To understand the current status and influencing factors of frailty occurrence among middle-aged and elderly patients with H-type hypertension, and to construct a predictive model for frailty risk in this population.

Based on univariate and binary logistic regression analyses, screen for independent influencing factors, construct a risk prediction model for the occurrence of frailty in H-type hypertension, and create a visual nomogram. Finally, evaluate the predictive value of the risk prediction model using the H-L goodness-of-fit test, ROC curve, and calibration curve.

This study included a total of 783 middle-aged and elderly patients with H-type hypertension, among whom 207 developed frailty (26.4%). Binary logistic regression analysis showed that age (OR=1.055, 95% CI: 1.032-1.079), education level (OR=0.656, 95% CI: 0.495-0.870), blood urea nitrogen (OR=1.215, 95% CI: 1.092-1.352), and high-density lipoprotein (OR=0.475, 95% CI: 0.273-0.826) were independent factors influencing the development of frailty in middle-aged and elderly patients with H-type hypertension. A logistic regression prediction model was constructed based on these influencing factors, with the Hosmer-Lemeshow goodness-of-fit test yielding a P-value of 0.836. The area under the ROC curve (AUC) was 0.733, 95% CI=0.694-0.771, indicating that the model has good discriminative ability. The calibration curve showed a high consistency between the predicted values and the observed values.

The incidence of frailty among middle-aged and elderly patients with H-type hypertension remains at a relatively high level. A risk prediction model based on these factors has certain predictive value for the occurrence of frailty in patients with H-type hypertension.

To address regional heterogeneity in multicenter studies, and to explore the association between sleep duration and cardiovascular disease (CVD) risk in the Chinese elderly population using a federated causal learning framework.

Data was obtained from the 2020 China Health and Retirement Longitudinal Study (CHARLS). A total of 10 638 adults aged 60 and above were included. To simulate multi-center collaboration scenarios with real regional heterogeneity, the original dataset was divided into seven geographically distributed datasets. A federated augmented inverse probability weighting (AIPW) estimator was used to estimate causal effects with comparison to centralized models. Subgroup analyses by gender were conducted to explore effect heterogeneity. The robustness of the method was explored by a sensitivity analysis.

Estimations from the federated causal learning models were consistent with those from the centralized model. Abnormal sleep duration was a significant factor influencing CVD risk. Compared to normal sleepers, short sleepers had a significantly increased risk of CVD (OR=1.029, 95% CI:1.016-1.042). Long sleepers also showed elevated risk (OR=1.019, 95% CI:1.005-1.034). The subgroup analysis revealed significant gender differences, and the sensitivity analysis also validated the robustness of the model.

In multicenter research, the federated causal learning systematically controls for confounders and regional heterogeneity. It provides methodological support for future privacy-preserving cross-center collaborative research.

To investigate the association between handgrip strength (HGS), its transitions, and the decline of activities of daily living (ADL) among middle-aged and older adults in China.

This study utilized data from waves 1 to 5 (2011 to 2020) of the China Health and Retirement Longitudinal Study (CHARLS). According to the Asian Work Group for Sarcopenia 2019 consensus, low HGS was defined as <28 kg for males and <18 kg for females. Based on the changes in HGS status from baseline to the second survey, participants were classified into four groups: stable normal HGS, normal HGS to low HGS, low HGS to normal HGS, and stable low HGS. ADL disability was measured by the number of daily activities with difficulty, with higher scores indicating poorer functional ability. Linear mixed-effect models were employed to investigate the association of handgrip strength and its transition patterns with ADL decline.

Individuals with low HGS exhibited a higher level of ADL disability (β=0.607, 95% CI: 0.523-0.690, P<0.001) and a faster progression of ADL disability (β=0.085,95% CI: 0.068-0.101, P<0.001) compared to those with normal HGS. Compared with individuals with stable normal HGS, those with stable low HGS (β=0.153, 95% CI: 0.120-0.185, P<0.001) experienced the most rapid progression of ADL disability, followed by those transitioning from normal HGS to low HGS (β=0.081, 95% CI: 0.059-0.103, P<0.001).

Lower HGS is associated with accelerated ADL disability progression. Dynamic changes in handgrip strength also provide significant prognostic value for assessing the risk of ADL decline. Regular monitoring of handgrip strength and its changes may aid in the prevention and delay of ADL decline.

To investigate the association between dynapenic abdominal obesity (characterized by reduced handgrip strength combined with abdominal obesity) and the risk ofdiabetes in middle-aged and older Chinese adults.

Using data from the China Health and Retirement Longitudinal Study (China Health and Retirement Longitudinal Study,CHARLS) 2011-2015, 4 556 participants aged ≥45 years without diabetes at baseline were included. Based on handgrip strength (men <28 kg, women <18 kg) and waist circumference (men ≥90 cm, women ≥85 cm), participants were categorized into four groups:non-dynapenic/non-abdominal obesity (ND/NAO),non-dynapenic/abdominal obesity (ND/AO),dynapenic/non-abdominal obesity (D/NAO), and dynapenic abdominal obesity (D/AO).Cox proportional hazards models were employed to analyze the association between each group and diabetes risk, and subgroup analysis was conducted to explore the association between dynapenic abdominal obesity and the risk of diabetes onset under different groupings.

After a mean follow-up of 4 years, 495 new cases of diabetes mellitus were recorded，representing an incidence rate of 10.9% and an incidence density of 27.2 per 1 000 person-years. Following multivariable adjustment, compared with the ND/NAO group, the ND/AO group exhibited a 71% increased risk of diabetes onset (HR=1.709, 95% CI: 1.395-2.095), while the D/AO group showed a 123% increased risk (HR=2.226, 95% CI: 1.472-3.366). No significant difference was observed in the D/NAO group (P>0.05), with subgroup analyses yielding consistent results.

Dynapenic abdominal obesity significantly increases the risk of diabetes among middle-aged and older Chinese adults,with a higher risk than abdominal obesity alone.

With the acceleration of population aging in China, the problem of depressive symptoms in the elderly is prominent, and there is health inequity between urban and rural elderly.

To investigate the influencing factors of depressive symptoms among Chinese elderly population and their urban-rural differences, so as to provide references for preventing depressive symptoms in the elderly.

Relevant data of 4 449 elderly individuals aged ≥ 60 years were collected from the 2022 China Family Panel Studies (CFPS). The chi-square test was used to compare the differences in the detection rate of depressive symptoms between urban and rural areas. Binary logistic regression was adopted to screen for the main influencing factors, and the random forest model was applied to rank these factors by their importance.

The detection rate of depressive symptoms among Chinese elderly was 25.20%, with rural elderly showing a higher rate (30.58%) than urban elderly (19.80%) (χ²=68.542, P<0.05).

of the regression analysis indicated that gender, chronic disease, self-rated health, napping, nighttime sleep time, interpersonal relationships, education level, retirement status, regional distribution, and income level are common influencing factors of depressive symptoms among the urban and rural elderly populations. The random forest model showed that, for the urban elderly population, the factors ranked in descending order of influence on depressive symptoms are good self-rated health (OR=0.396, 95% CI: 0.312-0.503), secondary school (OR=0.639, 95% CI: 0.473-0.862), and being retired (OR=0.726, 95% CI: 0.541-0.975). For the rural elderly population, the factors are good self-rated health (OR=0.472, 95% CI: 0.383-0.581), having chronic diseases (OR=1.918, 95% CI: 1.552-2.370), and nighttime sleep time <7h (OR=1.697, 95% CI: 1.365-2.110).

The higher detection rate of depressive symptoms among rural elderly warrants special attention to self-rated health, with particular focus on education level and retirement status for urban elderly, and chronic disease and nighttime sleep time for rural elderly, so as to formulate differentiated intervention strategies.

To analyze the current status of perceived risk of recurrence among patients with first-time upper gastrointestinal bleeding due to liver cirrhosis and to explore the impact of risk perception on bleeding recurrence within one year.

Patients hospitalized at a tertiary hospital from December 2023 to April 2024 with first-time upper gastrointestinal bleeding due to liver cirrhosis were enrolled. Baseline data and scores from the Perceived Risk of Recurrence Scale were collected. Logistic regression analyzed the effect of perceived risk levels on 1-year recurrence. ROC curves assessed the predictive value of risk perception for 1-year recurrence, and decision curve analysis evaluated its practical utility.

A total of 221 patients was enrolled, with 47 experiencing rebleeding during one-year follow-up. The risk perception score was 72.0 (65.0, 90.5). Logistic regression indicated that, after adjusting for confounding factors, risk perception was an independent protective factor against rebleeding. The AUC for predicting one-year rebleeding using risk perception was 0.847 (95% CI:0.779-0.915). The net benefit ratio for predicting 1-year bleeding recurrence risk was 0.03-0.80.

Patients with cirrhosis experiencing their first upper gastrointestinal bleeding event exhibit a low to moderate perception of recurrence risk, and this risk perception is significantly associated with bleeding recurrence.

To examine the association between anemia and hypertension among middle-aged and older Chinese women.

Baseline data of 5 575 women aged ≥45 years from the 2015 China Health and Retirement Longitudinal Study (CHARLS) were collected, with anemia in 2018 as the outcome. Multivariable logistic regression was used to assess cross-sectional and longitudinal relationships between anemia and hypertension. Restricted Cubic Splines (RCS) were used to analyze the dose-response relationship between hemoglobin and the risk of hypertension in middle-aged and elderly women.

Anemia was inversely associated with hypertension. In 2015, anemic women had a 25-35% lower prevalence of hypertension (Model 1: OR=0.65, 95% CI: 0.57-0.74; Model 4: OR=0.75, 95% CI: 0.63-0.88; both P<0.01). Over 2015—2018, baseline anemia reduced 3-year hypertension incidence by 42-50% (Model 1: OR=0.58, 95% CI: 0.43-0.79; Model 4: OR=0.50, 95% CI: 0.35-0.71; P<0.001). RCS showed a linear inverse relationship between hemoglobin level and hypertension risk. BMI influenced the strength of association, but no interaction was detected (all P > 0.05). Sensitivity analyses confirmed robustness.

Anemia is associated with lower prevalence and incidence of hypertension in middle-aged and older Chinese women.

This study aimed to characterize the epidemiology of HIV/AIDS through expanded screening to provide evidence for epidemic assessment and response.

Data were obtained from an expanded HIV screening program conducted in a district of Chengdu between 2019 and 2024. After collection and cleaning, datasets were analyzed using Excel 2019 and R 4.5.0. Categorical variables were summarized using frequencies and composition ratios, with between-group differences assessed by chi-square tests. Analyses focused on HIV positivity rates and seroconversion rates.

During the six-year period, the screening program reached 1 025 356 individuals, representing 76.17% of the target population, with a total of 1 901 438 tests performed. A total of 2 419 HIV-positive cases (1 463 cases were infected previously) and 221 seroconversion cases were identified. Most cases were male (75.86% and 69.23%, respectively) and aged 50 years or older (56.72% and 65.16%, respectively). The overall HIV positivity rate (, P<0.001) showed a significant increasing trend, whereas the seroconversion rate showed no significant trend (, P=0.241). The HIV positivity rate was highest in the 60-69 age group (376.92 per 100 000), while the seroconversion rate was highest in the 50-59 age group (81.56 per 100 000). The seroconversion rate among males was approximately 3.5 times that of females.

The epidemic is characterized by an increasing trend in the overall HIV positivity rate coupled with fluctuating seroconversion rates. Men over 50 years represent a key population at elevated risk, underscoring the need for targeted prevention and screening strategies in this demographic.

To identify risk factors for secondary fungal infection in patients with pneumoconiosis complicated by bacterial pneumonia and to develop a nomogram prediction model.

Clinical data of patients admitted to a tertiary occupational disease hospital between December 2021 and July 2024 were retrospectively analyzed and randomly divided into training and testing sets (7:3). Variables were selected using LASSO and multivariable logistic regression to construct a nomogram. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA).

Among 641 patients, 213 developed secondary pulmonary fungal infection. Multivariable analysis showed that invasive procedures (OR=3.440, 95% CI:2.111-5.699), elevated immature granulocyte percentage (OR=2.294, 95% CI:1.254-4.402), systemic glucocorticoid use (OR=2.196, 95% CI:1.114-4.327), repeated hospitalization (OR=2.094, 95% CI:1.280-3.464), and increasing age (OR=1.059, 95% CI:1.034-1.085) were associated with increased risk, whereas higher large platelet count was associated with reduced risk (OR=0.980, 95% CI:0.968-0.992). The nomogram achieved AUCs of 0.818 (95% CI:0.777-0.858) in the training set and 0.797 (95% CI:0.688-0.906) in the testing set. Calibration and DCA demonstrated good agreement and clinical net benefit.

The nomogram accurately predicts secondary fungal infection risk in this population, demonstrating favorable performance and potential for early risk stratification and targeted intervention.

To analyze the contamination characteristics of multiple mycotoxins in cornand corn products across districts and counties in Jinan City during 2022—2023, and to assess the cumulative exposure risk among different age groups.

We collected 173 samples of maize and products from 12 districts and counties in Jinan City from 2022 to 2023, and simultaneously detected 12 mycotoxins by isotope dilution liquid chromatography tandem mass spectrometry, and evaluated the cumulative exposure risk of the population of different age groups based on the data of dietary consumption of residents in Shandong Province by using compositional analysis combined with the equivalence factor (EF) and the exposure boundary value (MOE).

Fumonisins (FBs) were the most contaminated (detection rate, 91.3%, mean, 1 506.1 μg/kg), followed by deoxynivalenol and metabolites (tDON, detection rate, 89.6%, mean, 91.7μg/kg) and zearalenone (ZEN, detection rate,72.8%, mean,41.1μg/kg). 91.9% of samples contained two or more toxins concurrently, with FB+tDON+ZEN being the predominant co-contamination pattern. Contamination characteristics varied across districts: Laiwu District exhibited relatively higher FB detection levels(2 653.7 μg/kg), while Huaiyin District showed relatively higher tDON levels (259.6 μg/kg). No distinct high-risk areas for ZEN contamination were identified citywide. The MOE values for all population groups fell below the safety threshold (100),indicating potential health risks. At the same time, it is necessary to consider the uncertainty of evaluation caused by sample size and consumption data. The younger age group exhibited relatively higher risks. No statistically significant differences in exposure risk were observed between genders. FBs contributed the most (93.6%) to cumulative exposure risk and were identified as the primary risk factor. Corn milling products served as the main exposure source (Contribution rate 67%), with consumption levels positively correlated to mycotoxin exposure.

Mycotoxin contamination in Jinan exhibits a spatial distribution pattern characterized by higher levels in peripheral areas and lower levels in central areas. The population faces potential health risks from cumulative exposure to mycotoxins through the consumption of corn and corn products. Younger age groups, due to their higher intake per unit of body weight, should be prioritized as key targets for prevention and control.

To analyze the intervention effectiveness of the Integrated Maternal and Mental Care Model (I2Mcare) for perinatal depression (PND) in primary maternal and child health institutions and explore its implementation process’s facilitators and barriers.

A hybrid type 1 randomized effectiveness-implementation trial was conducted. PND high-risk pregnant women were randomly assigned to an intervention group (receiving I2Mcare) or a control group (receiving routine maternal care). Four times of depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. We use generalized linear mixed models to analyze the effect of intervention. Semi-structured interviews based on the Consolidated Framework for Implementation Research (CFIR) were administered to pregnant women and healthcare providers (n=27) to collect data on implementation factors. Qualitative data were analyzed by the thematic framework method.

A total of 153 pregnant women completed all 4 depression assessments, including 41 in the intervention group and 33 in the control group. No statistically significant differences in depression scores were found between the two groups during the first three assessments. However, in the fourth assessment, the depression score of the intervention group was significantly lower than that of the control group (P<0.05). Results from the Generalized Linear Mixed Models analysis indicated statistically significant effects for both the group difference (P=0.033) and the time effect (P<0.001). Key facilitators included the model’s relative advantages, China’s well-established maternal and child health system, strong foundational work from mental health departments and so on. Barriers encompassed insufficient public awareness, inadequate policy support and high clinical workload in obstetric departments.

The I2Mcare effectively alleviates depressive symptoms in high-risk pregnant women. Future scale-up should prioritize policy refinement, staff training, interdisciplinary collaboration, and public education.

To explore the mediating role of DNA methylation (DNAm) in the association between prenatal arsenic exposure and neonatal birth weight, and to identify DNAm-specific sites at different birth weight percentiles.

The data were obtained from the New Hampshire Birth Cohort Study (NHBCS), which included 270 mother-infant pairs. The quantitative correlation-based independent screening (QCSIS) method was combined with marginal quantitative regression analysis to identify DNA methylation (DNAm) sites associated with birth weight. After penalized estimation, the mediating effect analysis method was used to evaluate the mediating role of DNAm loci in the relationship between prenatal arsenic exposure and different birth weight percentiles.

After adjusting for maternal age, pre-pregnancy BMI, and other covariates, a total of 14 cytosine-phosphate-guanine pairs of nucleotides (CpG) sites with significant mediating effects were identified across 8 different birth weight quantiles. The eight birth weight percentiles were roughly divided into three groups: low, normal, and high birth weight, identifying 3, 3, and 8 CpG sites, respectively. The results showed that the cg17524924 site located in the ZNF542 gene significantly mediated the association between arsenic exposure and low birth weight (τ=0.3, ACME: -14.311，P=0.016) and (τ=0.4, ACME: -12.946, P=0.016); while the cg13486410 site located in the NDNF gene exhibited a positive mediating effect (τ=0.7, ACME: 14.041, P=0.030), suggesting that methylation at this site may partially offset the negative impact of prenatal arsenic exposure on neonatal birth weight.

This study finds that placental DNA methylation exerts quantile-specific mediating effects between arsenic exposure and neonatal birth weight. The results provide new insights into the mechanisms by which prenatal arsenic exposure affects fetal growth and development.

To explore the chain mediating role of emotional resilience and experiential avoidance in the relationship between parental psychological aggression and adolescent non-suicidal self-injury (NSSI), with particular attention to potential differences between fathers and mothers.

A cluster sampling method was employed. A total of 1 108 adolescents were surveyed using the Parent-Child Conflict Tactics Scale, Adolescents’ Emotional Resilience Questionnaire, Acceptance and Action Questionnaire-Ⅱ, and Adolescents Self-Harm Scale. Mediating effects were examined using a bias-corrected nonparametric percentile bootstrap method.

The prevalence of NSSI in this sample was 24.64%. In the separate models, both paternal and maternal psychological aggression positively predicted adolescent NSSI. Emotional resilience and experiential avoidance played a chain mediating role between both paternal and maternal psychological aggression and adolescent NSSI. In the integrated model including both paternal and maternal psychological aggression, the direct and indirect effects of maternal psychological aggression on adolescent NSSI remained statistically significant. The direct effect was 0.17(P<0.01), the independent mediating effect of emotional resilience was 0.012 (95% CI: 0.003-0.025), the independent mediating effect of experiential avoidance was 0.019 (95% CI: 0.007-0.038), and the chain mediating effect via emotional resilience and experiential avoidance was 0.015 (95% CI: 0.006-0.028). In contrast, both the direct and indirect effects of paternal psychological aggression on adolescent NSSI were not statistically significant.

Emotional resilience and experiential avoidance play a chain mediating role in the relationship between parental psychological aggression and adolescent NSSI, with maternal psychological aggression playing a dominant role.

To explore the relationship between body weight indicators and the TyG index (triglyceride-glucose index), as well as the combined indicators of these two factors, the triglyceride-glucose-weight index (TyG-BMI) and the triglyceride-glucose-waist circumference index (TyG-WC), and the risk of elevated blood pressure during follow-up among the adolescent population.

Using the convenient sampling method, students from the first, second and first-year senior grades of three schools in Sichuan Province were selected. A follow-up survey was conducted in March 2023, with an average follow-up period of 1.25 years and a dropout rate of 6.75%. The multivariate modified Poisson regression model was used to analyze the relationship between body mass index and TyG index, as well as the mixed indicators of the two (TyG-BMI and TyG-WC) and follow-up high blood pressure. The logistic regression model was used to explore the mediating effect of baseline TyG and follow-up TyG in the relationship between different body weight states and follow-up blood pressure levels.

Among the 812 teenagers who did not have high blood pressure at the baseline, the average age was 14 years old, and 40.30% were male. During the follow-up period, a total of 156 teenagers developed high blood pressure, with an incidence rate of 19.21%. In the multivariate adjusted Poisson regression analysis, both TyG-BMI and TyG-WC showed a positive correlation with elevated blood pressure at the follow-up (TyG-BMI: RR=1.009, P<0.05; TyG-WC: RR=1.004, P<0.05). In the mediating effect model, no mediating effect of baseline and follow-up TyG in the relationship between different weight statuses and follow-up high blood pressure was found.

We found that TyG-BMI and TyG-WC were associated with high blood pressure, but weight status played a key role in it.

To understand the epidemiological characteristics of falls among elderly patients with chronic diseases in the community, analyze the correlation between diabetes and fall outcomes, and provide a basis for identifying key intervention targets, reducing fall incidence, and developing fall intervention strategies.

A total of 1 198 elderly patients aged 60 and above were randomly selected from the chronic disease health management system as study subjects. Univariate and multivariate logistic regression analyses were employed to examine influencing factors of falls, as well as the association with diabetes.

Over the past year, the incidence of falls among elderly patients with chronic diseases was 25.96%, and the proportion of individuals at high risk of falls was 27.30%. Univariate analysis revealed that elderly patients with chronic diseases who had diabetes, poorer self-rated health status and sleep quality, reduced self-care and balance abilities, more severe depression, use of walking aids, a history of fractures, and abnormal gait exhibited significantly higher rates of falls (P<0.05). Multivariable logistic regression analysis showed that type 2 diabetes(OR=1.61, 95% CI: 1.14-2.27) was an independent risk factor for falls in older adults, good balance ability(OR=0.82, 95% CI: 0.75-0.89) was a protective factor(P<0.05), and depression(OR=1.28, 95% CI: 1.06-1.53) and history of previous fracture(OR=1.97, 95% CI: 1.44-2.71) were risk factors.

Elderly patients with diabetes in the community exhibit a higher incidence of falls and a greater proportion of fall risk. They should be paid close attention as a key population and it is essential to incorporate comprehensive assessments into their chronic disease management. Additionally, particular attention must be given to individuals with a history of fractures, impaired balance ability, or depression, through reinforced health education, rehabilitation, and psychological support, to mitigate fall risk ultimately.

To examine the impact of age on low health literacy level among residents in Fuyang District of Hangzhou, and to elucidate its interactive effect with other determinants.

A questionnaire survey was conducted among residents aged 15-69 years old by multi-stage stratified random sampling. Data on basic demographic characteristics and health literacy levels were collected. The associations were examined using the Mann-Whitney U test, Chi-square test, the restricted cubic splines (RCS) model, and multivariable-adjusted logistic regression models.Furthermore, multiplicative and additive interaction models were applied to explore the joint effects of age and other influencing factors on low health literacy.

Among the 640 respondents, 417 (65.16%) had a low health literacy level. After adjusting for potential confounders, the RCS model revealed a significant nonlinear dose-response relationship between age and the risk of low health literacy (P_nonlinear<0.01), with an inflection point at 51 years old. Subsequently, multivariate logistic regression analysis using this cut-off value demonstrated that individuals aged over 51 years old had a significantly higher risk of low health literacy (OR=3.377, 95% CI: 2.120-5.378, P<0.05). Regarding interaction effects, an additive interaction was observed between age and educational level (RERI=9.979, 95% CI: 0.389-19.569; AP=0.606, 95% CI: 0.368-0.843; SI=2.814, 95% CI: 1.442-5.492).

Age is an independent influencing factor of low health literacy levels among residents. Further interaction analysis reveals that individuals with advanced age and low educational attainment are identified as the key target population for health literacy promotion and intervention efforts.

To provide insights for optimizing social participation policies for older adults in China, to introduce a novel analytical perspective to policy research and to explore quantitative approaches to assess policy tools configuration.

Policy documents were collected from the websites of the State Council, the National Health Commission, and the PKULAW database using the literature collection method. The content of elderly policies was quantitatively analyzed using the policy tool classification theory and the PMC index, and the policies were evaluated using the four-quadrant method.

This study selected 17 policy documents as research objects. Specifically, there were 8 policies in Quadrant Ⅰ, 2 policies in Quadrant Ⅱ, 6 policies in Quadrant Ⅲ, and only 1 policy in Quadrant Ⅳ. Among the policy tools involved, there were 53 supply-side policy tools (57.0%), 23 demand-side policy tools (24.7%), and 17 environmental policy tools (18.3%). The average PMC index was 4.57, with the highest score being 7.17 and the lowest score being 2.87.

The structure of policy tools for social participation among older adults in China requires further optimization, with notable shortcomings in policy targeting, content richness, and innovation. The government should focus on refining the policy tool structure, clarifying policy goals, enriching policy content, and enhancing policy innovation to ensure the comprehensive and reasonable development of elderly policies and promote the implementation of the national strategy of active aging.

To analyze the coupling and coordination relationship between the elderly population and the supply of medical resources in Guangdong Province from 2000 to 2020, and to provide insights for optimizing regional medical resource allocation, improving health and well-being among the elderly, and proactively addressing population aging.

Using data from population censuses and statistical yearbooks, the entropy method and the coupling coordination degree model were applied to evaluate the coupling coordination and matching degree of the elderly system and medical resource supply system.

From 2000 to 2020, the matching degrees of the elderly population and medical resource supply in Guangdong Province evolved from mild mismatch to basic match. Spatially, all cities had reached a minimally matched level by 2020, however, significant regional disparities remained. The Pearl River Delta and western Guangdong regions exhibited higher matching degrees than eastern and northern Guangdong.

The matching degree between the elderly population and medical resource supply in Guangdong has improved overall, though regional gaps remain. It is recommended that regions tailor medical resource allocation according to local aging trends, while proactively addressing the structural service needs of the elderly, such as chronic disease management and rehabilitation nursing, to enhance the precision and adaptability of resource matching.

To evaluate the association between a body shape index (ABSI) and all-cause mortality in stroke patients.

Using data from 2005 to 2016 National Health and Nutrition Examination Survey (NHANES) and the National Death Index (NDI). The study involved 1 039 participants after applying exclusion criteria. The participants were divided into 5 groups. Continuous variables were expressed as （）, and the Kruskal-Wallis rank sum test was used. Categorical variables were expressed as n（%）, and Pearson’s χ² was used. Kaplan-Meier survival analysis, cox proportional hazards model and restricted cubic splines were utilized to estimate the association between ABSI and All-cause mortality in stroke patients.

The Kaplan-Meier survival analysis showed that the survival rate of patients with the high ABSI group was significantly lower than that of patients with the low ABSI group before and after weighting. Cox proportional hazards model showed that the high ABSI group(Q5) compared to the lowest quartile (Q1), was associated with a high incidence of all-cause mortality in stroke patients(before-weighting HR=2.41,95% CI:1.69-3.44; after-weighting HR=2.57,95% CI:1.62-4.07) after adjusting for potential confounders. Restricted cubic splines analysis showed that all-cause mortality in stroke patients increased significantly with ABSI exceeded a cutoff. Older adults and males are more susceptible to the ABSI. P<0.05 was considered as the difference was statistically significant.

The high ABSI group (Q5) is associated with a high incidence of all-cause mortality in stroke patients. ABSI is a risk factor for All-cause mortality in stroke patients.

To explore the long-term relationship between digital exclusion and depressive symptoms in middle-aged and older adults in China, to evaluate whether social participation serves as a mediator in this connection, and to guide interventions to reduce depression within this group.

A longitudinal analysis was conducted using data from the 2011-2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). Self-reported data were used to evaluate digital exclusion and social participation, while the presence of depressive symptoms was measured with the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D 10). Differences in the incidence of depressive symptoms among groups were assessed using Kaplan-Meier estimates and the log-rank test. Cox proportional hazards models were used to analyze the longitudinal association between digital exclusion and depressive symptoms, and causal mediation analysis was employed to test the mediating effect.

A total of 8 808 participants were included in the study. At baseline, 8 334 (94.6%) individuals were classified as digital exclusion group. Over a median follow-up of 7.00 years, 3 969 participants developed depressive symptoms. The survival analysis revealed that the cumulative incidence of depressive symptoms was significantly higher in the digital exclusion group than that in the digital inclusion group (Log-rank P<0.05). After controlling for confounders, Cox regression analysis showed that digital exclusion remained an independent risk factor for depressive symptoms (HR=1.37, 95% CI: 1.11-1.69). The mediation analysis found that social participation partially mediated the association between digital exclusion and depressive symptoms.

Digital exclusion is associated with an increased　risk of depressive symptoms among middle-aged and older Chinese adults. This association may be partially mediated by social participation. Promoting digital inclusion and encouraging social engagement may be potential strategies for the prevention and intervention of depression in this vulnerable group.

To explore the relationship between social isolation and frailty trajectories, and to provide evidence for targeted interventions and healthy aging.

Based on four waves (2011-2018) of the China Health and Retirement Longitudinal Study, 7 805 adults aged 45 years and above were included. Latent Class Mixed Models (LCMM) wereapplied to identify longitudinal trajectories of social isolation and the frailty index.Multinomial logistic regression was used to analyze factors associated with each trajectory, and conditional and joint probabilities were calculated to evaluate the correspondence between social isolation and frailty trajectories.

Four trajectories of social isolation were identified: Low-isolation stable (36.0%), Low-isolation rapid increase (2.7%), Moderate-isolation stable(52.7%), andHigh-isolation slow increase(8.7%)—along with three frailty trajectories: Robust stable(27.0%), Prefrail stable (54.2%), and Frailty worsening (18.8%).Joint probabilities further indicated that the combination of Moderate-isolation stable and Prefrail-stable had the highest overall probability (π_jk=0.29).

Levels and temporal patterns of social isolation are strongly associated with frailty development. Middle-aged and older adults with higher or increasing isolation levels, as well as those at the prefrail stage, should be prioritized in community-based interventions aimed at strengthening social support, maintaining physical function, and improving psychological well-being to delay frailty progression and promote healthy aging.

To examine the longitudinal association between informal caregiving and cognitive function among middle-aged and older Chinese adults, and to explore its heterogeneity.

Using five waves of longitudinal data (2011-2020) from the China Health and Retirement Longitudinal Study (CHARLS), this study included 4 841 adults aged 45 and above. Linear mixed-effects models were employed to analyze associations of informal caregiving and caregiving intensity with cognitive function, and investigated caregiving roles in relation to cognition, stratified by marital or cohabitation status.

Compared to non-caregivers, caregivers demonstrated better performance in global cognition (β=0.039, 95% CI:0.001-0.076, P=0.043) and executive function (β=0.040, 95% CI:0.003-0.078, P=0.037). High-intensity caregiving was positively associated with global cognition (β=0.101, 95% CI:0.039-0.164, P=0.001), episodic memory (β=0.076, 95% CI: 0.014-0.138, P=0.016), and executive function (β=0.101, 95% CI:0.039-0.164, P=0.001). Moderate-intensity caregiving was associated with higher episodic memory scores (β=0.123, 95% CI: 0.002-0.244, P=0.047). Spousal caregivers had lower levels of global cognition (β=0.196, 95% CI: 0.351-0.040, P=0.014), whereas grandparent caregivers who were separated, divorced, or widowed showed superior episodic memory (β=0.163, 95% CI:0.013-0.314, P=0.033).

The impact of informal caregiving on cognitive function in middle-aged and older adults varies significantly based on the caregiving role, intensity, and sociodemographic characteristics. Future policies should provide differentiated support for various caregiver groups to optimize their health outcomes.

To investigate the association between the Lifestyle Oxidative Balance Score (Lifestyle-OBS) and the risk of developing obstructive sleep apnea syndrome (OSAS), and to provide evidence for lifestyle interventions targeting OSAS.

Adults aged 20 years and older from four survey cycles of the National Health and Nutrition Examination Survey (NHANES) 2005-2008 and 2015-2018 were included. Lifestyle-OBS was calculated based on physical activity, body mass index (BMI), smoking, and drinking behaviors. Weighted logistic regression models analyzed the association between lifestyle OBS and OSAS risk, with dose-response relationships assessed using restricted cubic splines. Subgroup analyses were conducted concurrently.

A total of 5 368 individuals were included, among whom 3 601(67.09%) had OSAS. Weighted logistic regression analysis revealed that after adjusting for covariates, elevated Lifestyle-OBS was significantly negatively associated with the risk of OSAS (OR=0.801, 95% CI: 0.758-0.847). When Lifestyle-OBS was divided into four quartiles, the Q4 group had a reduced risk of OSAS compared with the Q1 group (OR =0.383, 95% CI: 0.288-0.510). Restricted cubic spline analysis revealed a linear negative-response association between Lifestyle-OBS and OSAS risk (P_{for nonlinearity}=0.351). Subgroup analysis revealed significant interactions between Lifestyle-OBS and OSAS risk in age, hypertension, and cardiovascular disease subgroups. The association between Lifestyle-OBS and OSAS was stronger in younger and middle-aged individuals without hypertension or cardiovascular disease.

Higher Lifestyle-OBS is associated with a reduced risk of OSAS.

To establish a method for the simultaneous determination of glyphosate and its metabolite aminomethylphosphonic acid in human urine by ion chromatography-tandem mass spectrometry(IC-MS/MS).

The urine sample was purified using an HLB solid-phase extraction cartridge. After diluted and filtered, the filtrate was used for analysis. Gradient elution was performed using a potassium hydroxide solution as the mobile phase, with separation on an Ionpac AS20 anion exchange column(250 mm×2 mm). Detection was carried out using electrospray ionization in negative ion mode with multiple reaction monitoring, and quantification was achieved via the external standard method.

Glyphosate and aminomethylphosphonic acid showed good linear relationships within the ranges of 0.5-50 μg/L and 4-100 μg/L, respectively, with correlation coefficients greater than 0.999. The method detection limits were 0.8 μg/L and 3.6 μg/L, respectively. The recovery rates of the method were 83.0% to 115.2%. The intra-day and inter-day relative standard deviations(RSDs) ranged from 1.2% to 7.8% and 3.5% to 9.2%, respectively.

This method is reproducible and accurate, and it is suitable for biological monitoring of glyphosate and its metabolite aminomethylphosphonic acid in urine samples of occupational populations.

To analyze the long-term trends in the incidence and mortality of four rodent-borne notifiable infectious diseases (plague, HFRS, leptospirosis, and typhus) in China from 1950 to 2020, providing a basis for understanding the epidemiological patterns and scientific prevention and control of these diseases.

Data on the annual incidence and mortality of plague, HFRS, leptospirosis (data available since 1955), and typhus from 1950 to 2020 were collected from the Public Health Science Data Center. Joinpoint regression was used for trend analysis. Five indicators—number of cases, incidence rate, number of deaths, mortality rate, and case fatality rate—were used to evaluate trends in incidence and mortality.

Plague: From 1950 to 2020, a total of 8 409 cases and 2 761 deaths were reported, with an incidence rate of 1.64×10^-4 per 100 000 and a case fatality rate of 32.83%. The number of cases, deaths, and incidence rate showed an overall declining trend (APC<0, P<0.05), while the decline in case fatality rate (AAPC=-3.50%, 95% CI: -7.29% to 0.43%) was not statistically significant. After 2002, the annual number of reported cases fluctuated between 0 and 68 (APC<0, P<0.05), with case fatality rates ranging from 0% to 100%. HFRS: From 1950 to 2020, a total of 1 684 077 cases and 48 390 deaths were reported, with an average annual incidence rate of 2.34 per 100 000 and a case fatality rate of 2.87%. The number of cases, incidence rate, number of deaths, mortality rate, and case fatality rate initially fluctuated upward and then declined. The number of cases peaked in 1986 (115 807 cases) and then fluctuated downward (APC=-6.66%, 95% CI: -8.15% to -5.13%). From 2007 to 2020, the number of cases fluctuated between 8 121 and 13 308. The number of deaths dropped below 200 after 2006 and below 100 after 2013. The case fatality rate remained between 0.46% and 1.31% after 1995. Leptospirosis: From 1955 to 2020, a total of 2 523 008 cases and 27 730 deaths were reported, with an average annual incidence rate of 3.64 per 100 000 and a case fatality rate of 1.10%. The mortality rate showed an overall declining trend (APC=-8.71%, 95% CI: -13.54% to -3.62%), while the trends in the number of cases, deaths, incidence rate, and case fatality rate were not statistically significant (APC>0, P>0.05). After 1999, the number of cases dropped below 10 000, and after 2006, it dropped below 1 000. The number of deaths dropped below 1 000 after 1988, below 100 after 2002, and below 10 after 2011. The case fatality rate showed an initial decline followed by an increase, ranging from 0% to 3.96% after 2000. Typhus: From 1950 to 2020, a total of 450 080 cases and 7 327 deaths were reported, with an average annual incidence rate of 0.62 per 100 000 and a case fatality rate of 1.63%. The number of cases, deaths, mortality rate, and case fatality rate showed an overall declining trend (APC<0, P<0.05).

During 1950-2020, China made remarkable progress in controlling rodent-borne infectious diseases, with the incidence and mortality of the four notifiable diseases reduced to low levels; nevertheless, the prevention and control of these diseases remains a serious challenge.

To analyze the trends in the prevalence and disease burden of enteric infectious diseases among the population under 20 years old in China from 1990 to 2021, to identify the severity and key affected populations, and to provide a reference basis for formulating prevention and intervention policies.

Data were sourced from the Global Burden of Disease Study (GBD) 2021 database. The Joinpoint regression model was used to analyze the temporal trends in the incidence, mortality, and disability-adjusted life years (DALYs) rates of enteric infectious diseases among the population under 20 in China from 1990 to 2021. The age-period-cohort analysis method was employed to assess the effects of age, period, and birth cohort on the trends in the disease burden.

The incidence rate of enteric infectious diseases in the population under 20 in China decreased from 48 373.02 per 100 000 in 1990 to 8 811.07 per 100 000 in 2021. The mortality rate decreased from 17.55 per 100 000 in 1990 to 0.43 per 100 000 in 2021. The DALYs rate decreased from 1 643.60 per 100 000 in 1990 to 52.31 per 100 000 in 2021. Joinpoint regression analysis showed that from 1990 to 2021, the incidence rate decreased by an average of 5.34% annually (AAPC=-5.34%, 95% CI: -5.50% to -5.18%), the mortality rate decreased by an average of 11.34% annually (AAPC=-11.34%, 95% CI: -11.71% to -10.97%), and the DALYs rate decreased by an average of 10.56% annually (AAPC=-10.56%, 95% CI: -11.03% to -10.10%). Age-period-cohort model analysis revealed that the 0-4 age group had a higher disease burden, significantly exceeding other age groups. With the progression of time periods, the risks of incidence, mortality, and DALYs for enteric infectious diseases in the population under 20 continued to decline. Compared to earlier birth cohorts, later birth cohorts had lower risks of incidence, mortality, and DALYs.

From 1990 to 2021, the incidence, mortality, and DALYs rates of enteric infectious diseases among the population under 20 years old in China showed a significant downward trend. However, for enteric infectious diseases children under 5 remain the key population, and comprehensive prevention and control measures should be implemented to further reduce the disease burden for this age group.

To compare the spatial pattern evolution characteristics and the spatial heterogeneity of influencing factors of newly reported AIDS incidence in mainland China before (2015-2019) and after (2020-2023) the COVID-19 outbreak, and to provide a scientific basis for targeted prevention and control in response to similar crises in the future.

Based on newly reported AIDS incidence and socioeconomic data from 31 provincial-level administrative regions in mainland China (2015-2023), spatial autocorrelation, ordinary least squares (OLS), and multiscale geographically weighted regression (MGWR) were employed for analysis.

The incidence of newly reported AIDS showed an upward trend from 2015 to 2019, but began to decline after the outbreak of COVID-19. By 2022, the incidence dropped to 3.69 per 100 000 population, with a slight rebound in 2023. Both before and after the COVID-19 outbreak, the incidence of newly reported AIDS exhibited significant and strengthening spatial positive autocorrelation. Hotspots consistently concentrated in Yunnan, Guizhou, Sichuan, Chongqing, Guangxi, and Hunan, with Hainan and Guangdong emerging as new hotspots. Coldspots persistently clustered in Northeast and North China. Before the COVID-19 outbreak, the number of health technical personnel per 10 000 people had a promoting effect on the incidence in the Southwest region, but this effect shifted to a suppressive one after the outbreak. Urbanization rate exerted a negative influence globally but a positive influence locally. Other variables demonstrated bidirectional influences, with spatial heterogeneity persisting throughout the study period.

s The spatial evolution of newly reported AIDS incidence varied before and after the COVID-19 outbreak, but both periods exhibited significant spatial clustering, with socioeconomic factors demonstrating spatial heterogeneity in their influence. We propose formulating differentiated AIDS prevention and control strategies tailored to local conditions, with particular focus on hotspot areas, to implement precision interventions for effective AIDS incidence reduction.

To analyze the disease burden of lung cancer attributable to high fasting plasma glucose (HFPG) in China from 1990 to 2021 and its trends, and to predict the disease burden trends from 2022 to 2036, providing evidence for targeted prevention and control measures.

Using the Global Burden of Disease (GBD) 2021 data, Joinpoint regression was employed to analyze the trends in age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALYs) rate (ASDR) of lung cancer attributable to HFPG in China. An age-period-cohort (APC) model was used to assess age, period, and cohort effects, and R software was utilized to predict future disease burden trends.

From 1990 to 2021, the ASMR and ASDR of lung cancer attributable to HFPG in China showed an overall upward trend, with average annual percentage changes (AAPCs) of 1.28% and 1.05%, respectively (both P<0.001). The disease burden was generally higher in males than in females. With increasing age, it showed a trend of initial increase followed by a decrease, with the highest increase in mortality and DALY rates observed in the 80-84 age group. The net drift values for mortality and DALYs rate in the APC model were 0.90% (95% CI: 0.69%-1.11%) and 0.89% (95% CI: 0.69%-1.08%), respectively. The age effect indicated that mortality peaked in the 90-94 age group, while DALYs rate peaked in the 75-79 age group. The period effect showed that mortality and DALYs risks initially increased and then decreased over time. The cohort effect revealed an overall upward trend in mortality and DALYs risks with successive birth cohorts. It was projected that by 2036, the ASMR of lung cancer attributable to HFPG in China may decline to 0.74 and 0.50 per 100 000 for males and females, respectively, while the ASDR may decrease to 18.59 and 10.62 per 100 000.

From 1990 to 2021, the disease burden of lung cancer attributable to HFPG in China exhibits an overall upward trend, with higher burdens observed in males and older adults. Greater attention should be paid to middle-aged and elderly male populations, and more targeted prevention and intervention policies should be implemented.

To explore the relationship between AH and genetic susceptibility of BC, as well as the potential mediating mechanisms, given that epidemiological investigations have explored the association between autoimmune hyperthyroidism (AH) and the risk of developing breast cancer (BC) while the causality is controversial and the potential mediating pathways remain unclear due to confounding factors.

Two-sample Mendelian randomization (MR) was employed to investigate the causal relationship between AH and BC, with molecularly stratified analyses encompassing all receptor-defined subtypes (ER+BC, ER-BC, luminal A-like, luminal B-like, luminal B/HER2-negative-like, HER2-enriched-like, and TNBC). Additionally, the two-step Mendelian randomization (TSMR) method was used to investigate the mediating role of immune regulatory factors. Statistical inference primarily utilized inverse variance-weighted (IVW) estimators, complemented by pleiotropy-robust sensitivity validation protocols. Heterogeneity was evaluated using Cochran’s Q test. Pleiotropy was detected by combining the MR-Egger intercept term and the MR-PRESSO method to ensure the robustness and reliability of the research results.

Genetically predicted AH was causally associated with luminal B-like BC (OR=0.940, 95% CI: 0.900-0.983, P=6.05×10^-3), whereas AH was not observed to be causally associated with other subtypes of overall BC. The cathepsin Z (CTSZ) was determined to be a mediator of the association between AH and luminal B-like BC, with a mediation ratio of 11.494% (95% CI: 2.124%-43.623%).

This study suggests that AH increases the expression of CTSZ and thus reduces the genetic susceptibility to luminal B-like BC, and understanding this mechanism provides new insights for the development of BC prevention strategies and interventions.

To investigate the relationship between body mass index (BMI) and diminished ovarian reserve (DOR) in women from southwestern China, analyzing the correlation between BMI and ovarian reserve markers: anti-Müllerian hormone (AMH) and antral follicle count (AFC).

A 1:1 age-matched case-control study was conducted, enrolling 3 751 women with DOR and 3 751 women with normal ovarian reserve who sought assisted reproductive services at a tertiary hospital in Sichuan Province between January 2022 and August 2024. Conditional logistic regression analysis and restricted cubic spline models were employed to examine the association and dose-response relationship between BMI and DOR. Spearman correlation and multivariable linear regression analyses were applied to assess the relationships between BMI and AMH and AFC.

Conditional logistic regression analysis revealed a significant association between obesity (OR=1.394, 95% CI: 1.112-1.747) and DOR. After adjusting for ethnicity, occupation, marital status, education level, smoking, and alcohol consumption, obesity (OR=1.357, 95% CI: 1.065-1.730) remained a risk factor for DOR. No non-linear relationship was observed between BMI and DOR. Spearman correlation analysis showed that both AMH and AFC were negatively correlated with BMI (P<0.001). In multivariable linear regression analyses adjusting for confounders, BMI demonstrated a negative association with AMH (P<0.001), whereas no significant association was observed between BMI and AFC (P>0.05).

Obesity is a risk factor for diminished ovarian reserve. BMI is negatively associated with AMH but not significantly correlated with AFC.