To investigate association between Body Roundness Index (BRI) and all-cause and cardiovascular disease (CVD)-specific mortality among patients with CVD.

A total of 188 428 CVD patients from UK Biobank were included. Cox proportional hazards regression and restricted cubic spline (RCS) analyses were used to examine the association and dose-response relationship between BRI and risks of deaths. Subgroup and sensitivity analyses were also conducted.

Over a median follow-up of 12.75 years, 21 548 deaths occurred, including 5 367 CVD-related deaths. In multivariable Cox models, higher BRI was positively associated with risks of all-cause, CVD, and ischemic heart disease (IHD) mortality (P for trend <0.001). Compared with the lowest quintile (Q1), participants in the highest quintile (Q5) had 32% higher risk of all-cause mortality (HR=1.32, 95% CI: 1.26-1.38), 71% higher risk of CVD mortality (HR=1.71, 95% CI: 1.55-1.89), and 104% higher risk of IHD mortality (HR=2.04, 95% CI: 1.76-2.37); no significant association was observed for stroke mortality. RCS analyses indicated a J-shaped association of BRI with all-cause and CVD mortality. With BRI=4.45 as the threshold, relatively flat mortality risk below the threshold and a steep increase above it. BRI was positively associated with IHD mortality without clear evidence of nonlinearity, and showed no association with stroke mortality.

Among patients with CVD, BRI exhibits a J-shaped association with all-cause and CVD mortality, a positive association with IHD mortality, and no association with stroke mortality.

To investigate the current status of knowledge, attitudes, and practices (KAP) and influencing factors of practices among Helicobacter pylori (H. pylori)-positive populations in rural China, and to provide a reference basis for adopting effective health education and health promotion strategies.

From October to December 2024, a multistage stratified cluster random sampling method was employed to select 168 administrative villages (neighborhood committees) from 27 rural counties across four provinces (Jiangsu, Anhui, Shandong, and Henan) as the study areas. All rural residents underwent H. pylori infection testing via the ¹³C-urea breath test, and a questionnaire survey was conducted among 16 144 individuals who were identified as H. pylori-positive. Cluster analysis and Logistic regression were utilized to assess the current status of knowledge, attitudes, and practices (KAP) and to identify behavioral influencing factors among the H. pylori-positive population.

The standardized scores for the knowledge, attitude, and practice dimensions among the H. pylori-positive population were (0.69±0.29), (0.91±0.15), and (0.73±0.15) points, respectively. K-means cluster analysis revealed that 27.99%, 5.49%, and 15.59% of the surveyed participants exhibited low levels in the knowledge, attitude, and practice dimensions, respectively. Based on knowledge and attitude levels, the population was categorized into four distinct characteristic groups: high knowledge-high attitude, low knowledge-high attitude, high knowledge-low attitude, and low knowledge-low attitude. The multivariate analysis results indicated that compared to the low knowledge-low attitude level group, the high knowledge-high attitude level group had a higher behavioral dimension level (OR=6.45, 95% CI: 5.45-6.83), followed by the low knowledge-high attitude level group (OR=2.48, 95% CI: 2.09-2.95). Compared to males, females had a higher behavioral dimension level (OR=1.46, 95% CI: 1.33-1.60). Compared to farmers, non-farmer occupational groups had a higher behavioral dimension level (OR=1.30, 95% CI: 1.18-1.44).

The H. pylori-positive population in rural areas demonstrates relatively positive attitudes but suboptimal knowledge and health practices. It is recommended to implement precise stratified intervention strategies tailored to different population characteristics. Emphasis should be placed on groups with low knowledge-low attitude and high knowledge-low attitude to enhance their cognitive levels and risk awareness. This approach provides evidence-based strategic support for the comprehensive prevention and control of H. pylori infection and gastric cancer in rural areas.

To investigate the association between PreDM transition and D/AO. The relationship between dynapenic abdominal obesity (D/AO) and the transition of prediabetes (PreDM) has not been fully explored, especially in middle-aged and elderly Chinese populations.

A total of 2 438 PreDM participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study (CHARLS) were included, and data from two waves (2011 and 2015) were used for prospective analysis. Logistic regression models were applied to examine the longitudinal association between D/AO and PreDM transition, while sensitivity analysis and subgroup analysis were conducted to evaluate the robustness of this association.

After adjusting for all covariates, D/AO was significantly associated with both PreDM regression (OR: 0.556; 95% CI: 0.340-0.909) and progression to diabetes mellitus (DM) (OR: 1.780; 95% CI: 1.158-2.736). Subgroup analysis showed that D/AO was significantly associated with PreDM regression in participants with a history of hypertension, without hyperlipidemia, with low social activity, without smoking or drinking habits, and with nighttime sleep duration ≤7.5 hours. Additionally, D/AO was significantly associated with PreDM progression to DM in participants without coronary heart disease, without hypertension, with a history of hyperlipidemia, and across different subgroups of nighttime sleep duration, smoking history, drinking history, and social activity levels.

Dynapenic abdominal obesity (D/AO) increases the risk of PreDM progressing to DM and reduces the likelihood of PreDM regression. These findings emphasize that in diabetes prevention strategies and public health policies, interventions aimed at improving muscle strength and reducing abdominal obesity should be enhanced for PreDM individuals and high-risk populations.

To investigate the association between systolic blood pressure (SBP) trajectories and the risk of stroke among older adults aged ≥65 years.

Older adults aged ≥65 years from Yangzhong City who participated in at least three rounds of Basic Public Health Service health check-ups between 2016 and 2019 and had no history of cardio-cerebrovascular disease were included.The incidence data of stroke were obtained from the Hospital Information System (HIS) of secondary and above hospitals in Yangzhong City, the Chronic Disease Surveillance Information System of Zhenjiang City, and self-reports from subjects during annual health examinations. Latent class mixed models (LCMM) were used to identify long-term SBP trajectories. Multivariable Cox proportional hazards models were applied to examine the association between different SBP trajectory groups and stroke incidence.

A total of 12 304 older adults were included in the study. LCMM identified two distinct SBP trajectory groups: a low initial SBP with a slight increase group (90.55%) and a high initial SBP with a steep increase group (9.45%). By the end of follow-up on December 31, 2024, totaling 60 266.59 person-years, with an average follow-up time of 4.90 years.2 495 new stroke cases were recorded, with an incidence density of 41.40 per 1 000 person-years. The incidence density was 39.74 per 1 000 person-years in the low initial SBP group and 57.91 per 1 000 person-years in the high initial SBP group. Multivariable Cox proportional hazards analysis showed that compared to the low initial SBP group, the high initial SBP group had a 20% higher risk of stroke (HR=1.20, 95% CI: 1.04-1.38). Stratified analysis showed that the association between SBP trajectory and stroke incidence differed significantly across age groups. In individuals aged over 70 years, the association was stronger (HR=1.26, 95% CI: 1.04-1.51), while in those aged 70 years or younger, the HR was 1.13 (95% CI: 0.91-1.39). The interaction between age and SBP trajectory was statistically significant (P for interaction=0.015).

Among older adults, those with a high initial SBP and a steep increase in SBP over time have a higher risk of stroke. This subgroup should be prioritized in stroke prevention efforts, with strengthened blood pressure monitoring and timely intervention recommended.

To develop and validate a risk prediction model for social frailty inelderly patients with type 2 diabetes mellitus.

A total of 455 elderly T2DM patients hospitalized in the endocrinology department of a Grade A tertiary hospital in Hebei Province between June 2024 and February 2025 were enrolled. Based on the HALFT scale, participants were categorized into asocial frailty group (n=169) and a non-social frailty group (n=286). They were randomly divided into a training set (n=318) and a test set (n=137) in a 7:3 ratio. Univariate analysis, Lasso regression, and multivariate regression were employed to identify influencing factors for social frailty. Risk prediction models were constructed using logistic regression, XGBoost, and Random Forest.The predictive performance of the models was evaluated, and the optimal model was selected.

Multivariate logistic regression analysis revealed that education level junior high school (OR=0.272, 95% CI: 0.101-0.730); high school (OR=0.275, 95% CI: 0.140-0.540); college (OR=0.064, 95% CI: 0.010-0.424); bachelor’s degree or above (OR=0.114, 95% CI: 0.021-0.618),e-health literacy (OR=0.954, 95% CI: 0.914-0.996), and social support (OR=0.897, 95% CI: 0.840-0.958) were protective factors against social frailty in elderly T2DM patients. In contrast, glycated hemoglobin (OR=1.315, 95% CI: 1.026-1.684), number of diabetic complications 2 complications (OR=2.813, 95% CI: 1.420-5.572); ≥3 complications (OR=6.196, 95% CI: 2.769-13.863), diabetic stress moderate (OR=3.022, 95% CI: 1.134-8.050); severe (OR=7.623, 95% CI: 2.543-22.854), and depressive (OR=2.940, 95% CI: 1.576-5.486) were identified as risk factors (P<0.05). In the test set, the area under the curve (AUC) for all models exceeded 0.800, with the Random Forest model demonst-rating the best performance (AUC=0.866).

The risk prediction mode-lfor social frailty in elderly patients with type 2 diabetes, developed based on the random forest model, exhibits good predictive abilityand can serve as a reference for the early identification of high-risk patients for social frailty in this population.

To examine the impact of the integrated urban-rural health insurance policy on depression levels among rural middle-aged and elderly populations.

A multi-period difference-in-differences model was constructed using five waves of the China Health and Retirement Longitudinal Study (CHARLS) data from 2011-2020 to evaluate policy effects.

The integration policy reduced depression scores among rural middle-aged and elderly individuals by 0.426 points (β=-0.426, P<0.05), with significant effects observed among rural males (β=-0.416, P<0.01) and middle-aged cohorts (β=-0.570, P<0.1). Improved chronic disease conditions partially mediated this effect.

The integration of health insurance significantly reduces depression levels among rural middle-aged and elderly individuals. Future efforts should focus on deepening institutional reforms, optimizing chronic disease coverage, and strengthening targeted interventions to enhance the physical and mental health security of this demographic.

To carry out long-term monitoring of SARS-CoV-2 variants in municipal wastewater in Shijiazhuang, to reveal the succession patterns of major epidemic variants and their correlation with population monitoring data, so as to provide scientific basis for the construction of modern infectious disease surveillance and early warning system with multiple trends and high sensitivity.

From January 2023 to June 2025 (a period spanning 30 months), monthly wastewater samples were collected from the Qiaodong Wastewater Treatment Plant in Shijiazhuang. Viral particles were enriched using membrane filtration method, followed by SARS-CoV-2 nucleic acids detection through real-time reverse transcription polymerase chain reaction (RT-qPCR). Next-generation sequencing (NGS) was employed to conduct viral whole-genome sequencing and identify major variant lineages. The results were then compared with local population infection surveillance data from the same period for correlation analysis.

RT-qPCR detection results showed that all wastewater samples were positive, and the major prevalent SARS-CoV-2 variants successively evolved of BA.5, XBB, JN.1, XDV lineage, which was basically consistent with the evolution trend of clinical monitoring data. Spearman correlation analysis showed significant positive correlations between wastewater samples and clinical infection samples for each variant’s monthly proportions (BA.5 lineage: ρ=1.000, P<0.001; XBB lineage: ρ=0.905, P<0.001; JN.1 lineage: ρ=0.817, P<0.001; XDV lineage: ρ=0.676, P<0.01). Kendall correlation analysis further confirmed a significant relationship between the variant composition in wastewater and clinical infection samples (τ=0.652, P<0.001).

The monitoring of SARS-CoV-2 variants in urban wastewater in Shijiazhuang can reflect the dynamic evolution of variants in the community population in real time, and can be used as an important information source for the future infectious disease surveillance and early warning system.

To explore the interaction between shift work and hyperuricemia (HUA) on the prevalence of non-alcoholic fatty liver disease (NAFLD).

The demographic data, lifestyle, shift work conditions, liver ultrasound, serum uric acid and other data of 3 349 workers in an automobile manufacturing enterprise in Guangzhou were collected. The effects of shift work and HUA on the prevalence of NAFLD were analyzed by binary logistic regression. The influence of the interaction between shift work and HUA on the risk of NAFLD was analyzed through multiplicative and additive interactions.

Among 3 349 subjects, the detection rate of NAFLD was 41.36% (1 385/3 349), the detection rate of HUA was 52.05% (1 743/3 349), and the proportion of shift workers was 73.16% (2 450/3 349). The multivariate logistic regression analysis showed that shift work (OR=1.349, 95% CI: 1.087-1.676) and HUA (OR=1.732, 95% CI: 1.436-2.088) were the risk factors for NAFLD. Shift work and HUA had no multiplicative interaction on the prevalence of NAFLD (OR=0.910, 95% CI: 0.600-1.380). The additive interaction analysis of Model 2 (adjusted for age and BMI) and Model 3 (fully adjusted model) showed a synergistic effect between shift work and HUA. The relative excess risk due to interaction (RERI) , attributable proportion due to interaction (API) and synergy index (S) of Model 2 were 13.865 (95% CI: 4.320-23.411), 0.628 (95% CI: 0.507-0.749), and 2.922 (95% CI: 2.107-4.051), The RERI, API and S of Model 3 are respectively 14.025 (95% CI: 2.004-26.046), 0.625 (95% CI: 0.476-0.774), 2.891 (95% CI: 1.940-4.308).

Shift work and HUA have an additive interaction effect on the prevalence of NAFLD. Optimizing the shift scheduling system and controlling serum uric acid may coordinate the prevention of the occurrence of NAFLD.

To explore the latent categories of depressive symptoms among food delivery riders and analyze the influencing factors of different categories.

Participants were selected through cluster randomized sampling from six food delivery service providers in Chengdu. Data were collected using a general information questionnaire, the Patient Health Questionnaire (PHQ), and the Core Occupational Stress Scale. Latent profile analysis (LPA) was employed to classify depressive symptoms, and multinomial logistic regression was conducted to identify associated risk factors.

Among the 560 food delivery riders, the depressive symptoms were divided into three latent categories: the no-depression-risk group (28.21%), the low-risk group of emotional depression (61.43%), and the high-risk group of emotional depression with medium-risk of cognitive depression (10.36%). Divorce was a risk factor for high-risk emotional depression-medium-risk cognitive depression (OR=2.22, 95% CI: 1.58-3.12); undergraduate degree or above was a risk factor for high-risk emotional depression-medium-risk cognitive depression (OR=3.17, 95% CI: 2.70-3.71); long working hours were a risk factor for depression (OR=2.70, 95% CI: 2.17-3.36); and social support was a protective factor for depression (OR=0.83, 95% CI: 0.76-0.91).

Timely and effective intervention measures should be formulated for different latent categories to relieve the depressive emotions of food delivery riders.

To investigate the molecular typing, virulence and antimicrobial resistance characteristics of food-borne Klebsiella pneumoniae in Guizhou Province, providing scientific evidence for targeted food safety risk assessment and regulatory decision-making in our province.

A total of 38 strains of Klebsiella pneumoniae were isolated from pre-packaged chilled ready-to-eat food and pig livers in 9 cities (states) of Guizhou Province from 2023 to 2024. Strains were screened by string test, whole genome sequencing and antimicrobial susceptibility test.

Four hypermucoviscous Klebsiella pneumoniae strains were isolated from 38 isolates. Through whole genome sequence analysis, 20 KL types, 30 ST types, 80 virulence genes and 35 drug resistance genes were obtained. ST 37 was the main strain. HmKp of ST65-KL2 carried iucA, iroB, ybtS, rmpA and clb genes, while ST490-KL3 carried iucA, iroB, ybtS and allS genes. The main β-lactamase resistance genes were bla_SHV-11, bla_SHV-1, bla_LAP-2. 5 of the strains carried bla_OXA-10 gene. The results of antibiotic susceptibility tests showed that the top five resistant antibiotics were ampicillin, tetracycline, chloramphenicol, florfenicol and sulfamethoxazole/trimethoprim, with resistance rates of 81.58%, 50.0%, 44.74%, 44.74% and 28.95% respectively. All isolates were sensitive to carbapenems.

The prevalence of virulence genes in Klebsiella pneumoniae in food in Guizhou Province is high, with a strong pathogenic potencial. The ST types and KL types of the strains are diverse.

To investigate the contamination levels of deoxynivalenol (DON), 3-acetyldeoxynivalenol (3-Ac-DON), and 15-acetyldeoxynivalenol (15-Ac-DON) in grains and their products in Chongqing, and to assess the dietary exposure levels and potential chronic health risks posed by these mycotoxins among residents of Chongqing.

Functional models (e.g. triangular distribution models) were employed to fit contamination data of DON and its acetyl derivativesfrom 794 samples across nine categories of grains and their products collected in Chongqing between 2018 to 2023. Parameter estimation was conducted based on distribution types. Probabilistic assessment (Monte Carlo simulation) was performed using data from the 2018 China Health and Nutrition Survey toestimate the exposure levels and characterize risks against established safety thresholds.

The average contamination levels of DON, 3-Ac-DON and 15-Ac-DON were 213.00, 0.09-4.48 and 0.75-5.51 μg/kg, respectively. Estimated daily intakes of DON and its derivatives varied by age group: 1.11-1.19 μg/(kg·d) (3-6 years), 0.85-0.94 μg/(kg·d) (7-17 years), 0.47-0.48μg/(kg·d) (18-59 years), and 0.50-0.52 μg/(kg·d) (≥60 years). At the 90th percentile (P₉₀), The exposure levels of most population groups exceeded the daily tolerable intake (TDI). At P₉₅, the exposures levels were 1.12 to 2.87 times the TDI for all population groups. Wheat flour products were identified as the primary source of DON and its acetyl derivatives.

The average dietary exposure of residents to DON and its acetylderivatives (3-Ac-DON and 15-Ac-DON) is at a safe level, and there may be a potential weight loss risk in high-exposure populations.

To analyze the trends and associated factors of complementary feeding practices (CFPs) among infants and young children (IYC) aged 6-23 months in rural areas of Liuzhou from 2017 to 2024.

Children nutrition improvement program monitoring data of 5 020 IYC in Liuzhou between 2017 and 2024 were retrospectively analyzed. The trends of CFPs were analyzed by trend χ²test, and the influencing factors of CFPs delivery by logistic regression analysis.

The prevalence of minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), egg and/or flesh food consumption (EFF), and zero vegetable or fruit consumption (ZVF) were 64.40%, 82.45%, 53.17%, 90.86%, and 15.14%, respectively. The prevalence of MDD and MAD decreased from 71.92% and 53.82% to 59.17% and 49.70% over the 8 year period, respectively (, 11.912, all P<0.01). The prevalence of MMF and ZVF increased from 77.20% and 9.75% in 2017 to 82.01% and 16.33% in 2024, respectively (, 33.036, all P<0.01). Multivariate logistic regression analysis showed that children of mothers with Miao ethnic group were negatively associated with MMF (OR=1.38, 95% CI: 1.06-1.79) and MAD (OR=1.37, 95% CI: 1.11-1.68). Mothers of senior high school/technical secondary school and above education were positively associated with MDD (OR=0.72, 95% CI: 0.58-0.88), MMF (OR=0.70, 95% CI: 0.55-0.90), and MAD (OR=0.70, 95% CI: 0.57-0.87). Fathers with Miao ethnic group were negatively associated with MMF (OR=2.04, 95% CI: 1.56-2.67) , and positively associated with ZVF (OR=1.44, 95% CI: 1.16-1.80). Fathers with Dong ethnic group were negatively associated with MMF (OR=1.84, 95% CI: 1.43-2.36). Employed fathers showed a significant association with a higher prevalence of MDD (OR=0.86, 95% CI: 0.74-0.99), MAD (OR=0.78, 95% CI: 0.68-0.90) and EFF (OR=0.70, 95% CI: 0.56-0.88), and lower prevalence of ZVF (OR=0.62, 95% CI: 0.52-0.74). The score for caregiver’s knowledge of feeding and nutrition were positively associated with MDD (OR=0.94, 95% CI: 0.89-0.98), MMF (OR=0.86, 95% CI: 0.80-0.91), MAD (OR=0.86, 95% CI: 0.82-0.90), and EFF (OR=0.89, 95% CI: 0.82-0.97). Children aged 12-23 months were more likely to have MDD (OR=0.35, 95% CI: 0.30-0.41), MAD (OR=0.59, 95% CI: 0.51-0.69), and EFF (OR=0.13, 95% CI: 0.10-0.16) but less likely to have ZVF (OR=0.22, 95% CI: 0.18-0.26). Children with a birth order of being third or greater were negatively associated with MAD (OR=1.26, 95% CI: 1.06-1.50). Multiple children were positively associated with MMF (OR=0.28, 95% CI: 0.14-0.58) and MAD (OR=0.58, 95% CI: 0.41-0.83). Children with diarrhea in the last 2 weeks were positively associated with MMF (OR=0.45, 95% CI: 0.26-0.76). Taking nutrient supplements were positively associated with MDD (OR=0.82, 95% CI: 0.71-0.94), MMF (OR=0.82, 95% CI: 0.68-0.98) and EFF (OR=0.72, 95% CI: 0.58-0.90).

Improvement in CFPs among children aged 6-23 months in rural areas of Liuzhou is unsatisfactory, specifically MDD and MAD. Attention needs to be paid to ethnic minorities, mothers with low education, fathers without job, children with young age and high birth order, and strengthening caregiver’ education on IYC feeding practices, in order to improve CFPs.

To analyze the impact of nighttime social media useon pregnancy-specific anxiety among pregnant women, to provide evidence to promote mental health during pregnancy.

Ainvestigation was completedamong pregnant women undergoing prenatal examinations at Qilu Hospital of Shandong University from December 2024 to March 2025 using instruments including self-made general information questionnaire, Nighttime-useSocial Media Scaleand Pregnancy-specific Anxiety Questionnaire (PAQ). Latent profile analysis was used to explore the latent classes of nighttime social media use, while logistic regression analysis was used to analyze the relationship between its latent profiles and pregnancy-specific anxiety.

A total of 855 pregnant women were included, the average score of nighttime social media use was 19.54±4.38, which could be divided into three latent classes including low-frequency use with good sleep (41.2%), high-frequency use with delayed sleep (49.2%), and high-frequency use with disrupted sleep (9.6%). Nighttime social media use significantly increased the risk of pregnancy-specific anxiety (P<0.001). The high-frequency use with delayedsleep group (OR=2.903, 95% CI=2.118-3.979) and the high-frequency use with disruptedsleep group (OR=5.087, 95% CI=2.771-9.339) had a higher risk of pregnancy-specific anxiety compared with the low-frequency use with good sleep group (P<0.001).

Nighttime social mediause is prevalent among pregnant women with significant inter-individual heterogeneity and increases the risk of pregnancy-specific anxiety. Particular emphasis should be placed on the impacts of nighttime social media use in pregnant woman, with targeted interventions implemented to promote physical and mental health during pregnancy.

To investigate the dynamic trajectories of cognitive function and its influencing factors among elderly populations relocated through poverty alleviation resettlement programs.

A multistage stratified sampling approach was used to select 740 elderly individuals from 24 resettlement sites across four cities and eight counties in Shanxi Province for three rounds of follow-up surveys. Latent growth mixture models (LGMM) identified cognitive trajectory categories, and multivariable logistic regression analyzed influencing factors.

The prevalence of cognitive impairment was 22.6%, with an overall upward trend in cognitive scores. LGMM identified two distinct trajectories: a “Peak-high cognitive function group” and a “Valley-low cognitive function group.” Advanced age (OR=2.914, 95% CI: 1.946-4.362), non-marital status (OR=2.551, 95% CI: 1.632-3.985), lack of regular physical exercise (OR=1.952, 95% CI: 1.327-2.873), and obesity (OR=2.652, 95% CI: 1.579-4.452) were significant risk factors for the low cognitive trajectory, while better basic functional ability was a protective factor (OR=0.723, 95% CI: 0.637-0.821).

While cognitive function showed overall improvement in the relocated elderly population, specific risk factors significantly increased the risk of cognitive decline. Recommendations include promoting early cognitive screening, expanding community sports facilities, and implementing family-based social support programs.

To construct the Compliance Scale for primary prevention of stroke among the elderly in the community, to evaluate the compliance level of the elderly in the community as a whole, and to provide reference tools for the investigation of the current situation of primary prevention, influencing factors and health education.

In accordance with the 2024 Guideline for the Primary Prevention of Stroke from the American Heart Association/American Stroke Association, the theory of self-care for chronic diseases was used as the theoretical framework. Literature review and Delphi method were used to conduct two rounds of consultation with 18 experts. A pilot study was conducted among community-dwelling older adults to validate the applicability of the scale items.

The questionnaire recovery rate for both rounds of inquiry reached 100%, and the expert authority coefficient was 0.89. In the two rounds of correspondence, the average importance of items was >3.5, the full score ratio was >0.2, the CV (coefficient of variation) stood at ≤0.25, and the Kendall W coordination coefficient was 0.305 and 0.265 respectively (all P<0.001). The final form is a community-based primary prevention behavior compliance scale for elderly stroke with 3 dimensions, 10 sub dimensions and 33 items.

Based on the guidelines for primary prevention of stroke (2024) and the theory of self-care for chronic diseases as the theoretical framework, the community elderly stroke primary prevention behavior compliance scale has good reliability and scientificity, and can be used as an evaluation tool to evaluate the community elderly stroke primary prevention behavior compliance.

To optimize medical cost control, enhance disease prevention systems, and reform healthcare payment models to investigate hospital care status, cost components, and influence factors for ischemic stroke patients in Changzhi, Shanxi.

Based on the hospitalization data of 90 465 patients with ischemic stroke in Changzhi from 2018 to 2023, a structural equation model was constructed to analyze the factors affecting hospitalization costs.

Ischemic stroke hospitalizations increase annually (males faster), with the 60-69 age group being predominant and onset age shifting older. The average length of stay is 11.58 days (decreasing), and the proportion of critical/urgent admissions rises, indicating increased disease severity. More patients undergo clinical pathways, with more cured/improved cases (suggesting medical advances). Patients with ≥2 admissions and those visiting tertiary hospitals are increasingyearly. The average hospitalization cost is 8 965.01, dominated by drug and diagnostic fees; while average cost, comprehensive service, treatment, and rehabilitation fees rise, diagnostic and drug costs decline. SEM analysis ranks influencing factors as: length of stay>hospital level>age>gender>number of admissions>clinical pathway implementation>condition at admission>medical insurance type.

Although initial progress in cost control is seen, patients’ economic burden remains heavy. It is necessary to optimize cost structure and hospitalization cycle management, focus on influencing factors, and strengthen whole-cycle disease prevention and control.

To examine the current status of public health responsibility development in public hospitals in Jiangxi Province and to propose targeted strategies.

A stratified random sampling approach was applied to select 271 hospitals across Jiangxi Province. A questionnaire survey was conducted covering eight dimensions, including disease prevention and control-public health collaboration. Descriptive analysis and chi-square tests were employed to assess the status of public health responsibility development in public hospitals and to compare differences across hospital levels.

A total of 258 hospitals were included in the study. Among them, 94.57% provided basic public health services, 89.15% had established independent public health departments, but only 49.22% had dedicated staff with a public health background. Significant differences were observed across hospital levels. Tertiary hospitals performed significantly better in establishing surveillance and early warning systems (100%), departments for infectious diseases (98.25%), and intelligent monitoring (84.21%) (P<0.05). Primary hospitals performed better in the coverage of basic public health services (100%) and public health performance evaluation (91.74%). In contrast, secondary hospitals lagged behind in establishing independent public health departments and staff training. General hospitals demonstrated overall superiority compared with non-general hospitals.

There are significant level-based differences in the implementation of public health functions in public hospitals in Jiangxi Province, requiring tailored strategies for each level.

To construct a set of scientific, systematic and specialty-specific operation evaluation index system for tertiary public psychiatric hospitals, and to provide tools and references for hospital refined management and health policy formulation.

Based on the balanced scorecard theory, the index pool was formed through policy analysis, literature research and semi-structured interviews, the final index system was determined by Delphi method, and the index weight was calculated by analytic hierarchy process.

After two rounds of expert consultation (the positive coefficient of experts reached 100%, the authority coefficient was 0.86-0.87, and Kendall’s W test was significant), the evaluation system consisting of 4 first-level indexes, 13 second-level indexes and 43 third-level indexes was finally established. The weight analysis showed that the patient dimension had the highest weight among the first-level indicators (0.466 8), followed by the financial dimension (0.277 6), highlighting the “patient-centered” service orientation; Among the three-level indicators, patient satisfaction and waiting time after outpatient appointment had the highest weight.

This index system effectively solves the problem of “acclimatization” of general evaluation standards in the field of psychiatry, is an important tool to promote high-quality connotative development, and has reference value for performance appraisal and policy improvement in the field of mental health.

To systematically analyze the overall architecture, evolution, and core issues of medical data trading policies in China, identify deficiencies within the policy system, and to provide a basis for subsequent policy optimization.

Using NVivo 12 Plus software, we conducted content mining and thematic coding of 48 policy texts related to medical data trading issued at the national level between 2015 and 2025. A structural model of policy elements was constructed, and a combined qualitative and quantitative analysis was performed.

Medical data trading policies in China have formed a three-tier governance structure of “top level design-institutional mechanisms-development pathways.” However, the system exhibits significant structural imbalances, including a fragmented framework and lack of industry-specific legislation at the top-level design tier; a dual weakness in operational safety rules and supplier incentives at the institutional mechanism tier; and lagging development of infrastructure and the professional service ecosystem at the development pathway tier.

The policy system should be improved by strengthening top-level design through industry-specific legislation, improving institutional mechanisms with operational safety rules and incentive schemes, and bolstering development pathways by fostering a professional service ecosystem. These measures aim to enhance the efficiency and security of medical data factor market allocation, thereby supporting the deep integration of the “Healthy China” and “Digital China” strategies.

To explore the correlation between digital literacy and the depression trajectory of the elderly in China.

Based on data from the three waves of the China Family Panel Studies (CFPS) from 2016 to 2020, this study applied a group-based trajectory model to construct the changing trajectory of depression among the elderly, and employed a multi-class logistic regression model to investigate the association between digital literacy and the depression trajectory.

Three trajectory groups were identified: “long-term non-depression group” (64.87%), “depression slow-rising group” (29.75%), and “long-term high depression group” (5.38%). Compared with elderly individuals in the long-term non-depression group, the possibility that the depression trajectory belonged to the depression slow-rising group (RRR=0.905, 95% CI: 0.851-0.962) and the long-term high depression group (RRR=0.681, 95% CI: 0.510-0.919) was smaller if the digital literacy was higher.

There is heterogeneity in the depression trajectories of older adults, and digital literacy significantly influences these trajectories. The digital literacy of the elderly population should be enhanced to alleviate their depression.

To investigate the separate associations of cumulative ACEs exposure and specific ACEs patterns with cognitive function among middle-aged and older adults.

Using data from the China Health and Retirement Longitudinal Study (2011-2020), 12 ACE indicators were included. Linear mixed-effects model was employed to analyze the longitudinal effects of the cumulative number of ACEs and ACE patterns on cognitive function, with ACEs patterns identified using latent class analysis.

Compared with those who did not experience ACEs, those who experienced ≥4 ACEs had a faster decline in cognitive function (β=-0.029, 95% CI: -0.045--0.012). Latent class analysis identified four ACE patterns: low ACEs, domestic abuse and bullying, emotional and physical neglect, and parental mental illness and death. Among these, the “parental mental illness and death” subgroup experienced faster cognitive decline than the low ACEs group (β=-0.018, 95% CI: -0.027--0.008).

Both cumulative ACEs exposure and specific adversity patterns are associated with accelerated cognitive decline in middle-aged and older adults. Individuals who have experienced ≥4 ACEs and parental mental illness and death require particular attention.

To explore the influence of depressive symptoms on the occurrence risk of Cardiovascular disease (CVD), and to inform prevention strategies for the middle-aged and elderly in China.

Data were available from China Health and Retirement Longitudinal Study (CHARLS), in which participants free of CVD were followed from baseline (2011) to 2020. The Center for Epidemiological Studies Depression Scale (CESD-10) was employed to evaluate depressive indications. Incident CVD events were defined according to the response by participants who reported a history of physician-diagnosed CVD in the follow-up. Cox proportional hazards regression was employed to assess the effect of depressive symptoms on the risk of cardiovascular events.

During the 9-year follow-up, a total of 1 799 incident cardiovascular disease (CVD) events were recorded. Participants with depressive symptoms exhibited a significantly higher incidence of CVD compared to those without depressive symptoms (HR=1.33, 95% CI: 1.21-1.47). When compared to the lowest quartile (Q1) of depressive symptom scores, the hazard ratios for CVD incidence were 1.25 (95% CI: 1.09-1.43) for the Q3 group and 1.59 (95% CI: 1.39-1.82) for the Q4 group.

Depressive symptoms are associated with an increased risk of cardiovascular disease incidence in middle-aged and elderly Chinese adults, and this association is independent of other potential confounding factors. A higher severity of depressive symptoms is associated with a greater risk of cardiovascular disease events.

To identify oxidative stress (OS)- and immune-related biomarkers and their therapeutic targets in diabetic nephropathy (DN). The development of DN is closely associated with chronic inflammation, which exhibits complex interactions between OS and immune-metabolic alterations, collectively driving disease progression.

Download the GSE142153 dataset and evaluate immune cell infiltration in its samples. Simultaneously perform differential analysis on this dataset, intersecting the resulting differentially expressed genes (DEGs) with overall survival-related genes (OSRGs) to identify OS-related differentially expressed genes (DE-OSRGs) in the DN process. Functional enrichment analysis clarified the biological roles of DE-OSRGs. A protein-protein interaction (PPI) network was constructed, and core DE-OSRGs were selected using the MCC algorithm in the cytoHubba plugin. After validating their reliability via ROC diagnostic curves, target miRNAs of DE-OSRGs were cross-analyzed with DN-related microRNAs to identify miR-150-5p, with binding sites subsequently validated. Finally, the expression of core DE-OSRGs and the mechanism of action of their target miRNAs were validated using a rat DN model.

Bioinformatics analysis identified TLR7 as the core DE-OSRG, and combined with target miRNA prediction, miR-150-5p was determined as the primary focus of this study. Animal experiments demonstrated that miR-150-5p agomir significantly downregulated TLR7 and NF-κB p65 expression (P<0.05), reduced the production of malondialdehyde (MDA), a marker of oxidative stress (P<0.05), and increased the activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) (P<0.05). Furthermore, miR-150-5p suppressed secretion of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) (P<0.05), mitigated immune cell infiltration, and improved renal pathological damage.

By down-regulating TLR7 and modulating the NF-κB pathway, miR-150-5p attenuates OS injury and inflammation in DN, thereby improving renal function and offering a promising therapeutic target.

To evaluate the effect of a comprehensive intervention program for individuals at high risk of cardiovascular disease in the Inner Mongolia Autonomous Region, and to provide a reference for the prevention and control of cardiovascular diseases in this region.

Data from the Inner Mongolia Autonomous Region Cardiovascular Disease High-Risk Population Early Screening and Comprehensive Intervention Project (2015—2024) were used to identify 3 354 high-risk individuals. Based on inclusion and exclusion criteria, these participants received comprehensive interventions over a 10-year period. Changes in lipid profiles, blood glucose, and blood pressure levels before and after the intervention were analyzed to assess the effectiveness of the program.

After 10 years of comprehensive intervention, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels decreased (t=23.477, t=18.013), while high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels increased (t=-4.096, t=-9.154). Fasting blood glucose levels also increased (t=-14.725). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased from 160.16±22.76 mmHg and 93.10±12.75 mmHg to 140.98±18.65 mmHg and 84.89±10.94 mmHg, respectively (t=49.481, t=38.451). All these changes were statistically significant (P<0.001). Analysis of intervention effects showed that the rates of dyslipidemia and abnormal blood pressure decreased (χ²=23.369, P<0.001; χ²=359.194, P<0.001), while the rate of abnormal blood glucose increased (χ²=357.752, P<0.001), with all differences being statistically significant.

The implementation of comprehensive interventions for populations at high risk of cardiovascular disease in the Inner Mongolia Autonomous Region is beneficial in reducing the prevalence of dyslipidemia and hypertension, highlighting its public health significance. However, close monitoring of triglyceride (TG) and fasting blood glucose levels is necessary, and further research is needed to explore their impact on cardiovascular disease.

To evaluate the outbreak investigation ability of epidemiological investigators in Disease Control and Prevention Institutions in Tianjin, to explore the influencing factors, and to provide a scientific basis for enhancing their competency.

A cross-sectional questionnaire survey was conducted among 874 epidemiological investigators across Disease Control and Prevention Institutions in Tianjin from May to June 2024. The respondents conducted self-assessment of individual outbreak investigation ability according to their actual situation. The outbreak investigation ability of epidemiological investigators and their main influencing factors were conducted through single factor analysis, and multiple linear regression analysis.

The total score M of outbreak investigation ability of epidemiological investigators in Disease Control and Prevention Institutions in Tianjin was 60.00 points. The results of the multiple linear regression analysis showed that the main influencing factors of the outbreak investigation ability score were: Age (aged 41-50: β=-5.060), Educational background (bachelor’s degree: β=6.685; postgraduate degree:β=11.336), No experience in infectious disease-related work (β=-2.519), No participation in on-site epidemiological training (β=-2.500), No participation in the outbreak investigation and disposal (β=-3.694), The number of case epidemiological investigations (>50 times: β=3.721), The number of trend analysis evaluations (1-5 times: β=9.903, 6-20 times: β=10.369, 21-50 times: β=8.401, >50 times: β=19.484), The number of completed epidemiological investigation reports (1-5 times: β=5.716, >5 times: β=5.058) (all P<0.05).

The main influencing factors include experience in handling epidemic outbreaks, the number of practical operations of epidemiological investigation core skills, systematic training, educational background, and age. Therefore, it is necessary to optimize practical training and drill mechanisms, and conduct outbreak investigation ability training at different levels for personnel of various age and educational background, to enhance the comprehensive handling ability of epidemiological investigators.

To understand the detection situation and epidemiological characteristics of human bocavirus (HBoV) in influenza-like cases in Guizhou Province in 2024, and analyze the molecular typing characteristics of its VP1 gene.

10 823 throat swab samples of influenza-like cases in Guizhou Province in 2024 were collected.Usingthe multiplex fluorescence quantitative PCR method, common respiratory pathogens were analyzed, and the detection rates across different genders, ages, and seasons were described. Qualified HBoV-positive samples were screened for VP1 gene sequencing. Genotype using BLAST and MEGA 11, and constructing a phylogenetic tree using the adjacency method.

A total of 97 cases of HBoV were detected, with a detection rate of 0.90%. Among them, 44 cases were mixed infections, with a detection rate of 0.41% (44/10 823), and rhinovirus (HRV) was the main pathogen of mixed infections. There was no statistically significant difference in the detection rate of HBoV among different genders (χ²=2.732, P=0.098) and seasons (χ²=5.989, P=0.112). There was a statistically significant difference in the detection rate among different age groups (χ²=92.019, P<0.001), with the 0-4 age group having the highest detection rate, which was significantly different from the detection rates of the other three age groups. A total of 25 VP1 gene sequences of HBoV were obtained, all of which are HBoV1 type, including three evolutionary branches: 1b (17 strains), 1a (7 strains), and 1e (1 strain).

In the influenza-like cases in Guizhou Province in 2024, HBoV is at a low level of prevalence, all of which are HBoV1 type, with 1b as the main epidemic strain. The main infected population is 0-4 years old, and the monitoring of HBoV in young age groups should be continuously strengthened.

To analyze the epidemiological characteristics of varicella in Yangzhou from 2018 to 2024 and to evaluate the impact of incorporating a two-dose varicella vaccination schedule into the immunization program on the reported incidence among preschool children.

Monthly incidence data of varicella among children aged 1-6 years and vaccination data were collected from China Disease Prevention and Control Information System and Jiangsu Provincial Comprehensive Service Management Information System for Vaccination, respectively. The study described the varicella vaccination coverage in Yangzhou from 2018 to 2024 and employed an interrupted time series analysis to evaluate the impact of immunization strategies on the reported incidence of varicella among preschool-aged children.

During the 2018-2024 period, the average annual reported incidence of varicella among preschool children in Yangzhou was 867.87 per 100 000. Following the implementation of the varicella immunization strategy, vaccination coverage rose substantially in the target population, with the average annual incidence significantly declining from 1 148.33 per 100 000 to 166.75 per 100 000 (χ²=2 272.2, P<0.001). Interrupted time series analysis revealed that after the introduction of the free two-dose varicella vaccination policy, the level change in the monthly reported incidence was -94.41 per 100 000 (P<0.001), indicating a significant immediate reduction. Furthermore, the previous upward trend in incidence was reversed, with a slope change of -3.95 per 100 000 per month (P=0.023).

The implemented varicella immunization strategy significantly increased vaccination coverage and effectively reduced the incidence and disease burden of varicella among preschool children.

To analyze trends in the disease burden of pressure injuries in China and globally from 1990 to 2021 and to project future patterns for 2022-2036.

Data on incidence, prevalence, disability-adjusted life years (DALYs), and their age-standardized rates for populations aged 0-95 years and above in China and worldwide were obtained from the GBD 2021 dataset released on May 16, 2024. Descriptive analyses were conducted to summarize the disease burden. Temporal trends were assessed using Join point regression. A decomposition analysis was applied to quantify the contributions of population growth, population aging, and epidemiological changes to variations in disease burden. Future trends were projected using a Bayesian age-period-cohort (BAPC) model.

From 1990 to 2021, the numbers of incident cases, prevalent cases, and DALYs attributable to pressure injuries increased both in China and globally. In China, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALY rate (ASDR) showed upward trends, whereas global rates generally declined. The increase was more pronounced among males than females in China. Age-specific analyses indicated that incidence, prevalence, and DALY rates increased with age in 2021. According to the average annual percent change (AAPC), China’s ASIR, ASPR, and ASDR exhibited an overall rising trend. Projections using the BAPC model suggest that these age-standardized rates in China will continue to increase in the coming years.

The disease burden of pressure injuries in China has increased over the past three decades, with a greater rise observed among males. The burden increases progressively with age. Future projections indicate a continued upward trend, highlighting the need for effective prevention and management strategies to mitigate the disease burden and improve patient outcomes.