To analyze the status quo and influencing factors of condom use in MSM population, and to provide reference for the formulation of intervention strategies.

From August to October 2022, a questionnaire survey was conducted among 281 MSM in Chengdu, Sichuan Province, including social demographic information, AIDS-related services, behavioral and psychological status. The random forest algorithm was used to reduce and screen the influencing factors of condom use, and then SHAP analysis was used to explain the random forest model after variable screening.

The rate of consistent condom use among MSM in the past 6 months was 65.5 %. When the number of variables after dimensionality reduction was 7, the random forest model had the best performance (AUC: 0.834). The results of SHAP analysis showed that the mean value of the importance of variables and the absolute value of SHAP were the score of condoms use self-efficacy (0.079 0), the score of AIDS-related discrimination (0.051 3), whether there was heterosexual behavior (0.029 9), living conditions (0.011 4), the way to find homosexual partners in the last six months (0.007 8), occupation (0.004 8) and sexual role (0.002 6). MSM who had low condom use self-efficacy scores, high AIDS-related discrimination scores, had heterosexual sex, and had contact with same-sex partners at home had poor condom use adherence, while MSM who lived alone, were students, and had both sex roles had better condom use adherence.

Improving the condom use self-efficacy of MSM, reducing HIV-related discrimination, focusing on and intervening in MSM with heterosexual partners, and MSM who often contact with homosexual partners at home may help to improve the condom use rate of MSM.

To construct and validate a scientific evaluation tool to measure the level of comprehensive competencies such as public health professional competencies, managerial competencies, and basic competencies of public health personnel in northeastern China disease prevention and control agencies.

The literature research method combined with the expert consultation method was used to establish the comprehensive competence question items, collectingdata through the questionnaire survey method for exploratory factor analysis, to complete the construction of the dimensional module of the evaluation tool and the division of its belonging to the measurement items, and to fit the structural model of the measurement tool by using the validation factor analysis. The reliability and validity of the measurement tool should be tested to form a comprehensive competence measurement tool for public health personnel.

A comprehensive competency evaluation index system for public health personnel of disease prevention and control institutions was finally formed, which included 25 items in three dimensions, namely, public health professional competency, management competency, and basic competency. The cumulative variance contribution rate was 70.97%, the model fit index was good (RMSEA=0.058, CFI=0.968, NFI=0.968), the Cronbach α for the scale was 0.864, and Cronbach α for the dimensions was 0.963, 0.961, and 0.959, respectively, with CR values of 0.945, 0.930, and 0.818, which has good reliability and validity.

The three dimensions of the scale constructed in the study objectively and scientifically evaluated the core competence of basic public health service personnel in primary healthcare institutions, providing a reference basis for rationally setting up the corresponding assessment indicators and training contents, and then enhancing the synthesis and competence of CDC public health personnel.

To understand the public’s intention on the scope of granting prescribing rights to public health physicians, to provide reference opinions on the pilot work in progress in China, and to provide scientific basis and support for further exploring the policy formulation and promotion of granting prescribing rights to public health physicians in the province.

Using snowball method to conduct this survey, combined with personal interview method to collect the suggestions of different occupational groups in Sichuan province on the different scope of practice of public health doctors.

A total of 1 706 valid questionnaires were collected in this study. The results showed that 89.45% of the respondents supported giving public health doctors the right to prescribe, 76.85%-83.06% of the respondents suggested that public health doctors’ right to prescribe diseases such as infectious diseases, chronic diseases, occupational diseases, parasites and endemic diseases be completely lifted. 90.97% of the respondents believed that public health doctors should be allowed to prescribe non-drug interventions to patients with chronic diseases and people at risk of chronic diseases.

Based on the existing pilot programme, the subsequent scope of practice of public health physicians’ prescriptive authority should be further improved, and consideration should be given to the gradual trial implementation of prescriptive authority for non-pharmacological interventions, so as to give full play to the functional advantages of public health physicians as prevention-oriented physicians, and at the same time the mechanism for the training, development and assessment of public health physicians should be strengthened, in order to provide the grass-roots level with a high-quality team of public health physicians.

To analyze the disease burden trends of stroke and its subtypes in China.

Using data from the Global Burden of Disease Study, descriptive statistical analysis and Joinpoint regression models were employed to examine trends from 1990 to 2021, while the Bayesian age-period-cohort (BAPC) model was applied to predict disease burden up to 2036.

From 1990 to 2021, the number of stroke cases in China increased by 142.65%, yet the standardized incidence rate decreased by 9.78%, and the mortality rate dropped by 43.01%. Subtype analysis revealed a significant increase of 35.72% in the incidence of ischemic stroke, while the mortality rate from subarachnoid hemorrhage declined by 82.70%. In 2021, the male-to-female ratio of incidence rose to 1.73, and the decrease in the Disability-Adjusted Life Years (DALYs) rate was 16 percentage points higher for women than for men, indicating a widening gender disparity compared to 1990. The age distribution exhibited a bimodal pattern, with the highest incidence rate observed in the 75-79 age group (2 005.45 per 100 000), and the largest decrease in standardized DALYs occurred in the 55-59 age group, increasing by 57.61% compared to 1990. Attributable risk analysis showed that high systolic blood pressure remains the primary risk factor, with a standardized mortality rate of 77.73 per 100 000. However, deaths associated with low physical activity have surged by 222.54% in the past two decades. By 2036, it is predicted that the standardized incidence of stroke among women will increase by 5.26% compared to 2021, while the mortality rate among men will decrease by 16.69%, further exacerbating gender disparities.

While China has achieved progress in stroke prevention, challenges persist due to population aging and evolving risk factors. Targeted interventions addressing the rise of ischemic stroke, younger-onset cases, and gender disparities are urgently needed, alongside enhanced air pollution control, metabolic syndrome management, and regionalized tertiary prevention networks.

To explore the metabolic characteristics and potential biomarkers of vitamin D deficiency in children and adolescents, and to provide a basis for early identification and prevention of vitamin D deficiency.

Sixty pairs of children and adolescents with vitamin D deficiency and normal levels (matched by age and gender) from the nutrition and health monitoring project of rural school-age children in Guangzhou from March to May 2023 were selected as the research subjects. Based on the determination of serum 25(OH)D and serum untargeted metabolomics, differentially expressed metabolites (set threshold: FC value >1.25 or <0.8, VIP value >1) were screened, and metabolic pathways were analyzed. Logistic regression was applied to screen potential biomarkers, and ROC curves were drawn to evaluate their accuracy.

56 differentially expressed metabolites (38 up-regulated and 18 down-regulated) were identified. The analysis of metabolic pathways showed that the steroid hormone biosynthesis pathway was statistically significant(P=0.001, Q_FDR=0.0982). Logistic regression analysis results showed that 12 potential biomarkers such as 7,8-epoxy-4Z,10Z,13Z,16Z,19Z-(OR=1.95, 95% CI: 1.20-3.17) had statistical significance in the association with vitamin D deficiency, and the AUC in the training set was 0.922(95% CI: 0.865-0.978), and in the test set was 0.910 (95% CI: 0.809-1), with high accuracy.

This study revealed the metabolic pathways related to vitamin D deficiency in children and adolescents and identified 12 potential biomarkers, providing a basis for clarifying the metabolic characteristics and carrying out early identification of vitamin D deficiency.

To describe the trends in treatment and diagnosis delays for tuberculosis patients in Xizang from 2014 to 2023 and to explore the influencing factors, providing a scientific basis for tuberculosis prevention and control in Xizang.

Tuberculosis patients diagnosed between 2014 and 2023 in Xizang were selected from the “Tuberculosis Management Information System” sub-system of the “China Disease Prevention and Control Information System”. The factors influencing treatment and diagnosis delays were analyzed using univariate χ² tests and multivariate logistic regression analysis.

Among the 34 469 reported tuberculosis patients in Xizang from 2014 to 2023, the median (interquartile range) time from symptom onset to first consultation (treatment delay) was 24 (10, 46) days, with a treatment delay rate of 67.5%; the median (interquartile range) time from first consultation to diagnosis (diagnosis delay) was 0 (0, 1) days, with a diagnosis delay rate of 7.6%. The treatment delay rate showed a downward trend from 2014 to 2023 (trend χ²=1 798.083, P<0.001), while the diagnosis delay rate exhibited an upward trend (trend χ²=197.689, P<0.001). Multivariate logistic regression analysis indicated that being aged ≤20 years, 21-40 years, having local residency, undergoing health examinations, lacking microbiological results, and the first consultation being in Lhasa, Linzhi, Naqu, or Ali regions were protective factors for treatment delay.Seeking treatment based on symptoms, referrals, being a farmer or herdsman, being a child or student, and the first consultation being in Shigatse or Changdu were risk factors for treatment delay. Recommendations based on symptoms and first consultation in Shigatse, Changdu, or Naqu were protective factors for diagnosis delay. Local residency and first consultation in Lhasa were risk factors for diagnosis delay.

There is a serious delay in treatment among tuberculosis patients in Xizang, while the level of diagnosis delay is relatively low. It is recommended to enhance tuberculosis awareness and education among key populations and improve the diagnostic and treatment capabilities of grassroots medical institutions to reduce delays in treatment and diagnosis for tuberculosis patients.

To explore the reciprocal predictive relationship between adolescent peer relationships and depression and anxiety, providing a basis for the implementation of mental health education for adolescents.

A longitudinal survey was conducted using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) among 3 840 students in grades 1-8 in Chengdu, Sichuan Province, over four waves spanning three years. The Random Intercept Cross-Lagged Panel Model (RI-CLPM) was employed to investigate the bidirectional relationships between peer relationships and depression and anxiety.

Among the participants, there were 1 877 boys, accounting for 48.9%. The age distribution was as follows: 1 100 individuals aged 6 to 8 years (28.7%), 1 768 individuals aged 9 to 11 years (46.1%), and 965 individuals aged 12 to 16 years (25.2%). In terms of grade distribution, there were 1 400 students in grades 1 to 3 (36.5%), 1 702 students in grades 4 to 6 (44.3%), and 738 students in grades 7 to 8 (19.2%). The results of the cross-lagged model indicated a significant negative correlation between peer relationships and depression and anxiety at the individual level (β=-0.71, P<0.001; β=-0.45, P<0.001). At the individual level, peer relationships at the previous time point significantly negatively predicted depression and anxiety at the subsequent time point, except for the fourth wave. Additionally, depression and anxiety at the previous time point significantly negatively predicted peer relationships at all follow-up time points.

This study reveals a complex bidirectional predictive relationship between adolescent peer relationships and depression and anxiety, offering theoretical insights and practical significance for adolescent mental health care and preventive interventions.

To analyze the degree of coupling and coordination between child health care services and pediatric medical resource allocation in Guangdong Province from 2012 to 2020, providing a reference for promoting the coordinated development.

Data on relevant indicators of child health care services and pediatric medical resource allocation from 2012 to 2020 were selected. A comprehensive evaluation was conducted using a comprehensive development index and relative development degree. The coupling coordination model was employed to analyze the coupling coordination between the two systems. Cold and hot spot analysis was utilized to explore the spatial and temporal clustering characteristics of the two systems.

There were significant regional differences in the development levels of child health care services and pediatric medical resources in Guangdong Province from 2012 to 2020, with the relative development degree consistently exceeding 1.2, indicating a lagging configuration of pediatric medical resource allocation. The coupling coordination type transitioned from a severely unbalanced and declining state to a barely coordinated state. Hotspot analysis revealed that from 2012 to 2020, the hotspot areas for the coupling coordination degree of the two systems included Guangzhou, Dongguan, and Shenzhen, with the clustering effect gradually strengthening and expanding southward.

It is essential to enhance the precision of pediatric resource allocation and reduce the disparities in development levels among regions. A macro perspective on the overall structure of child health care services should be adopted to achieve coordinated development between child health care services and pediatric medical resource allocation.

To investigate the mediating effect of prefrontal cortex volume in the association between long-term exposure to air pollution and the incidence of Type 2 Diabetes (T2DM), providing a basis for alleviating the burden and understanding the etiology of T2DM.

Utilizing data from the UK Biobank cohort, we analyzed the relationships among four air pollutants, eight prefrontal cortex volumes, and T2DM using multiple linear regression and logistic regression models. A multiple mediation analysis was conducted to estimate the overall mediating effect of the eight prefrontal cortex volumes.

A total of 26 624 participants were included in the study, with a T2DM incidence rate of approximately 2.0%. There was an overall negative correlation between air pollutant concentrations and prefrontal cortex volume. Increased concentrations of air pollutants were associated with a higher risk of T2DM; specifically, for every 1 standard deviation increase in PM_2.5 concentration, the odds ratio (OR) (95% confidence interval [CI]) was 1.062 (1.003-1.159). Decreased volumes of the right medial prefrontal cortex, left superior frontal gyrus, bilateral orbital frontal cortex, and right frontal pole were associated with increased T2DM risk, with OR (95%CI) values of 0.869 (0.755-0.949), 0.808(0.745-0.925), 0.897 (0.815-0.988), 0.823 (0.738-0.917), and 0.881 (0.796-0.974), respectively. The volume of the prefrontal cortex mediated the association between the four air pollutants and T2DM risk.

The study indicates that increased air pollutant concentrations elevate the risk of T2DM, and prefrontal cortex volume may serve as a significant mediating factor in the relationship between air pollution and T2DM. Reducing exposure to air pollutants and targeted interventions addressing factors affecting brain vitality, such as sleep and exercise, may effectively prevent the occurrence and progression of T2DM.

To analyze the impact of the implementation of high-quality development policies for public hospitals on the structure of medical expenses in public hospitals in Shanghai, providing a reference for controlling medical costs.

The structural change method was employed to analyze the changes in inpatient expense structures in various levels of public hospitals in a district of Shanghai from October 2019 to October 2023. A segmented time series analysis was conducted to examine the structural levels and trend changes in inpatient expenses before and after the policy implementation.

Following the implementation of the high-quality development policies, the proportion of drug costs and medical service fees in secondary and tertiary hospitals showed a decreasing trend, while the proportion of health materials costs increased. Conversely, in traditional Chinese medicine hospitals, the proportion of health materials costs and medical service fees decreased, while the proportion of drug costs increased. The inpatient expenses in tertiary hospitals, secondary hospitals, and traditional Chinese medicine hospitals decreased by 37.8%, 3.4%, and 9.4%,respectively.

The implementation of high-quality development policies for public hospitals has reduced inpatient expenses across various levels of hospitals in Shanghai; however, it does not impact the long-term effects on inpatient costs. There is a need for long-term monitoring of expense structures, scientific and reasonable calculations of medical service project costs, and the establishment of a more rational fiscal compensation mechanism to promote the high-quality development of public hospitals.