To quantitatively assess the causal association between tuberculosis（TB）prevention and control models in Xinjiang and the number of TB incidence in Kashgar region, and to provide a scientific basis for optimising TB prevention and control strategies.

Monthly reported incidence data of tuberculosis in Kashgar region from 2013 to 2023 were collected in this study. The epidemiological profile of TB in Kashgar was described using Joinpoint regression, and a Bayesian structural time series model was used to construct a counterfactual simulation of the number of TB cases in Kashgar to evaluate the effectiveness of the ‘Xinjiang model’ in a multidimensional way.

Joinpoint regression analysis showed that the average annual percentage change（APC）reversed from +21.24% before the policy implementation to -25.06%（P<0.05）, which was highly consistent with the time of policy initiation. The Bayesian structural time series model reflected inter-regional heterogeneity: the effectiveness of the intervention in Kashgar was outstanding（posterior probability 99.4%, P=0.006）, with a cumulative total of 30 659 TB cases prevented.

By using Joinpoint regression to capture the development trend of tuberculosis, and relying on the counterfactual framework to deduct the spatial and temporal heterogeneity, it was confirmed that the Xinjiang model could effectively control the existing tuberculosis epidemic in Kashgar, and provide scientific support for the optimisation of the policy of infectious disease prevention and control, as well as the practice of precision prevention and control in Xinjiang.

To develop and validate a risk prediction model for liver cirrhosis applicable to the general population, to reveal the association between common biomarkers and the risk of liver cirrhosis, and to provide a scientific basis for the assessment of liver cirrhosis risk in clinical and public health practice.

This study utilized data on 28 biomarkers and 6 covariates from the UK Biobank. Participants were enrolled between 2006 and 2010 and followed up until October 31, 2022. The primary outcome was new cases of liver cirrhosis. All participants meeting the inclusion and exclusion criteria were randomly divided into a training set and a test set at a ratio of 7:3. Based on the training set, three machine learning algorithms, namely XGBoost, Lasso-Cox regression, and random survival forest, were used to screen for key predictive variables influencing the occurrence of liver cirrhosis. Key feature variables were then used to construct a liver cirrhosis risk prediction model based on the Cox proportional hazards model. The performance of the prediction model was evaluated by comparing it with traditional scores, FIB-4 score and APRI score, and validated in the validation set.

A total of 237 965 eligible subjects were screened for this study, including 1 064 patients with liver cirrhosis and 236 801 non-liver cirrhosis patients. Five key variables influencing the occurrence of liver cirrhosis were identified by combining three machine learning methods and clinical application scenarios, namely γ-glutamyl transferase, aspartate aminotransferase, cystatin C, body mass index, and albumin. The liver cirrhosis risk prediction model constructed based on these five characteristic variables significantly outperformed the traditional FIB-4 score model and APRI score model in terms of predictive performance. The AUC values of the liver cirrhosis risk prediction model, FIB-4 score model, and APRI score model in the training set were 0.827（0.806-0.848）, 0.665（0.637-0.693）, and 0.740（0.713-0.766）, respectively; in the validation set, they were 0.811（0.776-0.845）, 0.664（0.621-0.708）, and 0.711（0.668-0.755）, respectively. The AUC values of the prediction model established in this study were superior to those of the two traditional scoring prediction models, and the differences were statistically significant（P<0.05）. Compared with the traditional FIB-4 score model and APRI score model, the liver cirrhosis risk prediction model constructed in this study demonstrated significant advantages in the two key indicators of net reclassification index（NRI）and integrated discrimination improvement index（IDI）（P<0.001）, and the results were highly consistent in both the training set and the test set. The results of the liver cirrhosis risk prediction model showed that cystatin C had high specificity and predictive value in the prediction of liver fibrosis diseases [HR=2.51, 95% CI: 2.22-2.83].

γ-glutamyl transferase, aspartate aminotransferase, cystatin C, body mass index and albumin are important factors influencing the onset of liver cirrhosis. The prediction model for the risk of liver cirrhosis constructed by using the feature variables obtained through multiple screening by machine learning has strong predictive ability and provides an effective tool for the early screening of the risk of liver cirrhosis.

To improve the structural quality of influenza surveillance data and enhance the performance of predictive models by leveraging an epidemic dynamics-informed data assimilation approach.

This study constructed a data assimilation framework that combined a Susceptible–Infectious–Recovered–Susceptible（SIRS）model with the Ensemble Adjustment Kalman Filter（EAKF）to assimilate weekly Goldstein indices（Influenza-like Illness Percentage × Positive Rate）from 21 cities in Sichuan Province. The signal-to-noise ratio（SNR）was used to evaluate the effect of data structure optimization, and predictive performance before and after assimilation was assessed using three forecasting models: ARIMA, RNN, and LSTM. Linear mixed-effect models were applied to quantify the impact of assimilation on SNR and root mean squared error（RMSE）. Statistical significance was defined as P<0.05.

After applying the SIRS-EAKF assimilation framework, the SNR significantly increased in 18 cities（85.7%）, with an average improvement of 3.26（P<0.01）. Across all three prediction models, RMSE were significantly reduced in the assimilated data group（all P<0.05）.

The SIRS-EAKF framework effectively suppressed the noise and enhanced the expression of the dominant epidemic signal through incorporating dynamical mechanisms. Without altering the structure of the prediction model, it significantly improved both the quality of influenza surveillance data and the predictive accuracy. This approach provides a robust methodological foundation for real-time epidemic forecasting and public health decision-making.

To compare the spatial-temporal multicomponent model with different spatial weight settings in different terrains, and to explore the optimal weight settings in different terrains. Then to study the distribution and influencing factors of influenza incidence in different terrains of Sichuan Province, so as to provide scientific basis for spatial weight settings and identification of risk influencing factors as well as the formulation of prevention and control measures.

Based on the influenza incidence data in Sichuan Province from 2016 to 2018, we conducted a descriptive analysis of the spatial and temporal influenza situation in different terrain areas（plains, hills and plateau mountainous regions）, explored the optimal weight settings for different terrains using a spatial-temporal multicomponent model, and further analyzed the spatial and temporal influenza propagation dynamics through the optimal model to quantify the effects of meteorological and socio-economic factors.

The optimal weights were inverse distance weights for plains and Power-law weights for hills and plateau and mountainous regions. The results of the factor analysis of the optimal model showed that the average temperature in the plains（RR=0.970, 95% CI: 0.958-0.982, P<0.001）, hills（RR=0.960, 95% CI: 0.942-0.978, P<0.001）and plateau and mountainous regions（RR=0.913, 95% CI: 0.868-0.960, P<0.001）were all inhibitory to the risk of influenza. Air pressure was protective in the plains（RR=0.990, 95% CI: 0.979-1.000, P=0.049）, while showing elevated risk in the hills（RR=1.044, 95% CI: 1.016-1.072, P=0.002）and plateau and mountainous regions（RR=1.005, 95% CI: 1.002-1.009, P=0.004）.

The spatial weights of plains, hills, plateau and mountainous regions should be carefully considered when constructing the model. Inverse distance weights are more suitable for plains, while Power-law weights are more suitable for hills, plateau and mountainous regions. Meanwhile, there are differences in the influence of influenza morbidity risk in different topographic areas, and it is suggested that different early warning and control measures should be developed according to the key risk factors in different areas and key risk characteristics of the areas.

To explore the association between different metabolic body weight subtypes and the risk of cardiovascular disease（CVD）incidence in middle-aged and elderly populations.

The study utilized data from the China Health and Retirement Longitudinal Study（CHARLS）, with the initial data collection phase implemented in 2011. By the end of the cohort follow-up in 2020, The final analytical sample comprised 6 353 eligible participants. Participants were classified into 6 and 4 metabolic subtypes respectively using combinations of body mass index, waist-to-height ratio, and ATP-III criteria. Cox regression was employed to explore the association between each metabolic subtype and the incidence of CVD.

During a 9-year follow-up, 1 825 individuals developed CVD. Of the total study population, 11.4%（n=730）met the criteria for obesity, with 16.0% of these obese individuals demonstrating a metabolically healthy profile. Compared to individuals who were of normal weight and metabolically healthy, those with metabolically healthy obesity（MHO）exhibited an increased risk of CVD（HR=1.70, 95% CI: 1.18-2.46）, while the risk was even higher in individuals with metabolically abnormal obesity（HR=2.48, 95% CI: 2.07-2.97）.Sensitivity analysis（using the four subtypes defined by waist-to-height ratio）found consistent results. Stratification by BMI revealed that, within normal weight and overweight populations, the risk of CVD was significantly elevated in metabolically abnormal groups compared to metabolically healthy groups. Subgroup analyses did not identify interactions between age, gender, education level,smoking, or drinking status and the various metabolic subtypes.

In middle-aged and elderly adults, MHO is linked to a higher risk of CVD. Among normal weight and overweight individuals, the risk of CVD is higher in metabolically abnormal groups than in metabolically healthy groups.MHO is not a benign subtype, and obese individuals need to enhance their weight management and lose weight in a reasonable manner.

To investigate the incidence of hypertension（HTN）among patients with type 2 diabetes mellitus（T2DM）under standardized management in Hotan City, and to explore its associated risk factors.

A retrospective cohort study was conducted on 1 053 T2DM patients without baseline hypertension who underwent continuous health examinations from 2016 to 2023 in Hotan, Xinjiang. With new-onset hypertension as the endpoint event, their physical examination data were collected and analyzed. A multivariate Cox proportional hazards regression model was employed to analyze the relevant influencing factors.

The average follow-up period was 4.29 years. The incidence density of hypertension among T2DM patients under standardized management was 134.66/1 000 person-years（95% CI: 124.18-145.80）, with a 5-year cumulative incidence rate of 48.81%（95% CI: 45.79-51.83）.The Cox regression analysis indicated that age ≥60 years（HR=3.41, 95% CI: 2.59-4.49）, retirement（HR=1.60, 95% CI: 1.07-2.41）, increased waist circumference（HR=1.01, 95% CI: 1.00-1.02）, and positive urinary protein（HR=1.92, 95% CI: 1.05-3.51）were independent risk factors. Male gender was a protective factor（HR=0.81, 95% CI: 0.68-0.96）. A non-linear, J-shaped relationship was observed between baseline systolic blood pressure and the risk of hypertension, with the risk significantly increasing when SBP exceeded approximately 115 mmHg.

The risk of hypertension remains high among T2DM patients under standardized management in Hotan City. It is imperative to strengthen risk assessment and management for high-risk populations, including the elderly, females, retirees, individuals with abdominal obesity, and those with positive urinary protein. For T2DM patients with elevated systolic blood pressure, intensive, full-course blood pressure monitoring and management are necessary to achieve early identification and effective control of hypertension.

To explore the differences in job burnout among female employees at different levels of the Centers for Disease Control and Prevention（CDCs）in Yunnan Province, along with its influencing factors, to provide information for reducing the prevalence of job burnout among female CDC employees, and stabilizing the CDC workforce.

A combination of stratified and random sampling methods was employed to survey female employees of all CDCs in Yunnan Province. The survey was conducted from March to April 2024 using the Maslach Burnout Inventory-General Survey（MBI-GS）. Using Chi-square test, binary logistic regression, and Fairlie decomposition methods, this study analyzed the influencing factors, level differences, and their main causes of job burnout among female CDC employees.

The overall job burnout rate among 4 257 female CDC employees was 83.58%. Specifically, the burnout rate was 81.09% among those employees at provincial and prefectural levels and 84.39% among county-level, with the difference being statistically significant（χ²=6.279, P=0.012）. Regression results indicated that age 45-54 years（OR=0.521, 95% CI: 0.278-0.977）, intermediate or senior professional titles（OR=1.907, 95% CI: 1.123-3.237; OR=2.219, 95% CI: 1.183-4.166）, workload（OR=1.833, 95% CI: 1.312-2.562）, and general sleep quality（OR=0.618, 95% CI: 0.420-0.910）were identified as factors influencing job burnout among female employees at provincial and prefectural levels CDC; Age groups（OR=0.645, 95% CI: 0.471-0.883; OR=0.526, 95% CI: 0.364-0.762; OR=0.306, 95% CI: 0.159-0.589）, welfare levels（OR=0.635, 95% CI: 0.501-0.806; OR=0.365, 95% CI: 0.262-0.508）, workload（OR=1.320, 95% CI: 1.075-1.621）, attention to CDC reforms（OR=0.613, 95% CI: 0.477-0.786）, and sleep quality（OR=0.563, 95% CI: 0.440-0.720; OR=0.353, 95% CI: 0.261-0.477）were identified as factors influencing job burnout among female employees at county-level CDC. The Fairlie decomposition results indicated that 58.37% of the level differences in job burnout were caused by the characteristic effect and 41.63% by the coefficient effect.

Female CDC employees in Yunnan Province exhibit a relatively high rate of job burnout, with significant variations observed across different levels of CDCs. And welfare levels are identified as the primary factor contributing to these disparities. It is recommended that the relevant departments pay attention to the issue of job burnout among female CDC employees. Stratified and differentiated interventions should be developed and implemented to alleviate burnout and reduce disparities in burnout levels among female CDC employees across different levels.

To investigate the impact of green space exposure on adverse treatment outcomes among newly diagnosed pulmonary tuberculosis patients in Suzhou.

Data from 18 502 newly treated pulmonary TB patients in Suzhou between January 1, 2014 and December 31, 2021 were collected. Green space exposure was quantified using the Normalized Difference Vegetation Index（NDVI）within 250-meter and 500-meter buffer zones around residential addresses. Cox proportional hazards regression models were applied to assess associations between green space exposure and adverse outcomes, adjusting for individual- and environmental-level covariates.

Among patients residing in high nighttime light（NTL）intensity areas, those in the highest quartiles（Q4 and Q5）of green space exposure within the 250-meter buffer exhibited significantly lower risks of adverse outcomes after covariate adjustment, with hazard ratios（HRs）of 0.692（95% CI: 0.487-0.984）and 0.353（95% CI: 0.183-0.683）, respectively. In the 500-meter buffer, stronger protective effects were observed, with HRs of 0.587（95% CI: 0.396-0.869）for Q4 and 0.212（95% CI: 0.078-0.582）for Q5. Wald tests for linear trends confirmed a dose-response relationship（P_trend<0.05）. Subgroup analyses revealed greater benefits of green space exposure for females, younger patients, indoor workers, urban residents, and clinically diagnosed cases.

Increased green space exposure is associated with reduced risks of adverse treatment outcomes among newly diagnosed PTB patients in high-NTL areas, underscoring its potential public health significance in tuberculosis management.

To provide scientific evidence for promoting salt reduction and establishing nutritionally healthy canteens.

Seven institutional and enterprise canteens in Chengdu’s chronic disease prevention zones were surveyed. Over four weeks, accounting and weighing methods were used to collect data on the usage of all condiments, weights of main/auxiliary ingredients in popular dishes, salt concentration in soups, per capita salt intake, dish-specific salt content and salt contribution rate, and condiment-derived salt contribution rates. The data was analyzed using the Kruskal-Wallis H test to compare differences between groups.

Condiment usage and total salt content varied significantly across canteens. Median salt intake was 5.2（4.0, 5.5）g per diner per meal, with 87.8% contributed by table salt, fermented bean paste, soy sauce, chicken essence, and monosodium glutamate. Salt content and contribution rates of popular dishes showed significant variation（H=20.433，P=0.002；H=19.045，P=0.004）. Median dish-specific salt contribution rate was 28.7%（14.4%,43.9%）. Bean products and vegetable dishes had the highest salt content（H=11.905，P=0.018）; home-style and spicy dishes contained more salt（H=9.567，P=0.048）. In savory dishes, table salt contributed most to condiment-derived salt（H=21.305，P<0.001）; in home-style/spicy dishes, fermented bean paste/tempeh dominated（H=24.700，P<0.001）. Median soup salt concentration was 0.28%（0.12%,0.38%）, with fish/vegetable soups highest and poultry soups lowest（H=22.668，P<0.001）.

Chengdu institutional canteens exhibit high salt-containing condiment usage. Nudge-based interventions may effectively advance salt reduction and nutritionally healthy canteen development.

To understand the contamination of pathogenic bacteria in prepared meat products in Sichuan Province and provide scientific basis for the prevention of foodborne diseases.

From 2020 to 2024（excluding 2021）, 756 samples of prepared meat products were collected from farmers’ markets, supermarkets, and retail stores etc, in 11 cities. The detection of Salmonella, Listeria monocytogenes, Staphylococcus aureus, Yersinia enterocolitica, and diarrheagenic Escherichia coli was carried out, according to the national food safety standard method.

The detection rate of Listeria monocytogenes was the highest, at 22.75%, followed by Salmonella, with a detection rate of 7.67%. The detection rates of Yersinia enterocolitica, Staphylococcus aureus, and diarrheagenic Escherichia coli were 3.47%, 1.82%, and 1.66%, respectively. The detection rate of Salmonella in chilled prepared meat（11.29%）was higher than that in frozen prepared meat（4.33%）, and the detection rate in bulk prepared meat（9.35%）was higher than that in prepackaged prepared meat（3.88%）. The main types of Salmonella were Salmonella enteritidis and Salmonella typhimurium, accounting for 28.81% and 25.42%, respectively. Salmonella enteritidis was mainly found in poultry meat（66.67%）, while Salmonella typhimurium was mainly found in livestock meat（37.14%）. The resistance rates of Salmonella to tetracycline and ampicillin were relatively high, at 50.00% and 47.50%, respectively.

Prepared meat products in Sichuan Province are contaminated by pathogenic bacteria to varying degrees. Targeted monitoring and supervision should be continuously carried out, and food safety publicity should be strengthened.

Toanalyze the dynamic evolution laws of the quality of life status of the elderly in communities and its influencing factors, so as to provide a reference basis for improving the quality of life of the elderly.

Using the data of the Ma’anshan Healthy Aging Cohort, 2 495 community residents aged ≥ 60 years old in Ma’anshan City were selected. Taking the clustering status of the scores of the World Health Organization Quality of Life-BREF（WHOQOL-BREF）as the main outcome indicator, a multi-state Markov（MSM）model was used to analyze the conversion patterns of the three quality of life statuses, namely low, medium, and high.

For individuals with moderate quality of life, the estimated probabilities of deteriorating to low quality of life, remaining at moderate quality of life, and improving to high quality of life were 0.220, 0.648, and 0.132 respectively in the 1-year observation, and evolved to 0.405, 0.448, and 0.148 respectively within the 5-year observation. The results of the multivariable MSM model analysis revealed the key factors influencing the dynamic transition of the quality of life of the elderly. Age is a negative predictor of the improvement of quality of life. Compared with the 60-69-year-old group, the probability of transition from low quality of life to moderate quality of life in the 70-79-year-old group（HR=0.638, 95% CI:0.484-0.841）and the group aged 80 and above（HR=0.404, 95% CI:0.255-0.641）decreased successively. Conversely, a higher level of education was a significant promoting factor. Compared with the illiterate group, those with primary school/junior high school education（HR=1.467, 95% CI: 1.089-1.975）and those with senior high school/junior college or above education（HR=1.909, 95% CI:1.282-2.844）were more likely to achieve an improvement in quality of life. In addition, having multiple chronic diseases（≥3 types）had a dual negative impact on the quality of life. It reduced the possibility of improving the quality of life（for example, from moderate to high quality of life, HR=0.638, 95% CI:0.417-0.877）and also increased the risk of deteriorating the quality of life（for example, from high to moderate quality of life, HR=1.512, 95% CI:1.156-2.625）. Factors such as marital status, smoking, living alone, and physical exercise also had a significant impact on the transition of the quality of life status.

This study uses a multi-state model to reveal the dynamic evolution law of the quality of life of the elderly. The high-quality-of-life state is unstable, but the low-quality-of-life state is reversible. Prospective intervention strategies should be formulated for high-risk groups to delay the decline process of their quality of life.

To analyze the current status and influencing factors of long-term care needs among middle-aged and older adults in China, and to provide a reference for optimizing long-term care services and formulating precise policy supply.

Using data from the 2020 China Health and Retirement Longitudinal Study（CHARLS）, this study focused on individuals aged 45 and above. Andersen’s Behavioral Model of Health Services Use was employed as the theoretical framework. Fisher’s exact test and multinomial logistic regression models were utilized for the analysis.

75.97% preferred home-based long-term care, 1.82% preferred long-term care in nursing homes, 1.05% chose hospital-based long-term care, and 21.16% selected other care options. In terms of predisposing characteristics, males were more likely to prefer nursing home care（OR=2.19, 95% CI=1.16-4.12）and other care options（OR=1.75, 95% CI=1.37-2.22）. Individuals aged 75 and above were more inclined toward hospital-based long-term care（OR=3.80, 95% CI=1.51-9.55）. Divorced（OR=23.62, 95% CI=3.69-151.30）, widowed（OR=43.70, 95% CI=12.88-148.27）, and other marital status groups（OR=26.45, 95% CI=7.50-93.35）were more likely to choose nursing home care. Regarding enabling resources, those with pensions or wages were less likely to choose nursing home care（OR=0.17, 95% CI=0.06-0.51）but more likely to select other care options（OR=3.74, 95% CI=2.93-4.77）. In terms of psychosocial factors, individuals who participated in social activities were less likely to prefer hospital care（OR=0.40, 95% CI=0.18-0.89）and other long-term care options（OR=0.54, 95% CI=0.43-0.67）. Those with depressive tendencies were more likely to prefer nursing home care（OR=0.40, 95% CI=0.14-0.91）.

The long-term care needs of middle-aged and older adults in China are influenced by factors such as gender, age, marital status, pensions or wages, participation in social activities, and depressive tendencies. There are still significant limitations in their autonomous choice of care options, with family-based care being the predominant preference. Therefore, the government should strengthen the top-level design of long-term care service systems, improve policy support, optimize the coordinated governance of multiple departments such as civil affairs, health, and medical insurance, increase support for home-based elderly care, and provide multi-level long-term care services.

To investigate the current status of talent cultivation, motivation, and evaluation of Centers for Disease Control and Prevention（CDCs）at the provincial, municipal and county level, and to provide a foundation for enhancing the construction of CDCs talent teams.

Convenient sampling and snowball sampling methods were adopted to conduct an online survey of in-service personnel from provincial, city, and county CDCs in 31 provinces（autonomous regions and municipalities）in China by Questionnaire Star. A 5-point Likert scale was used to score satisfaction.

Among the 3 626 participants, 46.9%, 35.9%, and 64.5% reported that their units had established talent cultivation, motivation, and evaluation mechanisms, respectively. The constructed proportion of the three mechanisms in provincial CDCs and CDCs in the western region was the highest, while that in county（district）CDCs and CDCs in the central region was the lowest.Statistically significant differences were observed in the scoring rates of the three mechanisms among different levels and regions（all P<0.001）. Training, professional title, and professional title again were the top keywords for the three mechanisms, with word frequency ratios of 64.4%, 24.4%, and 76.5% respectively. The satisfaction scores of the three mechanisms were 3.49±0.84, 3.55±0.90, and 3.40±0.83 points respectively. Moreover, there were significant differences in satisfaction scores of the three mechanisms among people with different professional titles and positions（all P<0.05）.

Both county（district）level CDCs and CDCs in the central region urgently need to strengthen the construction of talent cultivation and incentive mechanisms.Professional titles are currently the main basis for motivating and evaluating talents at all levels of CDCs.CDCs at all levels should further enrich the connotation of the talent mechanism according to the needs and suggestions of employees, explore and optimize the talent incentive and evaluation measures in line with the characteristics of CDCs.

To understand the personnel development status of childcare workers in Sichuan Province and their training requirement, and put forward countermeasures and suggestions.

An questionnaire survey was conducted among childcare workers in infant care institutions for children under 3 years of age across 21 cities in Sichuan Province. The survey was organized by Health Commission of Sichuan Province and the Decision-making Consultative Committee of Sichuan Provincial Committee and the Government of Sichuan Province. Chi-square test or Fisher’s exact test was used for multiple comparisons and Bonferroni correction to analyze the differences in training situations among different job types and institutional characters.

Among 9 662 childcare workers, 55.34% of them were with junior college diploma, 66.65% were with preschool education major, 20.53% didn’t receive qualification certificate. 93.07% of them had a monthly income of 4 000 yuan or less. 30.49% didn’t have the "Five Social Insurance and One Housing Fund", and 41.63% of them worked in institutions without a position promotion mechanism. 18.15% didn’t receive pre-job training, 15.76% didn’t received on-the-job training, and 86.53% would participate in regular training. The proportions of those engaged in health care who received pre-job training, on-the-job training, and would participate in regular training were higher than those of teachers and childcare workers（χ²=81.839，P<0.001；χ²=39.409，P<0.001；χ²=42.831，P<0.001）. The proportions of employees in private institutions who received pre-job and on-the-job training were higher than those in public institutions（χ²=18.526，P<0.01；χ²=24.227，P<0.001）.

The problem of childcare workers in Sichuan Province includes insufficient job fit, lack of systematic training, and limited career development,and et al. It is suggested to make targeted strategies in order to strengthen the construction of talent team of childcare workers and promote the healthy and sustainable development of childcare industry.

To systematically assess the service capacity of provincial occupational disease prevention and control institutions in China using SWOT analysis and explore pathways for high-quality development.

Employing stratified sampling based on the economic zone classification by the National Bureau of Statistics and distribution characteristics of high-risk industries, we selected 15 provincial occupational disease prevention and treatment institutions from 12 provinces across eastern, central, and western China. Data were collected through institutional questionnaires, expert questionnaires, and semi-structured in-depth interviews）, followed by systematic SWOT analysis of internal and external environmental factors.

Key strengths included comprehensive clinical service capabilities（100% providing health surveillance, 93.3% covering pneumoconiosis diagnosis and treatment）, concentrated resources, and professional authority in occupational health. Weaknesses encompassed talent shortages（reported by 86.7% of institutions）, inadequate preventive services（only 53.3% conducting hazard assessments）, and lagging informatization. Primary opportunities stemmed from national policies supporting medical-preventive integration（endorsed by 91.2% of institutions）and digital technology applications. Main threats included intensified market competition and insufficient public awareness of occupational health.

Provincial occupational disease prevention institutions should adopt a tripartite development strategy focusing on “standardization, technological empowerment, and mechanism innovation”: establish national-level medical centers to develop a comprehensive “prevention-diagnosis-rehabilitation-management” service system; develop regional medical-preventive integration to enhance coordinate occupational health monitoring with clinical services; and promote digital transformation through “Smart Occupational Health” initiatives to overcome data silos. Emphasis should be placed on recruiting and training high-caliber professionals and establishing standardized informatization frameworks to support the high-quality development of occupational disease prevention systems under the Healthy China Initiative.

To explore the influencing factors of payment differences in patients undergoing spine-related surgeries under the Diagnosis-Related Groups（DRG）payment system, and to provide evidencefor improving hospital medical insurance fund surplus and promoting high-quality hospital development.

We collected data from 1 798 inpatients undergoing spine-related surgeries and grouped under the DRG system, along with their medical insurance settlement cost information, at a large Grade-A tertiary hospital in Guangxi from January 1,2022 to December 31,2024. Descriptive statistics, univariate analysis, and multivariate regression models were employed to analyze factors influencing medical insurance payment differences. Structural equation modeling was further applied to validate correlations among variables.

Univariate analysis revealed that age, average length of stay, ADRG group, insurance fund type, case type, presence of complications, primary diagnosis group, and VBP participation status were significant factors influencing medical insurance payment differences in spine-related surgical patients（P<0.05）. The results of multiple linear regression analysis indicated that the top three factors influencing payment differences were ADRG group（β=-1.704,t=-29.369,P<0.001）, centralized procurement status（β=-1.244,t=-17.705,P<0.001）, and case type（β=-1.085,t=-11.257,P<0.001）. Structural equation modeling showed ADRG group as the most influential factor with a path coefficient of 0.55, followed by procurement policy（0.36）and case type（0.21）.

ADRG grouping is the primary determinant of payment differences. Under DRG payment systems, healthcare authorities should optimize disease group weights to reflect actual medical resource consumption and technical complexity. They should actively promote centralized volume procurement of high-value consumables while strengthening synergies between DRG payment and procurement policies. Hospitals need to optimize clinical pathways, control medical costs through rational diagnosis and treatment, thereby improving DRG payment difference levels.

To analyze the pathway through which social capital influences anxiety symptoms in patients with type 2 diabetes mellitus（T2DM）and to explore the mediating effect of sleep quality between these variables, thereby providing evidence for intervention strategies.

A total of 1 726 T2DM patients from 10 hospitals in Ningxia, China, were enrolled. Data were collected via face-to-face interviews using the Self-Rating Anxiety（SAS）and the Chinese version of the Social Capital Scale. The Bootstrap procedure was employed to test the mediating effects.

After adjusting for confounders, social capital exhibited a negative correlation with the prevalence of anxiety symptoms（r=-0.12, P<0.001）, sleep quality was negatively correlated with SAS scores（r=-0.32, P<0.001）, while social capital was positively correlated with sleep quality（r=0.07, P<0.05）. Sleep quality exhibited a partial mediating effect between social capital and anxiety symptoms（β=-0.025, 95% CI: -0.042- -0.009）. Age-stratified analysis revealed that in the elderly group, sleep quality demonstrated a significant mediating effect accounting for 29.2% of the total effect（β=-0.049, 95% CI: -0.079- -0.025）, whereas no statistically significant mediation was observed in the non-elderly group（P>0.05）.

Social capital may indirectly alleviate anxiety symptoms in T2DM patients through improving sleep quality, with this mediating pathway being particularly significant in the elderly population. In clinical practice, it is crucial to emphasize the integration of interventions targeting social capital reconstruction（e.g., community mutual-aid network development）and sleep management（e.g., cognitive behavioral therapy）. Particularly for elderly patients, this combined approach may enhance mental health outcomes through synergistic socio-physio-psychological mechanisms.

To explore the latent classes of social participation among older adults and their impact on cognitive function, providing a reference for improving cognitive function in the elderly.

Using 2018 CHARLS data, this study analyzed 3 577 adults aged ≥60. Cognitive function was assessed with MMSE. Latent class analysis was conducted in Mplus 8.3, and the BCH method was used to examine the effect of social participation patterns on cognition. Multivariate linear regression analyzed the association between participation categories and cognitive function.

Older adults’ social participation was classified into four latent classes: work-oriented [1 507（42.13%）], comprehensively active [176（4.92%）], volunteer-oriented [334（9.34%）], and low-level-social/family [1 560（43.61%）]. These classes differed significantly in age, education, etc.（P<0.05）. Cognitive function differed significantly across classes（χ²=158.689, P<0.05）. Multivariate linear regression showed the comprehensively active type had a protective effect on cognition（P<0.05）.

This study finds older adults’ social participation types are closely linked to cognitive function, with the comprehensively active group showing the highest levels. Types differ in demographic characteristics and significantly affect cognition. Policymakers and community workers should design and promote diverse, personalized activities based on older adults’ needs and conditions.

To explore the impact of college students’ perceived social support on their well-being, and investigate the moderating effects of gender and educational level on this relationship.

An investigation was conducted on 10 726 college students from eight ordinary institutions of higher education in Shandong Province, using the method of stratified cluster random sampling. Descriptive statistics, one-way ANOVA, and multiple linear regression models were used to analyze the impact of perceived social support on college students’ well-being.

Statistically significant differences were observed in college students’ subjective well-being across variables including education level, academic year, major, and whether they came from single-parent families（P<0.05）. Perceived social support exerted a positive influence on the level of college students’ subjective well-being（P<0.05）. Furthermore, the moderating effects of gender（β=0.045, 95% CI [0.021, 0.069], P<0.01）and education level（β=-0.050, 95% CI [-0.070, -0.030], P<0.01）on the relationship between perceived social support and college students’ subjective well-being were found to be statistically significant.

It is recommended to establish a comprehensive network of perceived social support and propose targeted measures for different gender and educational level groups to enhance college students’ well-being.

To investigate the association between loneliness and the risk of arthritis incidence among middle-aged and older adults in China.

Based on data from the China Health and Retirement Longitudinal Study（CHARLS）2011—2020, this study included 9 086 middle-aged and older adults who were free of arthritis at baseline. Participants were categorized into loneliness and non-loneliness groups according to Item 9 of the Center for Epidemiologic Studies Depression Scale（CES-D）. The Kaplan-Meier method was used to plot cumulative incidence curves, and Cox proportional hazards regression models were employed to assess the association between loneliness and incident arthritis risk.

By December 1, 2020, the mean follow-up time was 8.1 years, a total of 1 808 incident arthritis cases were recorded during follow-up. The loneliness group exhibited an arthritis incidence density of 29.36 per 1 000 person-years, compared with 23.05 per 1 000 person-years in the non-loneliness group. The cumulative incidence rate of arthritis was significantly higher in the loneliness group compared to the non-loneliness group（χ²=31.849, P<0.001）. After adjusting for multiple confounders, participants in the loneliness group demonstrated a 26% increased risk of arthritis development compared with the non-loneliness group（HR=1.26, 95% CI: 1.14-1.40）. Subgroup analyses stratified by age, sex, residence, educational level, health insurance status, smoking status, alcohol consumption, BMI, physical activity level, and other chronic diseases revealed largely consistent findings.

In the middle-aged and older adult population in China, loneliness is significantly associated with an elevated risk of incident arthritis. Promoting social connectivity and implementing targeted interventions to mitigate loneliness may serve as effective strategies for arthritis prevention in this population.

To explore the predictive relationships among depressive symptoms over time and identify core symptoms within the depressive symptom network in empty-nest older adults in China.

Data were obtained from 1 462 eligible empty-nest older adults in the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study（CHARLS）. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale（CESD-10）. A cross-lagged panel network（CLPN）model was fitted and analyzed using R version 4.3.3.

Feeling afraid, loneliness, and effortful behavior were the symptoms with the strongest outgoing predictive effects, significantly predicting changes in other symptoms at the next time point. Additionally, gender differences were observed: depressive symptoms in men were more likely to originate from loneliness, whereas in women, they were more associated with fear.

Intervention strategies should consider gender differences and focus on core symptoms to prevent the progression to high-risk depression among empty-nest older adults with depressive tendencies.

To establish a simultaneous determination method by inductively coupled plasma mass spectrometry（ICP-MS）for 32 elements and 15 rare-earth elements in whole blood including Ni, Sb, Li, Be, Mn, Co, Ge, Cd, Sn, Te, W, Tl, Bi, Ga, Cs, Mo, Cr, U, V, Ba, Sr, As, Al, Ti, Pb, Cu, Se, Rb, Zn, Fe, Ca, Mg, La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu and Y.

Blood samples were diluted 20-fold with a 0.05% Triton X-100-0.5% HNO₃ and then the analytes were determined by ICP-MS. Sc, Rh, Os, and Ir were selected as internal standards. The helium collision mode（KED）was used to eliminate interferences for some elements.

The 47 elements showed good linearities with correlation coefficients greater than 0.999. The method detection limits were 0.001-1.55 μg/L（Fe, Ca, and Mg were 0.01-0.06 μg/mL）. The within-batch RSDs were less than 10%, and the between-batch RSDs were less than 15%. The average recovery rates ranged from 75.6% to 120.9%. The average determination results of 22 elements in the whole-blood reference material were within the uncertainty range of the certified values.

This method is simple and fast, with high sensitivity, good stability, low detection limits, and it is suitable for the determination of 47 elements in blood samples.

To evaluate the safety and efficacy of two doses of recombinant zoster vaccine（RZV）in normal immune population over 50 years of age in Nanchang.

1 802 people over 50 years old who received two doses of RZV were selected as the observation group, and 2 132 people were simultaneously inoculated with Pneumococcal Vaccine Polyvalent（PPV23）and Quadrivalent influenza vaccines（QIV）in subjects over 50 years of age served as a control group. The incidence of adverse reactions and the incidence of Herpes zoster（HZ）within 1 year after vaccination were analyzed and compared between the observation group and the control group after vaccination.

In the observation group, the incidence of adverse reactions was 23.89%, the incidence of adverse reactions at inoculation site, abnormal vital signs and non-inoculation site were 16.79%, 9.05% and 7.69%, and the incidence of grade 1 and grade 2 adverse reactions were 22.42% and 1.47%. The incidence of adverse reactions in control group was 8.72%, the incidence of adverse reactions at inoculation site, abnormal vital signs and non-inoculation site were 7.38%, 2.06% and 1.17%, and the incidence of grade 1 and grade 2 adverse reactions were 7.60% and 1.13%. There were statistically significant differences in the incidence of adverse reactions between the observation group and the control group（χ²=187.817-339.938, P<0.05）, but there was no significant difference in the incidence of grade 2 adverse reactions（χ²=0.109-1.833, P>0.05）. Within one year after vaccination, the incidence of HZ was 0.33% in the observation group and 1.45% in the control group. The estimated vaccine effectiveness（VE）after two doses of RZV vaccine was 77.82%（95% CI:47.07%-90.70%）.

Two doses of RZV were highly effective. Although the incidence of adverse reactions is high but the degree is mild, it has a good safety.

To analyze the trends in incidence and disability-adjusted life years（DALYs）of neonatal tuberculosis in China from 1990 to 2021.

Based on the 2021 global burden of disease（GBD）study data, extracted incidence and DALYs of neonatal tuberculosis（infants aged <28 days）in China from 1990 to 2021. Using Joinpoint log-linear regression models, calculated the estimated annual percentage change（EAPC）, average annual percent change（APC）and annual percentage change（APC）by period to analyze trend variations across different drug-resistant tuberculosis types（drug-susceptible tuberculosis（DS-TB）, multidrug-resistant TB without extensive drug resistance（MDR-TB non-XDR）, and extensively drug-resistant tuberculosis（XDR-TB））.

China’s exhibited a pronounced downward trend in both incidence and DALYs of neonatal tuberculosis（incidence EAPC: -5.88%, AAPC: -4.74%; DALYs EAPC: -6.36%, AAPC: -5.23%）from 1990 to 2021. The most substantial decline occurred during 2000-2010（DALYs 2000-2003 APC: -17.65%）, but significantly slowed after 2015（DALYs 2015-2021 APC: -1.96%, P=0.229）. DS-TB incidence（AAPC: -4.72%）and DALYs（AAPC: -2.60%）similarly declined, mirroring overall epidemic patterns. A precipitous decline was observed in MDR-TB non-XDR（DALYs EAPC: -8.51%）.

Significant achievements have been made in neonatal tuberculosis control in China over the past three decades, with particularly notable reductions in the burden of DS-TB. However, the pace of tuberculosis control progress has slowed since 2013 amid escalating threats drug-resistant tuberculosis. Critical next steps include: intensified perinatal TB screening, advanced drug-resistance surveillance, molecular diagnostics deployment, and precision interventions for sustained neonatal TB burden reduction.

To analyze the epidemiological characteristics and temporal trends in Lower Respiratory Infections（LRIs）mortality among population aged ≥60 years in China from 2010 to 2021, providing evidence for formulating and optimizing prevention and control strategies to reduce LRIs-related deaths.

LRIs mortality data for population ≥60 years were collected from the National Disease Surveillance System Cause of Death Surveillance Dataset（2010-2012）and the Chinese Cause of Death Surveillance Dataset（2013-2021）by sex, urban-rural residence, region, and age group. Mortality rates were standardized using the 2010 National Population Census data. Crude and age-standardized mortality rates were calculated to describe the mortality status of LRIs. Joinpoint 5.4.0.0 software was used to calculate the annual percent change（APC）and average annual percent change（AAPC）to analyze the temporal trends, and the chi-squared test was applied to compare mortality rates across groups.

From 2010 to 2021, a total of 255 385 LRIs deaths occurred among the monitored population aged ≥60 years in China, accounting for 87.65% of all LRIs deaths. The overall crude mortality rate was 57.45 per 100 000 population, with males（63.07/100 000）having a significantly higher mortality rate than females（52.15/100 000）, urban areas（77.95/100 000）higher than rural areas（47.04/100 000）, and the western region（66.10/100 000）higher than the eastern（59.83/100 000）and central（48.17/100 000）regions（all P<0.001）. The age-standardized mortality rate for LRIs among population aged ≥60 years showed an overall downward trend from 2010 to 2020（AAPC=-8.25%, P<0.001）. Similar trends were observed in males（AAPC=-7.77%, P<0.001）, females（AAPC=-9.04%, P<0.001）, urban areas（AAPC=-8.02%, P<0.001）, the eastern region（AAPC =-7.79%, P<0.001）, and the central region（AAPC=-8.58%, P<0.001）, while rural（AAPC=-8.04%, P<0.001）and western regions（AAPC=-8.09%, P<0.001）exhibited steady declines. Among the population aged ≥60 years, LRIs mortality increased significantly with age, while the magnitude of decline showed an upward trend. The AAPCs for the age groups 65-69, 70-74, 75-79, 80-84, and ≥85 years were -3.16%, -5.76%, -6.60%, -8.33%, and -9.90%, respectively（all P<0.05）.

From 2010 to 2021, the mortality rate of LRIs among population aged ≥60 years in China showed a downward trend, which increased significantly with age and showed marked disparities by sex, age, urban/rural residence, and geographic region.The elderly males in urban and western regions are high-risk groups for LRIs-related deaths and require focused attention and targeted control measures.

To systematically review the current research status, feasibility, and future prospects of using large language models（LLMs）for mental health interventions.

We searched literature published between January 2023 and March 2025 on LLM-based mental health interventions across databases including CNKI, Wanfang Data, VIP, PubMed, Scopus, and Web of Science. After screening, the Mixed Methods Appraisal Tool（MMAT）was used for quality assessment. Key data were extracted, including study characteristics, model types, and supported languages.

Twenty-one English-language studies were included. Twelve studies employed population-based intervention trials, investigating the effects of LLMs in reducing anxiety, identifying and intervening in cognitive distortions, measuring and fostering psychological resilience in children, alleviating depression and loneliness, and enhancing willingness to engage in mindfulness training. Results indicated that LLMs demonstrated some efficacy in these tasks. Another seven studies supported the feasibility of LLM-based mental health interventions in three key areas: psychological knowledge consultation, emotional support, and therapeutic assistance. However, challenges such as bias, cultural adaptability, and privacy concerns remain. Seven studies used English as the model language, while thirteen applied prompt engineering or instruction fine-tuning to adapt the models, with adjusted models showing improved performance in specific mental health tasks. Quality assessment revealed that existing studies were limited.

LLMs show promising potential in mental health promotion. Future research should refine model strategies to enhance task performance and incorporate rigorously designed empirical research to ensure scientifically robust efficacy evaluations.

To systematically evaluate the prevalence of SO in diabetic patients in China.

Search for literature on the prevalence of SO in Chinese diabetic patients in 8 databases including PubMed, Web of Science, Embase, etc, with the search timeframe spanning from the databases’ inception to February 2025. Statistical analysis was conducted using Stata 15.0.

This meta-analysis included 13 studies involving 5 554 diabetes patients. The pooled results demonstrated a 14.9%（95% CI: 11.0%–18.8%）prevalence of SO among diabetic patients in China. Subgroup analysis showed that the prevalence was higher in studies where the participants were aged 60 or above, male, from the southeastern region, used bioelectrical impedance analysis（BIA）, diagnosed sarcopenia based on only a single assessment of muscle mass or strength, and used waist circumference（WC）as the diagnostic criterion for obesity. Meta-regression showed that none of the results were statistically significant（P>0.05）, and no sources of heterogeneity were identified.

The prevalence of SO among diabetic patients in our country is relatively high. Therefore, it is necessary to actively carry out health education for diabetic patients, strengthen early screening and intervention management, in order to prevent and slow down the progression of the disease.

To identify causal genes associated with frailty, a significant global health issue whose genetic mechanisms remain poorly understood, by integrating multi-tissue gene expression data.

This study integrated expression quantitative trait loci（eQTL）data from 49 human tissues and employed summary data-based Mendelian randomization（SMR）to analyze causal associations between gene expression and frailty. Genetic colocalization of signals was used to validate significant genes, followed by sensitivity analysis using two-sample Mendelian randomization, with MR-Egger regression and Cochran’s Q test to control for pleiotropy and heterogeneity. Gene Ontology（GO）enrichment analysis was performed for genes identified through SMR, colocalization, and sensitivity analyses.

Twenty causal genes（80 significant associations）linked to frailty were identified across 27 tissues. The top five genes showing multi-tissue causal associations included LRPPRC, RBM6, TTC12, RNF123, and CPS1. The final 20 causal genes were primarily enriched in mitochondrial function regulation, nuclear-mitochondrial signaling, and redox metabolic processes.

The causal genes identified in this study may influence the occurrence and development of frailty through mitochondrial function and nuclear signaling pathways.

To investigate the correlation between the C-reactive protein-albumin-lymphocyte（CALLY）index and chronic obstructive pulmonary disease（COPD）.

Using data from two cycles of the National Health and Nutrition Examination Survey（NHANES）in the United States from 2015 to March 2020, we conducted multivariate logistic regression, subgroup analysis, and restricted cubic spline analysis to explore the relationship between Log₂CALLY and COPD. The predictive accuracy of Log₂CALLY for COPD risk was assessed using receiver operating characteristic（ROC）curve analysis.

A total of 7 186 participants were included in this study, of whom 817（10.89%）had COPD. Multivariate logistic regression revealed that the prevalence of COPD in the highest quartile group was 40% lower compared to the lowest quartile group（OR=0.60, 95% CI:0.39-0.94, P=0.029）. Restricted cubic spline analysis confirmed a linear negative correlation between Log₂CALLY and COPD（P_non-linear=0.74）. No significant interactions were observed between age, gender, body mass index, smoking and drinking status, hypertension, diabetes, asthma, cardiovascular disease, and Log₂CALLY（P>0.05）. ROC curve analysis demonstrated that after full adjustment, the area under the curve（AUC）for Log₂CALLY in predicting COPD risk was 0.83.

The CALLY index is linearly negatively correlated with the risk of COPD, indicating its potential as a composite biomarker for early risk prediction of COPD.