlation coefficients.

A total of 218 lung cancer patients were included, with economic toxicity classified into three categories: moderate economic toxicity risk group (C3), mild economic toxicity group (C2), and no economic toxicity group (C1). Logistic regression results indicated that household savings of >10 000 to 29 999 yuan (OR=28.763, 95%CI: 3.653-226.508), household savings of ≤10 000 yuan (OR=9.753, 95%CI: 2.642-36.003), and loss of employment due to illness (C2 vs. C1: OR=10.763, 95%CI: 2.091-55.394; C3 vs. C1:OR=18.745, 95%CI: 3.579-98.190) were significant influencing factors of economic toxicity in lung cancer patients. Additionally, there was a positive correlation between economic toxicity and overall health-related quality of life scores (r=0.241, P<0.01).

There is significant heterogeneity in the economic toxicity experienced by lung cancer patients. Nurses should develop personalized intervention strategies based on these classification characteristics to identify lung cancer patients at risk of economic toxicity early and alleviate their economic burden, thereby improving their health-related quality of life.

To explore the association between mixed exposure to low concentrations of heavy metals (cadmium, lead, mercury) and bone density, as well as the mediating effects of alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BAP), parathyroid hormone (PT), calcium (Ca), and phosphorus (P).

A cross-sectional study was conducted based on NHANES survey data, including a total of 1 465 participants. Polynomial logistic regression was used to analyze related risk factors, and Bayesian Kernel Machine Regression (BKMR) was employed to assess the impact of mixed exposure to cadmium, lead, and mercury on bone density. The mediation effects of ALP, BAP, PT, Ca, and P in the relationship between exposure to cadmium (Cd), lead (Pb), mercury (Hg), and bone density were analyzed using the Mediation package in R software (Bootstrap method).

The results of polynomial logistic regression indicated that the risk of bone loss increased at the third quartile (T3) of Cd concentration (OR=1.56, 95%CI: 1.08-2.26); the risk also increased at the second quartile (T2) of Pb concentration (OR=1.49, 95%CI: 1.06-2.08). Conversely, the risk of osteoporosis decreased at T3 of Hg concentration (OR=0.38, 95%CI:0.15-0.94). BKMR model analysis revealed that increased concentrations of cadmium, lead, and mercury were associated with a decrease in bone density scores (T-score), with posterior inclusion probabilities for Cd, Pb, and Hg being 1, 1, and 0.47, respectively. Mediation analysis showed that Cd influenced bone density through the mediating effects of ALP and Ca, with mediation proportions of -32.3% and -64.9%, respectively. Hg affected bone density through the mediating effects of ALP and BAP, with mediation proportions of 7.3% and 61.8%. Pb influenced bone density through the mediating effects of ALP, BAP, and PT, with mediation proportions of 38.9%, 97.6%, and 1.5%, respectively.

There is a negative correlation between low concentrations of mixed exposure of cadmium, lead, and mercury and T-score, and the mediating effects of ALP, BAP, PT, and Ca are statistically significant.

To investigate the correlation between the triglyceride glucose product index (TyG) and kidney stones.

Based on the annual health check-up data of employees from a construction company in Hubei in 2022, subjects were divided into kidney stone group (n=854) and non-kidney stone group (n=1 636) according to the presence of kidney stones. Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were employed to assess the correlation between the TyG index and the risk of kidney stones.

A total of 2 490 subjects were included in the study. The kidney stone group had higher levels of age, body mass index (BMI), TyG index, uric acid, total cholesterol, triglycerides, low-density lipoprotein, diastolic blood pressure, and fasting blood glucose compared to the non-kidney stone group (P < 0.05). Multivariable logistic regression analysis indicated that the risk of kidney stones for the 2^nd, 3^rd, and 4^th quartiles of the TyG index was 1.071 times (OR=1.071, 95%CI: 0.822-1.394, P < 0.612), 1.174 times (OR=1.174, 95%CI: 0.886-1.556, P < 0.263), and 1.851 times (OR=1.851, 95%CI: 1.342-2.553, P < 0.001) that of the first quartile, respectively. Higher TyG index levels were associated with an increased risk of kidney stones (χ²=37.146, P < 0.001), indicating that the TyG index was a risk factor for the occurrence of kidney stones with a significant linear relationship. Subgroup analysis revealed that in overweight and obese populations (OR=1.494, 95%CI: 1.245-1.794, P < 0.001) and in populations with hyperlipidemia (OR=2.047, 95%CI: 1.606-2.61,P < 0.001), the TyG index remained positively correlated with the risk of kidney stones (P < 0.05).

A higher TyG index is associated with an increased risk of kidney stones, and early intervention in insulin resistance may help improve or reduce the incidence risk of kidney stones.

To establish a training system for laboratory operators in Biosafety Level 2 laboratories, aimed at enhancing the knowledge level of personnel, standardizing operational skills, and reducing laboratory accidents.

The Delphi method was employed to conduct two rounds of consultations with 17 experts in the field of biosafety from Beijing, Shanghai,Xinjiang, Fujian, Anhui, Chongqing, Guangzhou, and Shenzhen to determine the indicator system, while the Analytic Hierarchy Process (AHP) was used to establish the weights of the indicators.

The response rates for the two rounds of questionnaires were 94.44% and 100.00%, respectively, with expert authority coefficients of 0.962 and 0.944. The Kendall's coefficient of concordance (W) was high (all P < 0.01). Ultimately, the training system was defined to include 5 primary indicators, 21 secondary indicators, and 83 tertiary indicators.

This training system is structurally complete and content-rich, demonstrating strong scientific validity and reliability, and can serve as a reference for the training and assessment of laboratory operators in Biosafety Level 2 laboratories.