To analyze the status and influencing factors of latent tuberculosis infection (LTBI) screened by the recombinant mycobacterium tuberculosis fusion protein (EC) test in Henan Province, and to understand the willingness of LTBI individuals to accept preventive treatment, with the aim of providing data support for improving tuberculosis (TB) control strategies in Henan Province.

In 2023, the EC test was used to screen for LTBI and conduct preventive treatment among high-risk groups for TB (including school teachers and students, healthcare workers, close contacts, and HIV/AIDS patients) in counties participating in the Henan Province TB Care Action public welfare project. Excel 2019 and SPSS 21.0 software were used to analyze the data. Binary logistic regression model was used to analyze the influencing factors of latent tuberculosis infection.

A total of 4 818 subjects were included in the study, excluding those who had not been screened for latent infection due to other reasons such as screening contraindications. The positive rate of EC test was 4.42% (213/4 818). Four patients with active pulmonary tuberculosis were found, and the detection rate was 83.02/100 000 (4/4 818). 204 people met the criteria for preventive treatment, 86 people received preventive treatment, the acceptance rate was 42.16% (86/204), the completion rate was 89.53%(77/86), among which the main reason for refusal was that they thought they would not get sick (77.97% (92/118)). Binary logistic regression model analysis results showed that with students as the control group, medical staff (OR=9.762，95% CI：3.441-27.697), close contact staff (OR=6.853, 95% CI：3.074-15.277), HIV/AIDS (OR=4.387, 95% CI：1.582-12.165) were risk factors for TB infection.

Healthcare workers, close contacts, and HIV/AIDS patients are the focus of LTBI screening. Additionally, enhancing the awareness of preventive treatment among individuals with latent infections is crucial to improving the acceptance rate of preventive treatment and advancing TB control efforts in Henan Province.

To assess the current status and influencing factors of occupational health literacy (OHL) among key populations in Yunnan Province.

In accordance with the requirements of the National Key Population Occupational Health Literacy Monitoring and Intervention Technical Plan, a stratified cluster random sampling method was used to select workers from three key industries in the secondary sector and five key industries in the tertiary sector in Yunnan Province. A questionnaire survey was conducted to assess their OHL levels. The pearson χ² test and multivariate logistic regression analysis were used to analyze the influencing factors of OHL.

In 2023, the sample of Yunnan Province included 9 718 people. The overall OHL level was 48.4%, with the OHL level of the secondary sector was 55.0% and that of tertiary industry was 45.5%. Female workers had significantly higher OHL levels than males (χ²=11.529, P<0.05); higher income (χ²=166.574, P_{for trend}<0.001) and higher education levels (χ²=99.473, P_{for trend}<0.001) were positively associated with OHL levels. The multivariate logistic regression analysis showed that using “junior high school and below” and “monthly income<3 000 yuan” as reference groups, having a college degree or above (OR=1.180, 95% CI:1.042-1.335) and a monthly income of ≥9 000 yuan (OR=2.615, 95% CI:1.967-3.477) were protective factors for higher OHL levels (P<0.05). Using state-owned enterprises as the reference, working in private enterprises (OR=0.854, 95% CI:0.763-0.956) and public institutions (OR=0.865, 95% CI:0.756-0.991) were risk factors for OHL levels (P<0.05).

The OHL level in Yunnan Province needs to be further improved. Low-income groups, individuals with lower educational backgrounds, and workers in emerging industries should be key targets for future attention and intervention. To enhance OHL levels and safeguard workers’ health, targeted education and awareness campaigns should be designed based on the specific characteristics of each group.

To explore the mediating effect of self-compassion on social support and diabetes distress (DD) among community-dwelling elderly individuals with type 2 diabetes mellitus (T2DM).

From June to July 2024, a cross-sectional survey was conducted among elderly T2DM patients in communities in Nanjing. The survey used the general information questionnaire, DDS, SSRS, and SCS. A multiple linear regression model was employed to examine the factors influencing DD, and the mediating effect of self-compassion was analyzed by the Bootstrap method for validation.

The prevalence of DD among the respondents was 35.1%, and the scores for social support and self-compassion were (39.48±8.13) and (91.18±9.10), respectively. Social support and self-compassion were significantly positively correlated (r=0.344, P<0.001). Social support (β=-0.132, P<0.001) and self-compassion (β=-0.216, P<0.001) were the influencing factors of DD, and self-compassion exhibited a partial mediating effect in the relationship between social support and DD, accounting for 37.02% of the total effect.

Community healthcare workers should pay attention to the screening of DD among elderly T2DM patients, and actively explore comprehensive intervention strategies that integrate social support with self-compassion to enhance their psychological well-being.

To analyze the spatiotemporal trends of occupational noise-induced hearing loss (ONIHL) in the Chinese working population, predict its medium- and long-term disease burden, and provide scientific evidence for occupational disease prevention and control strategies.

Based on the Global Burden of Disease (GBD) 2021 database, data on Years Lived with Disability (YLDs) due to ONIHL in the Chinese working population between 1990 and 2021 were obtained. Joinpoint regression analysis was employed to assess temporal trends in disease burden, while an age-period-cohort (APC) model was developed to examine shifts in epidemiological patterns. Additionally, an Autoregressive Integrated Moving Average (ARIMA) model was applied to project the future burden of disease through 2040.

From 1990 to 2021, the average annual percentage change (AAPC) in the age-standardized rate of YLDs for ONIHL among the Chinese working population was 0.22%(95% CI: 0.19%-0.24%), with sex-specific rates of 0.15%(95% CI:0.13%-0.17%) in males and 0.33%(95% CI: 0.29%-0.37%) in females. In 2021, the age-standardized rate of YLDs was higher in males than in females, reaching a peak of 510.61 per 100 000 in individuals aged 60-64 years. According to the APC model, the YLDs rate increased with age and calendar period, and exhibited an initial increase followed by a decline across successive birth cohorts. Projections using the ARIMA model suggest that the overall age-standardized rate of YLDs is projected to increase to 166.66 per 100 000 by 2040.

From 1990 to 2021, the age-standardized rate of YLDs for ONIHL among the Chinese working population demonstrated a consistent upward trend, with males bearing a higher burden than females. The disease burden also escalated with increasing age. Over the next 19 years, the disease burden is expected to persist in rising, underscoring the urgent need to strengthen workplace noise control measures to mitigate the adverse health effects of occupational noise on the labor force.

To understand the prevalence of dyslipidemia among Nu residents with different characteristics in Yunnan Province, and analyze the associated risk factors of dyslipidemia.

In 2021, we used a multi-stage stratified cluster random sampling method to select permanent Nu residents aged 18 and above in Nujiang Prefecture, Yunnan Province as survey subjects. We obtained survey subject information through three parts: questionnaire survey, body measurement, and laboratory examination. To analyze the prevalence intensity and distribution characteristics of dyslipidemia among Nu residents in Yunnan Province, and to explore the related influencing factors of dyslipidemia among Nu residents.

This study included a total of 963 valid participants. The prevalence of dyslipidemia among Nu ethnicity residents aged 18 and above was 35.5%. The prevalence rates of hypercholesterolemia (TC), hypertriglyceridemia (TG), high LDL-cholesterol (LDL-C), and low HDL-cholesterol (HDL-C) were 15.5%, 12.4%, 10.6%, and 15.9%, respectively. Significant risk factors for dyslipidemia included age ≥60 years (OR=1.527, 95% CI=1.007-2.315), overweight (OR=3.194, 95% CI=1.417-7.197), obesity (OR=3.112, 95% CI=1.267-7.645), hypertension (OR=1.395, 95% CI=1.027-1.895), and diabetes mellitus (OR=2.022, 95% CI=1.341-3.049).

The prevalence rate of dyslipidemia among adults of the Nu ethnic group is close to the national average. The next step will be to focus on high-risk groups such as those aged≥60 years, overweight, and obese, while strengthening the management of patients with chronic diseases such as hypertension and diabetes to effectively reduce the prevalence of dyslipidemia.

To investigate the causal association of twelve lifestyle behaviors in six categories (including smoking, drinking, physical activity, sexual behaviors, sleep habits and nutrients) on uterine fibroids using mendelian randomization (MR) method, and to investigate the mediating role of obesity related indicators.

Using genome-wide association study data, bidirectional MR analysis was first performed to identify exposures with causal associations with the outcome, which were then incorporated into multivariable MR to evaluate the independent causal effect of each variable, and finally two-step MR was used to evaluate the mediating role of obesity in the above causal pathways. Univariable MR analysis primarily employed the inverse-variance weighted (IVW) method, with the MR-Egger regression and the weighted median method used as the robustness verification methods; Multivariable MR was performed using the multivariable IVW method.

IVW results showed that genetically predicted regular smoking (OR=1.150, 95% CI: 1.006-1.316, P=0.041), higher alcohol intake (OR=1.306, 95% CI: 1.092-1.563, P=0.004) and higher carbohydrate intake (OR=1.681, 95% CI: 1.151-2.456, P=0.007) were risk factors for uterine fibroids, and were consistent with the results of the MR-Egger regression and the weighted median method. No reverse causal relationship was found in reverse MR analysis (all P values<0.05). Multivariable MR analysis showed that regular smoking (OR=1.302, 95% CI: 1.124-1.507, P<0.001) and carbohydrate intake (OR=1.410, 95% CI: 1.053-1.887, P=0.022) had independent causal effects on uterine fibroids. The two-step MR analysis showed that the waist hip ratio adjusted by body mass index mediated the effect of regular smoking on uterine fibroids, with a mediation proportion of 16.2%.

Regular smoking and higher carbohydrate intake are associated with an increased risk of uterine fibroids, with obesity partially mediating the relationship between regular smoking and uterine fibroids, emphasizing the importance of healthy lifestyle and weight management in the prevention of uterine fibroids.

To investigate the heterogeneous effects of Diagnosis-Intervention Packet (DIP) payment reform on the quantity distribution and cost patterns of high/low-complexity cases (measured by Case Mix Index, CMI), and to reveal hospital hierarchical response mechanisms under cost-control pressures, thereby providing policy recommendations.

Using three-year pre-and post-DIP pilot data (2018-2023), we constructed a difference-in-differences (DID) fixed-effects model with medical insurance patients as the treatment group and non-insured patients as the control group. The model incorporated diagnosis-related group (DRG) fixed effects and a policy×high-CMI interaction term to quantify heterogeneous impacts across complexity levels.

The DIP policy significantly reduced per-case medical costs (β₃=-803.570, P<0.001), per-case medical service costs (β₃=-128.434, P=0.019), and per-case material costs (β₃=-290.519, P<0.001) in the treatment group, alongside a reduction in the absolute deviation from the mean by 228.644 CNY (P=0.016) and a shortened average length of stay by 1.080 days (P<0.001). Stratified by CMI, high-CMI cases exhibited additional reductions in per-case costs (β₃=-309.400), material costs (β₃=-549.843), and hospitalization days (β₃=-0.715) compared to low-CMI cases, yet showed an increase in per-case medical service costs (β₃=273.834).

Hospitals adopted distinct response mechanisms under DIP-driven cost constraints. For high-CMI cases, cost control was achieved through technology-for-materials substitution (prioritizing technical service income while reducing material expenditures), whereas low-CMI cases relied on comprehensive cost suppression.These findings highlight the need for complexity-tiered payment adjustments to balance cost containment and care quality.

To investigate the prevalence and associated factors of chronic pain among community-dwelling older adults in Shanghai, China.

A multi-stage stratified cluster sampling method was employed to recruit residents aged ≥60 years from August to November 2023. A structured questionnaire was used to collect data on demographic characteristics, pain status, and indicators of pain severity. Multivariate logistic regression was applied to identify factors associated with moderate to severe chronic pain.

A total of 3 606 valid responses were obtained. The overall prevalence of chronic pain was 73.9%, with mild pain being the most common (60.4%). The mean age of participants was 73.2±9.4 years. The most frequently reported pain sites were the lumbosacral region, shoulders, and neck. Major pain relief approaches included traditional therapies (55.7%), topical medications (41.5%), and oral analgesics (40.1%). Pain intensity was significantly correlated with psychological distress (r=0.793) and impaired daily functioning (r=0.795). Female sex (OR=1.291), higher educational attainment (OR=1.620-1.679), poor spousal health (OR=1.777-3.112), and impaired ability of daily living (OR=0.481) were independently associated with increased risk of moderate to severe pain.

Chronic pain is highly prevalent among older adults in Shanghai communities, predominantly manifesting as mild pain. Female gender, higher education level, poor spousal health, and limited self-care ability are significant risk factors for moderate to severe pain. Early identification of high-risk individuals and multidimensional interventions are essential to improve pain management and reduce the burden of chronic pain in this population.

To evaluate the health economy of the whole-process management strategy of personalized lung cancer screening according to the size of lung nodules compared with the annual screening strategy and the natural development strategy.

Based on the publicly available dataset from the US NLST, a decision tree-Markov model was constructed. Incremental cost-utility analysis was used to evaluate the economic efficiency of the three strategies, and one-way sensitivity analysis and probabilistic sensitivity analysis were conducted to test the stability of the model results.

Compared with the natural development strategy, the incremental cost-utility ratios (ICER) of the whole-process management strategy and the annual screening strategy were 82 798.96 yuan/quality-adjusted life year (QALY) and 71 168.05 yuan/QALY, respectively.Compared with the annual screening strategy, the ICER of the whole management strategy was 129 227.28 yuan/QALY. Univariate sensitivity analysis showed that the proportion of lung cancer patients with stage III and IV lung cancer had a significant impact on ICER. Probability sensitivity analysis showed that when the Willingness to pay (WTP) was 89 358 yuan/QALY, the economic probability of the whole management strategy was 0.279. When WTP was 268 074 yuan/QALY, the economic probability of the whole process management strategy was 0.826.

When WTP is 1 time the Gross Domestic Product (GDP), the annual screening strategy is the best choice. When WTP is 3 times the GDP per capita, the whole-process management strategy is the best choice.

To explore the relationship between smartphones usage, internet usage and subjective, objective cognitive functions.

Multi-stage cluster random sampling method was used to select 45-70 year old permanent residents from 7 sample villages in Pingyin County, Shandong Province who meet the standards. The subjective cognitive decline-questionnaire 9 (SCD-Q9) and the montreal cognitive assessment basic scale (MoCA-B) were used to evaluate the subjective and objective cognitive functions, respectively. The logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) of the relationship between smartphones usage, internet usage and subjective, objective cognitive function. Furthermore, the non-linear relationship between smartphones usage, internet usage and cognitive function scores was explored.

This study included 1 654 participants. Compared with those who did not use mobile phones, those who used mobile phones had a 42% lower risk of experiencing abnormal objective cognitive scores (OR=0.58, 95% CI: 0.46-0.73), and the risk of abnormal objective cognitive scores was relatively low when using a mobile phone for less than or equal to 2 hours per day or more than 2 hours per day (0.65, 0.51-0.82; 0.69, 0.55-0.88). Compared to those who did not use the internet, internet users had a 41% lower risk of experiencing abnormal objective cognitive scores (0.59, 0.47-0.74), and people who spent less than 1 hour online or more than 2 hours online had a lower risk of experiencing abnormal objective cognitive scores compared to those who spent less than or equal to 1 hour online (0.65, 0.52-0.83; 0.66, 0.52-0.83). Nonlinear correlation showed that as the duration of mobile phone use and internet usage gradually increased, the objective cognitive score showed a trend of first increasing and then decreasing.

People who use mobile phones and the internet have a lower risk of experiencing objective cognitive score abnormalities. As the duration of mobile phone use and internet usage increases, the objective cognitive score shows a non-linear trend of first increasing and then decreasing. Overuse of mobile phones and the internet (such as>5.5 h/d) may have adverse effects on cognitive function.