To clarify the key factors influencing the multi-subject synergistic effect of urban communities in response to public health emergencies and their interrelationships, thus enhancing the quality and efficiency of multi-subject collaboration in response to public health risks and providing references for the scientific and efficient work of urban communities under such conditions.

With the modified SFIC model as the theoretical framework, a system of influencing factors was established through literature research, semi-structured interviews, and the Delphi method. Fuzzy DANP was employed to clarify the influencing relationships among the factors and quantify their weights. The key influencing factors were identified with consideration to the centrality, causality, and weight ranking of the factors.

A system of factors influencing the multi-subject synergistic effect of urban communities in response to public health emergencies was established, consisting of 5 primary factors, 15 secondary factors, and 47 tertiary factors. Among the primary factors, synergy engine, synergy supervision, and synergy environment were of higher importance. The key secondary factors included leadership, organizational structure, and ideological consensus. The main tertiary factors were the support strength of policies, laws, and regulations, operability of systems, accuracy of information, timeliness of resource acquisition, timeliness of information sharing, capability of personnel teams, and risk identification capabilities.

To enhance the capacity of urban communities in response to public health risks in a coordinated manner and promote the long-term development of synergistic effects, efforts should be made to strengthen the spport of synergistic policies, give full play to the leading role of leadership, foster a solid foundation of ideological consensus, and optimize the support of data and intelligence.

To develop the initial scale of behavioral capability in the prevention and control of respiratory infectious diseases, thereby providing a scientific tool for the surveillance and evaluation of respiratory infectious diseases in China.

From November 2024 to February 2025, literature retrieval and expert interviews were conducted to define the concept of behavioral capability in the prevention and control of respiratory infectious diseases. Subsequently, an item pool was constructed based on the social cognitive and behavioral change theories. Finally, the scale items were determined via the nominal group technique and Delphi expert consultation.

Both rounds of Delphi expert consultation showed the response rate of 100% and the expert authority coefficient of 0.91. The mean score ranges of importance, necessity, feasibility, and semantic accuracy of each item were 3.33–4.81, 3.26–4.81, 3.41–4.81, and 3.48–4.70 in the first round of consultation and 4.04–4.89, 4.07–4.89, 3.78–4.74, and 3.96–4.78 in the second round, respectively. The full-score rates of the above four scoring dimensions in the first and second rounds were all >20% and >25%, respectively. The ranges of coefficients of variation of scores were 0.16–0.42, 0.16–0.43, 0.17–0.37, and 0.18–0.37 in the first round and 0.07–0.23, 0.07–0.35, 0.13–0.25, and 0.09–0.29 in the second round, respectively. The Kendall′s W values were 0.513, 0.496, 0.458, and 0.481 in the first round and 0.313, 0.299, 0.362, and 0.442 in the second round, respectively (all P < 0.01). Ultimately, the scale comprised 5 items for confidence, 9 items for competence, and 8 items for agency.

The constructed initial scale for behavioral capability in the prevention and control of respiratory infectious diseases and the selected items are scientific and reliable, which can provide an effective tool for the surveillance and evaluation of respiratory infectious diseases.

To establish comprehensive indicator systems for early warning of acute respiratory infection (ARI) based on multi-source data.

The Delphi method was adopted for expert consultation. Twenty experts were invited to score the necessity, availability, and sensitivity of different early warning indicators, and the weights were determined based on the scoring results.

The two rounds of expert consultation showed the expert positive coefficients being both 100%, the coefficients of expert authority being both 0.79, and the coefficients of concordance being 0.280 and 0.487 (P < 0.05), respectively. According to the characteristics of ARI in the stages of occurrence, transmission, and epidemics, two indicator systems–the early warning indicator system for risk of ARI and the early warning indicator system for potential clustering or outbreak of ARI–were established. The former included 22 indicators in 5 categories, and the latter included 29 indicators in 6 categories. In the early warning indicator system for risk of ARI, the top 3 indicators with the highest weights were immunization coverage rate (0.052), variations of known pathogens (0.051), and variations of dominant prevalent strains (0.051). In the early warning indicator system for potential clustering or outbreak of ARI, the top 3 indicators with the highest weights were surveillance data of respiratory syndrome (0.040), positive rate of specific pathogen (0.040), and number of cases reported in online direct report system (0.040).

The comprehensive indicator systems for early warning of ARI based on multi-source data and Delphi method established in this study have certain scientificity and practicability, which can provide support for improving the multi-point triggered early warning of infectious diseases.

To investigate the effect of tea polyphenols (TP) on sarcopenia in the rat model of type 2 diabetes mellitus (T2DM) by regulating the Wnt/β-catenin pathway.

Thirty 8-week-old SD rats were assigned into a control group (n=10) and a modeling group (n=20) according to body weight. The aged T2DM model was induced by a high-sugar and high-fat diet combined with injection of D-galactose and streptozotocin (STZ). Fasting blood glucose (FBG) ≥16.7 mmol/L and elevated P53 protein expression mark the occurrence of diabetes and aging. The relative wet weight of gastrocnemius muscle was compared among the control, model, and TP intervention (administration with TP at 300 mg/kg for 8 consecutive weeks after modeling for 7 weeks) groups. The area of intermuscular adipose tissue was observed via hematoxylin-eosin staining and semi-quantitatively analyzed. The expression levels of proteins including Wnt10b, β-catenin, PPAR-γ, and CEBPB in the gastrocnemius muscle were determined by Western blot.

The TP intervention group had lower FBG, higher relative wet weight of gastrocnemius muscle, and lower intermuscular fat infiltration (a decrease of 18.60%) at the end of the intervention than the model group (all P<0.05). TP intervention improved the pancreatic tissue structure in shape and area and alleviated the vacuolation of islet cells compared with the model group. In addition, TP intervention up-regulated the expression of Wnt10b and β-catenin while down-regulating the expression of PPARγ and CEBPB (all P<0.05).

TP intervention may improve muscle mass and reduce fat infiltration in the gastrocnemius muscle by activating the Wnt/β-catenin signaling pathway that regulates the differentiation of adipocytes.

To explore the influencing factors of the heat adaptive behavior of the elderly based on the model of private proactive adaptation to climate change.

A survey of heat adaptive behavior was conducted among 650 older adults in Guangzhou from June to September 2024. AMOS 26.0 was used to establish a model of the influence on heat adaptive behavior in older adults for analysis of the factors affecting heat adaptive behavior.

A total of 608 valid questionnaires were collected. The fitting index of the model of the influence on heat adaptive behavior of older adults was better than the qualified standard, indicating a good degree of fitting. The results of structural equation modeling test showed that risk experience (β = 0.136, P < 0.001) and social discourse (β = 0.309, P < 0.001) had positive effects on risk perception. Risk perception had a negative effect on maladaptation (β = −0.234, P < 0.01) and a positive effect on adaptive behavior (β = 0.327, P < 0.001). Maladaptation had a negative effect on adaptive behavior (β = −0.103, P < 0.001). Risk perception mediates the effects of risk experience and social discourse on adaptive behavior, with the mediation effect values of 0.045 and 0.101, respectively. The chain mediation between risk perception and maladaptation mediates the effects of risk experience and social discourse on adaptive behavior, with the mediation effect values of 0.003 and 0.007, respectively.

Improving older adults′ awareness of heat risks can lead to more active adoption of heat adaptive behavior, which can thus effectively reduce their vulnerability to the adverse effects of heat and ultimately reduce the heat-related health burden.

This study evaluates the applicability of three overseas simplified assessment models–the Treatment Eligibility in Africa for the Hepatitis B Virus (TREAT-B), the Hepatitis B in Africa Collaborative Network (HEPSANET), and the HBeAg, Platelet count, ALT, and Albumin (HePAA) score–for guiding antiviral therapy initiation in chronic hepatitis B virus (HBV) carriers in China. The findings are expected to inform the development of a simplified assessment tool for antiviral therapy initiation tailored to chronic HBV carriers in China.

The clinical data of 870 chronic HBV carriers who underwent regular follow-up by the Shandong Provincial Center for Disease Control and Prevention in Zhangqiu district, Jinan city, in November 2023 were retrospectively collected. Two hepatitis B specialists from a tertiary-level hospital assessed whether these chronic HBV carriers required antiviral therapy based on the Guidelines for the Prevention and Treatment of Chronic Hepatitis B (2022 Edition), and the assessment results served as the actual values. The simplified assessment models REAT-B, HEPSANET, and HePAA were used to determine whether chronic HBV carriers required antiviral therapy, with the results serving as predicted values. The actual values and predicted values were compared, and the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity of the three assessment models were calculated to evaluate their discriminatory ability.

Among the 706, 358, and 715 chronic HBV carriers who met the inclusion criteria for the TREAT-B, HEPSANET, and HePAA models, respectively, the number of carriers identified as eligible for antiviral therapy was 562 (79.6%), 282 (78.8%), and 571 (79.9%). The comparison between the predicted values and the actual values showed that REAT-B had the AUROC of 0.640 (95%CI: 0.597–0.683), the sensitivity of 26.3% (95%CI: 22.7%–30.2%), and the specificity of 92.4% (95%CI: 86.7%–96.1%). HEPSANET showed the AUROC of 0.568 (95%CI: 0.520–0.615), the sensitivity of 12.8% (95%CI: 9.1%–17.2%), and the specificity of 94.7% (95%CI: 87.1%–98.5%). HePAA showed the AUROC of 0.590 (95%CI: 0.553–0.625), the sensitivity of 22.8% (95%CI: 19.4%–26.4%), and the specificity of 92.4% (95%CI: 86.7%–96.1%). All the three models exhibited low accuracy in determining antiviral therapy eligibility for the HBV carriers in China.

The predictive accuracy of the REAT-B, HEPSANET, and HePAA models is low in China, and thus they are not suitable for use in China at present.

To sort out the digital health policy texts of China′s central government and its affiliated departments and analyze the characteristics and existing problems of the policies, thus providing suggestions for optimization of digital health policies.

A total of 37 digital health policies were collected from the websites of PKULaw, National Health Commission, and the State Council of China with the time interval from 2000 to 2024. A two-dimensional framework of policy tools-policy objectives was constructed for the quantitative analysis of the collected policy texts.

In the dimension of policy tools, environment-based tools (67%) were dominant, of which "sound mechanisms" accounted for the highest proportion (40%), while the supply-based (22%) and demand-based (11%) applications were obviously insufficient. Supply-based tools demonstrated high dependence on "scientific and technological support" (84%), with insufficient attention to "talent support" (12%) and "financial support" (4%). In the dimension of policy objectives, the policy distribution was concentrated on "performance guarantee" (32.5%) and "institutional rules" (17.7%), while "data resources" (11.3%) and "platform support" (7.1%) received less attention. Cross-analysis further revealed that there was a structural mismatch between policy tools and policy objectives.

It is recommended that the future efforts should be made to optimize the structure of policy tools and coordinate the combination of tools, balance the distribution of objectives considering the existing policy shortcomings, and focus on the multidimensional synergy of policy tools and policy objectives.

To investigate the current status of competency and training needs among primary-level infectious disease prevention and control personnel in Xinjiang Uygur Autonomous Region, providing a scientific basis for further exploring training models to enhance the competency of such personnel in primary-level health institutions.

In April 2025, a questionnaire survey was conducted among 700 members of primary-level infectious disease prevention and control personnel in Xinjiang Uygur Autonomous Region to understand their basic information, current competency, and training needs. The chi-square test was conducted for statistical analysis of the survey results.

In the self-assessment of competency, the qualification rates for "developing on-site health and epidemic prevention work plans and mobilizing resources during major natural disasters" and "designing, analyzing, and evaluating disease surveillance systems" were the highest, both at 91.57%. The self-assessed qualification rate for "conducting training and technical guidance" was low, with the lowest rate (68.7%) among personnel with educational background below junior college. The self-assessed qualification rates for "information acquisition, analysis, and utilization," "project application, planning, implementation, and management," and "conducting training and technical guidance" differed among personnel with different professional titles, educational backgrounds, majors, ages, and years of work experience (all P < 0.05). The self-assessed qualification rate for "conducting training and technical guidance" varied among the personnel with different professional titles, educational backgrounds, and years of work experience (all P < 0.05). The self-assessed qualification rate for "writing investigation reports, academic papers, and delivering presentations" also differed among personnel with different educational backgrounds, professional titles, and places of working (whether working in border regions or not) (all P < 0.05). Regarding training formats, the most frequently attended in the past were expert lectures, accounting for 97.29%. The highest training demand was for case analysis and practical exercises, at 81.07%.

The self-assessment of core competencies among primary-level infectious disease prevention and control personnel in Xinjiang Uygur Autonomous Region is generally good. However, there are notable shortcomings in higher-order soft skills such as "training and guidance" and "communication," as well as among specific groups (e.g., those with lower educational background or less experience). Training needs are broad and concentrated on practical skills such as emergency response and communication, with variations observed across different groups.

To analyze the source of infection and epidemiological characteristics of a pulmonary anthrax case in Henan province, thus providing a scientific basis for the prevention and control of pulmonary anthrax.

A pulmonary anthrax case reported in Henan province in January 2025 was investigated on site, with standard control measures implemented. Samples were collected from the patient and the environment for laboratory testing.

In this outbreak in Henan province, one case of pulmonary anthrax was reported. The patient, whose occupation was a farmer, was infected due to participating in sheep slaughtering or activities in a live sheep trading market. The early symptom was fever, followed by sudden asthma, difficulty in breathing, chest tightness, dizziness, headache, nausea and other symptoms. High-throughput gene sequencing of the lung tissue and alveolar lavage fluid both detected sequences of Bacillus anthracis, and the nucleic acid test for B. anthracis was positive. The serum sample tested positive for B. anthracis IgG antibody. The patient was cured and discharged after treatment. No relevant symptoms appeared in close contacts or at-risk personnel, and the nucleic acid test results for B. anthracis in relevant environmental samples were all negative.

This outbreak in Henan province is an incidental case of pulmonary anthrax caused by inhalation. The source of infection is sheep, with potential routes of infection involving slaughtering activities or exposure at the live sheep market.