Home Archive
Archive
2026 Volume 42 Issue 5  Published: 2026-05-10
    Criterion, Guideline, Consensus
  • Chinese Nutrition Society Hydration for Health Branch
    doi: 10.11847/zgggws1150031

    Microplastics refer to plastic particles with a particle size of less than 5 millimeters, which have been recognized by some institutions as a new type of environmental pollutant. Microplastics are widely present in marine, freshwater, atmospheric, and soil environments, and have also been detected in common foods and drinking water in daily life. Human is exposed to microplastics through multiple pathways, and multiple studies have detected the presence of microplastics in tissues such as feces, urine, blood, and placenta, suggesting potential health impacts. The expert consensus writing group of the Microplastics and Health Core Information of the Hydration for Health Branch of the Chinese Nutrition Society invited experts from multiple disciplines such as environment, food safety, nutrition, and journalism and communication from universities, research institutions, and Centers for Disease Control and Prevention serve as consultants. Based on the latest results and evidence from studies related to microplastics and health, and combined with the Delphi expert consultation method, an expert consensus on microplastics and health core information was developed. It is aimed to improve public awareness of microplastic exposure and its relationship with health. In this way, the risk of microplastic exposure in the body and microplastic pollution in the environment can be reduced, and ultimately the goal of the ecological environment protection and human health maintenance can be achieved.

  • Criterion, Guideline, Consensus
  • Bing WANG , Xin SHENG
    doi: 10.11847/zgggws1148763

    Secondary water supply is an important part of municipal pipe networks, directly impacting drinking water quality for thousands of households. To meet the requirements of the new situation and strengthen the sanitary management of secondary water supply facilities, the Beijing Center for Disease Prevention and Control ‌led the revision of‌ the Hygienic Specification for Facilities of Secondary Water Supply (GB 17051—1997) from 2020 to 2025. The revised standard, Hygienic Specification for Facilities of Secondary Water Supply (GB 17051—2025), was issued on May 30, 2025, and will be implemented on June 1, 2026. This article interprets the background, drafting principles, main concepts, and main contents of the revision, thus improving the understanding about the contents of the standard and guide the application of the standard.

  • Special Report—Sleep Health and Wellness
  • Xin GAO , Yingchen SANG , Xinying ZENG , Youjiao WANG , Ying LIU , Chi ZHANG , Zhiping PENG , Shiwei LIU
    doi: 10.11847/zgggws1149350
    Objective

    To understand the prevalence status and influencing factors of sleep rhythm problems among community residents aged ≥15 in 7 provinces (municipality) of China, thus providing a scientific basis for formulating intervention measures for sleep rhythm problems.

    Methods

    From March to October 2024, a multi-stage stratified cluster random sampling method was used to survey 50 400 community residents aged ≥15 in seven provinces (municipality), including Hebei, Liaoning, Jiangsu, Henan, Guangdong, Chongqing, and Shaanxi. The prevalence status and influencing factors of delayed sleep phase problem (DSPP) and advanced sleep phase problem (ASPP) were analyzed.

    Results

    Among the 46 193 community residents included in the analysis, 172 and 8 354 were detected with DSPP and ASPP, respectively, with weighted detection rates of 1.07% and 11.90%. The results of the multivariate unconditional logistic regression analysis showed that students or had current smoking, drinking, frequent use of electronic products before bedtime, and frequently eating late-night snacks were associated with a higher risk of DSPP, while those aged ≥40 had a lower risk of DSPP. Age ≥ 40, living in rural areas, drinking, and having chronic diseases were associated with a higher risk of ASPP, while the educational background of junior high school or above, office workers, students, other occupations, engaging in physical activity 3 to 4 times a week, and frequently eating late-night snacks were associated with a lower risk of ASPP.

    Conclusions

    The detection rate of sleep rhythm problems among community residents aged ≥15 in 7 provinces (municipality) of China is relatively high, with age, educational background, occupation, drinking habits, and whether frequently eating late-night snacks being common influencing factors for the detection of DSPP and ASPP.

  • Special Report—Sleep Health and Wellness
  • Yingchen SANG , Xinying ZENG , Ying LIU , Youjiao WANG , Xin GAO , Chi ZHANG , Zhiping PENG , Shiwei LIU
    doi: 10.11847/zgggws1149306
    Objective

    To understand the associations between different smoking behavior characteristics and sleep quality among Chinese male residents aged 15 years and above, thus providing scientific evidence for developing relevant intervention measures.

    Methods

    From March to October 2024, a multi-stage stratified cluster random sampling method was used to select survey subjects from 70 counties/districts in 7 provinces/autonomous regions/municipalities across China. Face-to-face interviews were conducted with electronic questionnaires, and 22 333 individuals were ultimately included in the analysis. The Rao-Scott χ2 test based on complex sampling design was conducted to compare demographic characteristics of male residents of different smoking status, and univariate analysis was performed to examine the associations between different smoking behavior characteristics and sleep quality. Multivariate logistic regression was adopted to analyze the associations of different smoking status and smoking behavior characteristics (smoking index, daily cigarette consumption, and smoking duration) with sleep quality among males.

    Results

    Among the 22 333 male residents aged 15 and above in China, 44.92% (8 561), 42.84% (9 905), and 12.24% (3 867) were non-smokers, current smokers, and former smokers, respectively. The prevalence of poor sleep quality was 20.42%. Univariate analysis showed that the prevalence of poor sleep quality differed among male residents of different smoking status (χ2 = 83.893, P < 0.000 1). In both current smokers and former smokers, there were statistically significant differences in the associations of daily cigarette consumption (χ2current smoker = 26.821; χ2former smoker = 10.958), smoking duration (χ2current smoker = 39.380; χ2former smoker = 9.078), and smoking index (χ2current smoker = 26.177; χ2former smoker = 9.389) with sleep quality (P < 0.05). Cochran-Armitage trend tests showed that as daily cigarette consumption (χ2current smoker = –6.741, χ2former smoker = –3.955), smoking duration (χ2current smoker = –13.775, χ2former smoker = –5.536), and smoking index (χ2current smoker = –9.294, χ2former smoker = –5.081) increased, the prevalence of poor sleep quality showed a linear increasing trend (P < 0.000 1). Multivariate logistic regression analysis, adjusted for confounders including age, gender household registration, geographic region, educational background, occupation, annual household income, alcohol consumption, exercise frequency, BMI, and chronic diseases, revealed that compared to non-smoking, both current smoking (OR = 1.312, 95%CI: 1.107–1.556) and former smoking (OR = 1.475, 95%CI: 1.173–1.854) were associated with a higher risk of poor sleep quality. Compared to non-smoking, the smoking index of <10 pack-years (OR = 1.293, 95%CI: 1.047–1.598), 10 to <20 pack-years (OR = 1.472, 95%CI: 1.177–1.841), 20 to <30 pack-years (OR = 1.470, 95%CI: 1.085–1.992), and ≥30 pack-years (OR = 1.283, 95%CI: 1.086–1.514) were associated with a higher risk of poor sleep quality. Compared to non-smoking, daily cigarette consumption of ≤10 cigarettes (OR = 1.197, 95%CI: 1.001–1.431), 11–20 cigarettes (OR = 1.421, 95%CI: 1.169-1.727), 21–30 cigarettes (OR = 1.608, 95%CI: 1.166–2.216), and >30 cigarettes (OR = 1.681, 95%CI: 1.208-2.338) were associated with a higher risk of poor sleep quality. Compared to non-smoking, smoking duration of 10 to <31 years (OR = 1.339, 95%CI: 1.109–1.618), 31 to <40 years (OR = 1.296, 95%CI: 1.093–1.536), and ≥40 years (OR = 1.327, 95%CI: 1.116–1.578) were associated with a higher risk of poor sleep quality.

    Conclusions

    Smoking associates with high risk of poor sleep quality, and the detrimental effect of smoking on sleep quality exhibits a dose-response relationship, suggesting that the cumulative effect of long-term nicotine exposure may be a key pathway for disrupting sleep quality.

  • Special Report—Sleep Health and Wellness
  • Youjiao WANG , Yingchen SANG , Xinying ZENG , Ying LIU , Xin GAO , Chi ZHANG , Zhiping PENG , Shiwei LIU
    doi: 10.11847/zgggws1149313
    Objective

    To examine the association between secondhand smoke (SHS) exposure and sleep quality among female non-current smokers aged ≥15 years in China, thereby providing evidence for formulating tobacco control strategies to improve sleep health.

    Methods

    A cross-sectional survey was conducted between March and October 2024. Through a multistage stratified cluster random sampling design, a total of 21 870 female non-current smokers aged ≥15 years were recruited from seven provinces (autonomous regions, municipalities) in China. Data on SHS exposure and sleep-related variables were collected through face-to-face electronic questionnaires administered by trained investigators. Complex sampling weights were adopted to describe the demographic characteristics and SHS exposure of participants. Rao-Scott chi-square tests were conducted to assess subgroup differences, and multivariate logistic regression models were employed to evaluate the association between SHS exposure and sleep quality after adjusting for potential confounders.

    Results

    Among the 21 870 participants, 12 082 (45.32%) resided in urban areas and 9 788 (54.68%) in rural areas. The overall prevalence of SHS exposure was 44.01%, with a higher exposure rate at home (22.79%) than in the workplace (15.90%). Univariate analysis revealed that females exposed to SHS had higher prevalence of poor sleep quality than those unexposed (32.54% vs. 23.59%, χ2 = 26.97, P < 0.01). Specifically, SHS exposure at home was associated with higher prevalence of poor sleep quality than non-exposure (36.10% vs. 25.00%, P < 0.01). A similar trend was observed in the workplace (29.50% vs. 18.00%, P < 0.01). After adjusting for confounders, multivariate logistic regression showed that SHS exposure was a significant risk factor for poor sleep quality at the overall level (OR = 1.87, 95%CI: 1.56–2.23), at home (OR = 1.76, 95%CI: 1.47–2.12), and in the workplace (OR = 1.62, 95%CI: 1.19–2.20).

    Conclusions

    SHS exposure was significantly associated with poor sleep quality among female non-current smokers aged ≥15 years in China, indicating that SHS exposure may be a modifiable risk factor for poor sleep quality in females.

  • Special Report—Applications of Artificial Intelligence in Public Health
  • Cheng TANG , Zhanchun FENG , Gang LI , Rui ZHAO
    doi: 10.11847/zgggws1146317
    Objective

    To analyze typical cases of AI-empowered proactive health management for chronic disease patients, providing mature references for advancing the application of AI in healthcare institutions and chronic disease patient management.

    Methods

    From October 20 to November 1, 2024, we searched platforms including the China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, Chinese Medical Journal Full-text Database, Health News, and the official websites of the National Health Commission and the Chinese Center for Disease Control and Prevention for the typical cases of AI-empowered proactive health management for chronic disease patients. Using the text analysis method based on key dimensions of proactive health concepts, we established a thematic framework through hierarchical coding to distill the practical outcomes of these cases.

    Results

    A total of 43 AI-empowered proactive health management cases for chronic disease patients were included as primary textual sources for framework construction. Three thematic frameworks—individual health responsibility, interpersonal relationship support, and disease management—were constructed. Individual health responsibility involved health monitoring, health assessment, and health education. Interpersonal relationship support included social support and psychological support. Disease management encompassed medication management, diet management, and personalized intervention. Through further screening, 10 representative cases were finalized, and an integrated pathway for AI-empowered proactive health management was distilled. That is, by integrating big data with human-machine interaction, a bidirectional proactive health management cycle was established between healthcare institutions and chronic disease patients, encompassing health monitoring, assessment/diagnosis, intervention reminders, and medication management.

    Conclusions

    AI enables integrated health management by bidirectionally empowering both healthcare institutions and chronic disease patients. This approach not only enhances patient engagement but also alleviates the workload of primary care providers.

  • Special Report—Applications of Artificial Intelligence in Public Health
  • Yuqian WU , Shuwen DONG , Xinrong XIANG , Zongxin LI , Jianzhe GAN , Pengzhe QIN
    doi: 10.11847/zgggws1148796
    Objective

    To compare the accuracy of multiple large language models (LLM) and manual judgment in predicting infectious disease trends.

    Methods

    Using monthly report data of 17 infectious diseases in Guangzhou from January to December 2024, we used five LLM and expert judgments from public health physicians for prediction and compared the predicted results with actual trends.

    Results

    A total of 99 predictions were conducted for 17 infectious diseases. The accuracy rate of prediction by public health physicians was 84.85%, and that of the AI-integrated prediction was 73.74%. The prediction accuracy of AI products followed the trend of Kimi (70.71%), Doubao (68.69%), Lingxi (68.69%, parallel), ERNIE Bot (65.66%), and Deep Seek (63.64%). On the basis of 99 referred data items related to dengue fever, norovirus infection, hand-foot-mouth disease, pertussis, and influenza, in the identification of epidemic inflection points, public health physicians showed the accuracy of 50.0%, followed by Kimi (30.0%), AI integration (20.0%), and Doubao (20.0%, parallel); public health physicians showed the F1 score of 0.56, followed by Kimi (0.40), Doubao (0.38), and AI integration (0.27).

    Conclusions

    Currently, public health physicians have higher accuracy in predicting infectious disease trends than AI, especially in identifying the impacts of complex social factors.

  • Special Report—Applications of Artificial Intelligence in Public Health
  • Jie LIU , Shuxin HAO , Bohan LIU , Yue LIU
    doi: 10.11847/zgggws1148202
    Objective

    To develop an intelligent question-answering model based on retrieval-augmented generation (RAG) to assist public health professionals in efficiently and accurately extracting key information from technical documents such as regulations, guidelines, manuals, and literature, thereby improving knowledge acquisition efficiency and standardized application capabilities.

    Methods

    On the basis of RAG, this study integrates an automated text preprocessing mechanism and employs the LangChain framework to construct a context-aware unified retrieval-augmented question-answering model powered by large language models (CURA-LLM). This model combines a threshold-managed information retrieval module with a response generation module supported by historical dialogue records.

    Results

    CURA-LLM demonstrated outstanding performance on three representative public health datasets related to operational guidelines, testing procedures, and legal regulations, with the F1 scores of 0.941, 0.891, and 0.947, and the cosine similarities of 0.968, 0.929, and 0.963, respectively. Moreover, CURA-LLM outperformed three existing domain-specific question-answering models in terms of retrieval relevance and answer accuracy.

    Conclusions

    CURA-LLM provides effective support for the intelligent interpretation and rapid extraction of knowledge from public health technical documents. It can assist personnel in quickly responding and standardizing execution in scenarios such as emergency responses, routine management, and professional training, offering strong potential for practical application.

  • Special Report—Applications of Artificial Intelligence in Public Health
  • Wenli LI , Xiaoxu YIN
    doi: 10.11847/zgggws1148951

    With the deepening application of artificial intelligence in the medical field, institutional challenges such as inconsistent data standards, algorithmic bias, and insufficient privacy protection are becoming increasingly prominent. This article systematically reviews the interaction mechanisms between algorithms and ethics in the human-machine symbiosis model of healthcare, analyzes the bioethical conflicts triggered by technology empowerment, and proposes an integrated framework for establishing a new order in intelligent healthcare. By implementing an algorithm-transparent dual-track disclosure system and a three-level dynamic authorization mechanism for sensitive data, the risk of decision-making black boxes is mitigated. Establishing a four-tier model for medical data based on the Data Security Law and creating a three-dimensional supervision mechanism of patient empowerment, ethical firewall, and industry disciplinary measures provide a collaborative governance path to bridge the gap between technological innovation and institutional response.

  • Epidemiological Research
  • Zeyu JIANG , Xin LIU , Ting LI , Dong LIANG , Sufang DUAN , Ignatius Man-Yau Szeto , Gang FENG , Wenxin LIANG , Tingchao HE , Hua JIANG , Yumei ZHANG
    doi: 10.11847/zgggws1148607
    Objective

    To investigate the associations of serum triglyceride (TG) levels with various metabolic abnormalities among adult residents in 5 cities of western China, thereby providing evidence for the prevention and management of metabolic syndrome in this region.

    Methods

    A multistage stratified cluster sampling method was used to recruit 990 adult permanent residents ≥18 years old from Chifeng, Hohhot, and Ordos in Inner Mongolia Autonomous Region, Lhasa in Xizang Autonomous Region, and Dali in Yunnan province between March and October 2023. Data were collected through questionnaires, physical examinations, and laboratory tests. Multivariate unconditional logistic regression models were used to analyze the associations between serum TG levels and various metabolic abnormalities, including overweight and obesity, central obesity, hypertension, elevated low-density lipoprotein cholesterol (LDL-C), decreased high-density lipoprotein cholesterol (HDL-C), elevated total cholesterol (TC), insulin resistance, diabetes, and hyperuricemia.

    Results

    A total of 939 adults were included in the final analysis. Among the surveyed population, 611 (65.0%), 163 (17.4%), and 165 (17.6%) had normal TG levels, borderline high TG, and elevated TG, respectively. The number (detection rates) of respondents with overweight and obesity, central obesity, hypertension, elevated LDL-C, decreased HDL-C, elevated TC, insulin resistance, diabetes, and hyperuricemia was 536 (57.1%), 432 (46.0%), 389 (41.4%), 94 (10.0%), 82 (8.7%), 237 (25.2%), 310 (33.0%), 227(24.2%), and 310 (33.0%), respectively. After adjusting for sex, age group, region, educational background, per capita monthly household income, smoking status, drinking status, physical activity level, and daily intake of cereals, tubers, vegetables, fruits, animal-based foods, dairy products, soy and nuts, salt, and oil, multivariate unconditional logistic regression analyses showed that adults with borderline high TG had higher detection rates of overweight and obesity (OR = 2.70, 95%CI: 1.80–4.04), central obesity (OR = 1.67, 95%CI: 1.13–2.48), hypertension (OR = 1.71, 95%CI: 1.15–2.54), elevated LDL-C (OR = 3.65, 95%CI: 2.03–6.59), elevated TC (OR = 3.42, 95%CI: 2.22–5.26), insulin resistance (OR = 2.65, 95%CI: 1.79–3.90), and hyperuricemia (OR = 2.31, 95%CI: 1.55–3.44) than the adults with normal serum TG levels. Adults with elevated TG had higher detection rates of overweight and obesity (OR = 4.68, 95%CI: 2.96–7.40), central obesity (OR = 4.25, 95%CI: 2.75–6.58), hypertension (OR = 1.83, 95%CI: 1.22–2.74), elevated LDL-C (OR = 4.66, 95%CI: 2.55–8.50), reduced HDL-C (OR = 5.85, 95%CI: 2.59–13.23), elevated TC (OR = 6.24, 95%CI: 3.98–9.79), insulin resistance (OR = 5.22, 95%CI: 3.47–7.83), diabetes (OR = 2.30, 95%CI: 1.50–3.52), and hyperuricemia (OR = 6.41, 95%CI: 4.22–9.73).

    Conclusions

    Elevated serum TG among adults in 5 cities of western China are positively associated with multiple metabolic abnormalities, including overweight and obesity, central obesity, hypertension, elevated LDL-C, decreased HDL-C, elevated TC, insulin resistance, diabetes, and hyperuricemia.

  • Epidemiological Research
  • Siying WU , Shiying LIN , Zhijian HU , Gang CHEN , Le YANG , Xiongpeng WU
    doi: 10.11847/zgggws1149342
    Objective

    To construct and evaluate an index system for assessing the medical care-prevention integration capabilities of clinical medical professionals, providing a reference for advancing the national strategy of medical care-prevention integration.

    Methods

    A literature review and a systematic review were conducted to preliminarily establish the framework for the index system. Twenty experts in relevant fields were selected for Delphi expert consultation, and the analytic hierarchy process (AHP) was employed to calculate the weights for each level of indexes. The established evaluation index system was then adopted to assess the medical care-prevention integration capabilities of 360 randomly selected undergraduates majoring in clinical medicine and 220 licensed clinical physicians in Fujian province in May 2025 via an online questionnaire.

    Results

    The expert positive coefficients in the two rounds of expert consultation were 90% (18/20) and 100.0% (18/18), indicating a high positive degree of experts. The expert authority coefficients in the two rounds were 0.564 and 0.777, with the second round demonstrating higher expert authority. The Kendall’s coefficients of concordance in the two rounds of expert consultation were 0.187 and 0.542 (both P < 0.001), being higher in the second round (χ2 = 325.89, P < 0.001), which indicated better concordance among experts. Following expert consultation, the final evaluation index system for medical care-prevention integration capabilities of clinical medical professional was established, comprising 4 first-level indexes, 12 second-level indexes, and 36 third-level indexes. The mean importance scores of the first-, second-, and third-level indexes ranged from 4.67 to 4.89, 4.39 to 4.78, and 4.31 to 4.94, respectively. The full-score rates of the first-, second-, and third-level indexes ranged from 44.44% to 72.22%, 38.89% to 72.22%, and 33.33% to 61.11%, with coefficients of variation ranging from 0.06 to 0.10, 0.08 to 0.12, and 0.04 to 0.13, respectively. The weights of the first-, second-, and third-level indexes ranged from 0.075 to 0.331, 0.139 to 0.528, and 0.075 to 0.625, respectively. The final sample included 342 undergraduates majoring in clinical medicine and 211 licensed clinical physicians from Fujian province, who showed the overall mean scores of (2.096 ± 0.696) and (3.076 ± 0.632), respectively, in medical care-prevention integration capabilities. The overall average score of licensed clinical physicians was higher than that of undergraduates majoring in clinical medicine (t = 9.609, P < 0.001). Licensed clinical physicians scored higher than undergraduates on all the three levels of indexes except the second-level index “preventive medicine knowledge” (all P < 0.001).

    Conclusions

    The established evaluation index system for medical care-prevention integration capabilities among clinical medical professionals demonstrates sound scientific validity and reliability. It provides a reference for accurately assessing the medical care-prevention integration service capabilities of clinical medical professionals.

  • Epidemiological Research
  • Zeyun ZHAO , Zhongliang LI , Xuelian ZHAO , Shangying HU , Li ZHANG , Fanghui ZHAO , Yong ZHANG
    doi: 10.11847/zgggws1149226
    Objective

    To investigate the awareness levels of human papillomavirus (HPV) and cervical cancer screening, as well as the acceptance of point-of-care testing (POCT) technology among women in Jinan, Shandong province, analyze the influencing factors, and assess their satisfaction with and attitudes toward the promotion of POCT technology.

    Methods

    A cross-sectional survey was conducted from May 2024 to June 2025 among 629 women aged 35–64 years who participated in the two-cancer screening program at two community health service centers in Jinan. Information on sociodemographic characteristics, awareness of HPV and cervical cancer screening, and acceptance of POCT technology was collected. Statistical analyses were performed with the chi-square test and binary logistic regression.

    Results

    A total of 629 valid questionnaires were obtained. Regarding awareness of HPV and cervical cancer screening, 46.26% of participants had heard of HPV, among whom 70.10% knew it as the primary cause of cervical cancer. Overall, 80.76% had heard of cervical cancer screening, whereas only 44.09% were aware of specific screening methods. The awareness rates of HPV testing, cytological examination, and visual inspection with acetic acid/Lugol′s iodine (VIA/VILI) were 33.86%, 24.61%, and 6.99%, respectively. Multivariable analysis showed that compared with women aged 35–44 years, those aged 55–64 years had the lowest awareness level of HPV and cervical cancer screening (OR = 0.17, 95%CI: 0.10–0.31). Compared with women with primary school education or below, those with college education or above had the highest awareness level (OR = 3.71, 95%CI: 1.44–9.56). Regarding acceptance of POCT, 55.96% of women expressed willingness to use POCT in future screening. Multivariable analysis indicated that compared with women with primary school education or below, those with senior high school education (OR = 0.43, 95%CI: 0.22–0.81) and those with college or undergraduate education and above (OR = 0.37, 95%CI: 0.17–0.81) showed increased acceptance of POCT. Freelancers (OR = 1.93, 95%CI: 1.08–3.42) and workers (OR = 2.33, 95%CI: 1.10–4.92) showed lower acceptance of POCT technology than unemployed women. In terms of satisfaction and attitudes toward promotion, 84.27% of participants believed that POCT could significantly save time and improve the efficiency of conventional screening; 83.94% believed that it could significantly improve the accuracy of conventional screening; 85.21% reported being very satisfied overall; 83.78% held a positive attitude toward its long-term application; and 83.62% were willing to recommend the technology to others.

    Conclusions

    Women in Jinan have established basic awareness of HPV and cervical cancer screening, while their understanding of specific screening technologies remains insufficient. Acceptance of POCT technology is at a moderate level, whereas satisfaction with and willingness to promote this technology are relatively high.

  • Survey and Report
  • Tian YU , Yanping WANG , Nan MENG , Yiran GAO , Min WEI , Qunkai WANG , Peng WANG , Kexin WANG , Qunhong WU
    doi: 10.11847/zgggws1148035
    Objective

    To explore the paths of driving factor combinations leading to the emergence of medical surge scenarios in the future crisis environment of "disease X" outbreak, thus providing references for enhancing the overall resilience of the medical and health service system.

    Methods

    From July to September 2024, 144 members of front-line medical staff in Heilongjiang province who had participated in the prevention and control of the COVID-19 epidemic were selected through the Questionnaire Star platform by the purposive sampling method. Seven variables–the transmission capacity of the infectious disease, the pathogenicity of pathogens, the immunity of residents, the number of medical staff, the reserve of emergency materials, the frequency of emergency rescue and skill training, and the effectiveness of patient triage and referral mechanisms–were selected based on the public safety triangle theoretical model. The fuzzy-set qualitative comparative analysis was performed to explore the configuration path.

    Results

    The results of necessity analysis showed that the consistency of the transmission capacity of the infectious disease, pathogenicity of pathogens, the immunity of residents, the number of medical staff, the reserve of emergency materials, the frequency of emergency rescue and skill training, and the effectiveness of patient triage and referral mechanisms were 0.546, 0.578, 0.485, 0.562, 0.491, 0.530, and 0.563, respectively (all < 0.9). There were no necessary conditions for a medical surge scenario in a future crisis environment of "disease X" outbreak. The conditional configuration analysis produced a total of 5 paths and 2 configurations, i.e., the weak epidemic-low bearing-weak response interweave driving surge type and the strong epidemic surge type with relatively sufficient preparation, with the overall consistency of 0.886 and the overall coverage of 0.532.

    Conclusions

    The occurrence of medical surge scenarios is the result of a combination of complex factors, and medical institutions must improve their response capabilities in all aspects such as personnel reserve and allocation, triage and referral, and material reserve.

  • Survey and Report
  • Lili ZHU , Xiaoning HAO , Zhi LIU , Jiale SUN , Jianqiang XU , Juan ZHENG , Fen LI , Xinru HUANG , Luxi ZOU
    doi: 10.11847/zgggws1148828
    Objective

    To systematically analyze the factors influencing the leadership competency of primary-level health emergency administrators in the field of infectious disease prevention and control, as well as their underlying mechanisms, thereby providing evidence-based references for enhancing the leadership competency of primary-level health emergency administrators.

    Methods

    From November 2019 to March 2021, this study adopted a multi-stage stratified random sampling method to randomly select 152 primary-level health emergency administrators from Jiangsu province, Hubei province, Hunan province, Guangdong province, Anhui province, and Inner Mongolia Autonomous Region, as the research subjects. Structural equation modeling (SEM) combined with the bootstrap method was utilized to analyze and validate the paths and mediating effects of these influencing factors.

    Results

    Through the survey of 152 primary-level health emergency administrators, this study found that human resource support had a positive impact on organizational climate (β = 0.461, P < 0.001). Organizational climate (β = 0.712, P < 0.001) and material resources support (β = 0.248, P = 0.004) had positive impacts on external social support. External social support had a positive impact on leadership competency (β = 0.519, P < 0.001). Through the mediating effect test, two mediating paths were identified. Mediating path 1 was material resources support → external social support → leadership competency (with an effect value of 0.129; 95%CI: 0.005–0.258), and mediating path 2 was human resource support → organizational climate → external social support → leadership competency (with an effect value of 0.170; 95%CI: 0.094–0.303).

    Conclusions

    The characteristics of infectious disease prevention and control reinforce the inevitability of the indirect transmission of the mechanisms influencing health emergency leadership competency. Leadership competency is formed through complex interactions between individuals and their environment. The sustainable improvement of leadership competency among primary-level health emergency administrators needs to be achieved by optimizing resource allocation and organizational climate, as well as improving the social support network.

  • Survey and Report
  • Shengjie ZHANG , Lieyu HUANG , Fei MO , Yan GUO
    doi: 10.11847/zgggws1148341
    Objective

    To construct a demand-oriented fairness optimization model to provide decision-making support for scientific allocation in response to the shortage and regional inequity in personnel allocation in disease prevention and control institutions of China.

    Methods

    On the basis of the provincial panel data from 2006 to 2019, the entropy weight method was used to integrate the indicators of infectious disease dimension (morbidity/mortality of five key infectious diseases, such as plague and cholera) and population dimension (such as density, dependency ratio, and topographic relief) for building the regional priority index. The index was embedded into the population-weighted Gini coefficient function, and thus the improved fairness metrics was proposed. A multi-objective optimization model with the dual objectives of minimizing the fairness coefficient and minimizing the amount of personnel adjustment was established, and the nondominated sorting genetic algorithm Ⅱ (NSGA-Ⅱ) was used to solve the Pareto optimal solution sets.

    Results

    The priority index showed that Sichuan, Xinjiang, and Guangxi were the areas with high demand for disease prevention and control personnel. Through the Pareto frontier, 80 sets of optimal solutions were obtained, revealing a significant trade-off between fairness and implementation cost. The cost of maximizing fairness (reducing the Gini coefficient value by 0.066 8) was the largest adjustment amount (19 410 people). It was possible to only alleviate the fairness issue to a certain extent (reducing the Gini coefficient by 0.014 4) with the minimum adjustment amount (1 660 people).

    Conclusions

    This study innovatively incorporates the quantification of demand differences into the assessment of resource allocation fairness and employees a multi-objective genetic algorithm to generate the Pareto solution sets, providing a quantitative tool for differentiated personnel allocation strategies in disease prevention and control institutions.

  • Survey and Report
  • Yun HUANG , Jiya DAI , Runing GUO , Weiyi CHEN , Xiaoliang CHEN , Meiling YANG , Wenjia LIANG , Jianhua HUANG , Yan LI
    doi: 10.11847/zgggws1148699
    Objective

    To develop an R program for processing complex work unit entries in the Notifiable Disease Surveillance and Reporting System, enabling active searching of school-based cluster epidemics.

    Methods

    Taking the data of acute hemorrhagic conjunctivitis, pertussis, and other infectious diarrhea diseases in Guangdong province, 2024 as an example, we designed an active searching algorithm in R 4.1.0. The program standardizes unstructured school names via text mining algorithms, counts cases by normalized school name, actively search for school-based cluster epidemics with the fixed threshold method, and compare them with the epidemics reported in the Public Health Emergency Management Information System (PHEMIS).

    Results

    When being aligned with PHEMIS reporting thresholds, the R program showed the positive predictive value of 100.00%. Among the reported school-based cluster epidemics, 67.65% (23/34) were detected by the R program. The R program identified 60.87% (14/23) cluster epidemics later than PHEMIS but achieved synchronized reporting of 39.13% (9/23) cluster epidemics. Moreover, the R program revealed 11 clusters meeting PHEMIS criteria but not reported. When the thresholds were lowered, more potential cluster epidemics were detected, and 2 signals were earlier than PHEMIS alerts.

    Conclusions

    This active searching framework can serve as a powerful supplement to PHEMIS, demonstrating operational value for early detection and containment of school-based cluster epidemics.

  • Survey and Report
  • Jie ZHAO , Dayong GU , Jianqing ZHANG , Yufan WU , Jie WEN , Tingting JIANG , Yuping WANG
    doi: 10.11847/zgggws1148778
    Objective

    To develop an imported dengue fever prediction model based on multi-fusion machine learning, aiming to enhance the scientific basis and foresight of infectious disease prevention and control at Guangzhou port.

    Methods

    Data on imported dengue fever cases at Guangzhou port from 2015 to 2019 were collected, along with meteorological indicators, inbound passenger volume, flight traffic, vegetation index, and vector density. After data cleaning and standardization, three base models (BP neural network, random forest, and CatBoost) were constructed. Weighted averaging and stacking ensemble strategies were then adopted to build dual-fusion and triple-fusion models. Model performance was evaluated based on mean squared error (MSE) and coefficient of determination (R2).

    Results

    The fusion models outperformed single models overall, demonstrating higher predictive accuracy and stability. Among them, the stacked ensemble of random forest and CatBoost achieved the best performance, with an MSE of 4.749 and an R2 of 0.601, significantly improving upon the best single model. SHAP analysis further revealed that humidity, sunshine duration, and diurnal temperature variation were the main driving factors, while inbound passenger volume also contributed substantially to predictions.

    Conclusions

    Multi-fusion machine learning models provide significant advantages in predicting imported dengue cases, offering strong support for early warning and the formulation of prevention strategies in port public health.

  • Review
  • Yawen YU , Xueyu LU , Yuxin GAO , Nuo SHEN , Fan YANG , Changmin NIU
    doi: 10.11847/zgggws1148856

    Global male fertility is experiencing a continuous decline, and inflammation is considered a key factor contributing to impaired semen quality. As a critical component of lifestyle, diets are closely associated with inflammation levels, among which anti-inflammatory diets hold potential value in modulating inflammation. Evidence from the literature indicates that inflammation induces oxidative stress and elevates pro-inflammatory cytokine levels, leading to reduced sperm count, motility, and concentration, accompanied by DNA damage and apoptosis. Anti-inflammatory diets can alleviate inflammatory states through multiple pathways, thereby improving sperm count, motility, and concentration, and ultimately enhancing semen quality. This review systematically summarizes the relationship between semen quality and inflammation, the mechanisms of anti-inflammatory diets, and research progress regarding the role of anti-inflammatory diets in improving male fertility, with the aim of providing a theoretical basis for the prevention of male infertility and the promotion of fertility preservation.

  • Public Health Forum
  • Minmin WANG , Zuokun LIU , Yinuo SUN , Xinyi SONG , Fangjing LIU , Minghui REN
    doi: 10.11847/zgggws1149238

    Global public health security is confronted with multiple challenges, including population growth, rapid urbanization, climate change, and the misuse of antibiotics, while the transnational spread of emerging infectious diseases has become a major global threat. Large-scale epidemics have exposed the fragility of the global public health governance system. The 2014 Ebola outbreak in West Africa prompted the international community to strengthen the implementation mechanisms of the International Health Regulations (2005), facilitated the establishment of regional institutions such as the Africa Centres for Disease Control and Prevention, and promoted the enhancement of national public health capacities. However, the COVID-19 pandemic once again underscored deficiencies in global information sharing, coordination, and resource allocation, further reinforcing the need for governance reform. In May 2025, the 78th World Health Assembly adopted the World Health Organization Pandemic Agreement–a milestone accord designed to establish a pathogen access and benefit-sharing system, reinforce the One Health approach, enhance the resilience of global health systems, and promote the research, development, and equitable distribution of pandemic-related health products. This agreement reflects the international community′s commitment to multilateral cooperation, yet its implementation and compliance still face considerable challenges. In the future, global health security governance needs to keep strengthening multilateral collaboration and uphold WHO′s central coordinating role, increase investment in digital health technologies and public health system capacity to improve surveillance, early warning, and response mechanisms, advance cross-sectoral coordination under the One Health principle, and integrate national health security planning into broader development strategies to build a shared community of health for all humankind.