To evaluate the association between gestational diabetes mellitus (GDM) and genitourinary tract infections during pregnancy (GUTIs) through retrospective analysis and Mendelian randomization (MR) analysis.

A retrospective analysis was conducted on 7 751 pregnant women who underwent prenatal check-ups and delivered between 2020 and 2022, comparing the rates of GUTIs between women with GDM and those without. Additionally, data from genome-wide association studies (GWAS) were selected, and the inverse-variance weighted (IVW) method was employed as the primary analytical approach, supplemented by weighted median (WM), weighted mode (WM), and MR-Egger regression methods. Sensitivity analyses were performed using MR-Egger regression, Cochran’s Q test, and leave-one-out analysis to investigate the causal relationship between GDM and GUTIs.

Both univariate chi-square tests (P=2.2×10^-16) and multivariate stepwise logistic regression analyses (P=2×10^-16) revealed a significant correlation between GDM and GUTIs. The two-sample MR study further confirmed a significant association between the two (IVW: β=0.211, P=0.013). The MR-Egger regression method did not indicate significant horizontal pleiotropy (P=0.813), and leave-one-out analysis and Cochran’s Q test showed no significant heterogeneity among all SNPs (P=0.876, P=0.938).

The presence of GDM may increase the risk of GUTIs. Effective screening and management of GDM patients could help reduce and prevent GUTIs.

To analyze the disease burden attributable to high BMI in postmenopausal women in China from 1990 to 2021, examine the trends of this burden, and predict the situation from 2022 to 2050 to guide future public health policies and interventions.

Utilizing data from the Global Burden of Disease (GBD) 2021 database, the study selected indicators such as the number of breast cancer deaths and disability-adjusted life years (DALYs) attributable to high BMI among postmenopausal women in China. Join point regression models were employed to analyze trends in mortality rates and DALYs, while age-period-cohort models were used to explore the effects of different ages, periods, and birth cohorts. The Bayesian Age-Period-Cohort (BAPC) package was applied to predict future disease burden trends.

From 1990 to 2021, the overall disease burden of breast cancer attributable to high BMI in postmenopausal women in China showed an increasing trend, with the number of deaths rising by 439.28% and DALYs by 441.27%. Both the age-standardized mortality rate and age-standardized DALYs rate increased (with average annual percent changes of 23.1% and 27.0%, respectively, P<0.001). The age-standardized mortality rate peaked at over 95 years, while the age-standardized DALYs rate peaked in the age group of 55 to 60.

The disease burden of breast cancer attributable to high BMI in postmenopausal women in China shows a continuous upward trend, with increases in mortality and DALYs rates surpassing global averages. It is anticipated that this burden will continue to rise over the next thirty years. Therefore, it is recommended to strengthen the prevention and control of overweight and obesity among postmenopausal women in China, enhance breast cancer screening rates, and implement targeted health education and public health interventions.

To explore the relationship between the duration of children’s internet usage and feelings of loneliness and depression.

From March to June 2023, a stratified cluster sampling method was employed to select students in grades three to six from a primary school in Handan. Data were collected using a basic information questionnaire, the Children’s Loneliness Scale (CLS), the Children′s Depression Self-Rating Scale (DSRSC), and an internet usage duration questionnaire. Statistical analysis was conducted using SPSS 26.0 software, employing frequency and percentage methods to describe the basic characteristics of the entire sample. Comparative analysis of the data was performed using t-tests and χ² tests, while multifactorial logistic regression analysis and correlation analysis were used for further data examination.

A total of 597 subjects were included in the study. The results indicated that, compared to children without feelings of loneliness, those with loneliness spent significantly more time on overall internet usage, watching television/listening to music, and playing games, while spending less time chatting (P<0.05). Logistic regression analysis revealed that children in the high total internet usage duration group had a higher risk of loneliness compared to the low duration group (OR=4.61, 95%CI: 1.19-6.50, P=0.028). Furthermore, children in the high gaming duration group also exhibited a higher risk of loneliness (OR= 1.29, 95%CI: 1.09-1.91, P=0.032). Additionally, the high gaming duration group showed a greater risk of depression compared to the low duration group (OR=1.23, 95%CI: 1.06-1.95, P=0.032). In contrast, children in the high study duration group had a lower risk of depression compared to the low duration group (OR=0.38, 95%CI: 0.14-0.95, P=0.042).

There is a positive correlation between the total duration of internet usage and gaming duration with the risk of loneliness in children, and longer gaming time is associated with a higher incidence of depression.

To investigate the mediating role of Activities of Daily Living (ADL) and social participation in the relationship between internet use and depression among empty nesters, providing references for reducing the risk of depression and improving quality of life in this population.

A total of 3 974 empty nesters aged 60 and above from the 2020 China Health and Retirement Longitudinal Study were selected as the research subjects. The ADL scale and the CESD-10 scale were used to measure the ADL and depression status of the empty nesters, respectively. Spearman correlation analysis was conducted to explore the relationships among internet use, ADL, social participation, and depression among empty nesters. The mediating effects of ADL and social participation in the relationship between internet use and depression were analyzed using Model 6 of the Process 4.1 plugin in SPSS.

Internet use had a significant direct effect on depression among empty nesters (β=-2.125, 95%CI: -2.593 to -1.654). The individual mediating effect of ADL was significant (β=-0.516, 95%CI: -0.641 to -0.389), as was the individual mediating effect of social participation (β=-0.159, 95%CI: -0.263 to -0.062). The chain mediating effect of ADL and social participation was also significant (β=-0.007, 95%CI: -0.011 to -0.002).

Internet use can directly negatively impact depression among empty nesters, and it can also influence depression through the individual or chain mediating effects of ADL and social participation.Therefore, to reduce the risk of depression among empty nesters, it is essential to increase their internet usage, enhance their ADL levels, and promote their social participation, thereby alleviating their depressive symptoms.

To explore the mediating effect of oral frailty on the relationship between health promotion behaviors and healthy aging among rural elderly individuals.

A multi-stage sampling method was employed to conduct a questionnaire survey involving 439 rural elderly participants in Chengde city, Hebei Province. The general information questionnaire, a healthy aging scale, a health promotion behavior scale, and an oral frailty screening scale were used.

The scores for healthy aging among rural elderly individuals in Chengde were (128.64±26.17), (64.01±16.18) for health promotion behaviors, and (6.06±3.05) for oral frailty. Spearman correlation analysis indicated significant correlations among the three variables. Mediation effect testing revealed that oral frailty partially mediated the relationship between health promotion behaviors and healthy aging, accounting for 20.47% of the mediation effect.

The level of healthy aging among rural elderly individuals is moderate. It is essential to implement health promotion behaviors and adopt relevant measures to reduce oral frailty to achieve healthy aging.

To understand the current status and influencing factors of treatment decision-making participation among patients with type 2 diabetes and to explore its correlation with the perception of complications risk.

A convenience sampling method was used to select patients with type 2 diabetes from the endocrinology department of a tertiary hospital in Shanxi Province between March and May 2024. A cross-sectional survey was conducted using a general information questionnaire, a patient participation in treatment decision-making questionnaire, and a diabetes risk perception scale.

A total of 210 valid questionnaires were collected.The overall score for the actual participation level in shared decision-making among patients with type 2 diabetes was (1.68±0.39), and the score for participation attitude was (1.46±0.27). There was significant inconsistency between the actual participation level and the participation attitude (Kappa=0.102, P<0.05). Multiple linear regression analysis revealed that age (B=0.692, 95%CI: 0.065-1.450), educational level (B=0.911, 95%CI: 0.300-1.522), satisfaction with medical services (B=-2.390, 95%CI: -3.726 to -1.053), and perception of complications risk (B=0.070, 95%CI: 0.010-0.129) were the main influencing factors of the actual participation level in decision-making among patients with type 2 diabetes (P<0.05).

The actual participation level in decision-making among patients with type 2 diabetes is relatively low, while their overall attitude towards participation is quite positive, indicating poor consistency between the two.Perception of complications risk is an important influencing factor for actual decision-making participation. Effective risk communication should be conducted to encourage patients to actively engage in decision-making, thereby reducing the occurrence and progression of diabetes complications.

To analyze the specific pathways for enhancing the resource allocation efficiency of elderly care institutions in China, providing a basis for the scientific development of resource allocation in these institutions.

The Data Envelopment Analysis (DEA) method was employed to calculate the comprehensive efficiency values of resource allocation in elderly care institutions across 31 provinces in China, which were used as the outcome variable. Five condition variables were selected for fsQCA analysis.

In 2022, the average comprehensive efficiency of resource allocation in elderly care institutions in China reached 0.878, indicating a relatively high overall level, although disparities existed among provinces.There were five pathways to improve the resource allocation efficiency of elderly care institutions, with an overall coverage of 0.614 528 and an overall consistency of 0.881 904, demonstrating strong explanatory power of the model.

The supply of beds is a crucial condition for achieving high efficiency in resource allocation in elderly care institutions. The synergistic effects between internal and external conditions facilitate the realization of high efficiency in resource allocation, and the interaction and coordination among conditions promote the emergence of pathways leading to high efficiency in resource allocation.

To analyze the impact of the separation of medicine and pharmacy and the integrated reform of medical expenses on medical service revenue in a district of Beijing.

Utilizing monitoring data from January 2016 to April 2024, a time breakpoint regression model was constructed for analysis.

Following the implementation of the separation of medicine and pharmacy reform, the proportion of medical service revenue and the average medical service revenue per visit in secondary and tertiary hospitals significantly increased (P<0.05). After the implementation of the integrated reform of medical expenses, the average medical service revenue per visit and the proportion of service revenue in secondary hospitals also saw significant increases (P<0.05).

After reform, the total amount and proportion of medical service revenue have significantly increased, with further optimization of the revenue structure and a more adequate reflection of the value of technical services. However, the proportion of medical service revenue remains relatively low. It is recommended to enhance the reform linkage mechanism, strengthen the supervision of medical services, promote the balanced distribution of medical resources, and focus on improving the service capacity of primary healthcare institutions.

To analyze the relationship between economic development level, ecological environment quality, and residents’ health level, and to explore the mediating effect of ecological environment quality between the two.

Based on provincial panel data from China from 2012 to 2022, a baseline regression model was established to analyze the relationship between economic development level and residents’ health level. The mediating effect of ecological environment quality was examined using the three-step method and Bootstrap testing.

There is a positive correlation between economic development level and residents’ health level (β=0.01, P<0.05). Environmental governance investment has a mediating effect on residents’ health level (β=-0.005, P<0.01). The quality of urban living environment did not show a significant indirect effect on residents’ health level through the non-parametric percentile Bootstrap test (95%CI: -0.001 to 0.004). The mediating effect of environmental governance pressure on residents’ health level was 0.003, accounting for 13.64% of the total effect, as verified by the non-parametric percentile Bootstrap test.

Economic development level has a significant positive impact on residents’ health level, and it can enhance residents’health level through the indirect effects generated by environmental governance pressure and investment.

To explore the mediating role of social activities in the relationship between sleep quality and cognitive function among elderly individuals with chronic diseases in the community.

From May to August 2022, a stratified convenience sampling method was employed to select 757 elderly individuals with chronic diseases from communities in Nanjing, Changzhou, Nantong, and Xuzhou, Jiangsu Province. The study utilized a general information questionnaire, the Beijing version of the Montreal Cognitive Assessment (MoCA), and the Pittsburgh Sleep Quality Index (PSQI) to assess the frequency and types of social activities, sleep quality, and cognitive function of the participants. The PROCESS mediation model was used to investigate the mediating effect of social activities between sleep quality and cognitive function. Results The scores for sleep quality among elderly individuals with chronic diseases showed a negative correlation with the level of participation in social activities (r=-0.114, P<0.01) and cognitive function (r=-0.169, P<0.001). Furthermore, the level of participation in social activities was positively correlated with cognitive function (r=0.146, P<0.001). Mediation effect testing indicated that social activities partially mediated the relationship between sleep quality and cognitive function (21.35%), with a mediation effect range of (95%CI: -0.035 to -0.006).

Social activities play a partial mediating role in the relationship between sleep quality and cognitive function among elderly individuals with chronic diseases in the community, indirectly affecting their cognitive function. Community workers should emphasize the importance of social activities in delaying cognitive decline among elderly individuals with chronic diseases, and strive to enhance their participation in social activities through comprehensive and multi-level approaches, thereby reducing the incidence of cognitive impairment.