To investigate the dual mediating effects of frailty and health literacy on the relationship between social support and quality of life among older adults based on the health ecological model.

A convenience sampling method was employed to survey 1 497 older adults using a general information questionnaire, social network relationship scale, Tilburg Frailty Indicator, health literacy assessment scale, and SF-6Dv2 quality of life assessment scale. Descriptive statistics, non-parametric tests, and correlation analyses were performed on the data, and the PROCESS macro in SPSS 26.0 was used to construct a multiple mediation effect model.

Significant differences in quality-of-life scores among older adults were observed based on different living areas (Z=-4.171, P <0.001), gender (Z=-2.378, P < 0.05), age (H=58.938, P < 0.001), education level (H=66.224, P < 0.001), occupation (H=78.662, P <0.001), and income sources (H=87.730, P < 0.001). Social support was significantly negatively correlated with frailty (r=-0.314, P < 0.01),while positively correlated with health literacy (r=0.398, P < 0.01) and quality of life (r=0.253, P < 0.01). Frailty was significantly negatively correlated with health literacy (r=-0.320, P < 0.01) and quality of life (r=-0.391, P < 0.01), whereas health literacy was significantly positively correlated with quality of life (r=0.219, P < 0.01). Frailty (effect size=0.094, 95%CI: 0.071-0.119) and health literacy (effect size=0.011, 95%CI: 0.012-0.037) partially mediated the effect of social support on quality of life, accounting for 43.7% and 5.1% of the total effect, respectively.

Frailty and health literacy play dual mediating roles in the relationship between social support and quality of life among older adults. It is essential to implement interventions that help older adults expand their social support networks, reduce levels of frailty, and enhance health literacy to improve their quality of life.

To investigate the contamination levels of Legionella pneumophila (Lp) in shower water at bathing venues in Shandong Province, the influencing factors, and antibiotic resistance, providing a scientific basis for formulating prevention and control strategies for Lp infections in the population.

Using a cluster random sampling method, 2 to 3 public bathing venues were selected annually from 16 cities in Shandong Province from 2020 to 2022 for testing Lp in shower water. The influencing factors on the detection rate of Lp were explored based on the time of water sample collection, the size of water tanks, water supply methods, and whether the tanks were disinfected. Serotyping and antibiotic resistance testing were conducted on positive samples to further analyze the characteristics of antibiotic resistance in Lp.

Among the 143 samples collected, 55 tested positives for Lp, yielding a positivity rate of 38.5%. Serological typing identified that serotype 1 (LP1) accounted for 51% of the positive Lp strains. The detection rate of Lp was influenced by various factors, including different water sample collection times (46.7% in October, 29.4% in April, χ²=4.49, P < 0.05), varying water tank storage capacities (50.8% for tanks with a capacity greater than daily water usage, 18.2%for those with a capacity less than daily usage, χ²=10.39, P < 0.01), and different sampling locations (26.5% at the water inlet of the pipeline, 44.7% at the showerhead, χ²=4.48, P < 0.05), with statistically significant differences observed within the groups. The 55 positive strains exhibited varying degrees of resistance to seven first-line treatment antibiotics, with the highest resistance rate to cefuroxime (90.9%) and the lowest to azithromycin (14.5%).

The positivity rate of Lp in shower water at bathing venues across 16 cities in Shandong Province is primarily influenced by environmental temperature and the retention of shower water in the water supply system. The Lp strains in the environment show significant resistance to antibiotics such as cefuroxime, rifampicin, and sulbactam. It is recommended to strengthen the monitoring of shower water, pay attention to changes in bacterial resistance, ensure the safety of shower water in public places, and protect the health of the population.

To analyze the influencing factors of carotid artery plaque occurrence based on a prospective dynamic cohort.

A nested case-control study was adopted. A total of 1 150 newly-diagnosed patients with carotid artery plaques from March 2018 to November 2023 were selected as the case group. According to the principles of the same gender, age ± 3 years, and the same year and month of the initial examination, 1 150 individuals without carotid artery plaques were individually matched at a ratio of 1:1 as the control group. Finally, 2 300 subjects were included in the study. A conditional Logistic regression model was used to analyze the influencing factors of carotid artery plaque occurrence. Meanwhile, the dose-response relationship between different exposure factors and the risk of carotid artery plaque was analyzed by using tertile stratification and restricted cubic spline (RCS).

The results of multivariate conditional Logistic regression analysis showed that abnormal serum high-density lipoprotein-cholesterol (HDL-C) (OR=1.370, 95%CI: 1.073-1.748), blood urea nitrogen/creatinine (OR=1.024, 95%CI: 1.004-1.044), and red blood cell distribution width-SD (OR=1.037, 95%CI: 1.003-1.072) were risk factors for carotid artery plaques, while total protein (OR=0.966, 95%CI: 0.944-0.988) was a protective factor.The RCS results showed that there was a negative linear dose-response relationship between HDL-C, total protein and the risk of carotid artery plaque, and a positive linear dose-response relationship between blood urea nitrogen/creatinine and the risk of carotid artery plaque (P _overall < 0.05, P _non-linear > 0.05). No dose-response relationship was found between red blood cell distribution width-SD and the risk of carotid artery plaque.

HDL-C, total protein, blood urea nitrogen/creatinine, and red blood cell distribution width-SD are associated with the occurrence of carotid artery plaques, and there is a linear dose-response relationship between HDL-C, blood urea nitrogen/creatinine, total protein and the risk of carotid artery plaque.

To explore the relationship between health literacy and health-related quality of life among residents in Qingdao, and to verify the mediating effect of self-efficacy and the moderating effect of chronic disease status in this relationship.

A multi-stage stratified random sampling method was used to select 7 000 permanent residents aged 15 to 69 years from 10 districts (cities) in Qingdao. Questionnaires were conducted using measurement tools such as the Health Literacy Monitoring Questionnaire and the European Quality of Life Five Dimensions Questionnaire (EQ-5D-3L). SPSS 24.0 software was used for data processing and statistical analysis, and the PROCESS plugin Bootstrap method was used to test the mediating and moderating effects.

A total of 6 385 valid questionnaires were retrieved, with an effective response rate of 91.21%. The health literacy score of the respondents was (44.912 ±14.461) points, the self-efficacy score was (12.908 ± 2.005) points, the health-related quality of life utility value was (0.972 ± 0.078) points, and the number of people with chronic diseases was 1 160, accounting for 18.17% of the total. Health literacy could not only directly and positively predict the health-related quality of life of residents (β=0.074, P < 0.001), but also affect it through the mediating effect of self-efficacy, with the mediating effect being 32.43%. Both the direct effect of health literacy on the health-related quality social support networks, reduce levels of frailty, and enhance health literacy to improve their quality of life.of life of residents and the mediating effect of self-efficacy were moderated by chronic disease status. Compared with those without chronic diseases, the effect of self-efficacy on health-related quality of life was significantly enhanced among single-chronic disease patients (B_simple=0.228, P < 0.001), and the enhancement effect of health literacy and self-efficacy on health-related quality of life was more significant among multiple-chronic disease patients (B_simple=0.167, P=0.003; B_simple=0.253, P <0.001).

Health literacy affects the health-related quality of life of residents through self-efficacy, and chronic disease status moderates the relationships among health literacy, self-efficacy, and health-related quality of life.

To explore a suitable research design for evaluating the long-term effects of vaccines, taking into account the heterogeneity caused by individual susceptibility, vaccination status, vaccination timing, and the confounding effects of healthcare-seeking behavior.

This study employed a Monte Carlo simulation method to extend the Test-Negative Design (TND),considering constant vaccine efficacy and two types of time-dependent vaccine efficacy under a fixed study duration model. A multivariable logistic regression model and a semi-parametric generalized additive model based on restricted cubic splines were constructed to evaluate the long-term effects of vaccines.

When only considering changes in vaccine efficacy, the estimated vaccine effectiveness (VE) curves from both models accurately fit the actual decay trend of VE, being only slightly higher than the true VE (approximately 1%-3%). The VE curves were minimally affected by vaccination rates, the mean probability of influenza-like illness in the entire population, and the probability of influenza-like illness in the vaccinated population.

The extended TND under a fixed study duration model provides a feasible new approach for evaluating long-term vaccine effectiveness, with the potential for application to other types of vaccines. Both models demonstrated good fitting performance over time with no significant differences. However, further exploration is needed to comprehensively consider other heterogeneous influencing factors and to conduct simulation experiments with the extended TND after group assignment.

To investigate the association between sedentary duration, physical activity, and male sperm quality.

Based on 1 578 semen samples from the Sichuan Human Sperm Bank, a linear regression model and restricted cubic spline analysis were employed to examine the linear and nonlinear associations of daily sedentary duration, weekly physical activity volume, and physical activity level with conventional semen parameters and sperm kinetic parameters.

Daily sedentary duration and weekly physical activity volume showed significant nonlinear associations with forward motility, immotility, and total motility (P <0.05). Additionally, weekly physical activity volume was significantly nonlinearly associated with average curvilinear velocity, average path velocity, average straight-line velocity, and average flagellar beat frequency (P < 0.05). Compared to the low activity group, the moderate and high activity groups had significant improvements in forward motility [% Change (95%CI): 4.302 (1.691-6.979), 2.816(0.227-5.472)], total motility [% Change (95%CI): 3.624 (1.227-6.079), 2.567 (0.179-5.012)], average curvilinear velocity [%Change (95%CI): 6.600 (3.021-10.304), 3.958 (0.446-7.594)], average path velocity [% Change (95%CI): 6.529 (2.987-10.193),4.012 (0.532-7.613)], and average straight-line velocity [% Change (95%CI): 5.992 (2.049-10.087), 4.221 (0.319-8.274)], with the moderate activity group showing more pronounced improvements.

Both insufficient and excessive daily sedentary duration are risk factors for male sperm quality, with insufficient sedentary duration potentially posing greater harm. Maintaining regular and moderate physical activity is beneficial for improving sperm quality.

To investigate the association between anxiety disorders and the risk of developing non-alcoholic fatty liver disease (NAFLD) in Caucasians.

This study was a prospective cohort study based on the UK Biobank database.Individuals who were not Caucasian, had missing racial information, had liver disease at baseline, had alcohol/drug use disorders or missing relevant diagnosis dates, or developed NAFLD within two years of follow-up were excluded, resulting in a total of 465 621 participants for analysis. The baseline survey conducted from 2006 to 2010 served as the starting point for follow-up, with NAFLD incidence, loss to follow-up, death, or end of follow-up as the endpoints. A multivariable Cox proportional hazards regression model was used to explore the association between anxiety disorders and the risk of developing NAFLD.

The participants accumulated 6 058 222 person-years of follow-up, with a median follow-up time of 13.50 years. There were 5 184 cases of NAFLD, with an incidence density of 8.56 cases per 10 000 person-years. After adjusting for covariates, the risk of developing NAFLD in individuals with anxiety disorders was increased by 0.75 times compared to those without anxiety disorders (HR=1.75, 95%CI: 1.32-2.32).

Anxiety disorders are associated with an increased risk of developing NAFLD in Caucasians, highlighting the need for enhanced clinical monitoring and prevention of NAFLD in patients with anxiety disorders.

To investigate the impact of serum vitamin C levels on metabolic syndrome in adults based on NHANES 2017-2018 data.

A total of 2 094 adults from the NHANES 2017-2018 dataset were included, with serum vitamin C levels as the primary exposure variable and metabolic syndrome, diagnosed according to the standards of the International Diabetes Federation and the American Heart Association, as the outcome variable. A multivariable logistic regression model was utilized to analyze the association between these variables, with subgroup analyses conducted for gender, age, and other factors.

The risk of metabolic syndrome decreased with increasing serum vitamin C levels (P _trend < 0.001). Compared to the lowest quartile of serum vitamin C levels (Q1), the highest quartile (Q4) exhibited a relatively lower risk of metabolic syndrome (OR=0.66, 95%CI:0.48-0.92). Subgroup analyses by gender and age indicated a more pronounced protective effect in women and individuals under 50 years of age; women in the highest serum vitamin C level group had a lower risk of metabolic syndrome (Q4 group: OR=0.42,95%CI: 0.28-0.63). Additionally, individuals under 50 years of age in the second and highest serum vitamin C level groups also had reduced risks of metabolic syndrome (Q3 group: OR=0.41, 95%CI: 0.25-0.68; Q4 group: OR=0.19, 95%CI: 0.13-0.30).

This study suggests that higher serum vitamin C levels may be associated with a lower risk of metabolic syndrome in adults, with a more pronounced effect observed in women and individuals under 50 years of age.

To evaluate the discriminative ability of the Kinetic Direct Peptide Reactivity Assay (kDPRA) for identifying the skin sensitization potential of chemicals.

A total of 31 chemicals with known skin sensitization strengths were selected.These chemicals were prepared in phosphate-buffered saline or acetonitrile to create solutions at concentrations of 1.25, 2.5, 5.0,10.0, and 20.0 mmol/L. A mixture of 40 μl of the above solutions with 120 μl of a 0.667 mmol/L cysteine peptide was prepared, alongside blank controls, solvent controls, test substance controls, and a positive control (cinnamaldehyde). The mixtures were incubated at 25°C for 10, 30, 90, 150, 210, and 1 440 minutes. After the respective incubation times, 40 μl of 3 mmol/L monobromination was added for 5 minutes, and fluorescence intensity was measured using an enzyme-linked immunosorbent assay (ELISA) reader with excitation at 390 nm and emission at 480 nm. The consumption rate and rate constant of the cysteine peptide were calculated, with the maximum logarithmic rate constant (log kmax) from the six time points serving as the evaluation metric for the skin sensitization potential of various chemicals.

Testing 2,4-dinitrochlorobenzene yielded log kmax values of -0.39,-0.28, and -0.31 across three tests, all classified as Category 1A sensitizers. Consistent sensitization classifications were obtained from three repeated tests on 10 chemicals. Expanding to 20 additional chemicals, 6 were classified as Category 1A and 14 as non-1A. The skin sensitization classifications for all 31 tested chemicals were consistent with the European Chemicals Agency (ECHA) database.

This method demonstrates good discriminative ability for assessing the skin sensitization potential of chemicals.