To understand the disease burden, age, period, and cohort impact of diarrhea caused by unsafe water in China from 1990 to 2021.

The mortality and disability-adjusted life year (DALY) rates of diarrhea caused by unsafe water in China from 1990 to 2021 were collected and organized through the 2021 Global Burden of Disease Study (GBD 2021).Joinpoint regression was used to analyze temporal trends and calculate the average annual percentage change (AAPC). Using Stata MP 17 (64-bit) software, a Bayesian age-period-cohort model was used to analyze the impact of age, period, and cohort on diarrhea caused by unsafe water in China from 1990 to 2021.

The mortality rate, standardized mortality rate, DALY rate, and standardized DALY rate of diarrhea caused by unsafe water in China showed a decreasing trend year by year from 1990 to 2021 (AAPC=-10.69%, -10.92%, -11.48%, -10.74%, P<0.001). Similar decreasing trends were observed in both males and females. The age effect in the APC model indicated that people under 5 years old and those over 65 years old had a higher risk of mortality from diarrhea caused by unsafe water (RR values were all>1). The period effect showed that the mortality and DALY risk of diarrhea caused by unsafe water decreased from 1990 to 2021. The cohort effect showed that the earlier the population was born, the higher the risk of death and DALY from diarrhea caused by unsafe water.

From 1990 to 2021, the mortality and DALY risk of diarrhea caused by unsafe water in China have decreased. However, children and the elderly still have a high risk of diarrhea caused by unsafe water. It is necessary to actively provide safe drinking water, reduce the spread and impact of diarrhea caused by unsafe water sources, and protect public health.

To translate McCusker Subjective Cognitive Impairment Inventory-Self Report (McSCI-S) into Chinese and to examine its reliability and validity.

The modified Brislin model was adopted to form the Chinese version of the McSCI-S scale through translation and back-translation processes. A convenience sampling method was used to investigate 460 residents from Huzhou. The reliability and validity of the scale were evaluated based on item response theory and classical test theory.

The Chinese version of the McSCI-S was a unidimensional instrument comprising 29 items. The S-CVI/Ave was 0.986. Confirmatory factor analysis showed that the model fit was good. The criterion-related validity coefficient was 0.506.The total Cronbach’s α coefficient of the scale was 0.970, and the test-retest reliability was 0.903.

The Chinese version of the McSCI-S has good reliability and validity and can be used as a self-report instrument for assessing subjective cognitive impairment among residents in China.

To analyze the spatial distribution characteristics and changing trends of newly reported echinococcosis cases in endemic areas of Sichuan Province from 2020 to 2024, so as to provide a reference for formulating precise prevention and control strategies.

Based on the China Disease Control and Prevention Information System, county-level data on new cases of echinococcosis reported from 2020 to 2024 in endemic areas of Sichuan Province were collected. GeoDa 1.2.0 software and ArcGIS 10.3 software were used to conduct global spatial autocorrelation analysis, local spatial autocorrelation analysis and hotspot analysis on the reported incidence rates.

From 2020 to 2024, 378 new cases of echinococcosis were reported in 35 endemic counties in Sichuan Province. The annual reported incidence rates were 2.11 per 100 000, 2.54 per 100 000, 2.80 per 100 000, 3.19 per 100 000, and 4.29 per 100 000, respectively. Among the endemic prefectures, Aba Prefecture recorded the highest average annual reported incidence rate (5.64 per 100 000), while Ganzi Prefecture ranked second (2.31 per 100 000). The global spatial autocorrelation analysis showed that the reported incidence rate of echinococcosis in Sichuan Province had a positive spatial correlation in 2020, 2022, and 2024 (Moran’s I=0.295, 0.257, and 0.109; Z>1.96; P<0.05 for all years), and was randomly distributed in 2021 and 2023 (Moran’s I=-0.065 and 0.042; Z<1.96; P>0.05 for both years). Local spatial autocorrelation analysis identified four clustering patterns: “High-High”, “High-Low”, “Low-High” and“Low-Low”. The “High-High” clusters were primarily concentrated in Aba County, Barkam City, and Rangtang County within Aba Prefecture. The hotspot analysis indicated that from 2020 to 2024, the hotspots of the reported incidence of echinococcosis in Sichuan Province shifted from Ruoergai, Hongyuan, and Heishui counties in the north-central region of Aba Prefecture toward the southwestern border areas between northern Aba Prefecture and Ganzi Prefecture, and the primary hotspot regions were concentrated in Rangtang County, Aba County, Barkam City, and Jinchuan County of Aba Prefecture, along with Seda County of Ganzi Prefecture.

From 2020 to 2024, the reported incidence rate of echinococcosis in endemic areas of Sichuan Province showed an increasing trend, with significant spatial clustering observed. It is recommended to strengthen the management of sources of infection and wildlife host control measures in hotspot areas, and to develop regional comprehensive prevention and control strategies.

To investigate the association between circadian syndrome (CircS) and metabolic dysfunction-associated steatotic liver disease (MASLD).

Utilizing data from the 2017—2020 US National Health and Nutrition Examination Survey (NHANES), 2 060 adults aged ≥20 years were included. MASLD was diagnosed based on vibration-controlled transient elastography (CAP ≥274 dB/m) and metabolic risk criteria. CircS was defined as meeting ≥4 components (abdominal obesity,dyslipidemia, hypertension, hyperglycemia, sleep duration ≤6 h/day, depressive symptoms). Multivariable logistic regression was used to analyze the association between CircS, the number of CircS components, and MASLD [odds ratio (OR) and 95%confidence interval(CI)], adjusting for demographic and lifestyle confounders. Subgroup analyses were performed, and a MASLD risk prediction nomogram was constructed using LASSO-selected variables.

Among the participants, 786 (38.2%) had MASLD and 839 (40.7%) had CircS. The fully adjusted model revealed a significant positive association between CircS and MASLD (OR=3.95, 95% CI: 3.19-4.90). The number of CircS components showed a dose-response relationship with the presence of MASLD (P for trend <0.05), with individuals having ≥6 components exhibiting the highest odds of MASLD (OR=8.35, 95% CI: 5.27-13.50). Subgroup analysis indicated a stronger association in younger adults aged <50 years (OR=5.69,95% CI: 4.12-7.87). The nomogram incorporating CircS demonstrated moderate predictive ability (training set AUC=0.715).

This study is the first to reveal an independent positive association between CircS and MASLD, particularly pronounced in younger adults, with a dose-response relationship. CircS may serve as a potential association marker for MASLD,suggesting that interventions targeting circadian rhythm disruption could represent a novel prevention and management strategy.

To understand the current situation of indoor particulate matter and microbial pollution in fitness centers in China, and their association with respiratory symptoms among practitioners.

In accordance with the National Health Risk Factor Surveillance Program for Public Places, this study investigated 280 fitness centers across 31 provinces(autonomous regions, municipalities) and the Xinjiang Production and Construction Corps from March to September 2022 (the warm season) and from October 2022 to February 2023 (the cold season). Air samples were collected to measure PM₁₀, PM_2.5,total plate count (TPC), and total fungal count (TFC), while a questionnaire survey was administered to practitioners. χ² tests were employed to compare the exceedance rates of these air quality parameters across different geographical regions and seasons. Additionally, logistic regression analysis was conducted to examine the association between indoor air pollutant exposure levels and the prevalence of respiratory symptoms among practitioners.

Among the measured air quality parameters, airborne TFC exhibited the highest exceedance rate (21.74%), particularly in southern regions during the warm season. The exceedance rates for PM₁₀, PM_2.5, and TPC were 8.21%, 14.25%, and 0.23%, respectively. Respiratory symptoms were reported by 23.15% of practitioners, with significant differences (P<0.05) observed across age, smoking history, alcohol consumption, and length of service. Logistic regression analysis identified elevated concentrations of PM₁₀≥225 μg/m³, PM_2.5≥135 μg/m³, TPC≥500 CFU/m³, and TFC≥250 CFU/m³ as significant risk factors for respiratory symptoms among gym practitioners (P<0.05). The corresponding adjusted OR (95% CI) were 3.64 (1.77-7.48), 2.19 (1.15-4.16), 3.84 (1.66-8.90),and 1.63 (1.09-2.44), respectively.

Exposure to PM₁₀, PM_2.5, TPC, and TFC in fitness centers in China may increase the risk of respiratory symptoms among practitioners.

To explore the independent and interactive effects of meteorological factors and air pollutants on the outpatient visits of respiratory diseases in Xining City, and to provide a scientific basis for urban public health protection in plateau areas.

A time-stratified case-crossover design was used. Outpatient visit data for respiratory diseases from three hospitals in Xining during 2016—2021 were included, and pollutant data were obtained from the China Air Quality Online Monitoring Platform. A generalized nonlinear model was applied to assess the lagged effects of CO, O₃, SO₂, NO₂, PM₁₀,PM_2.5 and temperature. Interactions were quantified using a bivariate response surface model, relative excess risk due to interaction (RERI), and attributable proportion (AP).

The single pollutant model analysis showed that the risk of outpatient visits increased with higher concentrations of CO and NO₂. SO₂, PM₁₀ and PM_2.5 showed a ‘first increase and then decrease’ curve, and the peak RRs were 1.69, 1.55 and 1.80, respectively. O₃ showed a ‘U’ shaped curve, and the trough RR was 0.76. The lag effect analysis indicated that same-day effects were strongest for SO₂, NO₂ and PM₁₀. The peak RR of SO₂ reached (RR=1.54, 95% CI: 1.26-1.88) at lag 7 days, and the cumulative lag effect of NO₂ reached (RR=1.20, 95% CI: 1.11-1.31) at lag 3 days. The interaction analysis showed that SO₂, NO₂, PM₁₀ and PM_2.5 had a significant synergistic effect at low temperatures, but had an antagonistic effect with O₃. Under high temperature conditions, it only had a synergistic effect with O₃.

The risk of respiratory diseases in Xining is affected by the concentration of pollutants, temperature and their interaction. Low temperature aggravates the health hazards of gaseous pollutants and particulate matter, and high temperature enhances the hazard effect of O₃.

To assess the contamination levels and health risks of lead (Pb), cadmium (Cd), arsenic (As), mercury(Hg), and copper (Cu) in Astragalus, Eucommia ulmoides leaves, and Cornus officinalis from Shaanxi Province, providing a scientific basis for safety evaluation and standard establishment.

Samples of Astragalus, Eucommia ulmoides leaves,and Cornus officinalis were collected from major producing areas in Shaanxi. The concentrations of the five heavy metals were determined using microwave digestion-inductively coupled plasma mass spectrometry (ICP-MS). The contamination levels were evaluated using the single-factor pollution index and the Nemerow composite pollution index, while health risks were assessed by comparing health guidance values or benchmark doses with estimated human exposure levels.

Both the single-factor pollution index and the Nemerow composite pollution index values for Astragalus and Cornus officinalis were below 0.7, indicating low heavy metal contamination and a safe consumption level. In contrast, Eucommia ulmoides leaves exhibited a Nemerow composite pollution index of 0.79, reaching the alert threshold, with Pb and Hg identified as the primary contaminants, necessitating stricter control during cultivation and processing. For all three food and medicinal substances, the exposure levels via dietary intake were higher than those via medicinal use. For Astragalus, Eucommia ulmoides leaves, and Cornus officinalis, the Pb exposure levels via dietary intake were 0.107 μg/kgBW, 0.698 μg/kgBW, and 0.266 μg/kgBW,respectively. The As exposure levels were 0.108 μg/kgBW, 0.138 μg/kgBW, and 0.039 μg/kgBW, respectively. The Cd exposure levels were 0.007 μg/kgBW, 0.060 μg/kgBW, and 0.011 μg/kgBW, respectively. The Hg exposure levels were 0.002 μg/kgBW, 0.031 μg/kgBW, and 0.007 μg/kgBW, respectively. The Cu exposure levels were 2.611 μg/kgBW, 1.979 μg/kgBW,and 0.987 μg/kgBW, respectively.

Astragalus and Cornus officinalis from Shaanxi pose minimal heavy metal contamination risks, whereas Eucommia ulmoides leaves require targeted monitoring for Pb and Hg. When dietary exposure was considered, the heavy metal exposure risks for all three food and medicinal substances were within acceptable limits.

To investigate the association between the Geriatric Nutritional Risk Index(GNRI) and metabolic syndrome(MS) among elderly people of ethnic minorities in Guizhou Province, providing scientific evidence for the health management of the elderly in this region.

Based on the “Southwest Regional Cohort Study of Natural Populations of Ethnic Minorities”, this study included 4 521 elderly individuals aged 60 and above from the Miao, Dong, and Bouyei ethnic groups in Guizhou Province. Data on demographic characteristics, lifestyle, physical examination, and biochemical indicators were collected. Logistic regression, subgroup analyses, and restricted cubic splines (RCS) were used to evaluate the association between GNRI and MS. Within each ethnic group, the optimal cut-offs from ROC curves (107.9 for the overall population, 108.0 for the Miao, 110.1 for the Dong, and 106.0 for the Bouyei) were applied to categorize GNRI into high and low levels for subsequent sensitivity analyses.

The overall prevalence of MS was 23.9%, with prevalence rates of 24.6%, 25.4%, and 21.3% among the Miao, Dong, and Bouyei ethnic groups, respectively. In Model 3, which adjusted for all covariates, GNRI as a continuous variable was positively correlated with MS risk in the total population, Miao, and Dong groups, with OR (95% CI) of 1.07 (1.05-1.09), 1.07 (1.04-1.10), and 1.07 (1.04-1.11), respectively. However, this association was not significant in the Bouyei group (P=0.172). When GNRI was categorized, in the total population and Miao and Dong groups, higher GNRI quartiles(Q2-Q4) were associated with a gradient increase in MS risk compared with the Q1 reference group. However, this association was not statistically significant in the Q2 group or in any quartile group of the Bouyei ethnic group. Sensitivity analysis showed that the high-GNRI group had a significantly increased risk of MS (overall population: OR=1.98; Miao: OR=2.43; Dong: OR=1.76; all P<0.001), whereas the association remained non-significant in the Bouyei population (OR=1.03, P=0.845). Subgroup analysis showed that GNRI interacted with ethnicity and educational level, with stronger associations in the Dong group and among individuals with lower educational levels. RCS analysis indicated a linear positive association between GNRI and MS in the total population, while a non-linear positive association was observed in the Dong, Miao, and Bouyei groups.

Among the elderly Miao and Dong populations in Guizhou, an elevated GNRI was an independent risk factor for MS. No such association was observed in the Bouyei ethnic group. The relationship between GNRI and MS varied by ethnicity, indicating that ethnicity-specific nutritional intervention cut-offs and MS prevention strategies should be developed.

To explore the association between serum 25-hydroxyvitamin D [25(OH)D] concentration and the risk of respiratory tract infections(RTIs) in obese populations, analyze the influence of obesity stratification on the relationship between the two, and provide a scientific basis for the infection prevention and control strategies of RTIs in obese populations.

Based on the data of the National Health and Nutrition Examination Survey（NHANES） of the United States from 2009 to 2018,participants over 20 years old were included as the research subjects. The relationship between serum 25(OH)D and the risk of RTIs in obese people was analyzed using multivariable logistic regression, subgroup analysis, restricted cubic spline analysis,and logistic inflection point model.

A total of 21 532 research subjects were finally included (12 989 cases in the non-obese group, 4 629 cases in the grade I obese group, 2 196 cases in the grade II obese group, and 1 718 cases in the grade III obese group), and there were significant differences in baseline characteristics among the groups (P<0.001). The overall prevalence rate of RTIs was 17.5%. Compared with the non-obese group, the serum 25(OH)D levels of obese people at all levels were significantly decreased, and the proportion of serum 25(OH)D deficiency increased with the aggravation of obesity (up to 16.9% in the grade III obese group). Serum 25(OH)D level was a protective factor for reducing the risk of RTIs. However, its protective effect showed a gradient decreasing trend with the increase of obesity degree. Among participants with adequate serum 25(OH)D, the protective effect persisted: grade I obesity group (OR=0.75, 95% CI: 0.62-0.88), grade II obesity group (OR=0.78, 95% CI: 0.70-0.86),and grade III obesity group (OR=0.82, 95% CI: 0.74-0.90). There was a clear threshold effect in the non-obese group (inflection point=29.96 nmol/L), the threshold in the grade I obese group shifted down to 25.97 nmol/L, while the grade II and grade III obese groups showed a linear relationship.

Obese individuals have a deficiency in serum 25(OH)D, which is closely associated with an increased risk of respiratory tract infections. Moreover, the higher the degree of obesity, the more limited the protective effect of serum 25(OH)D. Therefore, stratified joint intervention strategies need to be developed for obese individuals.

To explore the relationship between weight-specific handgrip strength (Wt-HGS) and metabolic syndrome(MetS) and its components, providing new evidence for metabolic risk assessment in children and adolescents.

Data were derived from the 2021 Evaluation and Monitoring of School-based Nutrition and Growth in Shenzhen (EMSNGS) study. Based on handgrip strength percentile reference standards, handgrip strength was categorized into quartiles (Q1-Q4) using both age-specific(Age-HGS) and weight-specific (Wt-HGS) percentiles, with Q1 defined as the low handgrip strength group. The prevalence of MetS and its components was compared between the low handgrip strength groups based on the two standards.

A total of 3 272 children and adolescents aged 10-18 years were included in the study, with a median age of 13.8 (11.9, 15.6) years and a MetS prevalence of 3.9% (n=129). The prevalence of MetS was significantly higher in the low handgrip strength group defined by Wt-HGS than in that defined by Age-HGS (boys: 9.4% vs 2.6%; girls: 5.9% vs 1.4%). Logistic regression analysis revealed that, compared to the highest quartile of Wt-HGS (Q4), the odds ratio (OR) for MetS risk in boys in the Q1 group was 5.26 (95% CI: 2.55-10.85), and for girls, the risk was even higher (OR=11.91, 95% CI: 2.78-51.04). After adjusting for age, puberty stage, and other potential confounders, the association remained statistically significant.

Lower Wt-HGS may be a risk factor for MetS in children and adolescents, highlighting the potential value of muscle strength assessment and targeted interventions in the early prevention and control of MetS.