Objective To understand the economic burden of hospitalized cases of mycoplasma p neumonia (MPP) in Wuhan in 2023, and to provide a scientific basis for the formulation and improvement of public health prevention and control policies. Methods A questionnaire survey was conducted on the hospitalized cases of MPP in Wuhan from January to October 2023. Non-parametric tests were used to analyze the differences in direct, indirect, and total economic burden among different groups of patients due to MPP. Multivariable Logistic regression was used to analyze the related factors affecting economic burden. Results A total of 342 cases of hospitalized MPP were investigated. The total economic burden was higher in severe cases and those with symptoms of fever, cough, and headache (P<0.001). Seeking medical treatment at a tertiary general hospital in a remote urban area (OR=0.156, 95% CI: 0.032-0.764), being aged 19-59 years (OR=13.706, 95% CI: 4.697-39.999), being aged ≥60 years (OR=57.661, 95% CI: 13.283-250.315), hospitalization lasting more than 7 days (OR=3.244, 95% CI: 1.624-6.479), and caregivers missing work for more than 7 days (OR=8.323, 95% CI: 4.108-16.862) were identified as factors associated with the total economic burden (P<0.05). Conclusion Visiting a children’s specialized hospital, severe cases, having symptoms of fever, cough, and headache, increasing age, length of hospital stay, and days of caregiver’s lost work all bring heavier economic burdens to patients. Public health policy interventions such as strengthening clinical diagnosis and treatment, and improving the medical security system should be strengthened to reduce the economic burden on patients.

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 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 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.

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 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 analyze the fairness and impact mechanisms of the allocation of public health physician resources in China. Methods The fairness of public health physician resource allocation in 31 provinces across the country was set as the outcome variable, and 7 indicators were selected from the government, socio-economic and individual levels as conditional variables, and a fuzzy set qualitative comparative analysis (fsQCA) was performed. Results There were large differences in the allocation of public health physician resources in 31 provinces in China. Single factors cannot constitute a necessary condition to affect the fair allocation of public health physician resources. There were 10 paths that affect the fair allocation of public health physician resources, of which 2 paths had high fairness configurations, with an overall consistency of 0.97 and an overall coverage of 0.61. There were 8 paths in low fairness configurations, with an overall consistency of 0.96 and an overall coverage of 0.83. Conclusion Population aggregation is the basic premise for determining the fair allocation of public health physician resources. Financial support and residents’ income are key guarantees to support the fair allocation of public health physician resources. Medical insurance and basic public health service subsidies are complementary support for promoting the fair allocation of public health physician resources. Multi-factor coupling is a systematic mechanism for realizing the fair allocation of public health physician resources.

Objective To evaluate the extent to which clinical doctors in Hebei Province have mastered the knowledge associated with the prevention and control of viral hepatitis C and its influencing factors, and supply a scientific basis to further improve and perfect the prevention and control strategies of hepatitis C. Methods The on-site investigation adopted the "Questionnaire on Hepatitis C Prevention and Treatment Knowledge for Clinical Doctors" devised by the National AIDS Prevention and Control Center. Its components involved demographic traits, fundamental prevention and treatment knowledge, diagnosis and treatment standards, as well as case reporting requirements, and others. Categorical variables were described using proportions and rates.The influencing factors of awareness of hepatitis C knowledge were studied by using the χ² test and multivariable logistic regression method. Results This survey obtained 2 858 questionnaires in total, and every single one of them was valid. The awareness rate of basic knowledge and professional knowledge was 95.31% (2 724/2 858) and 14.49% (414/2 858), respectively.In terms of basic knowledge content, the correct answer rate for "Hepatitis C can be cured" was the lowest, at 86.28%, while the correct answer rates for other questions were all above 90%. Regarding professional knowledge, 50% (8/16) of the questions had a correct answer rate below 50%. Among these, the question on "Diagnostic basis for diagnosing hepatitis C" had the lowest correct answer rate, at 13.89%. The educational background, department, hospital level and type of clinical doctor, as well as whether they have received hepatitis C knowledge training in the past year, all have an impact on their knowledge of hepatitis C. Doctors with a master’s degree or above had higher knowledge levels than those with a master’s degree or below (OR=2.324, 95% CI:1.706-3.166). Doctors in infectious diseases had higher knowledge levels than those in non-infectious diseases such as internal medicine (OR=0.275, 95% CI: 0.159-0.475). Doctors in tertiary hospitals had higher knowledge levels than those in secondary and lower-level hospitals (OR=1.462, 95% CI: 1.044-2.048). Doctors in provincial hospitals were better than those in county and municipal hospitals (OR=2.869, 95% CI: 1.978-4.161). Doctors who have received prevention and treatment knowledge training in the past year were higher than those who have not received training (OR=3.144, 95% CI: 2.386-4.143). Conclusion While many clinical doctors in Hebei Province have mastered the fundamental knowledge about hepatitis C prevention and treatment quite well, the level of their professional knowledge needs to be improved. Attention should be paid to strengthening the training on diagnosis, treatment and case reporting, etc. At the same time, differentiated training programs should be formulated for different groups to effectively improve the diagnosis and treatment level of clinicians.

Objective To analyze the duplicate reporting of hepatitis B in Guangxi from 2014 to 2023, providing data to support future research. Methods Duplicate cases of hepatitis B in Guangxi from 2014 to 2023 were identified by matching combinations of rules, including identity card number, name, sex, date of birth, contact number, and current address of patient. The duplicate reporting rates were calculated. Results A total of 499 965 hepatitis B cases were reported in Guangxi from 2014 to 2023, in which 46 439 cases were reported in duplicate, and the duplicate reporting rate was 9.29%. There was an upward trend in the duplicate reporting rate over the years (χ²_trend=6 156.939, P<0.001). The within-year duplicate reporting rate was 1.58%, and the cross-year duplicate reporting rate was 7.70%. The within-year duplicate reporting rate showed an increasing trend (χ²_trend=7.320, P=0.007). The duplicate reporting rate of each city ranged from 4.25% to 12.08% (χ²=3 284.620, P<0.001). The duplicate reporting rate increased with age group (χ²_trend=675.314, P<0.001). The duplicate reporting rate of hospitals of different levels ranged from 4.69% to 19.13% (χ²=24 388.260, P<0.001), with the highest duplicate reporting rate observed in secondary-level hospitals. After excluding duplicated records, the average annual reported incidence rate of hepatitis B in Guangxi from 2014 to 2023 was 92.60 per 100 000 population. Conclusion The report incidence rate of hepatitis B is overestimated because of the duplicate reporting. A cross-year and cross-area duplicate reporting checking system should be established to reduce the duplicate reporting, and improve the surveillance quality for hepatitis B.

Objective To investigate the effects of spicy diet on male semen quality. Methods This study recruited male volunteers from Chongqing and Puyang, analyzed the impact of spicy diets on male semen quality, and further conducted a stratified analysis by region to verify the stability of the conclusions. Logistic regression evaluated spicy diet’s association with abnormal semen quality (normal/abnormal classification). Results A total of 2 128 subjects were included in the study (1 394 from Puyang and 779 from Chongqing). Linear mixed-effects model analysis revealed that duration of chili consumption was positively correlated with semen volume(β=0.05, 95% CI: 0.01-0.09, P=0.012), sperm concentration (β=1.64, 95% CI:0.35-2.93, P=0.013), total sperm count (β=6.89, 95% CI: 0.89-12.89, P=0.024), progressive motility (β=1.22, 95% CI: 0.75-1.69, P<0.001), VCL (β=0.73, 95% CI: 0.36-1.11, P<0.001), BCF (β=0.24, 95% CI: 0.15-0.32, P<0.001), STR (β=1.31, 95%CI: 0.73-1.90, P<0.001), WOB (β=0.91, 95% CI: 0.22-1.61, P=0.010), and normal morphology rate (β=0.34, 95% CI: 0.18-0.50, P<0.001), while negatively correlated with head defect rate (β=-1.11, 95% CI: -1.54~-0.67, P<0.001) and neck defect rate (β=-1.20, 95% CI: -1.62~-0.77, P<0.001). Weekly frequency of chili consumption showed positive correlations with sperm concentration (β=2.48, 95% CI: 0.05-4.92, P=0.046) and progressive motility (β=1.06, 95% CI: 0.18-1.94, P=0.019). Monthly frequency of chili consumption was positively associated with VSL (β=0.82, 95% CI: 0.32-1.31, P=0.001) and VAP (β=0.85, 95% CI: 0.25-1.46, P=0.006). Both duration and weekly frequency of chili consumption exhibited dose-response protective effects on semen quality, showing progressively decreasing risks of abnormal semen quality with increasing consumption duration and frequency (P_trend<0.001 and 0.042, respectively). Those who had maintained a spicy diet for more than 3 years had a reduced risk of abnormal semen quality. Conclusion Spicy diet is associated with improved semen quality, with long-term consumption potentially reducing abnormality risk.