To investigate the current status of knowledge, attitudes, and practices (KAP) and influencing factors of practices among Helicobacter pylori (H. pylori)-positive populations in rural China, and to provide a reference basis for adopting effective health education and health promotion strategies.

From October to December 2024, a multistage stratified cluster random sampling method was employed to select 168 administrative villages (neighborhood committees) from 27 rural counties across four provinces (Jiangsu, Anhui, Shandong, and Henan) as the study areas. All rural residents underwent H. pylori infection testing via the ¹³C-urea breath test, and a questionnaire survey was conducted among 16 144 individuals who were identified as H. pylori-positive. Cluster analysis and Logistic regression were utilized to assess the current status of knowledge, attitudes, and practices (KAP) and to identify behavioral influencing factors among the H. pylori-positive population.

The standardized scores for the knowledge, attitude, and practice dimensions among the H. pylori-positive population were (0.69±0.29), (0.91±0.15), and (0.73±0.15) points, respectively. K-means cluster analysis revealed that 27.99%, 5.49%, and 15.59% of the surveyed participants exhibited low levels in the knowledge, attitude, and practice dimensions, respectively. Based on knowledge and attitude levels, the population was categorized into four distinct characteristic groups: high knowledge-high attitude, low knowledge-high attitude, high knowledge-low attitude, and low knowledge-low attitude. The multivariate analysis results indicated that compared to the low knowledge-low attitude level group, the high knowledge-high attitude level group had a higher behavioral dimension level (OR=6.45, 95% CI: 5.45-6.83), followed by the low knowledge-high attitude level group (OR=2.48, 95% CI: 2.09-2.95). Compared to males, females had a higher behavioral dimension level (OR=1.46, 95% CI: 1.33-1.60). Compared to farmers, non-farmer occupational groups had a higher behavioral dimension level (OR=1.30, 95% CI: 1.18-1.44).

The H. pylori-positive population in rural areas demonstrates relatively positive attitudes but suboptimal knowledge and health practices. It is recommended to implement precise stratified intervention strategies tailored to different population characteristics. Emphasis should be placed on groups with low knowledge-low attitude and high knowledge-low attitude to enhance their cognitive levels and risk awareness. This approach provides evidence-based strategic support for the comprehensive prevention and control of H. pylori infection and gastric cancer in rural areas.

To investigate the association between PreDM transition and D/AO. The relationship between dynapenic abdominal obesity (D/AO) and the transition of prediabetes (PreDM) has not been fully explored, especially in middle-aged and elderly Chinese populations.

A total of 2 438 PreDM participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study (CHARLS) were included, and data from two waves (2011 and 2015) were used for prospective analysis. Logistic regression models were applied to examine the longitudinal association between D/AO and PreDM transition, while sensitivity analysis and subgroup analysis were conducted to evaluate the robustness of this association.

After adjusting for all covariates, D/AO was significantly associated with both PreDM regression (OR: 0.556; 95% CI: 0.340-0.909) and progression to diabetes mellitus (DM) (OR: 1.780; 95% CI: 1.158-2.736). Subgroup analysis showed that D/AO was significantly associated with PreDM regression in participants with a history of hypertension, without hyperlipidemia, with low social activity, without smoking or drinking habits, and with nighttime sleep duration ≤7.5 hours. Additionally, D/AO was significantly associated with PreDM progression to DM in participants without coronary heart disease, without hypertension, with a history of hyperlipidemia, and across different subgroups of nighttime sleep duration, smoking history, drinking history, and social activity levels.

Dynapenic abdominal obesity (D/AO) increases the risk of PreDM progressing to DM and reduces the likelihood of PreDM regression. These findings emphasize that in diabetes prevention strategies and public health policies, interventions aimed at improving muscle strength and reducing abdominal obesity should be enhanced for PreDM individuals and high-risk populations.

To investigate the association between systolic blood pressure (SBP) trajectories and the risk of stroke among older adults aged ≥65 years.

Older adults aged ≥65 years from Yangzhong City who participated in at least three rounds of Basic Public Health Service health check-ups between 2016 and 2019 and had no history of cardio-cerebrovascular disease were included.The incidence data of stroke were obtained from the Hospital Information System (HIS) of secondary and above hospitals in Yangzhong City, the Chronic Disease Surveillance Information System of Zhenjiang City, and self-reports from subjects during annual health examinations. Latent class mixed models (LCMM) were used to identify long-term SBP trajectories. Multivariable Cox proportional hazards models were applied to examine the association between different SBP trajectory groups and stroke incidence.

A total of 12 304 older adults were included in the study. LCMM identified two distinct SBP trajectory groups: a low initial SBP with a slight increase group (90.55%) and a high initial SBP with a steep increase group (9.45%). By the end of follow-up on December 31, 2024, totaling 60 266.59 person-years, with an average follow-up time of 4.90 years.2 495 new stroke cases were recorded, with an incidence density of 41.40 per 1 000 person-years. The incidence density was 39.74 per 1 000 person-years in the low initial SBP group and 57.91 per 1 000 person-years in the high initial SBP group. Multivariable Cox proportional hazards analysis showed that compared to the low initial SBP group, the high initial SBP group had a 20% higher risk of stroke (HR=1.20, 95% CI: 1.04-1.38). Stratified analysis showed that the association between SBP trajectory and stroke incidence differed significantly across age groups. In individuals aged over 70 years, the association was stronger (HR=1.26, 95% CI: 1.04-1.51), while in those aged 70 years or younger, the HR was 1.13 (95% CI: 0.91-1.39). The interaction between age and SBP trajectory was statistically significant (P for interaction=0.015).

Among older adults, those with a high initial SBP and a steep increase in SBP over time have a higher risk of stroke. This subgroup should be prioritized in stroke prevention efforts, with strengthened blood pressure monitoring and timely intervention recommended.

To develop and validate a risk prediction model for social frailty inelderly patients with type 2 diabetes mellitus.

A total of 455 elderly T2DM patients hospitalized in the endocrinology department of a Grade A tertiary hospital in Hebei Province between June 2024 and February 2025 were enrolled. Based on the HALFT scale, participants were categorized into asocial frailty group (n=169) and a non-social frailty group (n=286). They were randomly divided into a training set (n=318) and a test set (n=137) in a 7:3 ratio. Univariate analysis, Lasso regression, and multivariate regression were employed to identify influencing factors for social frailty. Risk prediction models were constructed using logistic regression, XGBoost, and Random Forest.The predictive performance of the models was evaluated, and the optimal model was selected.

Multivariate logistic regression analysis revealed that education level junior high school (OR=0.272, 95% CI: 0.101-0.730); high school (OR=0.275, 95% CI: 0.140-0.540); college (OR=0.064, 95% CI: 0.010-0.424); bachelor’s degree or above (OR=0.114, 95% CI: 0.021-0.618),e-health literacy (OR=0.954, 95% CI: 0.914-0.996), and social support (OR=0.897, 95% CI: 0.840-0.958) were protective factors against social frailty in elderly T2DM patients. In contrast, glycated hemoglobin (OR=1.315, 95% CI: 1.026-1.684), number of diabetic complications 2 complications (OR=2.813, 95% CI: 1.420-5.572); ≥3 complications (OR=6.196, 95% CI: 2.769-13.863), diabetic stress moderate (OR=3.022, 95% CI: 1.134-8.050); severe (OR=7.623, 95% CI: 2.543-22.854), and depressive (OR=2.940, 95% CI: 1.576-5.486) were identified as risk factors (P<0.05). In the test set, the area under the curve (AUC) for all models exceeded 0.800, with the Random Forest model demonst-rating the best performance (AUC=0.866).

The risk prediction mode-lfor social frailty in elderly patients with type 2 diabetes, developed based on the random forest model, exhibits good predictive abilityand can serve as a reference for the early identification of high-risk patients for social frailty in this population.

To examine the impact of the integrated urban-rural health insurance policy on depression levels among rural middle-aged and elderly populations.

A multi-period difference-in-differences model was constructed using five waves of the China Health and Retirement Longitudinal Study (CHARLS) data from 2011-2020 to evaluate policy effects.

The integration policy reduced depression scores among rural middle-aged and elderly individuals by 0.426 points (β=-0.426, P<0.05), with significant effects observed among rural males (β=-0.416, P<0.01) and middle-aged cohorts (β=-0.570, P<0.1). Improved chronic disease conditions partially mediated this effect.

The integration of health insurance significantly reduces depression levels among rural middle-aged and elderly individuals. Future efforts should focus on deepening institutional reforms, optimizing chronic disease coverage, and strengthening targeted interventions to enhance the physical and mental health security of this demographic.

To carry out long-term monitoring of SARS-CoV-2 variants in municipal wastewater in Shijiazhuang, to reveal the succession patterns of major epidemic variants and their correlation with population monitoring data, so as to provide scientific basis for the construction of modern infectious disease surveillance and early warning system with multiple trends and high sensitivity.

From January 2023 to June 2025 (a period spanning 30 months), monthly wastewater samples were collected from the Qiaodong Wastewater Treatment Plant in Shijiazhuang. Viral particles were enriched using membrane filtration method, followed by SARS-CoV-2 nucleic acids detection through real-time reverse transcription polymerase chain reaction (RT-qPCR). Next-generation sequencing (NGS) was employed to conduct viral whole-genome sequencing and identify major variant lineages. The results were then compared with local population infection surveillance data from the same period for correlation analysis.

RT-qPCR detection results showed that all wastewater samples were positive, and the major prevalent SARS-CoV-2 variants successively evolved of BA.5, XBB, JN.1, XDV lineage, which was basically consistent with the evolution trend of clinical monitoring data. Spearman correlation analysis showed significant positive correlations between wastewater samples and clinical infection samples for each variant’s monthly proportions (BA.5 lineage: ρ=1.000, P<0.001; XBB lineage: ρ=0.905, P<0.001; JN.1 lineage: ρ=0.817, P<0.001; XDV lineage: ρ=0.676, P<0.01). Kendall correlation analysis further confirmed a significant relationship between the variant composition in wastewater and clinical infection samples (τ=0.652, P<0.001).

The monitoring of SARS-CoV-2 variants in urban wastewater in Shijiazhuang can reflect the dynamic evolution of variants in the community population in real time, and can be used as an important information source for the future infectious disease surveillance and early warning system.

To explore the interaction between shift work and hyperuricemia (HUA) on the prevalence of non-alcoholic fatty liver disease (NAFLD).

The demographic data, lifestyle, shift work conditions, liver ultrasound, serum uric acid and other data of 3 349 workers in an automobile manufacturing enterprise in Guangzhou were collected. The effects of shift work and HUA on the prevalence of NAFLD were analyzed by binary logistic regression. The influence of the interaction between shift work and HUA on the risk of NAFLD was analyzed through multiplicative and additive interactions.

Among 3 349 subjects, the detection rate of NAFLD was 41.36% (1 385/3 349), the detection rate of HUA was 52.05% (1 743/3 349), and the proportion of shift workers was 73.16% (2 450/3 349). The multivariate logistic regression analysis showed that shift work (OR=1.349, 95% CI: 1.087-1.676) and HUA (OR=1.732, 95% CI: 1.436-2.088) were the risk factors for NAFLD. Shift work and HUA had no multiplicative interaction on the prevalence of NAFLD (OR=0.910, 95% CI: 0.600-1.380). The additive interaction analysis of Model 2 (adjusted for age and BMI) and Model 3 (fully adjusted model) showed a synergistic effect between shift work and HUA. The relative excess risk due to interaction (RERI) , attributable proportion due to interaction (API) and synergy index (S) of Model 2 were 13.865 (95% CI: 4.320-23.411), 0.628 (95% CI: 0.507-0.749), and 2.922 (95% CI: 2.107-4.051), The RERI, API and S of Model 3 are respectively 14.025 (95% CI: 2.004-26.046), 0.625 (95% CI: 0.476-0.774), 2.891 (95% CI: 1.940-4.308).

Shift work and HUA have an additive interaction effect on the prevalence of NAFLD. Optimizing the shift scheduling system and controlling serum uric acid may coordinate the prevention of the occurrence of NAFLD.

To explore the latent categories of depressive symptoms among food delivery riders and analyze the influencing factors of different categories.

Participants were selected through cluster randomized sampling from six food delivery service providers in Chengdu. Data were collected using a general information questionnaire, the Patient Health Questionnaire (PHQ), and the Core Occupational Stress Scale. Latent profile analysis (LPA) was employed to classify depressive symptoms, and multinomial logistic regression was conducted to identify associated risk factors.

Among the 560 food delivery riders, the depressive symptoms were divided into three latent categories: the no-depression-risk group (28.21%), the low-risk group of emotional depression (61.43%), and the high-risk group of emotional depression with medium-risk of cognitive depression (10.36%). Divorce was a risk factor for high-risk emotional depression-medium-risk cognitive depression (OR=2.22, 95% CI: 1.58-3.12); undergraduate degree or above was a risk factor for high-risk emotional depression-medium-risk cognitive depression (OR=3.17, 95% CI: 2.70-3.71); long working hours were a risk factor for depression (OR=2.70, 95% CI: 2.17-3.36); and social support was a protective factor for depression (OR=0.83, 95% CI: 0.76-0.91).

Timely and effective intervention measures should be formulated for different latent categories to relieve the depressive emotions of food delivery riders.

To investigate the molecular typing, virulence and antimicrobial resistance characteristics of food-borne Klebsiella pneumoniae in Guizhou Province, providing scientific evidence for targeted food safety risk assessment and regulatory decision-making in our province.

A total of 38 strains of Klebsiella pneumoniae were isolated from pre-packaged chilled ready-to-eat food and pig livers in 9 cities (states) of Guizhou Province from 2023 to 2024. Strains were screened by string test, whole genome sequencing and antimicrobial susceptibility test.

Four hypermucoviscous Klebsiella pneumoniae strains were isolated from 38 isolates. Through whole genome sequence analysis, 20 KL types, 30 ST types, 80 virulence genes and 35 drug resistance genes were obtained. ST 37 was the main strain. HmKp of ST65-KL2 carried iucA, iroB, ybtS, rmpA and clb genes, while ST490-KL3 carried iucA, iroB, ybtS and allS genes. The main β-lactamase resistance genes were bla_SHV-11, bla_SHV-1, bla_LAP-2. 5 of the strains carried bla_OXA-10 gene. The results of antibiotic susceptibility tests showed that the top five resistant antibiotics were ampicillin, tetracycline, chloramphenicol, florfenicol and sulfamethoxazole/trimethoprim, with resistance rates of 81.58%, 50.0%, 44.74%, 44.74% and 28.95% respectively. All isolates were sensitive to carbapenems.

The prevalence of virulence genes in Klebsiella pneumoniae in food in Guizhou Province is high, with a strong pathogenic potencial. The ST types and KL types of the strains are diverse.

To investigate the contamination levels of deoxynivalenol (DON), 3-acetyldeoxynivalenol (3-Ac-DON), and 15-acetyldeoxynivalenol (15-Ac-DON) in grains and their products in Chongqing, and to assess the dietary exposure levels and potential chronic health risks posed by these mycotoxins among residents of Chongqing.

Functional models (e.g. triangular distribution models) were employed to fit contamination data of DON and its acetyl derivativesfrom 794 samples across nine categories of grains and their products collected in Chongqing between 2018 to 2023. Parameter estimation was conducted based on distribution types. Probabilistic assessment (Monte Carlo simulation) was performed using data from the 2018 China Health and Nutrition Survey toestimate the exposure levels and characterize risks against established safety thresholds.

The average contamination levels of DON, 3-Ac-DON and 15-Ac-DON were 213.00, 0.09-4.48 and 0.75-5.51 μg/kg, respectively. Estimated daily intakes of DON and its derivatives varied by age group: 1.11-1.19 μg/(kg·d) (3-6 years), 0.85-0.94 μg/(kg·d) (7-17 years), 0.47-0.48μg/(kg·d) (18-59 years), and 0.50-0.52 μg/(kg·d) (≥60 years). At the 90th percentile (P₉₀), The exposure levels of most population groups exceeded the daily tolerable intake (TDI). At P₉₅, the exposures levels were 1.12 to 2.87 times the TDI for all population groups. Wheat flour products were identified as the primary source of DON and its acetyl derivatives.

The average dietary exposure of residents to DON and its acetylderivatives (3-Ac-DON and 15-Ac-DON) is at a safe level, and there may be a potential weight loss risk in high-exposure populations.