To explore the influencing factors of two-week morbidity among hypertensive patients in Guizhou Province, and to compare the differences and complementarities between coincidence analysis (CNA) and logistic regression in identifying complex associations.

Data were obtained from the 2022 Guizhou Provincial Health Literacy Surveillance, and participants were individuals with self-reported hypertension. CNA and logistic regression were applied for statistical analysis.

A total of 1 344 hypertensive patients from 18 counties/districts were included, with a two-week morbidity rate of 36.09%. CNA identified four configurational pathways leading to high two-week morbidity: counties with higher proportions of ethnic minorities and higher obesity rates; counties with lower educational attainment and higher income or higher obesity rates; counties with higher educational attainment, lower smoking rates, but lower health literacy. The model had a consistency of 0.808, a coverage of 0.801, and a standardized robustness score of 0.75. Multivariable logistic regression showed that education below junior high school (OR=1.586, 95% CI: 1.216-2.068) and low health literacy (OR=1.762, 95% CI: 1.141-2.721) were risk factors for two-week morbidity among hypertensive patients.

From a multi-pathway perspective, this study shows that the risk of two-week morbidity among patients with hypertension in Guizhou is characterized by combinations of low educational attainment, low health literacy, high obesity prevalence, and ethnic minority concentration, providing evidence to inform county-level chronic disease management strategies in Guizhou and other resource-limited settings.

To explore the relationship between social support and family resilience in families of dementia patients, as well as its underlying mechanisms.

A questionnaire survey was conducted among 508 primary family caregivers of elderly dementia patients in Nanjing. Descriptive statistical analysis, regression analysis, and moderated mediation analysis were performed.

Social support had a significant positive impact on family resilience (β=0.351, P<0.01); Family cohesion partially mediated the relationship between social support and family resilience, with a mediation effect value of 0.527 (95% CI: 0.399-0.666), accounting for 60.04% of the total effect. The second half of the mediation pathway, through which social support influences family resilience via family cohesion, was moderated by psychological resilience (β=-0.017, P<0.01).

This study elucidates the relationship between social support and family resilience in families of dementia patients and its underlying mechanisms, providing a theoretical foundation and practical implications for enhancing family resilience in dementia care.

To compare the incident exposure design with the prevalent exposure design in cohort studies, to systematically evaluate the performance of different analytical methods within the incident exposure design framework, using the association between hypertension and cardiovascular disease as an example.

Based on the UK Biobank cohort, we selected an elderly population aged 60-65 years at baseline. Both prevalent exposure and incident exposure designs (time-window fixed grouping, time-zero random assignment, time-zero distribution matching, and time-dependent variable) were applied to assess the association between hypertension and incident cardiovascular disease.

Using the time-dependent variable as reference [hazard ratio (HR)=1.77, 95% confidence interval (CI): 1.68-1.88], the prevalent exposure design underestimated the effect size by 23% (HR=1.36) due to selection bias. The time-window fixed grouping introduced immortal time bias, leading to an 11% underestimation (HR=1.57). The time-zero random assignment and time-zero distribution matching, by defining a valid time-zero, partially controlled for bias, yielding HRs of 1.63 and 1.66, respectively. However, some degree of underestimation persisted.

The prevalent exposure design may systematically underestimate long-term disease risk. The event-based incident exposure design is recommended, particularly the time-dependent variable method which effectively controls for bias, to provide more reliable evidence for assessing the risk of incident cardiovascular disease associated with hypertension in elderly adults.

To compare the predictive performance of seasonal autoregressive integrated moving average (SARIMA) model, Prophet model, random forest (RF) model, extreme gradient boosting (XGBoost) model, and support vector regression (SVR) model on the incidence of other infectious diarrhea diseases in Baoshan District, Shanghai, and to explore the optimal forecasting model.

Using the monthly incidence rates of other infectious diarrhea diseases in Baoshan District, Shanghai from 2014 to 2022 as the training set, the SARIMA model, the Prophet model, the RF model with and without meteorological features, the XGBoost model with and without meteorological features, and the SVR model with and without meteorological features were constructed in Python to predict the monthly incidence rates from 2023 to 2024. The optimal model was selected by comparing the mean absolute error (MAE), root mean square error (RMSE) and mean absolute percentage error (MAPE) of the predicted and actual values.

From 2014 to 2024, a total of 6 868 cases of other infectious diarrheal diseases were reported in Baoshan District, Shanghai, with an average annual incidence rate of 28.81 per 100 000 population. The cases exhibited a bimodal seasonal distribution (peaking in summer and winter-spring). By comparing the predictive performance of different time series models on the monthly incidence rate from 2023 to 2024, the XGBoost model without meteorological features showed the best comprehensive performance in terms of fitting accuracy indicators (MAE=5.089, RMSE=6.844, MAPE=54.646%).

The XGBoost model without meteorological features is the best model for short-term prediction of other infectious diarrhea diseases in Baoshan District, which can provide a scientific basis for early warning and prevention of other infectious diarrhea diseases in Baoshan District.

To analyze the trend of mortality and life expectancy (LE) among people aged 60 years and above in China and globally from 1990 to 2021, to provide scientific evidence for improving the health of the aged.

Based on the GBD 2021 data, mortality rate, rank of causes of death, LE of the aged 60 years and above in China and globally were selected to compare the changes of each index from 1990 to 2019 and 2019 to 2021. The Joinpoint model was used to calculate the average annual percentage change (AAPC), and the ARIMA model was used to predict the mortality and LE of the aged.

Compared with 1990, the mortality rate of the aged in China and globally decreased significantly in 2019 (P<0.001), and the decline was greater in China. Compared with 2019, the mortality rate of the aged in the world increased in 2021, while it decreased slightly in China. The mortality rate of the older adults in the oldest age group in China was higher than that in the world. In terms of the ranking of causes of death, cardiovascular disease was always the first cause of death both in China and globally. Compared with 1990, the LE and health-adjusted life expectancy (HALE) of the aged in China and the world increased significantly in 2019(P<0.001). Compared with 2019, the LE and HALE of the aged in China increased in 2021, while the global values decreased. The LE of the older adults in the oldest age group in China was lower than that in the world. LE was higher in women than in men. The prediction showed that the LE of the aged in China would increase in the next 15 years, while the LE of the aged in the world would decline slightly.

The LE and HALE of the aged in China increased from 1990 to 2021, but decreased from 2019 to 2021 in the world. The health deficiencies, “unhealthy longevity”, and gender differences among the older adults in the oldest age group in China are prominent, and targeted, strengthened care and intervention are needed.

To analyze the epidemiological characteristics and spatiotemporal distribution of sexually transmitted infections (STIs) including HIV/AIDS, gonorrhea and syphilis in China from 2010 to 2020, providing scientific evidence for optimizing STIs prevention and control strategies.

Case data on STIs (HIV/AIDS, gonorrhea, syphilis) from 2010 to 2020 were extracted from the Public Health Data Center. Descriptive epidemiology, standard deviation ellipse, center of gravity migration modeling, and spatial autocorrelation analysis were employed to analyze epidemiological characteristics and spatial evolution patterns.

From 2010 to 2020, a cumulative total of 6 558 885 HIV/AIDS, gonorrhea and syphilis cases were reported across 31 provinces nationwide, with an average annual incidence rate of 43.55 per 100 000 population. Syphilis accounted for the highest proportion (73.68%), followed by gonorrhea (18.31%) and AIDS (8.01%). The incidence of AIDS continued to rise (1.20 → 4.43 per 100 000), syphilis fluctuated upward (26.86 → 33.08 per 100 000), while gonorrhea slightly decreased (7.91 → 7.49 per 100 000). Gonorrhea exhibited seasonal peaks in summer and autumn (July-October), whereas other STIs showed no distinct seasonal patterns. The primary high-risk group for AIDS was individuals aged 20 and above, while gonorrhea predominantly affected those aged 15-25. The high-risk group for syphilis shifted from infants and young children to individuals aged 85 and above. HIV/AIDS clustered in the southwest region and spread toward the northwest. Gonorrhea was prevalent in eastern regions (Zhejiang, Fujian) and southern China (Guangdong, Hainan). Syphilis originated in southern China (Guangdong, Guangxi Zhuang Autonomous Region) and spread toward the northwest (Qinghai, Xinjiang Uygur Autonomous Region). Global spatial autocorrelation analysis revealed significant positive spatial correlations between HIV/AIDS (except in 2010) and gonorrhea incidence, with increasing clustering intensity annually (Moran's I values: 0.08-0.36, P<0.05). Syphilis incidence primarily exhibited random distribution patterns (Moran's I values: 0.06-0.34, P>0.05). Standard deviation ellipses and center of gravity migration models revealed that the epidemic center was located at the junction of Sichuan, Chongqing, and Hunan provinces. From 2010 to 2020, the center first shifted northward and then southward, with the greatest displacement occurring in 2012 and 2019—2020.

STIs in China from 2010 to 2020 exhibited distinct spatio-temporal clustering. Given the substantial burden of sexually transmitted infections in China and the persistent southward shift of hotspots, differentiated interventions should be implemented in high-incidence areas and key populations across Southwest and South China. Strengthening cross-regional joint prevention and control mechanisms is imperative.

To use the adjusted Serfling regression model to estimate the excess epidemic periods and excess case numbers of hand, foot, and mouth disease in various age groups in Shenzhen from 2015 to 2024, providing a scientific basis for optimizing prevention and control strategies and conducting disease burden assessments.

Using the weekly incidence of hand, foot, and mouth disease in Shenzhen from 2015 to 2024, an adjusted Serfling regression model was established to estimate the baseline and epidemic threshold of the disease by age group, identify periods of excess epidemic, and calculate the number of excess cases.

From 2015 to 2024, a total of 642 903 cases of hand, foot, and mouth disease (HFMD) were reported in Shenzhen. The periods of excess incidence were predominantly concentrated between May and July. Across the entire population, these excess-incidence periods spanned a total of 89 weeks, with a weekly average of 1 422 excess cases, accounting for 35.11% of all reported cases. By age group, the weekly average numbers of excess cases were 802, 601, 261, and 131 for the 0-3 year, 3-6 year, 6-9 year, and >9 year groups, respectively. The corresponding proportions of excess cases relative to total cases in each group were 41.03%, 40.36%, 44.57%, and 46.03%, respectively. Furthermore, the 0-3 year age group consistently experienced an earlier onset of excess-incidence periods compared to other age groups, and both the duration of these periods and the average number of weekly excess cases were higher in this group than in all others.

The adjusted Serfling regression model provided a good fit for the incidence of hand, foot, and mouth disease in Shenzhen. Children under 6 years of age bore the highest disease burden, and implementing surveillance and early warning systems specifically targeting children aged 0-3 years could effectively shift the early warning threshold forward.

This study provides data support for the scientific prevention and control of bladder cancer in Gansu Province by analyzing the incidence status, trends, and predicting the incidence trend from 2022 to 2030 of bladder cancer in Gansu Province between 2010 and 2021.

By collecting regional tumor registration data from Gansu Province between 2010 and 2021, we included data meeting tumor data quality control requirements for analysis. Descriptive analyses were conducted by gender and urban-rural regions through calculation of incidence rates and related indicators. Trend analysis of bladder cancer incidence data in Gansu Province over the past 12 years was conducted using Joinpoint. The Bayesian age-period-cohort model analysis method was applied to predict the mortality trend of bladder cancer patients in Gansu Province from 2022 to 2030.

From 2010 to 2021, there were 3 245 new cases of bladder cancer in Gansu Province, with incidence rates, Chinese age-standardized incidence rate, and world-standard incidence rates being 4.88/10⁵, 3.38/10⁵, and 3.31/10⁵, respectively. The overall trend showed higher incidence rates in males than females, higher urban rates than rural areas, with statistically significant differences (all P values <0.05). Incidence rates increased with age, reaching a peak in the 80+ age group (81.96/10⁵). The cumulative rates for 0-64 years and 0-74 years were 0.17% and 0.39%, respectively, while the truncated rate for 35-64 years was 4.71/10⁵. From 2010 to 2021, the incidence of bladder cancer in Gansu Province increased by an average of 4.7% annually, with statistically significant trends (all P values <0.05). The annual percent change (APC=5.0%) was higher in males than females (APC=4.6%). Predictions indicate that the standardized incidence of bladder cancer in Gansu will rise from 2.96/10⁵ in 2021 to 3.50/10⁵ by 2030, with both gender-specific and urban-rural standardized incidence predictions showing upward trends.

From 2010 to 2021, the incidence of bladder cancer in Gansu Province showed an upward trend, and it is predicted that the incidence of bladder cancer will continue to increase from 2022 to 2030. Therefore, more attention should be paid to the impact of bladder cancer on population health, medical and health investment should be increased, and prevention and treatment efforts for elderly men with a high incidence of bladder cancer should be strengthened

To understand the distribution characteristics of cardiovascular disease (CVD) deaths among permanent residents in Hainan Province from 2018 to 2024, and to explore the relationship between socio-demographic characteristics, disease-related factors, regional factors, etc. and the place of death of CVD patients.

Using Hainan Province's cause-of-death data from the National Mortality Surveillance System, we described the distribution of CVD death places, and used univariate and multivariable logistic regression models to analyze the influencing factors of CVD deaths at home.

From 2018 to 2024, a total of 136 378 CVD deaths were collected, with 86.73% occurring at home and 9.38% occurring in medical and healthcare institutions. After adjusting for other factors, the analysis revealed that females (OR=1.07, 95% CI: 1.03-1.11) were more likely to die at home than males; the likelihood of dying at home grew gradually with age; compared to the Han ethnicity, the Li ethnicity (OR=1.64, 95% CI: 1.53-1.76) was more likely to die at home; compared to married individuals, widowed individuals (OR=1.46, 95% CI: 1.38-1.54) were more likely to die at home than unmarried (OR=0.49, 95% CI: 0.45-0.53) and divorced individuals (OR=0.51, 95% CI: 0.44-0.59); the higher the educational level, the lower the likelihood of dying at home; compared to workers, farmers (OR=2.79, 95% CI: 2.56-3.04) were more likely to die at home than individuals in other occupations; compared to rheumatic heart disease, hypertension and its complications (OR=1.29, 95% CI: 1.10-1.51) were more likely to die at home than other CVD subtypes; compared to the Eastern region, the Central region (OR=0.66, 95% CI: 0.63-0.70) and the Western region (OR=0.85, 95% CI: 0.82-0.89) were less likely to die at home.

The place of death for CVD among permanent residents in Hainan Province is mainly at home, and patients who are female, elderly, Li ethnicity, widowed, with low educational level, farmers, hypertension and its complications, and patients in the eastern region are more likely to die at home. Therefore, the specific conditions of CVD patients with different characteristics should be considered comprehensively to optimize the allocation of healthcare resources and improve clinical intervention and treatment capacity; meanwhile, a care model combining clinical care and community/home should be established to improve the quality of end-of-life care.

To investigate the association between trigyceride glucose index - body roundness index (TyG-BRI) and the risk of stroke in middle-aged and older adults using the CHARLS database.

This study conducted a longitudinal study using CHARLS data from 2011 to 2020. The TyG index was calculated from baseline fasting blood glucose and triglyceride levels. TyG-BRI was developed by integrating the TyG index with baseline waist circumference and height. Stroke was identified through follow-up questionnaires. After imputing missing data using MICE, we analyzed the data by stratifying TyG-BRI according to quartile levels and conducted Kaplan-Meier survival curve analysis. Meanwhile, a multivariable Cox proportional hazards regression model was used to assess the association between different TyG-BRI levels and the risk of stroke. Restricted cubic spline (RCS) analysis was employed to examine the dose-response relationship between TyG-BRI and the incidence of stroke. Finally, subgroup analyses and interaction tests were performed to explore the heterogeneity of the association between TyG-BRI and stroke among different populations.

A total of 7 709 individuals were included in the longitudinal study throughout the entire follow-up period, and 536 developed stroke. Both Cox regression and Kaplan-Meier analyses showed that higher TyG-BRI levels were associated with increased stroke risk. Using the first quartile (Q1) as reference, the fully adjusted model (Model 3) showed significantly elevated risks for Q2 (HR=1.39, 95% CI: 1.04-1.86), Q3 (HR=1.70, 95% CI: 1.28-2.27), and Q4 (HR=1.75, 95% CI: 1.28-2.40). RCS analysis revealed a linear relationship between TyG-BRI and stroke risk with an overall positive trend. Subgroup analyses did not identify any factors independently associated with stroke. Sensitivity analyses confirmed the robustness of these findings.

TyG-BRI shows potential as a useful indicator for early detection and prevention in stroke risk management.