To analyze the disease burden trends of stroke and its subtypes in China.

Using data from the Global Burden of Disease Study, descriptive statistical analysis and Joinpoint regression models were employed to examine trends from 1990 to 2021, while the Bayesian age-period-cohort (BAPC) model was applied to predict disease burden up to 2036.

From 1990 to 2021, the number of stroke cases in China increased by 142.65%, yet the standardized incidence rate decreased by 9.78%, and the mortality rate dropped by 43.01%. Subtype analysis revealed a significant increase of 35.72% in the incidence of ischemic stroke, while the mortality rate from subarachnoid hemorrhage declined by 82.70%. In 2021, the male-to-female ratio of incidence rose to 1.73, and the decrease in the Disability-Adjusted Life Years (DALYs) rate was 16 percentage points higher for women than for men, indicating a widening gender disparity compared to 1990. The age distribution exhibited a bimodal pattern, with the highest incidence rate observed in the 75-79 age group (2 005.45 per 100 000), and the largest decrease in standardized DALYs occurred in the 55-59 age group, increasing by 57.61% compared to 1990. Attributable risk analysis showed that high systolic blood pressure remains the primary risk factor, with a standardized mortality rate of 77.73 per 100 000. However, deaths associated with low physical activity have surged by 222.54% in the past two decades. By 2036, it is predicted that the standardized incidence of stroke among women will increase by 5.26% compared to 2021, while the mortality rate among men will decrease by 16.69%, further exacerbating gender disparities.

While China has achieved progress in stroke prevention, challenges persist due to population aging and evolving risk factors. Targeted interventions addressing the rise of ischemic stroke, younger-onset cases, and gender disparities are urgently needed, alongside enhanced air pollution control, metabolic syndrome management, and regionalized tertiary prevention networks.

To explore the association between multimorbidity patterns and new-onset depressive symptoms in a community population in Sichuan.

Based on the follow-up data of a Southwest cohort, multimorbidity patterns were identified among 16 long-term diseases using latent class analysis. Logistic regression model was used to investigate the associations of multimorbidity status, number of multimorbidity, and specific multimorbidity patterns with new-onset depressive symptoms. Differences in these associations within subgroups of age, sex, frequency of alcohol consumption, smoking status, and level of green space were compared by stratified analyses.

Multimorbidity status and number of multimorbidity were significantly associated with the risk of new-onset depressive symptoms with OR values of 1.46 (95% CI: 1.13-1.88) and 1.19 (1.09-1.29), respectively. Compared with hypertension multimorbidity pattern, hyperlipidemia multimorbidity and metabolic-skeletal multimorbidity were associated with the risk of depression onset with OR values of 1.69 (95% CI: 1.01-2.61) and 2.90 (95% CI: 1.47-5.71).

Multimorbidity can increase the risk of depression, and metabolic-skeletal multimorbidity has a higher risk of depression compared to hyperlipidemic multimorbidity.

Based on the life course theory, this study aims to understand the relationship between adverse childhood experiences (ACEs) and body roundness index (BRI) among Chinese older adults, as well as gender heterogeneity, in order to provide scientific evidence for the formulation of obesity prevention and control policies for older adults.

Data from 7 695 participants in the China Health and Retirement Longitudinal Study (CHARLS, 2013-2015) were analyzed. OLS regression and RCS models were used to assess the linear and dose-response relationships, respectively, and examine gender differences.

Of the 7 695 older adults included in the analysis, those who had experienced ACEs exhibited higher BRI compared to those who had not (β₁=0.68, P<0.01;β₂=0.74, P<0.01;β₃=0.78, P<0.01;β₄=0.74, P<0.01). The impact of ACEs on BRI was partially explained by family environment, living conditions, and policy environment, as outlined in the theory of health ecology. The RCS results showed a significant non-linear inverted “J” shaped distribution between ACEs and BRI in the overall population. Gender heterogeneity was observed, with a significant non-linear inverted “U” shaped distribution among males and a significant non-linear relationship among females.

ACEs are significantly linked to BRI in Chinese seniors, with gender differences. This has key implications for policy improvement, emphasizing healthy environments, risk prevention, counseling, and early interventions to reduce future health risks.

To analyze the status quo and influencing factors of condom use in MSM population, and to provide reference for the formulation of intervention strategies.

From August to October 2022, a questionnaire survey was conducted among 281 MSM in Chengdu, Sichuan Province, including social demographic information, AIDS-related services, behavioral and psychological status. The random forest algorithm was used to reduce and screen the influencing factors of condom use, and then SHAP analysis was used to explain the random forest model after variable screening.

The rate of consistent condom use among MSM in the past 6 months was 65.5 %. When the number of variables after dimensionality reduction was 7, the random forest model had the best performance (AUC: 0.834). The results of SHAP analysis showed that the mean value of the importance of variables and the absolute value of SHAP were the score of condoms use self-efficacy (0.079 0), the score of AIDS-related discrimination (0.051 3), whether there was heterosexual behavior (0.029 9), living conditions (0.011 4), the way to find homosexual partners in the last six months (0.007 8), occupation (0.004 8) and sexual role (0.002 6). MSM who had low condom use self-efficacy scores, high AIDS-related discrimination scores, had heterosexual sex, and had contact with same-sex partners at home had poor condom use adherence, while MSM who lived alone, were students, and had both sex roles had better condom use adherence.

Improving the condom use self-efficacy of MSM, reducing HIV-related discrimination, focusing on and intervening in MSM with heterosexual partners, and MSM who often contact with homosexual partners at home may help to improve the condom use rate of MSM.

Toanalyze epidemiological characteristics and influencing factors of mumps in Qinghai Province from 2014 to 2023 and provide reference for the prevention and control of mumps.

The incidence data of Mumps in Qinghai Province from 2014 to 2023 were collected, and the descriptive method was used to analyze the change changing pattern of Mumps incidence. Geographically and temporally weighted regression (GTWR) was established, the mean regression coefficients were calculated, and different factors (Social factors: GDP per capita, number of students in schools; Natural factors: annual average temperature, annual average wind speed, annual total precipitation, annual total sunshine hours) on the incidence of Mumps.

From 2014 to 2023, a total of 14 278 cases of Mumps were reported in Qinghai Province, with an average annual incidence rate of 24.06/100 000, of which the highest in 2019 (65.62/100 000) and the lowest in 2016 (8.28/100 000). The seasonal index showed that Mumps showed a bimodal epidemic trend in winter and summer. The male-to-female sex ratio was 1.2:1, the highest number of cases was found in 5-<15 years old (40.66%) and 15-<25 years old (35.94%); and the occupation was dominated by students (69.15%). The incidence rate was the highest in Xining City (29.29/100 000 people) and the lowest in Yushu Prefecture (8.49/100 000 people). The GTWR model results showed that there were positive associations between annual average temperature, per capita GDP, annual total precipitation and the incidence of Mumps; and negative associations between the number of students in schools, annual average wind speed, and annual total sunshine hours with the incidence rate of Mumps.

The reported incidence of Mumps in Qinghai showed an overall downward trend. Focus on children and students aged 5 to 25 in Xining; social and natural factors have spatial heterogeneity on the incidence of Mumps, and regional prevention and control measures can be formulated in each region according to the actual situation.

To describe and analyze the changes in the burden of cardiovascular disease (CVD) attributed to tobacco in China from 1990 to 2021, as well as to provide a basis for scientific prevention and control of CVD.

Weextracted CVD death and disability adjusted life year (DALY) data attributed to tobacco in China from the 2021 Global Burden of Disease Database from 1990 to 2021, analyzed their trends by Joinpoint software, and used Bayesian Age Period Queue Model (BAPC) to predict the changes in CVD disease burden attributed to tobacco in China from 2022 to 2030.

The number of CVD deaths attributed to tobacco in China rose from 54 300 in 1990 to 101 400 in 2021, with the standardized mortality rate decreasing from 75.59 per 100 000 in 1990 to 52.32 per 100 000 in 2021, representing an average annual decrease of 1.24% (95% CI: -1.53%~-0.95%). The DALYs caused by CVD attributed to tobacco in China increased from 15 158 million person-years in 1990 to 23 530 million person-years in 2021, with the standardized DALY rate decreasing from 1 766.25 per 100 000 in 1990 to 1 145.78 per 100 000 in 2021, representing an average annual decrease of 1.42% (95% CI: -1.63%~-1.20%). Prediction models indicated that the CVD disease burden attributed to tobacco in China from 2022 to 2030 will decrease over time, with the standardized mortality rate and standardized DALY rate potentially reaching 45.47 per 100 000 and 967.51 per 100 000, respectively, in 2030.

Although the standardized mortality rate and DALY rate of CVD attributed to tobacco in China have shown a downward trend from 1990 to 2021, the disease burden is still relatively heavy, with significant differences between genders and ages. This suggests that early prevention of CVD in the elderly population, especially in the elderly male population, should be further strengthened to effectively reduce the burden of CVD disease attributed to tobacco in China.

To explore the factors of depression symptoms in middle-aged and elderly patients with chronic diseases in China and establish a risk prediction model to provide a reference for achieving healthy aging.

Based on data from the fifth waves of the China Health and Retirement Longitudinal Survey, patients with chronic diseases aged ≥ 45 years were included in the study and randomly divided into training and testing sets at a ratio of 7:3. Based on the Health Ecology Model, factors were analyzed by chi-square test and binary logistic regression and a nomogram was constructed. The performance of the risk prediction model was evaluated using the area under the receiver operating characteristic curve, calibration curves, and the Hosmer-Lemeshow test.

The prevalence incidence of depression symptoms among middle-aged and elderly patients with chronic diseases was 49.71%. The results showed that gender, age, number of chronic diseases, BADL status, IADL status in the personal characteristics layer, late sleep duration and whether often bothered by pain in the behavior pattern layer, type of residence and satisfaction with children in the interpersonal network layer, education level and availability of shower facilities in the life and work layer were significantly correlated with depression symptoms among middle-aged and elderly patients with chronic diseases. The AUC values for the training and testing sets of depression symptoms risk prediction model among middle-aged and elderly participants with chronic diseases in China were 0.762 and 0.753, respectively. The calibration curve demonstrated good agreement between predicted and actual probabilities, and the Hosmer-Lemeshow test (P>0.05) confirmed the model’s satisfactory predictive performance.

The prevalence incidence of depression symptoms is relatively high among middle-aged and elderly patients with chronic diseases in China. Improving the quality of life of this population across multiple dimensions is essential for promoting healthy aging.

To explore the quantitative association and dose-response relationship between systemic immune inflammatory index (SII) and the risk of hypertension among petrochemical workers.

This cohort study included 2 386 occupational workers from a large petrochemical enterprise in southern China. Baseline data were collected in 2018 through occupational health monitoring, and follow-up data were obtained annually through regular physical exams until 2023. The study gathered demographic information, occupational exposure data, blood pressure, blood sugar, blood lipid levels, and SII results via questionnaires, hazard monitoring, physical exams, and laboratory tests. We used multivariate Cox proportional hazard regression models and restricted cubic spline analysis to examine the quantitative association and dose-response relationship between SII and new-onset hypertension. Stratified analyses were performed based on occupational exposure, age, and gender.

During the follow-up period, 645 new cases of hypertension were identified. SII was positively correlated with hypertension risk in a dose-dependent manner. The SII was categorized into three groups (T1, T2, and T3). After adjusting for covariates, the hypertension risk in the T2 and T3 groups was 1.40 (95% CI:1.16-1.70) and 1.30 (95% CI: 1.06-1.58), respectively, compared to the T1 group. The relationship between SII and hypertension risk followed a nonlinear, inverted U-shape: risk increased with higher SII values up to a point, then decreased (P=0.005, nonlinear P=0.007). Subgroup analysis revealed that the patterns observed in workers under 39 years old and male workers were consistent with the overall population. Noise exposure did not affect the association between SII and hypertension risk, but no such association was found among workers exposed to benzene and its homologs.

SII is positively correlated with hypertension risk in petrochemical workers in a dose-dependent manner, exhibiting a nonlinear dose-response relationship. These findings provide a basis for using SII in hypertension risk assessment and prevention strategies in petrochemical workers.

This study aims to investigate the association between polycyclic aromatic hydrocarbons (PAHs) exposure and the atherogenic index of plasma (AIP) by analyzing data from the National Health and Nutrition Examination Survey (NHANES).

Participants aged ≥20 years were selected from NHANES 2009-2016. Due to the left-skewed distribution of urinary PAHs metabolites (OH-PAHs), logarithmic transformation (lg) was applied to approximate a normal distribution. Participants were categorized into four quartiles based on lgOH-PAHs levels. A multiple linear regression model was used to evaluate the association between PAHs and AIP. A smoothing curve fitting approach was employed to explore potential nonlinear relationships, and subgroup analyses were conducted.

A total of 3 084 participants were included, including 1 560 females (50.6%) with an average age of (49.1±17.6) years.After adjusting for age, sex, race, education level, marital status, the ratio of family income to poverty, body mass index (BMI), smoking, alcohol consumption, hypertension, and high cholesterol, multiple linear regression analysis indicated a positive association between the highest quartile of PAHs exposure (Q4) (β=0.056, 95% CI: 0.021-0.091) and AIP compared to the lowest quartile (Q1). In sex-stratified subgroup analyses, higher PAHs exposure (Q4) (β=0.068, 95% CI: 0.010-0.126) was positively associated with AIP in the male population. A similar positive correlation was also found in the female population (β=0.047, 95% CI: 0.001-0.094). In BMI-stratified analyses, the association between PAHs exposure and AIP was significant in participants with BMI <25(β=0.096, 95% CI: 0.032-0.160). Smoothing curve fitting demonstrated an inverted U-shaped relationship between PAHs concentration and AIP.

This study found a strong association between PAHs exposure and AIP, suggesting that PAHs exposure may be an important risk factor for increased AIP.

To investigate the overall association between co-exposure to metals and phthalates (PAEs) and blood lipid indicators, as well as the role of metabolic disturbances and endogenous metabolites as mediators in this association.

A total of 74 residents from Guangzhou (n=35) and Qingyuan (n=39) were randomly selected, and their urine samples were analyzed for 15 metal elements and 9 PAE metabolites. Generalized linear models and generalized weighted quantile sum (gWQS) regression models were used to assess the association between individual pollutants, combined exposure, and blood lipid levels. Non-targeted metabolomics, meet-in-the-Middle (MITM) approach, and mediation analysis were performed to identify endogenous metabolites and metabolic pathways linking combined exposure with blood lipid changes, and to explore the mediating effects of metabolites.

The concentrations of seven metals, including arsenic and cadmium, and four PAE metabolites, including mono-isobutyl phthalate (MiBP), were significantly positively correlated with increased total cholesterol (TC). The weighted quantile sum (WQS) index, which represented the overall load of metal and PAE combined exposure, showed a dose-dependent relationship with TC increase. For each one-unit increase in the WQS index, TC increased by 0.43 (95% CI: 0.05-0.82) mmol/L. Eight metabolites, including perilla acid, dehydroepiandrosterone, octanoylcarnitine, arachidonic acid, estrone, kynurenine, glucose-6-phosphate, and ferulic acid, were significantly associated with the WQS index and TC levels, and exhibited significant mediating effects, and the corresponding mediation effects were 0.09 (95% CI: 0.02-0.27)，0.18 (95% CI: 0.04-0.35)、0.21 (95% CI: 0.02-0.44)、0.12 (95% CI: 0.02-0.24)、0.08 (95% CI: 0.02-0.21)、0.08 (95% CI: 0.01-0.20) and 0.09 (95% CI: 0.01-0.19), respectively. The biosynthesis pathway of steroid hormones was significantly enriched.

The biosynthesis pathway of steroid hormones and metabolites such as dehydroepiandrosterone and androstenone may mediate the overall association between combined exposure to metals and PAEs and the increase in TC levels, providing the metabolic perspective for the overall effect on blood lipids of co-exposure to metals and PAEs.

To explore the metabolic characteristics and potential biomarkers of vitamin D deficiency in children and adolescents, and to provide a basis for early identification and prevention of vitamin D deficiency.

Sixty pairs of children and adolescents with vitamin D deficiency and normal levels (matched by age and gender) from the nutrition and health monitoring project of rural school-age children in Guangzhou from March to May 2023 were selected as the research subjects. Based on the determination of serum 25(OH)D and serum untargeted metabolomics, differentially expressed metabolites (set threshold: FC value >1.25 or <0.8, VIP value >1) were screened, and metabolic pathways were analyzed. Logistic regression was applied to screen potential biomarkers, and ROC curves were drawn to evaluate their accuracy.

56 differentially expressed metabolites (38 up-regulated and 18 down-regulated) were identified. The analysis of metabolic pathways showed that the steroid hormone biosynthesis pathway was statistically significant(P=0.001, Q_FDR=0.0982). Logistic regression analysis results showed that 12 potential biomarkers such as 7,8-epoxy-4Z,10Z,13Z,16Z,19Z-(OR=1.95, 95% CI: 1.20-3.17) had statistical significance in the association with vitamin D deficiency, and the AUC in the training set was 0.922(95% CI: 0.865-0.978), and in the test set was 0.910 (95% CI: 0.809-1), with high accuracy.

This study revealed the metabolic pathways related to vitamin D deficiency in children and adolescents and identified 12 potential biomarkers, providing a basis for clarifying the metabolic characteristics and carrying out early identification of vitamin D deficiency.

To analyzing the relationship between dietary quality and depression.

Data from seven consecutive cycles of NHANES dietary data from 2007-2020. Using HEI-2015, AEHI, MDS, PDI, hPDI, uPDI and CDAI to evaluate dietary quality; analyzing the relationship between various dietary indices and depression through multivariate weighted logistic regression, and through Restricted Cubic Spline (RCS) analyzes the nonlinear relationship between dietary indices and depression, and conducts sensitivity analysis to ensure the stability of the results.

A total of 18 490 study participants were included, with a weighted mean age of 46.39±16.38 years. logistic regression results showed that the risk of depression was reduced in the HEI Q4 group compared with the HEI Q1 group (OR=0.786; 95% CI: 0.664-0.929), and in the PDI Q2 group compared with the PDI Q1 group (OR=0.847; 95% CI: 0.750-0.955). no nonlinear relationship was found between HEI, AHEI, MDS, PDI, hPDI and depression, and a nonlinear relationship was shown between uPDI, CDAI and depression.

The quality of meals has a significant impact on the occurrence of depression. Promote high-quality meals and increase the antioxidant capacity of food, which helps to prevent and slow down the occurrence and development of depression.

To analyze the effects of nighttime sleep duration on postpartum depressive symptoms of couples in Anhui Province on both partners based on the actor-partner interdependence model.

Depression screening using the Edinburgh Postnatal Depression Scale (EPDS) was performed on couples who brought their babies for child health checkups at 42 days, 3 months, 6 months, and 12 months postpartum to maternal and child healthcare facilities in Huaibei City, Jieshou City, Ma'anshan City, and Huangshan City, Anhui Province, from November 2023-October 2024, using the Edinburgh Postnatal Depression Scale (EPDS).To describe the general condition and detection of depressive symptoms in couples, and to analyze the association between the length of nighttime sleep and postpartum depressive symptoms in couples through the actor-partner interdependence model.

A total of 2 424 couples were included in the analysis, and the overall detection rates of depressive symptoms at the four postpartum time points were 18.7% and 19.7% for husbands and wives, respectively. The detection rates of depressive symptoms at the 4 postpartum time points were 17.0%, 20.4%, 19.7%, and 17.8% for husbands and 19.7%, 19.6%, 21.1%, and 18.3% for wives. Spearman's correlation analysis showed that the wife's nighttime sleep duration was negatively correlated with both her own and her husband's depression scores, and positively correlated with the husband's nighttime sleep duration, and the husband's nighttime sleep duration was negatively correlated with his own and his wife's depression scores.Furthermore, the wife's depression scores were positively correlated with her husband's depression scores. The actor-partner interdependence model showed that both wives' and husbands' nocturnal sleep duration were able to predict their own depressive symptoms(β=-0.890, 95% CI=-1.016--0.763, β=-0.417, 95% CI=-0.550--0.284, all P<0.001), the actor effect was significant; in terms of the partner effect, nighttime sleep duration of both wives and husbands predicts each other’s depressive symptoms(β=-0.200, 95% CI=-0.292--0.108, P<0.001).

Postpartum depression is more prevalent among couples in four sites in Anhui Province, and nighttime sleep duration is negatively associated with postpartum depression, with both couples interacting with each other, suggesting that psychological interventions need to be carried out jointly by both couples.

To explore the relationship between screen time and mental health problems of adolescents using restricted cubic spline model.

A questionnaire survey was conducted among 3 960 junior and senior high school students in Jinan, Weifang and Qingdao cities of Shandong Province from February to March 2023. Logistic regression model and restricted cubic spline model were used to analyze the correlation strength and dose-response relationship between screen time and psychological problems. Result 46.41% of adolescents in middle and high school had mental problems, and 29.70% reported that screen time(ST)>2 h/d. There was a nonlinear dose-response relationship between mild psychological problems and ST on rest day (P_nonlinear＝0.003, P_overall＝0.003), and the curve was approximately "J" shaped, and the risk increased beyond 1.5 h/d. ST>2 h/d on rest days was associated with mild psychological problems (OR=1.300, 95% CI;1.085-1.558). Stratified analysis showed that there was a nonlinear correlation between ST on rest day and mild mental problems (P_nonlinear<0.001), and a linear correlation between ST and moderate mental problems (P_nonlinear>0.05)(P_overall<0.001). Only smartphones and tablets were linearly associated with mild mental health problems (P_overall＝0.004), with increased risk beyond 2.0 h/d.

The average screen time over 1.5 h/d increases the risk of psychological problems. It is suggested to lighten students'study burden after class and reduce the use of electronic devices on rest days.

To analyze the prevalence of three cardiovascular diseases categories (hypertension, coronary heart disease and stroke), and their impact on activity of daily living (ADL) among the elderly in rural Dayao County of Yunnan Province.

A multi-stage stratified random sampling method was employed in selecting 1 382 rural residents≥60 years from Dayao County for questionnaire survey and physical examination.Multivariate logistic regression models were applied to analyze the association between the prevalence of hypertension, coronary heart disease (CHD), stroke and ADL.

Among the interviewed respondents, the prevalence of hypertension, CHD, stroke, and the impaired rate of physical activity of daily life (PADL), instrumental activity of daily life (IADL) and ADL was 66.2%, 14.6%, 5.9%, 6.6%, 36.5%, and 37.2%, respectively. The prevalence of hypertension, CHD, and stroke and impaired rate of PADL, IADL, and ADL increased with age (, P<0.05). Females had higher prevalence of hypertension, impaired rate of IADL and ADL than males (χ²=7.319, χ²=56.112, χ²=52.510, P<0.05). Older adults with lower level of education had lower prevalence of CHD (χ²=3.930, P<0.05) while they had higher impaired rate of PADL, IADL, and ADL than their counterparts (χ²=7.438, χ²=99.487, χ²=101.057, P<0.001). Similarly, older adults with lower household incomes had lower prevalence of CHD and stroke (χ²=6.442,χ²=4.250, P<0.05) while they had higher impaired rate of IADL and ADL (χ²=6.517, χ²=4.934, P<0.05) than their counterparts. The outcomes of the analysis utilizing multivariate logistic regression suggested that hypertensive older adults (OR=1.760, 95% CI: 1.037-2.985) and older adults who suffered from stroke (OR=3.692, 95% CI:1.989-6.856) were more likely to have higher impaired rate of PADL than their counterparts.

There is a relatively high prevalence of three types of cardiovascular diseases while low level of daily living activity among older adults in Dayao County. Reducing the prevalence of hypertension and stroke would be helpful to alleviate the impaired rate of activity of daily living.

To explore the pathways through which social support influences value co-creation behaviors in older adults, clarify the mediating role of service co-creation literacy, and examine the moderating effect of sense of community.

A random sampling method was employed to select elderly individuals from communities in Changzhi City as research subjects from September to November 2024. Data from 424 community-dwelling elderly individuals were included in the analysis. The data were analyzed using SPSS 24.0, and the PROCESS macro with the bootstrap method was utilized to test mediating and moderating effects.

(1) Social support has a significant direct effect on value co-creation behavior (β=0.114, 95% CI: 0.029-0.199, P=0.009); (2) Service co-creation literacy has a significant partial mediating effect between social support and value co-creation behavior, with a mediating effect size of 0.125(95% CI:0.060-0.189,P<0.001), accounting for 52.3% of the total effect; (3) Sense of community has a moderating effect on the impact of service co-creation literacy on value co-creation behavior (β=0.147,P<0.001).

This study reveals that by constructing a mechanism that emphasizes strengthening the social support system within community health services, cultivating service co-creation literacy among the elderly, and enhancing the sense of community, it is possible to effectively stimulate the elderly population’s participation in value co-creation behaviors in health services.

To comprehensively evaluate the medical quality level of tertiary general hospitals in Guangxi and propose targeted quality improvement strategies.

Through the fuzzy union of entropy-weighted TOPSIS method and RSR method, we evaluated the medical quality of general hospitals in Guangxi cities and towns from 2019 to 2022, and utilized the obstacle degree model for the diagnosis of obstacle factors of medical quality development.

The top three weights of medical quality evaluation indexes were the percentage of special medical service volume (0.334), the number of patients referred downstream (0.216), and the percentage of commented prescriptions (0.107); the medical quality levels of Nanning City, Liuzhou City, and Guilin City were in the forefront, and that of Fangchenggang City, Laibin City, and Hechi City were in the back; the barrier factor diagnosis showed that the medical quality was greatly affected by functional positioning and rational drug use, with the barrier degree of 73.77% and 17.70% respectively, but the barrier degree of functional positioning showed a decreasing trend year by year, and the barrier degree of rational drug use showed a rising trend year by year, in which the barrier degree of rational drug use in Nanning City and Guilin City in 2022 had exceeded that of functional positioning.

The development of healthcare quality is not balanced between cities in Guangxi and the focus of development is different, tertiary general hospitals should clarify their own functional positioning and strengthen the guarantee of rational medication use.

To understand the public’s intention on the scope of granting prescribing rights to public health physicians, to provide reference opinions on the pilot work in progress in China, and to provide scientific basis and support for further exploring the policy formulation and promotion of granting prescribing rights to public health physicians in the province.

Using snowball method to conduct this survey, combined with personal interview method to collect the suggestions of different occupational groups in Sichuan province on the different scope of practice of public health doctors.

A total of 1 706 valid questionnaires were collected in this study. The results showed that 89.45% of the respondents supported giving public health doctors the right to prescribe, 76.85%-83.06% of the respondents suggested that public health doctors’ right to prescribe diseases such as infectious diseases, chronic diseases, occupational diseases, parasites and endemic diseases be completely lifted. 90.97% of the respondents believed that public health doctors should be allowed to prescribe non-drug interventions to patients with chronic diseases and people at risk of chronic diseases.

Based on the existing pilot programme, the subsequent scope of practice of public health physicians’ prescriptive authority should be further improved, and consideration should be given to the gradual trial implementation of prescriptive authority for non-pharmacological interventions, so as to give full play to the functional advantages of public health physicians as prevention-oriented physicians, and at the same time the mechanism for the training, development and assessment of public health physicians should be strengthened, in order to provide the grass-roots level with a high-quality team of public health physicians.

To explore the mediating effect of depressive symptoms on the relationship between handgrip strength and activities of daily living (ADL) in older adults, so as to provide a reference for the prevention and intervention of ADL impairment in this population.

Based on the 2015 survey data from the China Health and Retirement Longitudinal Study (CHARLS), a study was conducted involving 2 344 seniors aged 60 and above. Descriptive analysis and partial correlation analysis were conducted using SPSS 25.0, and the PROCESS macro program was employed to test for mediation effects.

The detection rate of low handgrip strength among elderly individuals in our country is 20.09%, the detection rate of depressive symptoms is 34.94%, and the rate of Activities of Daily Living (ADL) impairment is 20.95%. Handgrip strength is negatively correlated with depressive symptoms (r=-0.055, P<0.01); handgrip strength is also negatively correlated with ADL impairment (r=-0.143, P<0.001), while depressive symptoms are positively correlated with ADL impairment (r=0.259, P<0.001). Depressive symptoms have a partial mediating effect between handgrip strength and ADL in the elderly, with the mediation effect accounting for 12.68%.

Handgrip strength can have a significant impact on the activities of daily living (ADL) of older adults due to symptoms of depression, highlighting the importance of self-exercise for this demographic. Interventions that combine improvements in handgrip strength with a reduction in the risk of depressive symptoms may be effective in maintaining the daily living capabilities of older individuals.

To investigate the correlation between online dating and the occurrence of risky sexual behaviors among transnational migrant populations, and to provide scientific evidence for preventing the spread of human immunodeficiency virus(HIV) among transnational migrant populations.

The snowball sampling method was adopted to collect data on transnational migrant populations residing in China. The initial survey seeds were from Yiwu, Guangzhou, Beijing and Hangzhou. Demographic information and data related to sexual behaviors (including the number of casual sexual partners, dating methods, the frequency of condom use, etc.) were collected through questionnaires. The multivariate logistic regression model was used to analyze the correlation between dating methods and risky sexual behaviors.

A total of 341 people were surveyed, with 199 people using condoms consistently, accounting for 58.36%; 99 people using condoms sometimes, accounting for 29.03%; and 43 people never using condoms, accounting for 12.61%. 112 people had multiple casual partners, accounting for 32.84%; and 229 people had only one casual partner, accounting for 67.16%. 48 people met their casual partners through online dating, accounting for 14.08%; and 293 people met their casual partners through non-online dating, accounting for 85.92%. The multivariate logistic regression analysis showed that compared with those who met their casual partners through online dating, those who met their casual partners through non-online dating had a higher probability of using condoms consistently (OR value of 3.358, 95% CI of 1.184-9.522).

Unprotected sexual behaviors among transnational migrant populations are associated with online dating.

To develop a liquid-liquid extraction combined with ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry (LLE-UHPLC-MS/MS) method for simultaneous determination of nine monoester phthalate metabolites (mPAEs) in urine.

1 ml urine sample was subjected to enzymatic hydrolysis by the addition of ammonium acetate solution and β-glucuronidase at 37 °C on a shaker for 16 h. Subsequently, 20 μl of formic acid was added and thoroughly mixed. Liquid-liquid extraction was performed with 3 ml of ethyl acetate, then the mixture was centrifuged and the supernatant was concentrated under nitrogen flow. The residue was reconstituted with 0.20 ml of acetonitrile-water solution (50∶50, v/v). Chromatographic separation was performed on a BEH C18 column (2.1 mm×100 mm, 1.7 μm) using a mobile phase of 0.10% acetic acid in acetonitrile and 0.10% aqueous acetic acid. Analytes were ionized via electrospray ionization (ESI) in negative ion mode and detected by multiple reaction monitoring (MRM), and quantification was achieved through the internal standard curves.

Good linear relationship was obtained for the analytes within 0.50 to 200 ng/ml, with correlation coefficients greater than 0.999. When 1 ml of urine sample was utilized for analysis, the detection limits and the quantitation limits of the method were 1.5×10^-3 to 0.29 ng/ml and 4.9×10^-3 to 0.98 ng/ml, respectively. The recovery rates of the method ranged from 87.05% to 111.5%, with intra-day relative standard deviations of 0.31% to 3.05%, and inter-day relative standard deviations of 0.59% to 3.46%. The nine monophthalates in 277 urine samples from healthy individuals were determined by the proposed method. Except for mono-benzyl phthalate (MBzP), which had a detection rate of 87.73%, the detection rates of other monophthalates were 100%. Mono-butyl phthalate (MnBP) had the highest median concentration of 194.10 μg/g creatinine, while MBzP had the lowest median concentration of 3.7×10^-2 μg/g creatinine.

The established method for simultaneous determination of 9 monophthalates in urine samples was simple, sensitive, and accurate, which is suitable for the accurate exposure assessment of these substances in urine.

To analyze the trend of Colon and rectum cancer (CRC) burden attributable to low physical activity in China from 1990 to 2021, and to provide a reference for the development of effective public health strategies and healthcare resource allocation.

Relying on the Global Burden of Disease Study 2021 database, this study focused on the data of CRC burden attributable to low physical activity, including death and disability-adjusted life years (DALYs), among people ≥25 years old in China. Joinpoint regression was used to analyze the trends and turning points of disease burden changes, age, period and cohort effects of mortality were estimated with the age-period-cohort model, and autoregressive integral moving average (ARIMA) model was used to predict the disease burden dynamics in 2022-2030.

Between 1990 and 2021, the number of deaths, crude death rate, number of DALYs, and crude DALY rate attributable to low physical activity for CRC in China increased, with the number of deaths rising from 5 735 to 16 698, and the crude death rate from 0.78/100 000 to 1.53/100 000; the number of DALYs increased from 128 353 to 320 464 years. Crude DALY rate increased from 17.55/100 000 to 29.44/100 000.Joinpoint analysis showed that the mortality and DALY rates were increasing; the total population had a fluctuating downward trend in the standardized mortality rate and the standardized DALY rate, with an average annual percentage change of -0.21%(P>0.05) and -0.29(P<0.05) for males and females, respectively. Gender differences were observed in age-standardized mortality and DALY rate trends. The age effect showed that the CRC mortality rate attributable to low physical activity basically increased with age in China, and the relative risk (RR) ranged from 0.04 to 10.75 in each age group; the period effect showed that the mortality rate monotonically increased with the period, and the RR ranged from 0.69 to 1.59 in each period; and the cohort effect showed that the mortality rate progressively decreased with the development of birth cohorts, and the RR of each birth cohort ranged from 0.25 to 5.23. The differences in the effects between genders were not significant.The ARIMA model showed that the burden will continue to increase in China from 2022 to 2030.

The burden of CRC attributable to low physical activity in China showed a significant upward trend from 1990 to 2021, with gender differences. The age, period, and cohort effects of its mortality risk are evident. Targeted measures are urgently needed to effectively curb the rising disease burden.

To construct and validate a prediction model for high-risk sexual behaviors among rural residents aged 50 and above, in order to achieve early identification of high-risk groups and provide a scientific basis for the formulation of precise intervention measures.

From February to April 2024, 50-year-old and above permanent residents were conveniently sampled in rural areas of Luzhou City, Sichuan Province as the modeling group. From May to June, residents of the same age group were selected in rural areas of Liangshan Yi Autonomous Prefecture using the same method as the validation group. LASSO regression was used to screen variables, and then Logistic regression analysis was conducted on the screened variables. Variables with a P value less than 0.05 were used to construct a prediction model, and its predictive performance was evaluated.

The incidence rate of high-risk sexual behavior in this study was 28.52% (154/540).The predictive model included five predictive factors: gender, sexual behavior under the influence of alcohol, history of sexually transmitted disease infection, having a regular sexual partner, and social support, providing a scientific basis for the prediction of high-risk sexual behavior. The area under the ROC curve of the predictive model in the modeling group and the validation group was 0.940(95% CI:0.914-0.965) and 0.971(95% CI:0.951-0.992), respectively. The calibration curves showed good consistency, and the P values of the Hosmer-Lemeshow test were all greater than 0.05.The DCA had high positive yield between 1%-93% and 2%-98%, respectively.

The prediction model based on LASSO-Logistic regression analysis demonstrated good predictive performance and potential for practical application.

To explore the association between frailty status and RA through trajectory analyses, and to provide a scientific basis for targeted measures to reduce the risk of RA.

Survey data from the 2004-2018 American Health and Retirement Study (HRS) were analyzed for potential categories of frailty using growth mixture models for the three waves of data from 2004-2010. Using 2010 as the baseline, four waves of data from 2010 to 2018 were tracked to analyze the association between different frailty statuses and participants’ RA risk, and Cox proportional risk models were used to describe the associations between different frailty states and the development of RA.

The baseline population totaled 3 677 individuals, including 1 337 (36.4%) males; 2 340 (63.6%) females. Four frailty trajectories were identified through growth mixture modeling, with a high frailty lowering group (10.6%), a persistent high frailty group (20.1%), a persistent low frailty group (34.0%), and a low frailty elevation group (35.3%). Analysis of Cox proportional risk regression modeling showed that, in the fully adjusted model with the low frailty elevation group as the reference, the persistent high frailty group had a 0.255-fold increased risk of developing RA 0.255-fold (HR=1.255, 95% CI: 1.001-1.576), and the risk of developing RA increased 0.422-fold in the high frailty-reduced group (HR=1.422, 95% CI: 1.071-1.888).

Frailty is a risk factor for RA, and the risk of developing RA is increased in the high frailty reduction group and the persistent high frailty group.

To explore the potential causal relationship between gut microbiota and female infertility using the Mendelian randomization (MR) method and to determine the role of blood metabolites as potential mediators.

Gut microbiota data from 18 340 participants in 24 cohorts published by the MiBioGen Consortium, blood metabolite data from the Canadian Longitudinal Study of Aging (CLSA) cohort and Finnish R10 database on female infertility were used. The inverse variance weighting, weighted median, and MR-Egger regression method were used to investigate the causal relationship between 211 gut microbiota and 1 091 blood metabolites with female infertility. A two-step Mendelian randomization method was used to explore the potential mediating role of blood metabolites between gut microbiota and female infertility.

IVW results showed that 2 phyla, 1 class, 2 orders, 2 families, 12 genera of known gut microbiota were significantly causally associated with the female infertility. Among them, genus Lachnospira (OR=0.589, 95% CI: 0.361-0.961, P=0.035), genus Ruminococcus torques group (OR=0.756, 95% CI: 0.613-0.923, P=0.007), etc. showed a significant negative correlation with female infertility. Order Burkholderiales (OR=1.174, 95% CI: 1.062-1.284, P=0.001), genus Coprococcu2 (OR=1.174, 95% CI: 1.062-1.297, P=0.002), etc. showed a significant positive correlation with female infertility. Mediation analysis revealed that five blood metabolites could mediate the relationship between five gut microbiota and female infertility.

This study indicates that certain blood metabolites can mediate the relationship between gut microbiota and female infertility. Further investigations are warranted to explore the potential mechanisms underlying these associations.

To construct and validate a scientific evaluation tool to measure the level of comprehensive competencies such as public health professional competencies, managerial competencies, and basic competencies of public health personnel in northeastern China disease prevention and control agencies.

The literature research method combined with the expert consultation method was used to establish the comprehensive competence question items, collectingdata through the questionnaire survey method for exploratory factor analysis, to complete the construction of the dimensional module of the evaluation tool and the division of its belonging to the measurement items, and to fit the structural model of the measurement tool by using the validation factor analysis. The reliability and validity of the measurement tool should be tested to form a comprehensive competence measurement tool for public health personnel.

A comprehensive competency evaluation index system for public health personnel of disease prevention and control institutions was finally formed, which included 25 items in three dimensions, namely, public health professional competency, management competency, and basic competency. The cumulative variance contribution rate was 70.97%, the model fit index was good (RMSEA=0.058, CFI=0.968, NFI=0.968), the Cronbach α for the scale was 0.864, and Cronbach α for the dimensions was 0.963, 0.961, and 0.959, respectively, with CR values of 0.945, 0.930, and 0.818, which has good reliability and validity.

The three dimensions of the scale constructed in the study objectively and scientifically evaluated the core competence of basic public health service personnel in primary healthcare institutions, providing a reference basis for rationally setting up the corresponding assessment indicators and training contents, and then enhancing the synthesis and competence of CDC public health personnel.

To explore the external influencing factors of undergraduates’degree of satisfaction withthe Bachelors’program in preventive medicine, so as to provide a reference for improving the quality of public health higher education.

Data were obtained from the Ministry of Education’s Yangguang Gaokao information platform. The outcome variables included overall satisfaction, satisfaction with campus facilities, satisfaction with teaching quality, and satisfaction with employment outcomes. Multilevel linear regression models were employed to analyze influencing factors.

Among the 87 included universities, the average overall satisfaction score was 3.94±0.41, with employment satisfaction receiving the lowest average score of 3.61±0.52. Institutions in the eastern region reported the highest levels of satisfaction, while those in the western region reported the lowest. Regression analysis revealed that universities with preventive medicine subjects ranked in the top 50% had significantly lower levels of overall satisfaction (β=-0.299, 95% CI: -0.545 to -0.053), campus facilities satisfaction (β=-0.273, 95% CI: -0.523 to -0.022), and employment satisfaction (β=-0.379, 95% CI: -0.671 to -0.087). In models incorporating interaction terms, the development level of the Healthy China initiative in eastern regions was found to have a significantly negative effect on satisfaction compared to the western region (overall satisfaction: β=-0.861, 95% CI: -1.655 to -0.067), whereas per capita GDP had a significantly positive effect on satisfaction (overall satisfaction: β=0.089, 95% CI: 0.013 to 0.166).

Institutional preventive medicine ranking was negatively associated with student satisfaction. The provincial health system and economic levels showed varying influences on student satisfaction across different regions.