Objective To analyze the awareness of nutritional health knowledge among school-age children in Sichuan Province, identify shortcomings and related issues of nutritional health knowledge, and provide a scientific basis for nutritional intervention policies. Methods From October 2023 to May 2024, a multi-stage sampling method was used to collect nutritional health knowledge questionnaires from 12 674 school-age children in 21 districts and counties of Sichuan Province through a questionnaire survey. Descriptive statistical analysis and multivariable analysis were conducted based on survey content. Results The nutritional health knowledge scores [median (interquartile range)] of school-age children in Sichuan Province (including lower elementary school students) in 2023—2024 were 73.00 (63.00-84.00). Scores for lower elementary, upper elementary, middle school, and high school groups were 90.00 (80.00-95.00), 72.00 (62.00-82.00), 69.00 (58.00-77.00), and 66.00 (57.00-74.00), respectively. The higher the grade level, the lower the score, and this was statistically significant. The score rate ranges for the five knowledge dimensions of dietary recommendations, food classification and characteristics, food and growth development and health, food selection, and food safety were 54.82%-81.66%, 60.31%-91.40%, 69.85%-89.50%,71.65%-86.20%, and 69.38%-84.07%, respectively. The lower elementary school grade group had the highest score in each knowledge dimension, and the senior high school group had the lowest score rate. The awareness rate (excluding lower elementary grades) was 32.98%, and the awareness rates for upper elementary school grades, middle school, and high school were 41.91%, 31.12%, and 23.34%, respectively. The higher the grade level, the lower the awareness rate, and this was statistically significant (χ²=249.432, P<0.001). Univariate analysis results showed that gender, grade level, region, whether living on campus, the educational level and occupation of the parents of school-age children had statistically significant differences in the awareness rate of nutritional health knowledge (P<0.05). Logistic regression analysis results showed that the grade level, region (urban or rural), whether living on campus, father’s education and occupation were important factors affecting the awareness level of nutritional health knowledge among school-age children in Sichuan Province. Conclusion There is significant room for improvement in the awareness rate of nutritional health knowledge among school-age children in Sichuan Province. To improve the nutritional health literacy of school-age children, it is necessary to further strengthen the publicity and education of nutritional health knowledge.

Objective To establish a method for the rapid detection of 15 N-nitrosamines in bacon by enhanced matrix removal dispersive solid phase extraction combined with gas chromatography-tandem mass spectrometry (GC-MS/MS). Methods The samples were extracted with acetonitrile oscillation, frozen for 30 minutes, and then centrifuged at low temperature. The extract was further purified using an enhanced lipid removal purification tube (QuEChERS EMR-lipid) and an EMR-lipid stripping tube. The N-nitrosamines were separated on a polar capillary column, detected in the multiple reaction monitoring (MRM) mode and quantified by the matrix-matched external standard method. Results The linear correlation coefficients of the method were greater than 0.990 in the range of 0.2-40.0 μg/L, with the detection and quantification limits of 0.03-0.30 and 0.1-1.0 μg/kg, respectively. The recoveries were 64.1%-106.1% at three spiked levels (2.0, 5.0, 10.0 μg/kg)，with the relative standard deviations (RSDs) ranging from 3.48% to 14.55%. Conclusion The method does not require activation, equilibration, or elution steps, consumes less solvent, is simple and rapid, and is suitable for the rapid detection of 15 N-nitrosamines in bacon.

Objective Aging is a common starting point for many diseases, and homeostatic dysregulation (HD) is an important intervention indicator of aging. This study investigates the association between Tibetan noodle consumption and HD. Methods Using baseline survey data from the China Multi-Ethnic Cohort study (CMEC), HD was constructed on the basis of clinical biomarkers and anthropometric indices. Dietary information was obtained from the Food Frequency Questionnaire (FFQ). Multivariable linear regression analysis was used to explore the association between Tibetan noodle consumption and HD.Stratified analyses were conducted by sex, age, and BMI to explore the heterogeneity of the association effect. Results A total of 4 485 study participants were included. Compared with non-consumption of Tibetan noodles, a weekly consumption frequency of more than 7 times was associated with lower HD (β=-0.304, 95% CI: -0.593~-0.015). Similarly, a weekly intake exceeding 1 050 grams of Tibetan noodles demonstrated reduced HD (β=-0.130, 95% CI: -0.245~-0.014). Additionally, sex might act as a potential effect modifier. Conclusion Tibetan noodle consumption was inversely associated with HD, suggesting that consumption of Tibetan noodles, a specialty diet, has potential value in improving HD and slowing down aging.

Objective To explore the patterns and influencing factors of multimorbidity in the elderly. Methods A total of 7 354 adults aged ≥60 years in Huai’an District, Hongze District and Lianshui County of Huai’an City were investigated for chronic diseases and their risk factors. Hierarchical clustering was used to determine the multimorbidity patterns. Apriori algorithm was used to explore the association rules between chronic diseases. Binary logistic regression analysis was used to explore the influencing factors of major multimorbidity patterns. Results The prevalence of chronic diseases was 81.93%, and the prevalence of multimorbidity was 42.62%.Hierarchical clustering grouped eight chronic diseases into three categories. The two main multimorbidity patterns were: ① hypertension, diabetes, dyslipidemia, stroke, and myocardial infarction; ② asthma and COPD. The Apriori algorithm identified hypertension, diabetes,dyslipidemia, and stroke as the multimorbidity pattern of cardiovascular and cerebrovascular diseases, and COPD and asthma as the multimorbidity pattern of chronic respiratory diseases. In the multimorbidity pattern of cardiovascular and cerebrovascular diseases,compared with those without eight chronic diseases, increasing age, former smoking and current non-smoking, increasing BMI and central obesity increased the risk of cardiovascular and cerebrovascular disease comorbidity by 0.022 (OR=1.022, 95% CI: 1.012-1.033),0.466 (OR=1.466, 95% CI: 1.081-1.987), 0.144 (OR=1.144, 95% CI: 1.117-1.172), 0.505 (OR=1.505, 95% CI: 1.283-1.766). In the multimorbidity pattern of chronic respiratory diseases, compared with those without eight chronic diseases, former smokers and current non-smokers (OR=3.851, 95% CI: 2.132-6.956), central obesity (OR=1.696, 95% CI: 1.064-2.701) were the risk factors, while being female (OR=0.366, 95% CI: 0.229-0.587) and decreased BMI (OR=0.926, 95% CI: 0.869-0.994) were the protective factors. Conclusion Hypertension, stroke, dyslipidemia and diabetes are easy to coexist, and asthma and COPD are easy to coexist. Smoking was an important risk factor for multimorbidity. Central obesity was a risk factor for both multimorbidity patterns, especially for the cardiovascular and cerebrovascular multimorbidity pattern.

Objective To accurately evaluate the influencing factors and urban-rural differences in the well-being among the elderly in Guizhou Province, so as to provide scientific basis and practical strategies for enhancing the well-being of the elderly. Methods Using stratified and convenience sampling methods, 1 500 elderly aged 60 and above who met the survey requirements were selected from six prefectures in Guizhou Province. The well-being of Older People Scale (WOOP) was applied for questionnaire surveys. Combined with the random forest model and the ordered logistic regression analysis, the importance evaluation and the urban-rural differences of the influencing factors on the well-being of the elderly in Guizhou Province were analyzed. Results The overall well-being level of the elderly in Guizhou Province was relatively high, and that in urban areas was slightly higher than that in rural areas. The mean value of subjective well-being among urban elderly was 4.21±0.65, while that of rural elderly was 4.11±0.75. The results of the random forest model and the ordered logistic regression analysis showed that physical health, mental health, social life, receiving support, acceptance and resilience, feeling useful, independence, and making ends meet were important influencing factors for the well-being of the elderly. The regression coefficient values of these factors all showed significance at the 0.001 level. Among them, the making ends meet (with a weight value of 0.231) was the core driving factor for the well-being of rural elderly. Meanwhile, mental health (with a weight value of 0.136) and physical health (with a weight value of 0.122) were the core driving factors for the well-being of urban elderly.Living situation (β=0.880, z=6.751, P<0.001) had a significant impact on the well-being of urban elderly but has no significant impact on that of rural elderly. Conclusion There are significant urban-rural differences in the influencing factors of the well-being of elderly in Guizhou Province. To enhance the well-being of elderly, it is necessary to start from multiple dimensions and implement precise policies. In rural areas, priority should be given to increasing the income of rural elderly. While in urban areas, efforts should be focused on optimizing the living situation of the elderly and building a comprehensive and multi-level medical and elderly care service support system.

Objective To investigate the influencing factors of anemia and anemia exacerbation in people living with HIV/AIDS (PLWHA) during antiretroviral therapy (ART), as well as the impact of anemia on the prognosis of PLWHA. Methods This retrospective cohort study collected baseline and follow-up data for PLHIV who initiated ART at a specialized infectious-disease hospital in Guangzhou from February 10, 2004 to March 29, 2019. A generalized linear mixed-effects model was used to analyze the factors influencing anemia during long-term ART in PLWHA without anemia at baseline. The Cox proportional hazards model was used to analyze both the influencing factors of anemia exacerbation in those with baseline anemia and the impact of baseline anemia and follow-up anemia on the prognosis. Results There were 11 688 PLWHA, of whom 3 853(32.97%) had anemia at baseline. Among 7 835 PLWHA without anemia at baseline, 1 695 (21.63%) developed anemia during the follow-up. Among 3 470 PLWHA with mild or moderate anemia at baseline, 845 (24.35%) had anemia exacerbation during the follow-up. Risk factors for follow-up anemia in PLWHA included being female, aged ≥50 years at ART initiation, being married/cohabiting, being divorced/separated/widowed, blood transmission, baseline opportunistic infections, higher number of baseline clinical symptoms, the initial ART regimen containing Zidovudine (AZT), CD4 cell count <200 cells/μL, and abnormal serum creatinine. Risk factors for anemia exacerbation included being female, being married/cohabiting, being divorced/separated/widowed, an interval of ≥6 months from diagnosis to ART initiation, ≥2 categories of baseline clinical symptoms, an initial ART regimen containing AZT, and abnormal serum creatinine. The risk of death in PLWHA without anemia at baseline but developing anemia during the follow-up was 5.02 times (95% CI: 2.45-10.27) than that among those without anemia at both baseline and during the follow-up. The risk of death with anemia at both baseline and during the follow-up was 6.00 times (95%CI: 3.04-11.85) than that among those without anemia at both baseline and during the follow-up. Conclusion Follow-up anemia and anemia exacerbation during ART are affected by multiple factors. Baseline anemia and follow-up anemia are important risk factors for the prognosis of PLWHA. Anemia screening for high-risk groups should be strengthened to strive for early detection, early diagnosis, and early treatment, thereby reducing the risk of death of PLWHA.

Objective To establish a prediction model to assess the risk of death in patients with Klebsiella pneumoniae (Kp) infection, and to provide a reference for the development of targeted prevention and control strategies for nosocomial infections. Methods Patients with Klebsiella pneumoniae(Kp) infection at the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2022 were used as the training dataset. LASSO-logistic regression was applied to identify independent risk factors for death in Kp-infected patients, and a mortality risk nomogram was constructed. Patients with Kp infection from January 2023 to December 2023 were used as the validation dataset. Model discrimination, accuracy, and clinical utility were comprehensively evaluated using the area under the receiver operating characteristic curve (ROC), the calibration curve, and the decision analysis curve. Results A total of 1 972 Kp-infected patients were included in the training dataset, of which 234 Kp-infected patients died with a mortality rate of 11.87%. A total of 1 148 Kp-infected patients were included in the validation dataset, of which 126 Kp-infected patients died with a mortality rate of 10.98%. The results of LASSO-logistic regression modeling showed that patients aged >70 years, carbapenem resistance, mechanical ventilation, indwelling urinary catheter, diabetes mellitus, hematologic infections, white blood cell count >10×10⁹/L and hemoglobin <115 g/L were all associated factors for death in patients with Kp infection (OR=24.6, 95% CI: 16.56-39.38; OR=2.44, 95% CI: 1.70-3.52; OR=4.97, 95% CI: 3.08-8.21; OR=2.99, 95% CI: 1.75-5.19; OR=18.24, 95% CI: 9.27-38.12; OR=2.75, 95% CI: 1.69-4.49; OR=4.18, 95% CI: 2.88-6.09; OR=2.65, 95% CI: 1.79-3.93). The areas under the ROC curve of the training dataset and validation dataset were 0.900 (95% CI: 0.876-0.924) and 0.843 (95% CI: 0.812-0.874), respectively. The calibration curve was close to the baseline curve, and the decision analysis curve was close to the upper right corner. Conclusion By analyzing the factors related to the death of Kp-infected patients, we constructed a nomogram prediction model of the risk of death of Kp-infected patients, which has good accuracy, discrimination, and clinical utility, and according to which targeted nosocomial infection prevention and control measures can be implemented.

Objective To explore the spatiotemporal characteristics of pulmonary tuberculosis (TB) in China and its macro influencing factors, and to provide a theoretical basis for the formulation of TB prevention and control measures. Methods The data of tuberculosis incidence in China from 2011 to 2020 were collected. A two-stage distributed lag nonlinear model (DLNM) was constructed to assess the lag effect and nonlinear relationship of meteorological factors on TB incidence, and a hierarchical Bayesian spatiotemporal model was used to analyze the relationship between population, economic factors, health services, and TB incidence. Results TB incidence in China was on a downward trend, with spatial clustering, and there were intensifying hotspots (Sichuan Province) and persistent hotspots(Liaoning Province, Shaanxi Province). The attributable fractions of low temperature(<6.7 ℃), low relative humidity(<55.59%), high wind speed(>3.00 m/s), and short sunshine duration(<2.7 hours) were 14.44%, 5.75%, 3.30%, and 7.88%, respectively. The urbanization rate(RR=1.009, 95% CI: 1.007-1.012) and the night light index (RR=1.009, 95% CI: 1.007-1.013) were positively correlated with TB incidence, while the number of hospital beds(RR=0.996, 95% CI: 0.994-0.998) and the proportion of elderly population (RR=0.973, 95% CI: 0.969-0.979) were negatively correlated with it. Conclusion The TB incidence in China has generally shown a downward trend. Attention should be paid to the prevention and control of hotspots, and the monitoring of macro influencing factors should be strengthened to take intervention measures as early as possible.

Objective This study aims to explore the relationship between socioeconomic status (SES) and intrinsic capacity (IC) in older adults, as well as the mediating role of healthy lifestyle. Methods Based on data from the Hubei Memory and Aging Cohort Study (HMACS), SES was assessed based on education, occupation, and income, and then categorized into high, medium, and low groups. Healthy lifestyle score (0-6 points) was constructed based on smoking, drinking, diet, social activities, physical exercise, and intellectual leisure activities. IC was assessed according to the indicators recommended by the WHO (2015). Group differences were compared using χ² tests or variance analysis. We performed a multivariable logistic regression analysis to assess the association between SES and IC impairment, and general linear regression models were used to analyze the association between SES and IC. A mediation model was employed to assess the mediating effect of healthy lifestyles on the association between SES and IC, with comparisons across sex and SES groups. Results A total of 5 628 eligible participants aged ≥60 years were included. Older adults with high SES had significantly higher healthy lifestyle scores than those with low SES (P<0.05). The IC impairment in the middle and low SES groups was 1.507 times (95% CI: 1.289-1.762) and 6.476 times (95% CI: 5.051-8.304) than that of the high SES group, respectively, both with P<0.001. SES and IC were significantly positively correlated (β=0.530, 95% CI: 0.505-0.555, P<0.001), with the strongest association in the low SES group (β=1.004,95% CI: 0.773-1.234, P<0.001). Healthy lifestyle partially mediated the relationship between SES and IC, with a mediation effect of 9.25%. The mediation effects were 8.32% in males and 10.19% in females. The mediation effect was significant only in the medium SES group (15.03%), with no significant mediation observed in the low or high SES groups. Conclusion In older adults, SES and IC are significantly positively correlated. SES is associated with IC both directly and indirectly through a healthy lifestyle, with mediating effects varying by sex and SES. Therefore, health promotion measures for older adults should fully consider sex and SES differences, emphasize the improvement of healthy lifestyles, enhance IC in older adults, and promote healthy aging.

Objective To investigate the association between the dietary index for gut microbiota (DI-GM) and metabolic syndrome (MetS), thereby providing a theoretical basis for preventing MetS through dietary modulation of the gut microbiome. Methods Data from 17 558 adults participating in the 2007—2018 U.S. National Health and Nutrition Examination Survey (NHANES) were analyzed, with MetS determined according to the NCEP ATP III criteria. The DI-GM score was constructed based on 14 food items or nutrients obtained from two 24 hour dietary recalls. Logistic regression models and restricted cubic spline (RCS) analysis were used to evaluate the relationship between DI-GM and MetS, and subgroup as well as sensitivity analyses were conducted. Results In the fully adjusted model, the risk of MetS decreased with increasing DI-GM scores (OR=0.94, 95% CI: 0.91-0.98). Specifically, individuals in the highest DI-GM quartile (Q4) had an 18% lower risk of MetS than those in the lowest quartile (OR=0.82, 95% CI: 0.72-0.95). RCS analysis indicated a linear inverse dose-response relationship between DI-GM and MetS (P for nonlinear=0.185). Subgroup analyses showed the inverse association was stronger in females, non-Hispanic Black individuals, and those with higher education levels(P for interaction<0.05). Sensitivity analyses confirmed the stability of the results(OR=0.94, 95% CI: 0.90-0.98). Conclusion This study demonstrates that maintaining a diet favorable to gut microbiota health can reduce the risk of MetS. These findings suggest that improving dietary patterns to modulate the gut microbiome may offer a novel strategy for the prevention and management of MetS.