To investigate the causal relationship between four lipid parameters—triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)—and uterine leiomyoma (UL) using a two-sample Mendelian randomization (MR) analysis approach.

Genome-wide association study (GWAS) data for UL and the four lipid parameters were obtained from the IEU open GWAS database. Single nucleotide polymorphisms (SNPs) strongly associated with the lipid parameters were selected as instrumental variables. Two-sample MR analyses were conducted using methods such as inverse variance weighted (IVW) analysis. Subsequently, reverse MR analysis was performed to assess whether there was a reverse causal relationship between the lipid parameters and UL.

The IVW method indicated a negative correlation between TG and the risk of UL (OR=0.996, 95%CI: 0.994-0.998, P<0.001) and a positive correlation between HDL-C and the risk of UL (OR=1.002, 95%CI: 1.000-1.003, P=0.012). No correlation was found between TC or LDL-C and the incidence of UL (P>0.05). Reverse MR analysis did not reveal any reverse causal relationship between the lipid parameters and UL (P>0.05). No horizontal pleiotropy was detected in the above studies (P>0.05).

The level of TG in the body is negatively correlated with the incidence of UL, while the level of HDL-C is positively correlated with the incidence of UL. There is no reverse causal relationship between the four lipid parameters and UL.

To analyze the epidemic characteristics of rubella in Nanning from 2005 to 2022, providing a reference for rubella prevention and control.

Reported rubella cases in Nanning from 2005 to 2022 were collected, and the Join Point regression model was utilized to analyze the trend of incidence. The spatial autocorrelation analysis and spatiotemporal scanning were employed to assess the clustering of rubella cases.

A total of 4 001 rubella cases were reported in Nanning from 2005 to 2022, with 12 outbreaks and no fatalities. The average annual incidence rate was 3.17 per 100 000, displaying an initial increase followed by a decrease, then another increase and decrease, with significant peaks in 2011 and 2018. Cases were concentrated between March and June, with the incidence rate in urban areas (3.70 per 100 000) being higher than that in rural counties (2.48 per 100 000). Males (3.58 per 100 000) had a higher incidence than females (2.72 per 100 000), and the highest average annual incidence rate was observed in the age group of 10 to 19 years, predominantly among students (73.53%). The proportion of students decreased, while the proportions of farmers, commercial service workers, homemakers, the unemployed, and other professions increased. Spatial autocorrelation analysis indicated significant clustering, with a trend of “high-high” clusters shifting from surrounding counties to the urban center, ultimately shrinking and disappearing, while “low-low” clusters exhibited a merging trend.Spatiotemporal scanning identified two clusters covering seven counties and districts.

Significant progress has been made in rubella prevention and control in Nanning, with the incidence still primarily affecting the 10 to 19 age group and a noted shift in the age of onset. It is recommended to continue strengthening rubella vaccination for age-appropriate children, while also targeting vaccination efforts towards key populations such as middle school students and women of childbearing age.

To understand the status of heart-focused anxiety (HFA) in patients with coronary heart disease and to construct a structural equation model based on the theory of stress processes to analyze the influencing factors and correlations among various variables.

A convenience sampling method was used to select 247 patients with coronary heart disease who visited the Department of Cardiology at the Affiliated Hospital of Yangzhou University from December 2023 to June 2024 for a questionnaire survey. A structural equation model was employed to investigate the influencing factors and path analysis of HFA in these patients.

A total of 247 patients with coronary heart disease were included, with a mean score of (25.77±8.39) on the heart anxiety questionnaire, and the HFA detection rate was 33.2% (82 cases). The structural equation model indicated that positive coping, negative coping, social support, and disease perception had direct effects on HFA, with effect values of -0.226, 0.275, -0.272, and 0.204, respectively (all P < 0.01). Social support had an indirect negative effect value on HFA of-0.187 (95%CI: -0.302 to -0.096), accounting for 40.74% of the total effect. The disease perception had an indirect positive effect value on HFA of 0.335 (95%CI: 0.242 to 0.385), accounting for 62.27% of the total effect.

HFA symptoms are relatively common in patients with coronary heart disease. Healthcare professionals can reduce the level of HFA in patients by guiding them to establish correct disease cognition, adopt positive coping strategies, and actively seek social support.

To identify key influencing factors of non-alcoholic fatty liver disease (NAFLD) and construct a Bayesian network model to explore its pathogenesis.

The study was based on the Beijing Health Management Cohort. The LASSO regression was employed to screen for relevant influencing factors of NAFLD, and 10-fold cross-validation was used to select the optimal penalty parameter λ. Based on the selected variables, structural learning was conducted using the Bayesian network model, and the model fit was evaluated through the Bayesian Information Criterion (BIC) and cross-validation for path analysis.

During the 5-year follow-up period, 22.83% of the 30 001 study participants developed NAFLD (n=6 850), with an incidence density of 45.7 per 1 000 person-years. Six key influencing factors were identified: AGE, BMI, HDL-C, FPG, ALT, and DBP, and a Bayesian network model was constructed based on these factors. The Bayesian network analysis revealed 23 pathways for the development of NAFLD, with the pathway having BMI as the root node being the most frequent (12 pathways), followed by age groups (5 pathways). The pathway AGE→DBP→FPG→NAFLD showed a significantly higher incidence probability in individuals under 45 years compared to those over 45. In cases of low BMI, the pathway BMI→HDL→ALT→NAFLD indicated a higher probability of NAFLD compared to other BMI groups.

The Bayesian network model elucidated the pathways of NAFLD development and clarified the impact of key factors on its onset, providing a theoretical basis for early screening and intervention of NAFLD.

To analyze the trends in the incidence, prevalence, mortality, and disease burden of thalassemia in China from 1990 to 2019, providing a reference for further disease prevention and control.

Data related to the incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALYs) of thalassemia in China were extracted from the Global Burden of Disease Study (GBD) 2019 database. The Join point regression model was utilized to analyze the annual percentage change (APC) and average annual percentage change (AAPC) of the age-standardized incidence rate, prevalence rate, mortality rate, and DALYs rate.

From 1990 to 2019, the number of new thalassemia cases in China decreased from 100 686 to 60 132, with the age-standardized incidence rate declining by 3.88% (AAPC=-0.60%). The number of deaths fell from 6 776 per year to 2 191 per year, leading to a 69.68% reduction in the age-standardized mortality rate (AAPC=-4.04%). DALYs decreased from 541 696 per year to 141 284 per year, with a 71.10% reduction in the age-standardized DALYs rate (AAPC=-4.90%, P < 0.05). The number of individuals with thalassemia decreased from 684 066 to 642 042, although the age-standardized prevalence rate increased by 19.15%(AAPC=0.58%, P < 0.05). Between 1990 and 2019, the disease burden of thalassemia for both males and females showed a declining trend, but the incidence and prevalence rates remained consistently higher in females compared to males, with the male-to-female ratios for age-standardized incidence rate, prevalence rate, DALYs rate, and mortality rate ranging from 0.76 to 0.78, 0.77 to 0.80, 0.94 to 1.07, and 0.97 to 1.12, respectively. The highest mortality and DALYs rates for thalassemia were observed in the age group under 5 years with a notable decline in the 5-to-9-year age group followed by stabilization. Over the last two decades, the mortality and DALYs rates gradually shifted towards older age groups.

The burden of thalassemia in China has alleviated from 1990 to 2019, exhibiting gender and age disparities, along with a trend towards an aging population.

To analyze the trends in coronary heart disease (CHD) mortality in China from 1992 to 2021, providing a basis for adjusting and optimizing CHD prevention and treatment policies.

This study employed the Join point regression model to calculate the annual percentage change in mortality trends, exploring variations in CHD mortality over consecutive time periods. Additionally, an age-period-cohort (APC) model was utilized to compute effect coefficients, assessing the individual impacts of age, period, and birth cohort on CHD mortality risk.

From 1992 to 2021, the overall mortality rates for CHD in both genders showed an upward trend, with average annual percentage changes of 0.584%, 0.979%, and 0.097%, respectively. The APC model estimates revealed that the mortality risk for the age group of 90 to 94 was 614.97 times higher for males and 519.08 times higher for females compared to the age group of 15 to 19. In terms of period effects, the CHD mortality risk for males and females from 2017 to 2021 was 2.58 times and 1.78 times higher, respectively, than that from 1992 to 1996. Regarding cohort effects, individuals born between 1902 and 1906 had a CHD mortality risk 25.07 times and 24.41 times higher for males and females, respectively, compared to those born between 2002 and 2006.

The overall CHD mortality rate in China is on the rise, with a focus on male and elderly populations. Age, period, and birth cohort each have independent effects on CHD mortality risk. Therefore, a multifaceted approach is necessary to advance preventive measures, control risk factors, and reduce mortality risks among residents.

To evaluate the long-term trends in mortality rates attributed to AIDS and sexually transmitted infections (STIs) due to unsafe sexual behavior in China from 1990 to 2019.

Data on AIDS and STI mortality attributed to unsafe sexual behavior were sourced from the Global Burden of Disease Study (GBD) 2019. An age-period-cohort model was employed to assess potential age, period, and cohort effects on long-term trends.

From 1990 to 2019, the overall annual percentage change in mortality rates attributed to unsafe sexual behavior was 3.4% (95%CI: 3.0%-3.7%) for females and 6.4% (95%CI: 6.0%-6.8%) for males in China. Among different age groups, males aged 25 to 79 showed a higher annual percentage change than females (P<0.05). In the reference cohort, male mortality rates increased with age, while female mortality rates declined after the age of 79. The period mortality risk for males exhibited a consistently increasing trend, whereas the period mortality risk for females slightly decreased between 2010 and 2014 but increased thereafter. Mortality risks for both males and females born after 1925-1929 showed an upward trend over time.

Between 1990 and 2019, there was an increase in mortality rates attributed to AIDS and STIs due to unsafe sexual behavior among both males and females in China. Unsafe sexual behavior remains a significant issue in the prevention and control of AIDS and STIs. Strengthening sexual education, promoting condom use during sexual activities, and ensuring cleanliness in sexual behavior are essential.

To investigate the shared genetic structure between six autoimmune diseases (AIDs) and ten psychiatric disorders (PDs) using Genome Structural Equation Modeling (GSEM) and Mendelian randomization (MR).

The research employed linkage disequilibrium score regression to assess the genetic correlations between diseases. GSEM was introduced for exploratory factor analysis on odd-numbered chromosomes and confirmatory factor analysis on even-numbered chromosomes for cross-validation, along with path analysis to establish a three-factor model and hierarchical model.Additionally, a multivariable genome-wide association study was conducted on latent factors to test the bidirectional causal relationships between mediating variables and factors, thereby revealing the complex genetic relationships among the diseases.

GSEM results indicated that the selected 16 diseases could be explained by a three-factor model consisting of three independent factors, which fitted the research data best (χ²=865.291, AIC=929.291, CFI=0.940, SRMR=0.097). In this model, Factor 1 and Factor 3 exhibited characteristics closely related to autoimmune diseases, while Factor 2 primarily encompassed psychiatric disorders, with scleroderma serving as a mediating variable linking the two types of diseases. MR results revealed a bidirectional causal effect between scleroderma and Factor 2 and Factor 3.

GSEM and MR can be utilized to uncover the shared genetic structure and causal effects between AIDs and PDs, thereby highlighting their interactions and providing an important methodological tool for understanding the genetic relationships among complex diseases.

To investigate the impact of changes in the concentrations of major gaseous pollutants in the air of Shijiazhuang on the outpatient visits for neurological disorders in children.

Data on air pollutants, meteorological conditions, and outpatient visits for pediatric neurological disorders from 2013 to 2021 in Shijiazhuang were collected. A case-crossover study based on conditional logistic regression models was employed to assess the effects of changes in NO₂ and SO₂ concentrations on the outpatient visits for neurological disorders in children.

During the study period, for every increase of 10 μg/m³ in NO₂ concentration, the risk of outpatient visits for neurological disorders in children increased by 1.445% (95%CI: 0.980%-1.911%); for every increase of 10 μg/m³ in SO₂ concentration, the risk increased by 0.408% (95%CI: 0.161%-0.655%). Stratified analysis revealed that girls and children aged 7 to 14 years were sensitive populations to SO₂ exposure, and the harmful effects of gaseous pollutants on the neurological system of children were stronger in winter.

Exposure to gaseous pollutants in Shijiazhuang is associated with an increase in outpatient visits for neurological disorders in children, with variations in effects observed based on gender, age, and season.

To investigate the effects of daily average temperature and relative humidity on the incidence of hand, foot, and mouth disease (HFMD) in Qingdao, as well as their lagged effects, providing data support for prevention and control strategies in the city.

Utilizing HFMD case data from 2010 to 2019 provided by the Qingdao Center for Disease Control and Prevention and meteorological data measured by the China National Meteorological Science Data Center, we first employed Pearson correlation analysis to identify key meteorological factors. Subsequently, the Prophet model was used to analyze the periodicity and trends of HFMD incidence in relation to meteorological factors. Finally, a distributed lag nonlinear model was applied to quantify the lagged effects.

The study found that when the daily average temperature in Qingdao ranged from 23°C to 30°C, the relative risk (RR) of HFMD significantly increased, peaking at approximately 2.2 when the temperature reached 30°C. Similarly, when relative humidity was between 70% and 90%, the RR increased notably, peaking at around 2.5 as humidity approached 90%. Additionally, the effects of daily average temperature and relative humidity on HFMD incidence exhibited lagged characteristics, typically with a lag period of about 7 days. When the daily average temperature exceeded 17°C, the risk of HFMD transmission due to lagged effects gradually increased; likewise, when relative humidity surpassed 70%, the lag period was approximately 7 days, resulting in a significant enhancement of transmission risk.

The findings indicate that when the temperature in Qingdao approaches 23°C or humidity nears 70%, there will be a significant impact on HFMD incidence one week later. Therefore, it is recommended that relevant departments in Qingdao implement preventive measures in advance during these meteorological conditions to reduce the risk of HFMD transmission.

To evaluate the association between gestational diabetes mellitus (GDM) and genitourinary tract infections during pregnancy (GUTIs) through retrospective analysis and Mendelian randomization (MR) analysis.

A retrospective analysis was conducted on 7 751 pregnant women who underwent prenatal check-ups and delivered between 2020 and 2022, comparing the rates of GUTIs between women with GDM and those without. Additionally, data from genome-wide association studies (GWAS) were selected, and the inverse-variance weighted (IVW) method was employed as the primary analytical approach, supplemented by weighted median (WM), weighted mode (WM), and MR-Egger regression methods. Sensitivity analyses were performed using MR-Egger regression, Cochran’s Q test, and leave-one-out analysis to investigate the causal relationship between GDM and GUTIs.

Both univariate chi-square tests (P=2.2×10^-16) and multivariate stepwise logistic regression analyses (P=2×10^-16) revealed a significant correlation between GDM and GUTIs. The two-sample MR study further confirmed a significant association between the two (IVW: β=0.211, P=0.013). The MR-Egger regression method did not indicate significant horizontal pleiotropy (P=0.813), and leave-one-out analysis and Cochran’s Q test showed no significant heterogeneity among all SNPs (P=0.876, P=0.938).

The presence of GDM may increase the risk of GUTIs. Effective screening and management of GDM patients could help reduce and prevent GUTIs.

To analyze the disease burden attributable to high BMI in postmenopausal women in China from 1990 to 2021, examine the trends of this burden, and predict the situation from 2022 to 2050 to guide future public health policies and interventions.

Utilizing data from the Global Burden of Disease (GBD) 2021 database, the study selected indicators such as the number of breast cancer deaths and disability-adjusted life years (DALYs) attributable to high BMI among postmenopausal women in China. Join point regression models were employed to analyze trends in mortality rates and DALYs, while age-period-cohort models were used to explore the effects of different ages, periods, and birth cohorts. The Bayesian Age-Period-Cohort (BAPC) package was applied to predict future disease burden trends.

From 1990 to 2021, the overall disease burden of breast cancer attributable to high BMI in postmenopausal women in China showed an increasing trend, with the number of deaths rising by 439.28% and DALYs by 441.27%. Both the age-standardized mortality rate and age-standardized DALYs rate increased (with average annual percent changes of 23.1% and 27.0%, respectively, P<0.001). The age-standardized mortality rate peaked at over 95 years, while the age-standardized DALYs rate peaked in the age group of 55 to 60.

The disease burden of breast cancer attributable to high BMI in postmenopausal women in China shows a continuous upward trend, with increases in mortality and DALYs rates surpassing global averages. It is anticipated that this burden will continue to rise over the next thirty years. Therefore, it is recommended to strengthen the prevention and control of overweight and obesity among postmenopausal women in China, enhance breast cancer screening rates, and implement targeted health education and public health interventions.

To explore the relationship between the duration of children’s internet usage and feelings of loneliness and depression.

From March to June 2023, a stratified cluster sampling method was employed to select students in grades three to six from a primary school in Handan. Data were collected using a basic information questionnaire, the Children’s Loneliness Scale (CLS), the Children′s Depression Self-Rating Scale (DSRSC), and an internet usage duration questionnaire. Statistical analysis was conducted using SPSS 26.0 software, employing frequency and percentage methods to describe the basic characteristics of the entire sample. Comparative analysis of the data was performed using t-tests and χ² tests, while multifactorial logistic regression analysis and correlation analysis were used for further data examination.

A total of 597 subjects were included in the study. The results indicated that, compared to children without feelings of loneliness, those with loneliness spent significantly more time on overall internet usage, watching television/listening to music, and playing games, while spending less time chatting (P<0.05). Logistic regression analysis revealed that children in the high total internet usage duration group had a higher risk of loneliness compared to the low duration group (OR=4.61, 95%CI: 1.19-6.50, P=0.028). Furthermore, children in the high gaming duration group also exhibited a higher risk of loneliness (OR= 1.29, 95%CI: 1.09-1.91, P=0.032). Additionally, the high gaming duration group showed a greater risk of depression compared to the low duration group (OR=1.23, 95%CI: 1.06-1.95, P=0.032). In contrast, children in the high study duration group had a lower risk of depression compared to the low duration group (OR=0.38, 95%CI: 0.14-0.95, P=0.042).

There is a positive correlation between the total duration of internet usage and gaming duration with the risk of loneliness in children, and longer gaming time is associated with a higher incidence of depression.

To investigate the mediating role of Activities of Daily Living (ADL) and social participation in the relationship between internet use and depression among empty nesters, providing references for reducing the risk of depression and improving quality of life in this population.

A total of 3 974 empty nesters aged 60 and above from the 2020 China Health and Retirement Longitudinal Study were selected as the research subjects. The ADL scale and the CESD-10 scale were used to measure the ADL and depression status of the empty nesters, respectively. Spearman correlation analysis was conducted to explore the relationships among internet use, ADL, social participation, and depression among empty nesters. The mediating effects of ADL and social participation in the relationship between internet use and depression were analyzed using Model 6 of the Process 4.1 plugin in SPSS.

Internet use had a significant direct effect on depression among empty nesters (β=-2.125, 95%CI: -2.593 to -1.654). The individual mediating effect of ADL was significant (β=-0.516, 95%CI: -0.641 to -0.389), as was the individual mediating effect of social participation (β=-0.159, 95%CI: -0.263 to -0.062). The chain mediating effect of ADL and social participation was also significant (β=-0.007, 95%CI: -0.011 to -0.002).

Internet use can directly negatively impact depression among empty nesters, and it can also influence depression through the individual or chain mediating effects of ADL and social participation.Therefore, to reduce the risk of depression among empty nesters, it is essential to increase their internet usage, enhance their ADL levels, and promote their social participation, thereby alleviating their depressive symptoms.

To explore the mediating effect of oral frailty on the relationship between health promotion behaviors and healthy aging among rural elderly individuals.

A multi-stage sampling method was employed to conduct a questionnaire survey involving 439 rural elderly participants in Chengde city, Hebei Province. The general information questionnaire, a healthy aging scale, a health promotion behavior scale, and an oral frailty screening scale were used.

The scores for healthy aging among rural elderly individuals in Chengde were (128.64±26.17), (64.01±16.18) for health promotion behaviors, and (6.06±3.05) for oral frailty. Spearman correlation analysis indicated significant correlations among the three variables. Mediation effect testing revealed that oral frailty partially mediated the relationship between health promotion behaviors and healthy aging, accounting for 20.47% of the mediation effect.

The level of healthy aging among rural elderly individuals is moderate. It is essential to implement health promotion behaviors and adopt relevant measures to reduce oral frailty to achieve healthy aging.

To understand the current status and influencing factors of treatment decision-making participation among patients with type 2 diabetes and to explore its correlation with the perception of complications risk.

A convenience sampling method was used to select patients with type 2 diabetes from the endocrinology department of a tertiary hospital in Shanxi Province between March and May 2024. A cross-sectional survey was conducted using a general information questionnaire, a patient participation in treatment decision-making questionnaire, and a diabetes risk perception scale.

A total of 210 valid questionnaires were collected.The overall score for the actual participation level in shared decision-making among patients with type 2 diabetes was (1.68±0.39), and the score for participation attitude was (1.46±0.27). There was significant inconsistency between the actual participation level and the participation attitude (Kappa=0.102, P<0.05). Multiple linear regression analysis revealed that age (B=0.692, 95%CI: 0.065-1.450), educational level (B=0.911, 95%CI: 0.300-1.522), satisfaction with medical services (B=-2.390, 95%CI: -3.726 to -1.053), and perception of complications risk (B=0.070, 95%CI: 0.010-0.129) were the main influencing factors of the actual participation level in decision-making among patients with type 2 diabetes (P<0.05).

The actual participation level in decision-making among patients with type 2 diabetes is relatively low, while their overall attitude towards participation is quite positive, indicating poor consistency between the two.Perception of complications risk is an important influencing factor for actual decision-making participation. Effective risk communication should be conducted to encourage patients to actively engage in decision-making, thereby reducing the occurrence and progression of diabetes complications.

To analyze the specific pathways for enhancing the resource allocation efficiency of elderly care institutions in China, providing a basis for the scientific development of resource allocation in these institutions.

The Data Envelopment Analysis (DEA) method was employed to calculate the comprehensive efficiency values of resource allocation in elderly care institutions across 31 provinces in China, which were used as the outcome variable. Five condition variables were selected for fsQCA analysis.

In 2022, the average comprehensive efficiency of resource allocation in elderly care institutions in China reached 0.878, indicating a relatively high overall level, although disparities existed among provinces.There were five pathways to improve the resource allocation efficiency of elderly care institutions, with an overall coverage of 0.614 528 and an overall consistency of 0.881 904, demonstrating strong explanatory power of the model.

The supply of beds is a crucial condition for achieving high efficiency in resource allocation in elderly care institutions. The synergistic effects between internal and external conditions facilitate the realization of high efficiency in resource allocation, and the interaction and coordination among conditions promote the emergence of pathways leading to high efficiency in resource allocation.

To analyze the impact of the separation of medicine and pharmacy and the integrated reform of medical expenses on medical service revenue in a district of Beijing.

Utilizing monitoring data from January 2016 to April 2024, a time breakpoint regression model was constructed for analysis.

Following the implementation of the separation of medicine and pharmacy reform, the proportion of medical service revenue and the average medical service revenue per visit in secondary and tertiary hospitals significantly increased (P<0.05). After the implementation of the integrated reform of medical expenses, the average medical service revenue per visit and the proportion of service revenue in secondary hospitals also saw significant increases (P<0.05).

After reform, the total amount and proportion of medical service revenue have significantly increased, with further optimization of the revenue structure and a more adequate reflection of the value of technical services. However, the proportion of medical service revenue remains relatively low. It is recommended to enhance the reform linkage mechanism, strengthen the supervision of medical services, promote the balanced distribution of medical resources, and focus on improving the service capacity of primary healthcare institutions.

To analyze the relationship between economic development level, ecological environment quality, and residents’ health level, and to explore the mediating effect of ecological environment quality between the two.

Based on provincial panel data from China from 2012 to 2022, a baseline regression model was established to analyze the relationship between economic development level and residents’ health level. The mediating effect of ecological environment quality was examined using the three-step method and Bootstrap testing.

There is a positive correlation between economic development level and residents’ health level (β=0.01, P<0.05). Environmental governance investment has a mediating effect on residents’ health level (β=-0.005, P<0.01). The quality of urban living environment did not show a significant indirect effect on residents’ health level through the non-parametric percentile Bootstrap test (95%CI: -0.001 to 0.004). The mediating effect of environmental governance pressure on residents’ health level was 0.003, accounting for 13.64% of the total effect, as verified by the non-parametric percentile Bootstrap test.

Economic development level has a significant positive impact on residents’ health level, and it can enhance residents’health level through the indirect effects generated by environmental governance pressure and investment.

To explore the mediating role of social activities in the relationship between sleep quality and cognitive function among elderly individuals with chronic diseases in the community.

From May to August 2022, a stratified convenience sampling method was employed to select 757 elderly individuals with chronic diseases from communities in Nanjing, Changzhou, Nantong, and Xuzhou, Jiangsu Province. The study utilized a general information questionnaire, the Beijing version of the Montreal Cognitive Assessment (MoCA), and the Pittsburgh Sleep Quality Index (PSQI) to assess the frequency and types of social activities, sleep quality, and cognitive function of the participants. The PROCESS mediation model was used to investigate the mediating effect of social activities between sleep quality and cognitive function. Results The scores for sleep quality among elderly individuals with chronic diseases showed a negative correlation with the level of participation in social activities (r=-0.114, P<0.01) and cognitive function (r=-0.169, P<0.001). Furthermore, the level of participation in social activities was positively correlated with cognitive function (r=0.146, P<0.001). Mediation effect testing indicated that social activities partially mediated the relationship between sleep quality and cognitive function (21.35%), with a mediation effect range of (95%CI: -0.035 to -0.006).

Social activities play a partial mediating role in the relationship between sleep quality and cognitive function among elderly individuals with chronic diseases in the community, indirectly affecting their cognitive function. Community workers should emphasize the importance of social activities in delaying cognitive decline among elderly individuals with chronic diseases, and strive to enhance their participation in social activities through comprehensive and multi-level approaches, thereby reducing the incidence of cognitive impairment.

To summarize the evidence related to cognitive interventions for patients with subjective cognitive decline.

A systematic search was conducted in databases such as BMJ Best Practice, JBI, PubMed, and CNKI for evidence related to cognitive interventions for patients with subjective cognitive decline, including clinical guidelines, clinical decisions, systematic reviews, expert consensus, and evidence summaries, with a search timeframe from the establishment of the database to December 7, 2023.

A total of 12 articles were included, comprising one guideline, one expert consensus, and 10 systematic reviews. Evidence was summarized across 11 domains, including principles of cognitive intervention, types, dosage, formats, locations, content, auxiliary measures, assessment, implementation methods, effects, and evaluations, resulting in 31 pieces of evidence.

Cognitive interventions can improve cognitive function and mental health in patients with subjective cognitive decline. Healthcare professionals should develop and apply personalized cognitive intervention plans tailored to clinical contexts and patient preferences.

To explore the mediating role of post-traumatic growth between post-stroke fatigue and self-management behaviors in stroke patients during recovery, as well as the moderating effect of caregiver contributions on the relationship between post-stroke fatigue and post-traumatic growth.

A convenience sampling method was used to collect data from 329 stroke patients in recovery and their primary caregivers. The study utilized a general information questionnaire, the Fatigue Severity Scale, the Post-Traumatic Growth Inventory, the Caregiver Contribution Scale for Self-Care in Stroke Patients, and the Stroke Self-Management Behavior Assessment Scale. Data analysis was performed using descriptive statistics, variance analysis, and correlation analysis with Mplus 8.3 software, while the PROCESS macro was employed to validate mediation and moderation effects.

Post-traumatic growth served as a mediator between post-stroke fatigue and self-management behaviors (e=-0.072, 95%CI: -0.119 to -0.032), accounting for 18.18% of the total effect. The interaction term between post-stroke fatigue and caregiver contributions positively predicted post-traumatic growth (β=0.095, P < 0.05).

Healthcare professionals should focus on enhancing the level of post-traumatic growth in stroke patients during recovery and recognize the significant role of caregivers in the recovery process, thereby improving self-management behaviors.

To investigate the effect of the Lifestyle Inflammation Score (LIS) on the risk of developing inflammatory bowel disease.

Utilizing data from the prospective cohort study of the UK Biobank (UKB), the Lifestyle Inflammation Score was calculated, and participants were categorized into three groups based on their tertiles: LIS1 (<-0.18), LIS2 (-0.18 to 0.50), and LIS3 (>0.50). The cumulative incidence of IBD and its subtypes was calculated using the Kaplan-Meier method, and inter-group comparisons were conducted using the Log-rank test. Cox regression models were employed to analyze the hazard ratios (HR) and 95% confidence intervals (95%CI) for the occurrence of IBD, ulcerative colitis (UC), and Crohn’s disease (CD) across different LIS groups.

A total of 365 343 participants were included in the study, with a median follow-up period of 12.62 years. The incidence counts for IBD, UC, and CD were 2 784, 1 969, and 993, respectively. The Log-rank test revealed a statistically significant difference in the cumulative incidence of IBD among the three groups (χ²=7.973, P<0.05). Using the occurrence of IBD as the dependent variable and LIS grouping as the independent variable, after adjusting for confounding factors such as age, gender, history of breastfeeding, and appendectomy, the risk of developing IBD was found to increase in the LIS3 group compared to LIS1 group (HR=1.155, 95%CI: 1.041-1.281). In subgroup analyses, the risk of developing UC was also elevated in the LIS3 group compared to LIS1 (HR=1.150, 95%CI:1.015-1.304), while no significant trend was observed in the CD subgroup.

The Lifestyle Inflammation Score is positively correlated with the risk of IBD and UC, but does not significantly increase the risk of CD.

To explore the relationships among symptoms of depression, anxiety, sleep disorders, and feelings of loneliness in a community-dwelling elderly population through network analysis, and to investigate the differences in network structure and core symptoms between genders.

A convenience sampling method was employed to survey 1 325 elderly individuals in Chengdu, Sichuan Province, regarding their symptoms of depression, anxiety, sleep disorders, and loneliness.Network analysis, centrality analysis, and robustness analysis were conducted to examine the associations among the symptoms.Additionally, differences in the network among subgroups by gender were analyzed.

The most central symptoms in the network of community elderly were identified as“fatigue”, “sleep problems”,“low mood”, and “feeling neglected” (Z≥1). No statistically significant differences were found in the network structure and connection strength between different gender subgroups (P>0.05). However, the mediating centrality of“low mood” was higher in males than in females (P<0.05), while the strength centrality of “tension” was lower in males than in females (P<0.001).

The network structure of disease symptoms aids in understanding the mechanisms of mental health issues among the elderly and the relationships between different conditions. It is recommended that community health service centers focus on preventing and alleviating feelings of fatigue among the elderly, while also addressing their sleep issues, low mood, and feelings of neglect to enhance overall mental health.

To establish a gas chromatography-tandem mass spectrometry (GC-MS/MS) method for detecting 21 types of herbicides in drinking water based on solid phase extraction (SPE) pre-treatment technology.

A 500 ml water sample was extracted using a C₁₈ solid phase extraction column, followed by elution with a 5 ml mixture of ethyl acetate and dichloromethane (1:1). The eluent was collected and concentrated near dryness using vacuum centrifugation, and then reconstituted with 1 ml of ethyl acetate for analysis by gas chromatography-mass spectrometry in multiple reaction monitoring (MRM) mode.

Within the concentration range of 5.0 μg/L to 200.0 μg/L, the herbicides exhibited good linearity, with correlation coefficients ranging from 0.9 954 to 0.9 998. The limits of detection (LOD) ranged from 0.11 μg/L to 1.21 μg/L, while the limits of quantification (LOQ) ranged from 0.33 μg/L to 3.64 μg/L. Precision (RSD) was found to be between 1.6% and 6.3%, and the recovery rates ranged from 74.3% to 112.7%.

This method demonstrates a wide linear range, accuracy, and reliability, making it suitable for the detection of multiple herbicides in water.

To quantify the health benefits of interventions targeting ozone exposure on diabetes prevalence under different strategies, providing scientific support for policies aimed at reducing atmospheric ozone levels to mitigate diabetes.

Utilizing questionnaire, physical examination data, and atmospheric data from a cohort of 16 607 participants in Chengdu, Southwest China, we employed a Logistic regression model to explore the association between ozone and diabetes risk. We simulated ratio interventions, fixed-value interventions, and threshold interventions for ozone concentration using the parametric G formula method to quantify the reduction in diabetes prevalence under each intervention strategy.

An increase of 1 mg/m³ in ozone corresponded to an odds ratio (OR) of 1.07 (95%CI: 1.01-1.13). Reducing ozone concentration by 5%, controlling it at P₅₀ (85.20 mg/m³), or lowering it to P₇₅(86.12 mg/m³) or below could respectively reduce diabetes prevalence by 27.38% (23.47%-31.28%), 8.35% (4.01%-12.70%), and 10.50% (6.00%-15.01%).

Various strategies to intervene on ozone concentration can reduce diabetes prevalence, with ratio interventions showing the most significant effectiveness. Future measures should consider local ozone levels and comprehensively account for seasonal variations, regional differences, and pollution sources to implement interventions aimed at percentage reductions in overall ozone concentration, thereby reducing diabetes risk.

To analyze the characteristics and trends of HIV strain subtypes among newly reported HIV-infected individuals in Hunan Province in 2023, and to understand the molecular epidemiological patterns of HIV strains in the region.

Blood samples were collected from 539 newly reported HIV-infected individuals in Hunan Province in 2023. RNA was extracted, and the pol gene region was amplified using nested PCR. Subtype identification and recombination analysis were performed using phylogenetic trees and online tools.

A total of 490 valid sequences were obtained, predominantly from males (77.55%, 380/490), Han ethnicity (90.20%, 442/490), heterosexual transmission (72.04%, 353/490), and individuals aged over 60 (33.47%, 164/490). The transmitted drug resistance (TDR) rate was 7.76%, with the majority of TDR mutations occurring in non-nucleoside reverse transcriptase inhibitors (NNRTIs). Sixteen subtypes were detected, with CRF07_BC (41.22%, 202/490) being the most prevalent, followed by CRF01_AE (31.84%, 156/490), CRF08_BC (8.98%, 44/490), CRF55_01B (4.29%, 21/490), B (4.29%, 21/490), CRF85_BC (2.45%, 12/490), C (1.84%, 9/490), and unique recombinant forms (URF) (2.04%, 10/490). The CRF07_BC subtype included two subclusters: 07_BC_MSM (52.97%, 107/202) and 07_BC_other (47.03%, 95/202). Seven subclusters of CRF01_AE were identified, with the C1 subcluster being the most prevalent (45.51%,71/156). Unique recombinant forms (URF) were most frequently reported in Changsha (40.00%, 4/10), primarily among young individuals engaging in homosexual transmission (80.00%, 8/10); CRF85_BC was most frequently reported in Shaoyang (91.67%, 11/12), primarily among older individuals involved in non-marital commercial heterosexual transmission (58.33%, 7/12).

The distribution of subtypes in Hunan Province is diverse, showing certain changes compared to past regional distributions and compositions, with the emergence of some new recombinant subtypes. Local monitoring of HIV subtypes should be further strengthened.

To systematically evaluate the factors influencing the willingness to accept HIV post-exposure prophylaxis (PEP) among men who have sex with men (MSM) in China.

Studies related to the willingness to accept HIV PEP among MSM published before September 5, 2024, were searched in PubMed, Web of Science, The Cochrane Library, EM base, China National Knowledge Infrastructure (CNKI), Wan fang, VIP, and CBM databases. Meta-analysis of the included factors was conducted using Rev Man 5.3 software.

A total of 26 studies were included, with 31 600 participants, and 20 influencing factors were extracted. The results of the meta-analysis indicated that factors promoting the willingness to accept HIV PEP included: age ≤ 30 years (OR=1.65, 95%CI:1.31-2.07), monthly income of 5 000-10 000 yuan (OR=1.96, 95%CI: 1.51-2.55), monthly income > 10 000 yuan (OR=1.98, 95%CI:1.03-3.80), having an HIV-positive sexual partner (OR=2.47, 95%CI: 1.21-5.05), multiple sexual partners (OR=2.51, 95%CI: 1.90-3.32), online sexual partners (OR=2.03, 95%CI: 1.55-2.65), awareness of HIV-related knowledge (OR=2.33, 95%CI: 1.81-3.00), awareness of PEP-related knowledge (OR=2.17, 95%CI: 1.33-3.54), having consulted about PEP (OR=26.09, 95%CI: 5.34-127.41), use of recreational drugs (OR=2.01, 95%CI: 1.18-3.42), condom use (OR=2.10, 95%CI: 1.66-2.66), HIV testing at least twice a year (OR=2.33, 95%CI: 1.80-3.02), sexually transmitted infections (OR=1.93, 95%CI: 1.52-2.45), commercial sex work (OR=3.21, 95%CI:1.95-5.30), and peer education (OR=1.60, 95%CI: 1.23-2.08). The factor hindering willingness was identified as being gay (OR=0.34,95%CI: 0.23-0.49).

The factors influencing the willingness to accept HIV PEP among MSM in China are various and complex. Future efforts should focus on enhancing the promotion and dissemination of knowledge related to HIV and PEP to reduce the incidence of HIV within the MSM population.

To explore the clinical application value of the blood creatinine to cystatin C ratio (CCR) in diagnosing skeletal muscle mass reduction in patients with non-alcoholic fatty liver disease (NAFLD).

A total of 388 NAFLD patients hospitalized at Karamay Central Hospital from October 2023 to March 2024 were selected and divided into a training set (310 cases) and a validation set (78 cases) at an 8:2 ratio. Clinical data and body composition data were collected for both groups. Multivariate logistic regression analysis was performed to identify risk factors for skeletal muscle mass reduction and to construct a nomogram model. The model’s predictive performance was evaluated using ROC curves and Hosmer-Lem show calibration curves.

Among the 388 patients surveyed, 187 exhibited skeletal muscle mass reduction. Significant differences were observed between the skeletal muscle mass reduction group and the non-reduction group in terms of BMI, CCR, and hs-CRP (P<0.05). Restrictive cubic splines indicated an “L” shaped relationship between CCR and skeletal muscle reduction, while hs-CRP demonstrated a “J” shaped relationship (both P<0.001). Logistic regression analysis revealed that a higher CCR was a protective factor for skeletal muscle mass (OR=8.579, 95%CI:3.459-13.905). The AUC of the ROC curve for the nomogram prediction model was 0.89 (95%CI: 0.856-0.951). The model exhibited good fit, and the calibration plot demonstrated a strong alignment with the standard curve.

BMI, CCR, and hs-CRP are independent risk factors for skeletal muscle mass reduction in NAFLD patients. The established nomogram model can provide individualized risk predictions and assist in the early identification of high-risk populations.

To summarize the levels of vitamin D in patients with common ocular diseases and explore the relationship between low vitamin D levels and the occurrence of ocular diseases.

A search was conducted in the PubMed, Web of Science, Embase, and Cochrane databases up to May 25, 2024, to collect meta-analysis studies assessing the relationship between vitamin D and ocular diseases. Additionally, observational studies not included in existing meta-analyses were collected, and the effect size and 95% confidence interval (CI) were calculated using the random effects weighted mean difference (WMD). The results of the studies were included in the meta-analysis, culminating in an umbrella review.

This study included 13 meta-analyses and 15 observational studies (11 case-control studies and 4 cross-sectional studies). The meta-analysis indicated that the overall weighted mean difference (WMD) for vitamin D and ocular diseases was -2.17 (95%CI: -2.50 to -1.84; P=0.282, I²=18.7%). The overall odds ratio (OR) for vitamin D in ocular diseases was 0.96 (95%CI: 0.92 to 0.99; P<0.001, I²=87.1%). The robustness of the conclusions was verified through trial sequential analysis (TSA).

Higher vitamin D levels are significantly associated with a reduced risk of developing glaucoma and myopia, yet showing an association with an increased risk of non-infectious uveitis (NIU).

To investigate the relationship between the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio and the incidence of diabetes in the Chinese population.

Data of Chinese adults from 2010 to 2016 were extracted from the DRYAD database. Cox regression models were employed to explore the association between the AST/ALT ratio and diabetes incidence, while smooth curve fitting was used to identify non-linear relationships. A piecewise linear regression function was applied to determine the optimal risk threshold.

A total of 86 145 participants were included in the study. After adjusting for covariates, a negative correlation was found between the AST/ALT ratio and diabetes incidence (HR=0.44, 95%CI: 0.38-0.51, P<0.001). The piecewise linear regression function identified the optimal risk threshold at 1.3. For values to the left of the threshold, HR=0.3, 95%CI: 0.2-0.3, P<0.001; for values to the right, HR=0.9, 95%CI: 0.7-1.2, P=0.561.

The AST/ALT ratio is a predictor of diabetes occurrence and is negatively correlated with diabetes incidence.