To analyze trends in energy and macronutrient intake among adults aged 35 years and older in Guizhou Province from 1991 to 2023, and examine their associations with demographic characteristics such as gender, urban/rural residence, and age groups, so as to provide scientific evidence for formulating targeted nutrition improvement measures.

This study utilized cross-sectional data from the China Health and Nutrition Survey (CHNS) spanning 1991—2023, focusing on adult residents aged 35 years and older in Guizhou Province. Dietary data were collected using a three-day 24-hour recall method combined with household weighing techniques. Energy and nutrient intakes were calculated based on the Chinese Food Composition Table. To control for changes in age-sex structure over time, data were weighted using direct standardization (with the 2023 age-sex distribution as the standard population). Macronutrient energy contributions were adjusted using the energy residual method. Linear regression models analyzed long-term trends in major food groups and macronutrient energy contribution ratios, estimating annual change values (β) and their 95% confidence intervals (95% CI). Interaction terms were introduced to test for trend differences across urban/rural areas, gender, and age groups. The models were adjusted for education level, smoking history, and drinking history.

A total of 8 596 adult residents aged 35 years and older in Guizhou Province were surveyed. Between 1991 and 2023, residents’ intake of vegetable oils and animal-based foods increased, while intake of animal fats and cereals/tubers decreased (P<0.001). The carbohydrate energy contribution decreased from 66.3% to 43.7% (β=-0.644, 95% CI: -0.681～-0.608), while the energy contribution from fats increased from 22.8% to 46.6% (β=0.669, 95% CI: 0.630～0.707). The energy contribution from proteins remained relatively stable (β=-0.024, 95% CI: -0.032～-0.017). Interaction analysis revealed that the rate of increase in fat energy contribution was significantly faster among rural residents than among urban residents (β=0.613, 95% CI: 0.545-0.682). Additionally, rural residents exhibited faster growth in plant oil and animal-based food intake, along with a more pronounced decline in cereal and tuber consumption (all P<0.001). Compared with adults aged 60 years and older, the 35-44 and 45-59 age cohorts exhibited more pronounced trends of increasing fat intake and decreasing carbohydrate intake (P<0.01).

From 1991 to 2023, the dietary patterns of adults aged 35 and older in Guizhou Province underwent a rapid shift from a traditional high-carbohydrate model to a high-fat model, with the fat energy contribution ratio far exceeding the upper limit recommended by dietary guidelines. The pace of this transformation exhibited significant population heterogeneity, with rural residents and middle-aged and young adults experiencing more rapid changes. This suggests that future nutrition intervention measures require greater targeting.

To analyze the spatiotemporal trends in the global disease burden of breast cancer attributable to excessive red meat intake from 1990 to 2021, explore the causal relationship between red meat consumption and breast cancer, and provide a scientific basis for nutritional interventions in breast cancer.

Based on data from the Global Burden of Disease (GBD) study, mortality and disability-adjusted life years (DALYs) were used as evaluation indicators. Joinpoint regression and age-period-cohort models were employed to analyze trends and effects. Mendelian randomization (MR) was utilized to infer the causal association between red meat consumption and breast cancer.

The disease burden exhibited a distribution pattern characterized by “low in Africa and Asia, and medium-to-high in Europe, the Americas, and Oceania”. From 1990 to 2021, the age-standardized mortality rate and DALY rate decreased by 19.22% and 14.87%, respectively, with a slight increase observed after 2015. Between 2019 and 2021, indicators in both males and females showed a short-term increase. The average annual percentage changes in mortality and DALYs were -0.717% and -0.536%, respectively. The decline in mortality was slightly greater in females than in males, while the decline in DALYs was greater in males. The peak disease burden occurred in the 47.5-52.5 years age group, with a resurgence of risk observed in the 1992 birth cohort. MR analysis confirmed a causal relationship between high beef intake and breast cancer (univariate IVW OR=1.511; multivariable IVW OR=3.390), while no definitive association was found for pork or lamb.

The global disease burden of breast cancer attributable to excessive red meat intake has generally declined, though spatial and gender differences exist, along with a recent resurgence. Excessive beef consumption is a potential risk factor for breast cancer. Differentiated nutritional intervention strategies should be developed, focusing on controlling excessive beef intake and monitoring red meat consumption trends in younger cohorts.

To investigate the association of calcium supplementation dosage and timing with blood pressure among pregnant women aged 30 years and older in Chengdu.

Pregnant women with singleton pregnancies aged ≥30 years who delivered at a hospital in Chengdu between January 2022 and December 2024 were enrolled. Baseline characteristics, calcium supplementation information, and blood pressure data during pregnancy were collected. Multiple linear regression models were employed to analyze the association between calcium supplementation and blood pressure. Dose-response analysis was conducted within the supplementation group, and sensitivity analysis was performed using the magnitude of blood pressure increase during pregnancy as the outcome.

A total of 796 pregnant women with singleton pregnancies aged ≥30 years were included, with a median age of 32 years, and 46% received calcium supplementation during pregnancy. After adjusting for confounding factors, the calcium supplementation group showed a mean reduction of 4.29 mmHg (P<0.001) in systolic blood pressure (SBP) and 3.82 mmHg (P=0.048) in diastolic blood pressure (DBP) compared to the non-supplementation group. For every 100 mg/d increase in calcium intake, SBP decreased by 0.45 mmHg (P=0.016) and DBP decreased by 0.27 mmHg (P=0.009). Stratified analysis revealed that the most significant blood pressure-lowering effect occurred in those who initiated supplementation pre-pregnancy (SBP: β=-4.71, P<0.001; DBP: β=-4.32, P=0.031). Calcium supplementation was associated with a reduction in SBP among the 30-34 age group (β=-5.02, P<0.001), while no statistically significant difference was observed in the ≥35 age group. Furthermore, sensitivity analysis demonstrated that the magnitude of increase in SBP and DBP during pregnancy was reduced by an average of 1.09 mmHg (P=0.040) and 0.63 mmHg (P=0.037), respectively, in the supplementation group compared to the non-supplementation group.

Calcium supplementation during pregnancy is significantly associated with lower blood pressure levels among pregnant women aged ≥30 years, demonstrating a clear dose-response relationship. The blood pressure-lowering effect is more pronounced with earlier initiation of supplementation, particularly in the population aged 30-34 years.

The aim was to analyze the incidence, birth, and intervention status of fetal complex congenital heart defects (CCHDs) in Guangxi Zhuang Autonomous Region (Guangxi), providing a basis for preventing and controlling CCHDs.

Based on data from the Guangxi Birth Defects Surveillance Network (2017—2022), all fetuses and perinatal infants delivered in maternity care institutions were included. CCHDs were diagnosed according to ICD-10 standards and provincial guidelines. The incidence rate (overall, <28 weeks, and ≥28 weeks), birth rate, and intervention rate for CCHDs were calculated. Python 3.12 was utilized to perform trend tests, intergroup comparisons, and risk ratio (RR) analyses.

Between 2017 and 2022, the overall incidence rate of fetal CCHDs was 10.21 per 10 000. The incidence rate for fetuses <28 weeks of gestation (8.50 per 10 000) was significantly higher than that for fetuses ≥28 weeks (1.72 per 10 000). The birth rate was 0.79 per 10 000. Between 2017 and 2022, the overall incidence and the incidence in the <28 weeks group showed a significant increasing trend (β>0, P<0.001), while the incidence in the ≥28 weeks group showed a significant decreasing trend (β=-0.075, P<0.001). The overall incidence was significantly higher in male fetuses (11.49 per 10 000) than in females (8.04 per 10 000) (RR=1.428). The incidence was significantly higher among mothers aged ≥35 years compared to the appropriate-age group (P<0.001). The overall intervention rate for CCHDs was 88.43%. The intervention rate was significantly higher in the <28 weeks group (97.47%) than in the ≥28 weeks group (43.55%). The top 10 most frequent CCHDs subtypes were complete atrioventricular septal defect, tetralogy of Fallot, single ventricle, double outlet right ventricle, complete transposition of the great arteries, pulmonary atresia, persistent truncus arteriosus, hypoplastic left heart syndrome, coarctation of the aorta, and hypoplastic right heart syndrome.

The incidence of fetal CCHDs in Guangxi has shown an increasing trend, and male fetuses and older pregnant women were identified as high-risk groups. Although early intervention (<28 weeks) was highly effective, the rate of intervention at ≥28 weeks was insufficient, suggesting a need to optimize the diagnosis and management pathway during late pregnancy.

To systematically analyze key barriers and facilitators to the implementation of community-based atrial fibrillation (AF) screening using the consolidated framework for implementation research (CFIR), thereby informing the optimization of implementation strategies for community-based AF screening in primary care.

From September to December 2024, purposive sampling was used to recruit 26 healthcare workers from Yuexiu District, Guangzhou, including 24 primary healthcare workers and 2 cardiologists from tertiary hospitals, for semi-structured interviews. A hybrid analytical strategy was adopted, combining CFIR-guided directed content analysis with frequency counts of CFIR constructs and their subdimensions, distinguishing barrier and facilitator attributes. The top 10 most frequently mentioned factors were identified separately among barriers and facilitators as key determinants of community AF screening implementation.

The barriers to implementing community-based AF screening were primarily identified at the individual level (5 factors) and in the inner setting (3 factors). The top 3 most frequently cited barriers were: insufficient primary care workforce, inadequate AF-related knowledge among primary care providers and residents’ low preference for community-based healthcare services. The facilitators primarily emerged in the inner setting (5 factors). The top 3 most frequently cited facilitators were: performance-linked incentives for screening teams, enhanced diagnostic and treatment capacity and confidence in AF management through support from tertiary hospitals, and clear delineation of responsibilities within screening teams.

The successful implementation of community AF screening is influenced by multiple factors. Implementation strategies should be developed based on the local context and targeted at key influencing factors.

To evaluate the effect of reporting immunization information by smartphone in border areas.

A total of five townships in Tengchong City, a border area of Yunnan Province, were randomly selected as project areas. All the village clinics in the project areas changed the previous computer reporting mode and used smartphones to report immunization information. Six months after the implementation of the project, the quality of information reporting and vaccination coverage rate of immunization program were compared before and after the implementation, and the satisfaction of information reporting staff was investigated.

After six months of using smartphones to report immunization information, the complete rate of children’s information reporting increased by 6.26%, the timely rate of vaccine information reporting increased by 74.59%, the complete rate of vaccine information reporting increased by 85.23%, the accuracy rate of vaccine information reports calculated on a per-child basis increased by 22.67%, the overall coverage rate of immunization program vaccines increased by 8.30%, and the vaccination coverage rates of PV4, DT, MCV2, and MenAC2 all increased, with only the HepB2 vaccination coverage rate decreasing. The satisfaction rate of information reporters towards using smartphones to report immunization information was 92.16%.

It is possible to use smartphones to report immunization information in border areas. The use of smartphones to report immunization information in village clinics with small vaccination volumes, lack of wired broadband or computers, and low computer operation skills of personnel, as well as temporary vaccination units and household vaccination, has certain applicability.

To conduct a quantitative analysis of national level suicide prevention policies and provide reference recommendations for refining and optimizing such policies.

Policies issued at the national level from January 2000 to December 2024 were retrieved from government websites, including those of the State Council, the National Health Commission, the Ministry of Education, and the Ministry of Civil Affairs, and analyzed using content analysis.

A total of 49 policy documents were included. In the X dimension, supply-oriented, environmental, and demand-oriented policy tools accounted for 37.9%, 53.9%, and 8.2%, respectively. On the Y-dimension, implementing entities were predominantly government departments (34.59%), followed by medical and mental health institutions (32.33%), social organizations (13.53%), media platforms (9.77%), and schools (9.77%). The Z-dimension policy intensity scored an average of 2.04 points.

China’s suicide prevention policies exhibit structural imbalances in tool composition (dominated by environmental and supply-side measures with weak demand-side support), uneven distribution of implementing entities, and insufficient policy intensity. Recommendations include optimizing the policy tool mix, improving coordination mechanisms among implementing entities, and elevating both the policy level and implementation intensity to provide stronger institutional support for related work.

To analyze the current status and efficiency optimization pathways of mental health resource allocation in Province S and to provide empirical evidence for optimizing provincial resource allocation and improving resource utilization efficiency.

Based on mental health resource data from 16 prefecture-level cities in Province S in 2024, this study employed Data Envelopment Analysis (DEA) to evaluate the efficiency of resource allocation and used Fuzzy-set Qualitative Comparative Analysis (fsQCA) to identify configurational conditions associated with different efficiency levels.

Mental health resources in Province S have exhibited rapid growth but remain unevenly distributed overall. Among the 16 prefecture-level cities in Province S, only four cities, namely JN, DY, WF, and WH achieved strong DEA efficiency, with an average overall efficiency score of 0.829. Three high-efficiency configurational pathways were identified, namely the economic support-oriented, service-driven, and resource integration-oriented types, with an overall consistency of 0.808. In addition, one low-efficiency pathway, characterized by input imbalance, was identified, with an overall consistency of 0.907.

The overall efficiency of mental health resource allocation in Province S still has considerable room for improvement. Prefecture-level cities can optimize the layout and supply patterns of mental health resources according to their specific configurational characteristics and local conditions, and explore context-specific pathways to enhance the overall performance of the provincial mental health service system.

To examine the association between social activity participation and incident cognitive impairment (CI) and to quantify the delay in onset among middle-aged and older adults in China.

Using five waves of longitudinal data from the China Health and Retirement Longitudinal Study (2011—2020), 9 245 participants without baseline CI were included in the study. A multi-state Markov model was constructed, and Cox models were used to estimate the association between social activity frequency and CI occurrence. Discrete-time Markov multi-state models and cumulative transition risks were utilized to compare the onset time differences between high and low social participation scenarios.

Each 1 SD increase in social activity frequency was associated with a 10.36% lower risk of CI (HR=0.896, 95% CI: 0.864-0.928). Compared with low participation, high participation delayed the first CI occurrence by 0.81 years (95% CI: 0.64-1.13 years). Stratified analysis showed that males, those aged <65 years, those with higher education levels, urban residents, and those without chronic diseases were associated with longer delays in onset; whereas among females, those with higher education levels, and those with chronic diseases, the delay benefit of more frequent social participation was more pronounced.

Higher social participation is associated with both a lower CI risk and a later onset, with particularly notable delay among older adults with chronic conditions. Integrating social participation with chronic disease management may be a useful public-health strategy to prevent cognitive impairment among middle-aged and older adults in China.