To examine the longitudinal association between informal caregiving and cognitive function among middle-aged and older Chinese adults, and to explore its heterogeneity.

Using five waves of longitudinal data (2011-2020) from the China Health and Retirement Longitudinal Study (CHARLS), this study included 4 841 adults aged 45 and above. Linear mixed-effects models were employed to analyze associations of informal caregiving and caregiving intensity with cognitive function, and investigated caregiving roles in relation to cognition, stratified by marital or cohabitation status.

Compared to non-caregivers, caregivers demonstrated better performance in global cognition (β=0.039, 95% CI:0.001-0.076, P=0.043) and executive function (β=0.040, 95% CI:0.003-0.078, P=0.037). High-intensity caregiving was positively associated with global cognition (β=0.101, 95% CI:0.039-0.164, P=0.001), episodic memory (β=0.076, 95% CI: 0.014-0.138, P=0.016), and executive function (β=0.101, 95% CI:0.039-0.164, P=0.001). Moderate-intensity caregiving was associated with higher episodic memory scores (β=0.123, 95% CI: 0.002-0.244, P=0.047). Spousal caregivers had lower levels of global cognition (β=0.196, 95% CI: 0.351-0.040, P=0.014), whereas grandparent caregivers who were separated, divorced, or widowed showed superior episodic memory (β=0.163, 95% CI:0.013-0.314, P=0.033).

The impact of informal caregiving on cognitive function in middle-aged and older adults varies significantly based on the caregiving role, intensity, and sociodemographic characteristics. Future policies should provide differentiated support for various caregiver groups to optimize their health outcomes.

To investigate the association between the Lifestyle Oxidative Balance Score (Lifestyle-OBS) and the risk of developing obstructive sleep apnea syndrome (OSAS), and to provide evidence for lifestyle interventions targeting OSAS.

Adults aged 20 years and older from four survey cycles of the National Health and Nutrition Examination Survey (NHANES) 2005-2008 and 2015-2018 were included. Lifestyle-OBS was calculated based on physical activity, body mass index (BMI), smoking, and drinking behaviors. Weighted logistic regression models analyzed the association between lifestyle OBS and OSAS risk, with dose-response relationships assessed using restricted cubic splines. Subgroup analyses were conducted concurrently.

A total of 5 368 individuals were included, among whom 3 601(67.09%) had OSAS. Weighted logistic regression analysis revealed that after adjusting for covariates, elevated Lifestyle-OBS was significantly negatively associated with the risk of OSAS (OR=0.801, 95% CI: 0.758-0.847). When Lifestyle-OBS was divided into four quartiles, the Q4 group had a reduced risk of OSAS compared with the Q1 group (OR =0.383, 95% CI: 0.288-0.510). Restricted cubic spline analysis revealed a linear negative-response association between Lifestyle-OBS and OSAS risk (P_{for nonlinearity}=0.351). Subgroup analysis revealed significant interactions between Lifestyle-OBS and OSAS risk in age, hypertension, and cardiovascular disease subgroups. The association between Lifestyle-OBS and OSAS was stronger in younger and middle-aged individuals without hypertension or cardiovascular disease.

Higher Lifestyle-OBS is associated with a reduced risk of OSAS.

To establish a method for the simultaneous determination of glyphosate and its metabolite aminomethylphosphonic acid in human urine by ion chromatography-tandem mass spectrometry(IC-MS/MS).

The urine sample was purified using an HLB solid-phase extraction cartridge. After diluted and filtered, the filtrate was used for analysis. Gradient elution was performed using a potassium hydroxide solution as the mobile phase, with separation on an Ionpac AS20 anion exchange column(250 mm×2 mm). Detection was carried out using electrospray ionization in negative ion mode with multiple reaction monitoring, and quantification was achieved via the external standard method.

Glyphosate and aminomethylphosphonic acid showed good linear relationships within the ranges of 0.5-50 μg/L and 4-100 μg/L, respectively, with correlation coefficients greater than 0.999. The method detection limits were 0.8 μg/L and 3.6 μg/L, respectively. The recovery rates of the method were 83.0% to 115.2%. The intra-day and inter-day relative standard deviations(RSDs) ranged from 1.2% to 7.8% and 3.5% to 9.2%, respectively.

This method is reproducible and accurate, and it is suitable for biological monitoring of glyphosate and its metabolite aminomethylphosphonic acid in urine samples of occupational populations.

To analyze the long-term trends in the incidence and mortality of four rodent-borne notifiable infectious diseases (plague, HFRS, leptospirosis, and typhus) in China from 1950 to 2020, providing a basis for understanding the epidemiological patterns and scientific prevention and control of these diseases.

Data on the annual incidence and mortality of plague, HFRS, leptospirosis (data available since 1955), and typhus from 1950 to 2020 were collected from the Public Health Science Data Center. Joinpoint regression was used for trend analysis. Five indicators—number of cases, incidence rate, number of deaths, mortality rate, and case fatality rate—were used to evaluate trends in incidence and mortality.

Plague: From 1950 to 2020, a total of 8 409 cases and 2 761 deaths were reported, with an incidence rate of 1.64×10^-4 per 100 000 and a case fatality rate of 32.83%. The number of cases, deaths, and incidence rate showed an overall declining trend (APC<0, P<0.05), while the decline in case fatality rate (AAPC=-3.50%, 95% CI: -7.29% to 0.43%) was not statistically significant. After 2002, the annual number of reported cases fluctuated between 0 and 68 (APC<0, P<0.05), with case fatality rates ranging from 0% to 100%. HFRS: From 1950 to 2020, a total of 1 684 077 cases and 48 390 deaths were reported, with an average annual incidence rate of 2.34 per 100 000 and a case fatality rate of 2.87%. The number of cases, incidence rate, number of deaths, mortality rate, and case fatality rate initially fluctuated upward and then declined. The number of cases peaked in 1986 (115 807 cases) and then fluctuated downward (APC=-6.66%, 95% CI: -8.15% to -5.13%). From 2007 to 2020, the number of cases fluctuated between 8 121 and 13 308. The number of deaths dropped below 200 after 2006 and below 100 after 2013. The case fatality rate remained between 0.46% and 1.31% after 1995. Leptospirosis: From 1955 to 2020, a total of 2 523 008 cases and 27 730 deaths were reported, with an average annual incidence rate of 3.64 per 100 000 and a case fatality rate of 1.10%. The mortality rate showed an overall declining trend (APC=-8.71%, 95% CI: -13.54% to -3.62%), while the trends in the number of cases, deaths, incidence rate, and case fatality rate were not statistically significant (APC>0, P>0.05). After 1999, the number of cases dropped below 10 000, and after 2006, it dropped below 1 000. The number of deaths dropped below 1 000 after 1988, below 100 after 2002, and below 10 after 2011. The case fatality rate showed an initial decline followed by an increase, ranging from 0% to 3.96% after 2000. Typhus: From 1950 to 2020, a total of 450 080 cases and 7 327 deaths were reported, with an average annual incidence rate of 0.62 per 100 000 and a case fatality rate of 1.63%. The number of cases, deaths, mortality rate, and case fatality rate showed an overall declining trend (APC<0, P<0.05).

During 1950-2020, China made remarkable progress in controlling rodent-borne infectious diseases, with the incidence and mortality of the four notifiable diseases reduced to low levels; nevertheless, the prevention and control of these diseases remains a serious challenge.

To analyze the trends in the prevalence and disease burden of enteric infectious diseases among the population under 20 years old in China from 1990 to 2021, to identify the severity and key affected populations, and to provide a reference basis for formulating prevention and intervention policies.

Data were sourced from the Global Burden of Disease Study (GBD) 2021 database. The Joinpoint regression model was used to analyze the temporal trends in the incidence, mortality, and disability-adjusted life years (DALYs) rates of enteric infectious diseases among the population under 20 in China from 1990 to 2021. The age-period-cohort analysis method was employed to assess the effects of age, period, and birth cohort on the trends in the disease burden.

The incidence rate of enteric infectious diseases in the population under 20 in China decreased from 48 373.02 per 100 000 in 1990 to 8 811.07 per 100 000 in 2021. The mortality rate decreased from 17.55 per 100 000 in 1990 to 0.43 per 100 000 in 2021. The DALYs rate decreased from 1 643.60 per 100 000 in 1990 to 52.31 per 100 000 in 2021. Joinpoint regression analysis showed that from 1990 to 2021, the incidence rate decreased by an average of 5.34% annually (AAPC=-5.34%, 95% CI: -5.50% to -5.18%), the mortality rate decreased by an average of 11.34% annually (AAPC=-11.34%, 95% CI: -11.71% to -10.97%), and the DALYs rate decreased by an average of 10.56% annually (AAPC=-10.56%, 95% CI: -11.03% to -10.10%). Age-period-cohort model analysis revealed that the 0-4 age group had a higher disease burden, significantly exceeding other age groups. With the progression of time periods, the risks of incidence, mortality, and DALYs for enteric infectious diseases in the population under 20 continued to decline. Compared to earlier birth cohorts, later birth cohorts had lower risks of incidence, mortality, and DALYs.

From 1990 to 2021, the incidence, mortality, and DALYs rates of enteric infectious diseases among the population under 20 years old in China showed a significant downward trend. However, for enteric infectious diseases children under 5 remain the key population, and comprehensive prevention and control measures should be implemented to further reduce the disease burden for this age group.

To compare the spatial pattern evolution characteristics and the spatial heterogeneity of influencing factors of newly reported AIDS incidence in mainland China before (2015-2019) and after (2020-2023) the COVID-19 outbreak, and to provide a scientific basis for targeted prevention and control in response to similar crises in the future.

Based on newly reported AIDS incidence and socioeconomic data from 31 provincial-level administrative regions in mainland China (2015-2023), spatial autocorrelation, ordinary least squares (OLS), and multiscale geographically weighted regression (MGWR) were employed for analysis.

The incidence of newly reported AIDS showed an upward trend from 2015 to 2019, but began to decline after the outbreak of COVID-19. By 2022, the incidence dropped to 3.69 per 100 000 population, with a slight rebound in 2023. Both before and after the COVID-19 outbreak, the incidence of newly reported AIDS exhibited significant and strengthening spatial positive autocorrelation. Hotspots consistently concentrated in Yunnan, Guizhou, Sichuan, Chongqing, Guangxi, and Hunan, with Hainan and Guangdong emerging as new hotspots. Coldspots persistently clustered in Northeast and North China. Before the COVID-19 outbreak, the number of health technical personnel per 10 000 people had a promoting effect on the incidence in the Southwest region, but this effect shifted to a suppressive one after the outbreak. Urbanization rate exerted a negative influence globally but a positive influence locally. Other variables demonstrated bidirectional influences, with spatial heterogeneity persisting throughout the study period.

s The spatial evolution of newly reported AIDS incidence varied before and after the COVID-19 outbreak, but both periods exhibited significant spatial clustering, with socioeconomic factors demonstrating spatial heterogeneity in their influence. We propose formulating differentiated AIDS prevention and control strategies tailored to local conditions, with particular focus on hotspot areas, to implement precision interventions for effective AIDS incidence reduction.

To analyze the disease burden of lung cancer attributable to high fasting plasma glucose (HFPG) in China from 1990 to 2021 and its trends, and to predict the disease burden trends from 2022 to 2036, providing evidence for targeted prevention and control measures.

Using the Global Burden of Disease (GBD) 2021 data, Joinpoint regression was employed to analyze the trends in age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALYs) rate (ASDR) of lung cancer attributable to HFPG in China. An age-period-cohort (APC) model was used to assess age, period, and cohort effects, and R software was utilized to predict future disease burden trends.

From 1990 to 2021, the ASMR and ASDR of lung cancer attributable to HFPG in China showed an overall upward trend, with average annual percentage changes (AAPCs) of 1.28% and 1.05%, respectively (both P<0.001). The disease burden was generally higher in males than in females. With increasing age, it showed a trend of initial increase followed by a decrease, with the highest increase in mortality and DALY rates observed in the 80-84 age group. The net drift values for mortality and DALYs rate in the APC model were 0.90% (95% CI: 0.69%-1.11%) and 0.89% (95% CI: 0.69%-1.08%), respectively. The age effect indicated that mortality peaked in the 90-94 age group, while DALYs rate peaked in the 75-79 age group. The period effect showed that mortality and DALYs risks initially increased and then decreased over time. The cohort effect revealed an overall upward trend in mortality and DALYs risks with successive birth cohorts. It was projected that by 2036, the ASMR of lung cancer attributable to HFPG in China may decline to 0.74 and 0.50 per 100 000 for males and females, respectively, while the ASDR may decrease to 18.59 and 10.62 per 100 000.

From 1990 to 2021, the disease burden of lung cancer attributable to HFPG in China exhibits an overall upward trend, with higher burdens observed in males and older adults. Greater attention should be paid to middle-aged and elderly male populations, and more targeted prevention and intervention policies should be implemented.

To explore the relationship between AH and genetic susceptibility of BC, as well as the potential mediating mechanisms, given that epidemiological investigations have explored the association between autoimmune hyperthyroidism (AH) and the risk of developing breast cancer (BC) while the causality is controversial and the potential mediating pathways remain unclear due to confounding factors.

Two-sample Mendelian randomization (MR) was employed to investigate the causal relationship between AH and BC, with molecularly stratified analyses encompassing all receptor-defined subtypes (ER+BC, ER-BC, luminal A-like, luminal B-like, luminal B/HER2-negative-like, HER2-enriched-like, and TNBC). Additionally, the two-step Mendelian randomization (TSMR) method was used to investigate the mediating role of immune regulatory factors. Statistical inference primarily utilized inverse variance-weighted (IVW) estimators, complemented by pleiotropy-robust sensitivity validation protocols. Heterogeneity was evaluated using Cochran’s Q test. Pleiotropy was detected by combining the MR-Egger intercept term and the MR-PRESSO method to ensure the robustness and reliability of the research results.

Genetically predicted AH was causally associated with luminal B-like BC (OR=0.940, 95% CI: 0.900-0.983, P=6.05×10^-3), whereas AH was not observed to be causally associated with other subtypes of overall BC. The cathepsin Z (CTSZ) was determined to be a mediator of the association between AH and luminal B-like BC, with a mediation ratio of 11.494% (95% CI: 2.124%-43.623%).

This study suggests that AH increases the expression of CTSZ and thus reduces the genetic susceptibility to luminal B-like BC, and understanding this mechanism provides new insights for the development of BC prevention strategies and interventions.

To investigate the relationship between body mass index (BMI) and diminished ovarian reserve (DOR) in women from southwestern China, analyzing the correlation between BMI and ovarian reserve markers: anti-Müllerian hormone (AMH) and antral follicle count (AFC).

A 1:1 age-matched case-control study was conducted, enrolling 3 751 women with DOR and 3 751 women with normal ovarian reserve who sought assisted reproductive services at a tertiary hospital in Sichuan Province between January 2022 and August 2024. Conditional logistic regression analysis and restricted cubic spline models were employed to examine the association and dose-response relationship between BMI and DOR. Spearman correlation and multivariable linear regression analyses were applied to assess the relationships between BMI and AMH and AFC.

Conditional logistic regression analysis revealed a significant association between obesity (OR=1.394, 95% CI: 1.112-1.747) and DOR. After adjusting for ethnicity, occupation, marital status, education level, smoking, and alcohol consumption, obesity (OR=1.357, 95% CI: 1.065-1.730) remained a risk factor for DOR. No non-linear relationship was observed between BMI and DOR. Spearman correlation analysis showed that both AMH and AFC were negatively correlated with BMI (P<0.001). In multivariable linear regression analyses adjusting for confounders, BMI demonstrated a negative association with AMH (P<0.001), whereas no significant association was observed between BMI and AFC (P>0.05).

Obesity is a risk factor for diminished ovarian reserve. BMI is negatively associated with AMH but not significantly correlated with AFC.

This study aims to explore the relationship between serum vitamin B12 levels and the prevalence of chronic liver diseases in the older adults, and then provide clues for the prevention and treatment of chronic liver diseases.

This study was based on the data from the baseline of the West China Health and Aging Cohort Study from May 2022 to November 2023. A total of 4 563 subjects were included in the study. Multivariable logistic regression analysis and restricted cubic spline analysis were employed to explore the association between serum vitamin B12, liver steatosis or liver fibrosis, and chronic liver diseases.

Multivariable Logistic regression analysis showed that compared with the Q1 level of serum vitamin B12, the Q4 level of vitamin B12 would increase the risk of viral hepatitis (OR: 1.96, 95% CI: 1.23-3.19). Compared with the Q1 level, the Q4 level was positively correlated with liver stiffness measurement (LSM) level, and this positive correlation was strengthened with the increase of serum vitamin B12 level (OR: 1.55, 95% CI: 1.20-1.99). No significant correlation between serum vitamin B12 level and controlled attenuation parameter (CAP) value (P>0.05). In addition, linear correlations of serum vitamin B12 levels with both the hepatic steatosis group and the hepatic fibrosis group were found in this study.

This study found that an increase in serum vitamin B12 levels was associated with viral hepatitis in chronic liver diseases, and higher levels of serum vitamin B12 were also observed in patients with liver fibrosis, suggesting a possible complex relationship between vitamin B12 and liver diseases and providing new clues for further exploring the pathogenesis of liver disease.