To establish gestational age-specific weight gain trajectories associated with birth outcomes—small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA)—among females with different pre-pregnancy body mass index (preBMI) categories in Guangxi, China, and to compare these trajectories with the current national guidelines. The goal is to provide evidence for developing region-specific recommendations on gestational weight gain (GWG).

This study included 5 562 singleton pregnant females who delivered at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region between 2019 and 2021 and had complete clinical records. Gestational weight gain percentile curves were constructed for each birth weight category based on different preBMI strata and were compared with national guideline ranges. Logistic regression was used to assess associations between preBMI-specific GWG at different gestational stages and neonatal birth weight outcomes.

For AGA outcomes, the recommended total GWG ranges were 12.81-16.50 kg for underweight females, 11.87-16.17 kg for normal-weight females, 10.46-15.41 kg for overweight females, and 7.51-13.29 kg for obese females. These ranges were all slightly higher than those suggested by the national guidelines,indicating potential regional differences in gestational weight gain. Total GWG was negatively associated with the risk of SGA and positively associated with the risk of LGA, with the impact on SGA gradually diminishing as preBMI increased. For SGA,weight gain during the first and second trimesters was negatively associated with the risk of SGA in females with underweight and normal pre-pregnancy BMI, while a similar trend was observed in overweight females during the second trimester. For LGA,weight gain in the first and second trimesters was positively associated with the risk of LGA in underweight and overweight females. In normal-weight females, a similar association was observed across all trimesters, whereas in obese females, positive associations were found in the first and third trimesters.

Gestational weight gain demonstrates significant regional characteristics. Developing region-specific and preBMI-based gestational age-specific GWG guidelines may be crucial for effectively reducing the incidence of both SGA and LGA.

To analyze the trend and influencing factors of stunting among infants and young children (IYC) aged 6-23 months in rural areas of Liuzhou from 2017 to 2023, to provide evidence for early prevention and intervention for stunting.

Children nutrition improvement projects monitoring survey data of 4 175 IYC in Liuzhou between 2017 and 2023 were retrospectively analyzed. Complementary feeding practices were assessed using WHO/UNICEF 2021 IYC feeding indicators. The trend of stunting prevalence was analyzed by χ² trend test, and the risk factors of stunting were analyzed by logistic regression analysis.

The prevalence of stunting in the IYC in rural Liuzhou decreased from 11.52% in 2017 to 3.85% in 2023 (χ²_trend=41.914, P<0.001). Multivariate logistic regression analysis showed that mothers of Miao ethnicity (OR=1.63, 95%CI: 1.13-2.37), mothers of Dong ethnicity (OR=1.74, 95% CI: 1.24-2.44), middle school and below education (primary school or below: OR=1.94, 95% CI: 1.22-3.08; middle school: OR=1.64, 95% CI: 1.10-2.44), preterm birth (OR=4.27,95% CI: 2.89-6.30), term SGA (OR=3.04, 95% CI: 2.25-4.09), boys (OR=1.96, 95% CI: 1.51-2.55), aged 12-23 months (OR=1.93, 95% CI: 1.45-2.57) , unmet minimum meal frequency (OR=1.45, 95% CI: 1.08-1.95) were risk factors for stunting.Mother's occupation as agriculture (OR=0.57, 95% CI: 0.37-0.87), father's occupation as non-agriculture (OR=0.45, 95% CI:0.30-0.68), feeding and nutrition knowledge scores (OR=0.78, 95% CI: 0.70-0.86) were protective factors.

The prevalence of stunting among IYC aged 6-23 months in rural areas of Liuzhou showed a decreasing trend from 2017 to 2023,but was higher than the national average level. Attention needs to be paid to preterm births, term SGA, mothers from ethnic minorities or with low educational level, and complementary feeding practices for IYC, in order to reduce the incidence of stunting.

To examine the relationship between postnatal passive smoking and neuropsychological development in rural 2-year-old children.

This study, based on a birth cohort study conducted in rural Yunnan Province in the previous period, followed up with assessments of passive smoking at ages 1 and 2, and a total of 293 mother-child pairs were included in the study. Passive smoking exposure was assessed through self-reports and children's urinary cotinine tests. At age 2, cognitive, language, and motor development were evaluated using the Bayley-III scales. Stata software and multivariate binary logistic regression models were used to analyze the association between between postnatal passive smoking exposure and neuropsychological development in 2-year-old children.

Passive smoking exposure rates of 293 toddlers were 45.73%at age 1 and 65.19% at age 2. Mean cognitive, language, and motor scores at age 2 were 100.73±18.60, 99.50±16.99, and 101.05±19.86, with developmental delay rates of 7.51%, 15.07%, and 14.43%, respectively. The results of the logistic regression analyses showed that passive smoking at age 1 increased the risk of language development delay (OR=2.036, 95%CI: 1.025-4.046).

Passive smoking in infancy is a risk factor for lagging language development in 2-year-old children. It is recommended to create a smoke-free growing environment for infants and toddlers to protect and promote early neuropsychological development.

To develop a quality assessment scale for children's musculoskeletal disorders health short videos and evaluate its reliability and validity.

The initial scale was developed through literature review, semi-structured interviews, and Delphi expert consultation. A total of 240 health short videos on children's musculoskeletal disorders were selected from Douyin as research subjects and evaluated by two raters. The 480 datasets were randomly divided into two groups for item analysis and reliability/validity testing.

The scale consisted of 22 items across five dimensions (presentation literacy, creator authority, information comprehensibility, video production quality, and audience feedback). The item-level content validity index and scale-level content validity index were both 1.00. The scale demonstrated a Cronbach's α of 0.812,inter-rater reliability of 0.872, and test-retest reliability of 0.914. All items had factor loadings above 0.400, and the cumulative variance explanation rate of the five dimensions was 67.464%. Confirmatory factor analysis indicated good model fit.

The quality assessment scale for children's musculoskeletal disorders health short videos exhibits good reliability and validity, effectively evaluating the quality of relevant short videos.

To analyze the relationship between longitudinal changes in blood pressure and new-onset cardiovascular diseases (CVD) in older adults with hypertension in the community of Suzhou, and to provide a reference threshold for blood pressure management in older adults.

The physical examination data from 4 019 older adults with hypertension who participated in health check-ups at a community health service center in Suzhou from 2021 to 2023 were collected.Generalized Estimating Equations (GEE) and Restricted Cubic Splines(RCS) models were used to analyze the association between blood pressure changes and new-onset CVD in older adults with hypertension.

A total of 365 new cases of new-onset CVD were observed among older adults, with a cumulative incidence rate of 9.1%. GEE analysis showed that after adjusting for the control variables, diastolic blood pressure (DBP) was negatively associated with the risk of new-onset CVD (OR=0.97, 95% CI: 0.96-0.98, P<0.001), while pulse pressure (PP) was positively associated with the risk of new-onset CVD (OR=1.01, 95% CI: 1.00-1.01, P<0.05). The RCS model showed that there were significant non-linear dose-response relationships between low DBP and the increased risk of new-onset CVD, and between low PP and the decreased risk of new-onset CVD (non-linear test P<0.05). Subgroup analysis showed that DBP≤84 mm Hg and ≥95 mm Hg, and PP between 77 to 88 mm Hg in the uncontrolled systolic blood pressure(SBP) group were significantly associated with an increased risk of new-onset CVD,while PP≤51 mm Hg in the controlled SBP group was significantly associated with a decreased risk of new-onset CVD.

Low and/or high DBP may increase the risk of new-onset CVD in older adults with hypertension in the community, while low PP has a protective effect on new-onset CVD. However, when SBP is not controlled, PP will increase the risk of new-onset CVD in a higher threshold range.

To assess the level of residents’ sense of gain in basic public health services, analyze its potential categories and influencing factors, and explore the improvement direction in the supply of basic public health services.

Through multistage sampling, 1 383 adult residents who received public health services in Shanxi Province were surveyed by electronic questionnaire in July 2023, and the residents’ sense of gain and its influencing factors were explored based on latent profile analysis.

The average score of residents’ sense of gain in basic public health services on a percentile scale was (59.03±18.17). The residents’ sense of gain in basic public health services could be classified into four categories based on the scores in six dimensions: high sense of gain (37.88%), relatively high sense of gain (33.55%), relatively low sense of gain(15.83%), and low sense of gain (12.73%), and the sense of gain varied among residents with different educational attainment, monthly income and age.

The overall level of residents’ sense of gain in basic public health services is moderately high, indicating that the supply effect of basic public health services is relatively satisfactory. However, in light of the characteristics presented by different categories of residents, managers need to adopt differentiated strategies such as popularizing service projects and its free nature or intensifying precise publicity and education efforts for special groups.

To examine the utilization and influencing factors of rehabilitation services among certified persons with disabilities in China, providing a basis for meeting the rehabilitation service needs of disabled individuals and enhancing service utilization.

Using data from the 2023 national survey on the subjective perceptions and evaluations of the status of persons with disabilities and the national database on persons with disabilities, a descriptive analysis and binary logistic regression analysis were conducted to assess factors associated with rehabilitation service use among certified persons with disabilities.

Among 8 667 certified persons with disabilities, 2 244 individuals used rehabilitation services in the past year, with a utilization rate of 25.89%. Among those who used rehabilitation services, 89% used one type of service, while only 11% used two or more types. Multivariate regression analysis showed that middle and higher income levels (OR=1.318,95% CI: 1.158-1.502; OR=1.625, 95% CI: 1.423-1.856), receipt of disability subsidies (OR=1.515, 95% CI: 1.329-1.726),and health insurance (OR=1.395, 95% CI: 0.972-2.003) were significant factors promoting the use of rehabilitation services.Individuals with mental disabilities (OR=3.034, 95% CI: 2.357-3.904) and physical disabilities (OR=1.202, 95% CI: 0.975-1.483) were more likely to use rehabilitation services. Regarding community support, the presence of rehabilitation service stations (OR=1.174, 95% CI: 1.026-1.343), day care centers (OR=1.439, 95% CI: 1.242-1.668), suitable cultural and sports facilities for persons with disabilities (OR=1.323, 95% CI: 1.170-1.496), and accessibility features in public service locations (OR=1.174, 95% CI: 1.036-1.329) positively influenced rehabilitation service utilization.

The utilization of rehabilitation services among persons with disabilities is closely associated with socioeconomic status, type of disability, and supportive community environments.

To explore the cognition of medical staff within the tightly-knit county-level medical consortium in Xinyi County, Jiangsu Province regarding the reform of medical insurance payment methods and the influencing factors, and to provide references for deepening the reform of medical insurance payment methods within the medical consortium.

By using stratified cluster sampling method, a questionnaire survey was conducted among 1 415 medical staff within the medical consortium of Xinyi City from October 2021 to January 2022. The random forest model was employed to screen variables and multivariate logistic regression analysis was conducted to analyze the influencing factors.

Medical staff had a relatively high level of understanding of the medical insurance payment methods of disease-based payment (87.1%) and service-item-based payment (74.3%); they had a relatively high level of recognition of the medical insurance payment methods of disease-based payment (75.1%) and bundled payment based on medical consortium (51.7%). 91.7% of the medical staff were relatively familiar with the reform. The working institutions were township health centers and community health service centers (OR=2.300, 95% CI: 1.205-4.391), and medical staff with senior professional titles or above (OR=4.701, 95% CI: 1.610-13.727) had a relatively high level of understanding of the reform. 81.5% of the medical staff expressed their recognition of the reform. Doctors (OR=2.032, 95% CI: 1.459-2.828), nurses (OR=1.638, 95% CI: 1.073-2.501), medical staff with a master's degree or above (OR=2.399, 95% CI: 1.050-5.480), and medical staff with shorter working years (OR_11-15years=0.546, 95% CI: 0.327-0.911; OR_16-20years=0.516, 95% CI: 0.285-0.932; OR_≥21years=0.443, 95% CI:0.272-0.722) had a relatively high level of recognition of the reform.

The level of awareness and acceptance of new payment methods such as bundled payment for total medical expenses by medical staff within the tightly-knit county-level medical consortium still needs to be improved. It is suggested that measures such as stratified training and the introduction of talent incentive policies for grassroots medical institutions be adopted to enhance the awareness and recognition of medical staff.

To analyze the independent effects and interaction of tobacco dependence level and depression on health related quality of life (HRQoL) among current smokers.

The data was from the 2021 “Psychology and Behavior Investigation of Chinese Residents” (RBICR) and a total of 1 399 cases were included in the analysis. Tobacco dependence level, depression, and HRQoL were assessed using the fagerstrom test for nicotine dependence scale, the patient health questionnaire-9 and the European five-dimensional five-level health scale. Mplus 7.0 and R software were used for analyses.

The latent class analysis supported low and high level tobacco dependence level, with mean health utility value of 1.00(0.95, 1.00) and 1.00(0.89, 1.00), respectively, and the difference was statistically significant (Z=-5.521, P<0.001). The mean health utility values of the depressed and non-depressed groups were 1.00(0.84, 1.00), 1.00(0.95, 1.00), and the difference was statistically significant (Z=-7.580, P<0.001). Tobit regression analysis found that tobacco dependence level (β=-0.030, 95% CI:-0.043~-0.018) and depression(β=-0.068, 95%CI: -0.083~-0.053) were negatively associated with health utility value. Interaction analysis found no multiplicative interactions between tobacco dependence level and depression on HRQoL (OR=1.039, 95% CI: 0.589-1.831). There was a additive interaction between tobacco dependence level and depression on HRQoL, with high levels of tobacco dependence and depression co-existing at a higher risk of unhealthiness than the two factors alone(RERI=1.411, 95% CI: 0.055-2.767), and the synergistic effect was 1.464 times greater than the sum of the effects of the two factors alone(SI=1.464, 95% CI: 0.990-2.163), and the proportion of all unhealthy smokers attributable to high levels of tobacco dependence with a synergistic effect of depression was 25.87%(AP=25.87%, 95% CI: 3.91%-47.82%). Sensitivity analysis found that AP and SI index increased.

Tobacco dependence level and depression were negatively associated with HRQoL, and there was an additive interaction on HRQoL. Reducing tobacco dependence level among current smokers, developing targeted smoking cessation interventions and preventing depressive symptoms are important for improving current smokers’ HRQoL.