To analyze the relationship between the ratio of glycated albumin to glycated hemoglobin (GA/HbA1c)and all-cause mortality in adults with metabolic syndrome MetS.

This study is a retrospective cohort study utilizing data from the National Health and Nutrition Examination Survey (NHANES) and the National Death Index (NDI) from 1999 to 2004. A total of 1 497 eligible participants were included and followed up until December 31, 2019. The relationship between the GA/HbA1c ratio and all-cause mortality in MetS patients was assessed using Kaplan-Meier survival curves, multivariable weighted Cox regression, and restricted cubic splines.

Among a weighted population of 55 224 898 eligible individuals with a median follow-up of 16.3 years, there were 501 cases of all-cause mortality. Participants were divided into three groups(T1, T2, T3) based on weighted tertiles of the GA/HbA1c ratio. After adjusting for covariates, a higher GA/HbA1c ratio (T3) was associated with an increased risk of all-cause mortality in MetS patients compared to the lowest tertile (T1) (HR=1.335, 95%CI:1.010-1.772). The restricted cubic spline analysis also revealed a non-linear “S” shaped relationship between the GA/HbA1c ratio and all-cause mortality (non-linear P<0.05). Subgroup analyses (all interaction P>0.05) and sensitivity analyses (HR=1.344, 95%CI: 1.014-1.783) showed similar results.

There is a non-linear association between the GA/HbA1c ratio and all-cause mortality in patients with metabolic syndrome, with higher GA/HbA1c ratios linked to an increased risk of all-cause mortality in these patients.

To explore the relationship between depression and angina pectoris, as well as the mortality risk associated with their comorbidity, providing references for the treatment and prognostic management of angina pectoris patients.

Based on the National Health and Nutrition Examination Survey (NHANES) database from 2009 to 2018, data from 11 232 individuals aged 40 and older were analyzed using logistic regression and restricted cubic spline models to investigate the relationship between depression and angina pectoris. Survival curves (Kaplan-Meier) and Cox regression models were employed to examine the differences in mortality risk among four groups.

Logistic regression analysis revealed statistically significant risks of angina pectoris across various depression groups (mild depression group OR=1.78, 95%CI: 1.48-2.20; moderate depression group OR=3.40, 95%CI: 2.62-4.42; severe depression group OR=5.16, 95%CI: 3.94-6.77), indicating that higher levels of depression correlate with greater risk of angina pectoris (W=151.93, P<0.001), suggesting that depression was a risk factor for angina pectoris. In the overall population, the dose-response relationship between the two exhibited a gradually decreasing slope, indicating an increasing trend in angina pectoris risk with worsening depression. The Kaplan-Meier curves and Cox regression models demonstrated that the mortality risk in the comorbid depression and angina pectoris group was higher than that in the depression-only and angina pectoris-only groups, even after adjusting for all potential confounding factors (HR=2.35, 95%CI: 1.77-3.12).

There is a significant correlation between depression and angina pectoris, with the mortality risk in the comorbid depression and angina pectoris group being higher than in either the depression-only or angina pectoris-only groups. Future treatment of angina pectoris should also emphasize the assessment, prevention, and treatment of depression to improve long-term patient outcomes.

To analyze the comprehensive efficiency and total factor productivity changes of county-level medical and health sub-centers (referred to as “sub-centers”) in Sichuan Province, providing valuable references for the continuous advancement of sub-center construction and the healthy development of grassroots medical and health systems nationwide.

A total of 302 sub-centers in Sichuan Province were selected as the research subjects, and the DEA-Malmquist index model was employed to measure and evaluate their static and dynamic efficiencies.

Using 21 cities and prefectures as decision-making units, the comprehensive efficiency of the sub-centers was 0.884, with 12 cities and prefectures experiencing increasing returns to scale and 9 achieving optimal operational efficiency. Analyzing the time series of the 302 sub-centers as decision-making units, the total factor productivity of the sub-centers increased by 1.4%; regionally, total factor productivity rose in 16 cities and prefectures.

The construction of sub-centers in Sichuan Province has been a successful pilot project, with overall operational efficiency being relatively good. However, significant regional development disparities and insufficient technological advancement persist. The government and relevant departments should continue to strengthen policy guidance, develop scientific and reasonable planning, focus on solidifying the grassroots talent base, and enhance information technology infrastructure to empower the vitality of sub-center healthcare.

To understand the epidemiological characteristics and pathogen spectrum changes of severe hand, foot, and mouth disease (HFMD) in Jiangxi Province, and to grasp the trend changes in different time periods and populations, providing a scientific basis for the formulation and optimization of HFMD epidemic prevention and control strategies.

A descriptive analysis of the monitoring data of severe HFMD in Jiangxi Province from 2008 to 2023 was conducted, and the Join point regression model was used to analyze the characteristics and trend changes in incidence by year and gender.

From 2008 to 2023, a total of 2 281 severe cases were reported in Jiangxi Province, with laboratory-confirmed cases accounting for 73.26%. The proportion of severe cases decreased from 17.12‰ in 2010 to 0.15‰ in 2023 (APC = -34.74%). The peak incidence occurred from April to July, with a male-to-female ratio of 2.13:1, primarily affecting children under three years old(86.45%). The overall trend in the proportion of severe cases among males and females was consistent, with both showing a year-on-year decline from 2010 to 2023; however, the average annual reduction was greater in females (37.86%) than in males(32.84%). EV-A71 was the dominant strain among laboratory-confirmed cases (79.89%), but the proportion of other enteroviruses significantly increased.

Since 2010, the incidence of severe HFMD in Jiangxi Province has shown a year-on-year declining trend. EV-A71 remains the dominant pathogen, but it has not been detected since 2017; thus, there is a need to strengthen genetic typing of other enteroviruses in severe cases. Children under three years old are the key target for intervention, and targeted measures should be implemented to reduce the risk of infection in this population.

To investigate the levels of formaldehyde, benzene, toluene, xylene, and ammonia in the air of hotels, barbershops, beauty salons, and gyms in Shijiazhuang city, and to assess the carcinogenic and chronic non-carcinogenic risks associated with these chemical pollutants in the air of the four types of public venues.

From 2019 to 2023, air samples were collected from operational barbershops, beauty salons, hotels, and gyms in Shijiazhuang to monitor the levels of formaldehyde, benzene, and ammonia. The assessment of inhalation exposure to chemical pollutants was conducted using the health risk assessment methods established by the U.S. Environmental Protection Agency (EPA) to evaluate the carcinogenic and chronic non-carcinogenic risks for workers.

The exceedance rates of formaldehyde in the air of the four public venues were 10.49%, 4.65%, 8%, and 3.13%, respectively, while the exceedance rates of ammonia in beauty salons and barbershops were 5.81% and 2%, respectively. The carcinogenic risk of formaldehyde in all four types of public venues exceeded 10^-6, with the 75^th percentile carcinogenic risk value for formaldehyde in beauty salons exceeding 10^-4. For benzene, half of the carcinogenic risk values in hotels, barbershops, and gyms fell within the range of 10^-6 to 10^-4, with a higher proportion of benzene carcinogenic risks in beauty salons also within this range. The hazard quotients for formaldehyde in all four public venues were greater than 1, with the 25^th percentile hazard quotient for formaldehyde in beauty salons exceeding

There are significant carcinogenic and chronic non-carcinogenic risks associated with formaldehyde in the air of the four types of public venues in Shijiazhuang city, with beauty salons exhibiting higher risks. The elevated carcinogenic risk of benzene in beauty salons warrants attention.

To analyze the significance of various factors affecting depression in middle-aged and elderly individuals, as well as the association between different demographic characteristics and depression based on the theory of social determinants of health, providing a reference for improving the physical and mental health of this population.

Using data from the 2020 China Health and Retirement Longitudinal Study, the research focused on individuals aged 45 and above. A random forest model was employed to rank the importance of factors influencing depression in this demographic, and association rule mining was conducted to analyze population characteristics.

The depression rate among middle-aged and elderly individuals was 34.7%. The random forest model indicated that the top 11 variables influencing depression, ranked by their Mean Decrease Accuracy (MDA) values, were as follows: impaired Activities of Daily Living (ADL) (20.24%), chronic diseases(19.12%), social participation (18.72%), medical insurance (18.10%), age (16.77%), self-rated health status (15.31%), emotional support (11.91%), economic support (10.80%), internet usage (10.67%), education level (9.97%), and sleep duration(9.77%) (P<0.05). The results of association rule mining revealed that the combination of impaired ADL, chronic diseases, age ≥ 66 years, lack of medical insurance, and sleep duration < 7 hours significantly increased the risk of depression in middle-aged and elderly individuals, with a support of 20.740% and a confidence of 77.786%, indicating a risk 3.751 times greater than those without these characteristics.

The factors influencing depression in middle-aged and elderly individuals are multidimensional. Impaired ADL, chronic diseases, age ≥ 66 years, lack of medical insurance, and sleep duration < 7 hours are critical factors affecting depression. Screening for these key factors can identify high-risk populations, thereby reducing the risk of depression and improving the mental health levels of middle-aged and elderly individuals.

To investigate the impact of air pollution on blood pressure control in hypertensive patients.

Data from the China Health and Nutrition Survey collected between 2011 and 2015 were analyzed, including 2 860 participants from Shanghai, of which 831 were hypertensive patients. Air pollution monitoring data for Shanghai during the same period were obtained from the National Urban Air Quality Release Platform. Demographic information, daily habits, health status, and hypertension-related data were collected via questionnaires. Logistic regression was employed to analyze the effect of air pollutants on achieving blood pressure targets, and a mixed-effects model was used to study interactions among air pollutants and their interactions with antihypertensive medications.

A total of 831 adult hypertensive patients were included, with a blood pressure control rate of 35.14%. The odds ratios (OR) and 95% confidence intervals (CI) for O₃ exposure on day 0, the previous 7 days, and the previous 60 days were 1.012 (1.005-1.020), 1.009 (1.002-1.016), and 1.013 (1.003-1.022), respectively. For CO during the same periods, the OR and 95%CI were 1.084 (1.030-1.140), 1.064 (1.030-1.100), and 1.126 (1.050-1.208), respectively. The OR and 95%CI for SO₂ on day 0 and the previous 7 days were 1.056 (1.004-1.110) and 1.024 (1.003-1.046), respectively. SO₂ exposure on day 0 and the previous 7 days (P=0.008; P=0.043) and CO exposure in the previous 60 days (P<0.001) may influence the effectiveness of antihypertensive medications; CO on day 0 and SO₂ on the same day may interact regarding blood pressure control rates (P=0.045); O₃ exposure in the previous 7 days, SO₂ on the same day, and CO on the same day may also interact concerning blood pressure control rates (P=0.004; P<0.001).

O₃, SO₂, and CO are associated with blood pressure control rates. Recent and long-term exposure to O₃ and CO may affect blood pressure control, while recent exposure to SO₂ may influence the efficacy of antihypertensive medications. It is recommended to enhance air pollution monitoring and management, providing guidance for hypertensive patients to improve blood pressure control outcomes.

To provide a new perspective for exploring the influencing factors of depression symptoms in individuals aged 45 and older in China, helping reveal the complex relationships among potential influencing factors.

Using data from the China Health and Retirement Longitudinal Study (CHARLS) 2018, independent variables were determined based on the five dimensions of the health ecological model. A total of 8 485 individuals aged 45 and older were included. The LASSO algorithm was employed for variable selection, and the Apriorism algorithm from association rules was utilized to mine the causal association rules of depression symptoms among the elderly in China from multiple dimensions.

The detection rate of depression symptoms among middle-aged and elderly individuals in China was 38.42%. The variables selected by LASSO regression included gender from the personal traits layer, self-rated health, life satisfaction, disability, number of chronic diseases, visual impairment, hearing impairment, and nighttime sleep duration from the behavioral traits layer, as well as household registration type and education level from the living and working conditions layer. The Apriorism algorithm identified 21 strong association rules, with the highest support of 20.71%, maximum confidence of 68.40%, and the highest lift of 1.78. Key association factors for depression symptoms among the elderly included living in rural areas, having two or more chronic diseases, nighttime sleep duration of less than 6 hours, being female, having a disability, poor self-rated health, and being relatively satisfied with life, with primary school education. Compared to those with excessive nighttime sleep duration, individuals with insufficient nighttime sleep duration exhibited a higher risk of depression symptoms. The factor of rural residence was highly correlated with nighttime sleep duration of less than 6 hours and having two or more chronic diseases.

This study suggests considering depression issues from three dimensions: personal traits, behavioral traits, and living and working conditions, emphasizing the need to pay special attention to rural populations and patients with comorbid chronic diseases during depression symptom screening.

To investigate whether C-reactive protein (CRP) can modulate the relationship between obesity phenotypes and stroke risk in middle-aged and elderly individuals through a cohort study.

Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), participants from the baseline survey in 2011 and follow-ups in 2013, 2015, and 2018 were selected. Based on the participants’ weight status (overweight/obese) and metabolic abnormalities, they were categorized into four obesity phenotypes: Metabolically Healthy Normal Weight (MHNO), Metabolically Healthy Overweight/Obese (MHO), Metabolically Unhealthy Normal Weight (MANO), and Metabolically Unhealthy Overweight/Obese(MAO). Additionally, participants were grouped into three categories based on CRP quartiles. The Cox proportional hazards regression model was employed to analyze the relationship between obesity phenotypes, CRP, and stroke, incorporating interaction terms between obesity phenotypes and CRP in the regression model. Finally, stratified analyses were conducted to explore whether CRP modulates the relationship between obesity phenotypes and stroke.

Totally 6 868 participants were included in this study, with 421 (6.13%) experiencing a stroke during the 7-year follow-up period. The Cox proportional hazards regression model indicated that, compared to the MHNO group, the risk of stroke increased by 66%, 85%, and 151% for the MHO, MANO, and MAO groups, respectively, with hazard ratios (HR) and 95% confidence intervals (CI) of 1.66 (1.15-2.38), 1.85 (1.39-2.46), and 2.51 (1.92-3.29), respectively. Furthermore, stratified analysis revealed that in the CRP T1 group, the MHO and MANO groups did not show an increased risk of stroke compared to the MHNO group (P > 0.05). In the CRP T2 group, the risk of stroke for the MHO and MANO groups increased by 111% and 127%, with HR and 95%CI of 2.11 (1.11-4.02) and 2.27 (1.29-3.98), respectively. Similarly, in the CRP T3 group, the risks for the MHO and MANO groups increased by 93% and 89%, with HR and 95%CI of 1.93 (1.06-3.50) and 1.89 (1.17-3.05), respectively.

CRP can modulate the relationship between obesity phenotypes and stroke in middle-aged and elderly individuals.

To explore the impact pathways of cognitive decline, risk perception, and self-efficacy on the safe medication practices of empty nesters, utilizing the risk perception attitude framework theory.

A stratified cluster random sampling method was employed to conduct a questionnaire survey involving 361 empty nesters. Multiple linear regression analysis and structural equation modeling were used to construct the impact pathways.

The average score for safe medication practices among empty nesters was 30.59±3.61. Path analysis revealed that cognitive decline directly predicted safe medication practices (β=-0.134) and also indirectly influenced these practices through risk perception and self-efficacy. This included the independent mediating effects of self-efficacy (β=-0.066) and risk perception (β=-0.131), as well as the chain mediating effect of risk perception and self-efficacy (β=-0.088) (all P<0.05).

The level of safe medication practices among empty nesters urgently needs improvement, particularly focusing on those with cognitive decline. Enhancing self-efficacy and correcting risk perception biases may elevate safe medication practices among cognitively impaired empty nesters.