Latest ArticlesTo analyze the disease burden and changing trends of iron deficiency anemia (IDA) among children and adolescents in China from 1990 to 2021, and to provide evidence for policymakers to formulate prevention and control strategies.
Data from the Global Burden of Disease (GBD) 2021 study were used to extract indicators of iron deficiency anemia (IDA) among Chinese children and adolescents aged 0-19 years, including prevalent case number, prevalence, disability-adjusted life years (DALYs), and DALYs rate. Joinpoint regression models were established using Joinpoint Regression Program 4.9.0.0 to quantify trends in these indicators.
In 2021, the prevalent case number, prevalence, DALYs, and DALYs rate of IDA among Chinese children and adolescents aged 0-19 years were 1 171.77×104,3 505.11/105,28.94×104, and 86.57/105, respectively. Compared with 1990, these values decreased by 71.94%, 62.65%, 75.88%, and 67.88% (all P<0.001). Gender differences revealed that females had significantly higher values than males in all four indicators except DALYs rate (P<0.001), with smaller declines than males. Age distribution of IDA exhibited a “U-shaped” pattern: the group under 5 years had the highest burden (486.69×104 cases, prevalence 6 034.48/105), while the 15-19 years group showed a rebound, particularly in females (184.61×104 cases, prevalence 5 337.18/105), approaching the levels of the group under 5 years.
The disease burden of IDA among Chinese children and adolescents has significantly decreased. However, notable age- and gender-based disparities persist, necessitating focused efforts to sustain gains in IDA prevention and control among children under 5 years of age, while addressing the resurgence of IDA among adolescent females. Further exploration of tailored nutrition strategies and comprehensive measures is essential.
Monkeypox (MPX) is a significant global public health issue, characterized by high contagion and universal susceptibility among populations, thereby imposing a considerable economic burden on both society and individual patients. The Monkeypox (MPXV)virus has been circulating within the human population for several years and continues to evolve. However, there are currently no specific antiviral treatments available for MPX, making this disease a major concern. Current evidence indicates that the MPXV can survive and remain infectious in certain environments, with its survival time varying across different settings, influenced by environmental factors such as contaminated surfaces and temperature. This article provides a comprehensive review from various perspectives, including an introduction to the MPXV, environmental wastewater monitoring, surface environmental monitoring, virus persistence at varying temperatures, and air monitoring, thereby offering insights for the early detection and prevention of MPX.
To understand the quality of notifiable infectious diseases reporting in Sichuan Province from 2023 to 2024 and its influencing factors, and to provide reference basis for improving the reporting quality.
A total of 263 medical institutions were randomly selected by stratified sampling. Through on-site data review, case screening and spot checks, and verification of the reporting system, an investigation was conducted on the implementation of the management of notifiable infectious disease reporting in medical institutions, as well as the reporting rate of notifiable infectious diseases, the timely reporting rate, the completeness rate of filling, the accuracy rate of filling, and the consistency rate of online reporting information. Statistical analysis was conducted using R software 4.4.1. Logistic regression was used to analyze the influencing factors of report quality, and the TOPSIS method was adopted to evaluate the comprehensive filling quality of infectious disease reporting cards.
From 2023 to 2024, a total of 263 medical institutions were investigated, and the reporting rate of notifiable infectious diseases was 98.69%. The reporting rate in public medical institutions was higher than that in private ones (χ2=4.49, P< 0.05). The reporting rates of public medical institutions at or above the prefectural-level, county-level, and township-level showed a decreasing trend (Z=-5.68, P<0.01). The reporting rate of admission and discharge registration was the highest, followed by the outpatient department, and the reporting rate of radiological imaging registration was the lowest. The central region had the highest reporting rate (99.73%), while the three-state region had the lowest (94.00%). The timely reporting rate of the infectious disease report card was 95.40%, the complete filling rate was 97.15%, the filling accuracy rate was 86.78%, and the consistency rate of online report information was 94.49%. The comprehensive filling quality of infectious disease report cards in public township-level medical institutions is the best, followed by public county-level, public prefectural-level and public provincial-level medical institutions in sequence. The comprehensive filling quality of private medical institutions is the worst. Setting and filling norms for outpatient logs and admission and discharge logs, as well as conducting self-inspection notifications and rewards and punishments in a standardized manner, could improve the quality of infectious disease reporting.
The quality of notifiable infectious diseases reporting in medical institutions in Sichuan Provincewas generally good, but there are still weak areas and links in the reporting management work. Attention should be paid to the underreporting of public low-level medical institutions and the quality problems of the reporting cards of private and public high-level medical institutions. The quality of filling in basic information such as outpatient and admission and discharge registration, self-examination and feedback of abnormal information in radiological imaging registration should be strengthened.
To explore the intervention effect of group cup stacking games on elderly individuals with advanced age and mild cognitive impairment (MCI).
Using a self-controlled before-and-after design and convenience sampling, 30 elderly individuals with advanced-age MCI from a nursing home in Guangzhou were selected as the research subjects. They received a 6-week intervention of group cup stacking games. The Mini Mental State Examination (MMSE), the Connections Test Executive Time, Digit Breadth, and General Self-Efficacy Scale were used to assess the overall cognitive functioning, executive functioning, attention, and self-efficacy of the participants, respectively. Differences between pre- and post-intervention were compared by paired t-test and Wilcoxon signed rank test.
A total of 29 subjects were finally included in the study. Compared with pre-intervention, the overall cognitive function score of the subjects increased post-intervention (0.447, 95% CI: 0.062-0.826, P=0.023), and the score in the orientation cognitive domain also increased (0.380, 95% CI: -0.01-0.754, P=0.034). There were no statistically significant differences in the execution time of the Trail Making Test (0.123, 95% CI: -0.244-0.487, P=0.964), the Digit Span Test score (0.022, 95% CI: -0.343-0.385, P=0.707), and the self-efficacy score (0.297, 95% CI: -0.077-0.667, P=0.121).
The group cup stacking game intervention helps improve the overall cognitive function and orientation of elderly MCI patients with advanced age, and promotes their physical and mental health.
To establish a risk evaluation index system for delayed thrombolysis in patients with acute ischemic stroke (AIS) based on the three-dimensional framework of demand-supply-interaction, and to provide scientific evidence for clinical risk warning and intervention decision-making.
Literature analysis and focus group interviews were used to preliminarily establish an index system. The Delphi method and analytic hierarchy process were employed to determine indicator weights, followed by preliminary validation.
A total of 21 experts were consulted with an average working experience of (22.67±9.46) years, 12 of whom held deputy senior titles or above. The effective questionnaire recovery rate for both rounds was 100%, with an expert authority coefficient of 0.901 and coordination coefficients of 0.238 and 0.290, respectively. The final index system comprised 2 first-level indicators, 10 second-level indicators, and 95 third-level indicators. Classified by the three-dimensional demand-supply-interaction framework, the primary indicators were out-of-hospital delay factors (0.833 3) and in-hospital delay factors (0.166 7). Preliminary validation showed significant positive correlation between the total index score and door-to-needle time (r=0.72, P<0.001).
This study preliminarily constructs an operational risk evaluation index system for delayed thrombolysis in AIS patients, providing a theoretical framework for early risk identification, clinical decision support, and prognosis improvement. However, large-scale prospective studies are needed to further validate its clinical effectiveness.
Objective To analyze the changes in the disease burden of stroke attributable to low physical activity in China from 1990 to 2021, and to provide a scientific basis for the development of prevention and control strategies for stroke. Methods Data on mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for stroke attributable to low physical activity in China from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021. The disease burden of stroke attributable to low physical activity in China was analyzed by gender and age group from 1990 to 2021. The Joinpoint regression model was utilized to analyze the trends in disease burden. Results From 1990 to 2021, the number of deaths, mortality rates, YLLs, YLLs rates,YLDs, YLDs rates, DALYs, and DALYs rates attributable to low physical activity in China showed an upward trend, with increases of 129.80%, 90.48%, 97.39%, 63.26%, 216.74%, 162.17%, 112.94%, and 76.05%, respectively. The age-standardized mortality rate, age-standardized YLLs rate, and age-standardized DALYs rate showed a downward trend, with decreases of 20.14%, 25.68%, and 18.75%,respectively, while the age-standardized YLDs rate has increased by 18.26% compared to 1990. Joinpoint regression analysis results indicated that the average annual percent change (AAPC) for the age-standardized mortality rate, age-standardized YLLs rate, age-standardized DALYs rate, and age-standardized YLDs rate attributable to low physical activity from 1990 to 2021 were-0.72%, -0.96%, -0.68%, and 0.92%, respectively. Gender-stratified analysis revealed that in 2021, the age-standardized mortality rate, age-standardized YLLs rate, and age-standardized DALYs rate attributable to low physical activity were higher in males than in females. Meanwhile, the decline in the age-standardized mortality rate, age-standardized YLLs rate, and age-standardized DALYs rate attributable to low physical activity was more rapid in females compared to males. Age-stratified results indicated that the disease burden of stroke attributable to low physical activity increased with age but showed a trend toward affecting younger individuals. Conclusion The disease burden of stroke attributable to low physical activity in China remains substantial, indicating a need for targeted and comprehensive prevention and control measures, particularly for key populations such as the elderly, males, and middle-aged and young adults.
Objective This study investigates potential relationships between distinct physical activity patterns and metabolic syndrome (MS) to provide evidence for exercise-based prevention and control of MS. Methods Utilising data from 15 338 US adults in NHANES 2011—2020, participants were stratified into physical activity patterns. Metabolic syndrome (MS) was diagnosed via NCEP-ATP III criteria. Multivariable logistic regression evaluated associations between activity patterns and MS risk. Restricted cubic splines(RCS) were used to model dose-response relationships, and subgroup analyses were conducted. Results Compared with inactive individuals, both weekend warriors (aOR=0.856, 95% CI: 0.736-0.995) and regular exercisers(aOR=0.758, 95% CI: 0.690-0.833) exhibited significant inverse associations with MS risk. RCS analysis demonstrated a progressive reduction in MS risk with increasing total physical activity duration (P≤0.001). Subgroup analyses revealed enhanced protective effects for weekend warriors among adults aged >60 years(aOR=0.679, 95% CI: 0.518-0.887) and males(aOR=0.792, 95% CI: 0.639-0.979). In the regular exercise group, increases in activity duration, intensity, and frequency were significantly associated with lower MS risk. Conclusion This study demonstrates that both regular exercise and weekend warrior physical activity patterns correlate with reduced metabolic syndrome risk, highlighting the importance of physical activity in comprehensive MS prevention and intervention strategies.
Objective To establish a prediction model to assess the risk of death in patients with Klebsiella pneumoniae (Kp) infection, and to provide a reference for the development of targeted prevention and control strategies for nosocomial infections. Methods Patients with Klebsiella pneumoniae(Kp) infection at the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2022 were used as the training dataset. LASSO-logistic regression was applied to identify independent risk factors for death in Kp-infected patients, and a mortality risk nomogram was constructed. Patients with Kp infection from January 2023 to December 2023 were used as the validation dataset. Model discrimination, accuracy, and clinical utility were comprehensively evaluated using the area under the receiver operating characteristic curve (ROC), the calibration curve, and the decision analysis curve. Results A total of 1 972 Kp-infected patients were included in the training dataset, of which 234 Kp-infected patients died with a mortality rate of 11.87%. A total of 1 148 Kp-infected patients were included in the validation dataset, of which 126 Kp-infected patients died with a mortality rate of 10.98%. The results of LASSO-logistic regression modeling showed that patients aged >70 years, carbapenem resistance, mechanical ventilation, indwelling urinary catheter, diabetes mellitus, hematologic infections, white blood cell count >10×109/L and hemoglobin <115 g/L were all associated factors for death in patients with Kp infection (OR=24.6, 95% CI: 16.56-39.38; OR=2.44, 95% CI: 1.70-3.52; OR=4.97, 95% CI: 3.08-8.21; OR=2.99, 95% CI: 1.75-5.19; OR=18.24, 95% CI: 9.27-38.12; OR=2.75, 95% CI: 1.69-4.49; OR=4.18, 95% CI: 2.88-6.09; OR=2.65, 95% CI: 1.79-3.93). The areas under the ROC curve of the training dataset and validation dataset were 0.900 (95% CI: 0.876-0.924) and 0.843 (95% CI: 0.812-0.874), respectively. The calibration curve was close to the baseline curve, and the decision analysis curve was close to the upper right corner. Conclusion By analyzing the factors related to the death of Kp-infected patients, we constructed a nomogram prediction model of the risk of death of Kp-infected patients, which has good accuracy, discrimination, and clinical utility, and according to which targeted nosocomial infection prevention and control measures can be implemented.
Objective To explore the patterns and influencing factors of multimorbidity in the elderly. Methods A total of 7 354 adults aged ≥60 years in Huai’an District, Hongze District and Lianshui County of Huai’an City were investigated for chronic diseases and their risk factors. Hierarchical clustering was used to determine the multimorbidity patterns. Apriori algorithm was used to explore the association rules between chronic diseases. Binary logistic regression analysis was used to explore the influencing factors of major multimorbidity patterns. Results The prevalence of chronic diseases was 81.93%, and the prevalence of multimorbidity was 42.62%.Hierarchical clustering grouped eight chronic diseases into three categories. The two main multimorbidity patterns were: ① hypertension, diabetes, dyslipidemia, stroke, and myocardial infarction; ② asthma and COPD. The Apriori algorithm identified hypertension, diabetes,dyslipidemia, and stroke as the multimorbidity pattern of cardiovascular and cerebrovascular diseases, and COPD and asthma as the multimorbidity pattern of chronic respiratory diseases. In the multimorbidity pattern of cardiovascular and cerebrovascular diseases,compared with those without eight chronic diseases, increasing age, former smoking and current non-smoking, increasing BMI and central obesity increased the risk of cardiovascular and cerebrovascular disease comorbidity by 0.022 (OR=1.022, 95% CI: 1.012-1.033),0.466 (OR=1.466, 95% CI: 1.081-1.987), 0.144 (OR=1.144, 95% CI: 1.117-1.172), 0.505 (OR=1.505, 95% CI: 1.283-1.766). In the multimorbidity pattern of chronic respiratory diseases, compared with those without eight chronic diseases, former smokers and current non-smokers (OR=3.851, 95% CI: 2.132-6.956), central obesity (OR=1.696, 95% CI: 1.064-2.701) were the risk factors, while being female (OR=0.366, 95% CI: 0.229-0.587) and decreased BMI (OR=0.926, 95% CI: 0.869-0.994) were the protective factors. Conclusion Hypertension, stroke, dyslipidemia and diabetes are easy to coexist, and asthma and COPD are easy to coexist. Smoking was an important risk factor for multimorbidity. Central obesity was a risk factor for both multimorbidity patterns, especially for the cardiovascular and cerebrovascular multimorbidity pattern.
Objective This study investigates the mediating effects of general self-efficacy and social participation on the relationship between physical function and physical resilience (PR) among older adults. Methods The elderly in five communities selected by cluster sampling in Xinxiang City were surveyed using the Simplified Physical Fitness Test Scale,Physical Resilience Scale, General Self-Efficacy Scale, and the Social Participation Scale from March to November 2024.Descriptive statistics, variance analysis, and correlation analysis were conducted, and a chain mediation effect model was constructed using Mplus 8.3. Results A total of 1 071 elderly people in the community were surveyed, the PR score of the elderly in the community was (48.81±5.66), and the PR of the elderly was positively correlated with physical function, general self-efficacy, and social participation (all P<0.05). After including control variables such as age, sleep duration, and living arrangement, general self-efficacy and social participation played a chain mediating effect between physical function and PR,with a mediating effect value of 0.311, accounting for 55.24% of the total effect. Conclusion Physical function in the elderly can directly affect PR, and can also indirectly affect PR through general self-efficacy and social participation. The PR of older adults can be improved by improving their physical functioning, self-efficacy, and social participation.
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