To analyze the epidemiological characteristics and trends of other infectious diarrhea among children under 18 years old in Guangzhou City from 2014 to 2020, and to explore the correlation between climatic factors and the incidence of the disease, so as to provide reference for the early prevention of infectious diseases.

The data of cases of other infectious diarrhea and meteorological data of children under 18 years old in Guangzhou City from 2014 to 2020 were collected through the Chinese Infectious Disease Reporting System and the Guangzhou Meteorological Bureau. The correlation between meteorological factors and the incidence of other infectious diarrhea was analyzed using negative binomial regression.

A total of 104 566 cases of other infectious diarrhea among children under 18 years old were reported in Guangzhou City from 2014 to 2020, with a male-to-female ratio of 1.48∶1. The incidence rate was the highest in 2017 (980.83 per 100 000) and the lowest in 2020 (388.22 per 100 000). The peak of incidence occurred from October to March of the following year. Children under 5 years old accounted for 87.95% of all cases. The number of cases of other infectious diarrhea was negatively correlated with the temperature of the previous 6 days (IRR=-0.07), and positively correlated with the temperature difference on the day of onset (IRR=0.02) (both P < 0.05). It was also positively correlated with the wind speed of the previous 7 days (IRR=0.07, P < 0.05), but there was no statistically significant correlation with the relative humidity on the day of onset (IRR=-0.00, P > 0.05).

Low temperature, large temperature difference, and high wind speed can increase the risk of other infectious diarrhea. It is necessary to strengthen the prediction and early warning in conjunction with meteorological changes, and warn kindergartens and schools to enhance preventive measures against the clustering of other infectious diarrhea cases.

To systematically evaluate the relationship of exposure to five heavy metals, namely lead, arsenic, cadmium, mercury and aluminum with obesity in children and adolescents, so as to provide a scientific basis for subsequent research in the area.

Four Chinese databasesc (CBM, VIP, CNKI and Wanfang) and four foreign databases (OVID, PubMed, Web of Science and EBSCO), were searched to collect relevant studies, and the search period was from the establishment of the database to May 5, 2024. After 2 investigators independently screened the literature, extracted the data and evaluated the risk of bias of the included studies, the results were analyzed quantitatively and summarized qualitatively.

A total of 5 cohort studies on lead exposure and 17 cross-sectional studies involving exposure to lead (n=13), cadmium (n=8), mercury (n=8), arsenic (n=4), and aluminum (n=1) were included. Meta analysis of the 2 cohort studies showed that lead exposure was not associated with the risk of overweight and obesity in children (RR=0.76, 95%CI=0.50-1.16, P > 0.05). The cross-sectional study Meta-analysis results showed that lead exposure was negatively associated with the risk of childhood overweight (OR=0.70, 95%CI=0.59-0.84, 2 studies) and obesity (OR=0.71, 95%CI=0.58-0.87, 3 studies); cadmium exposure was negatively associated with the risk of childhood overweight (OR=0.83, 95%CI=0.73-0.95, 2 studies) and obesity risk(OR=0.70, 95%CI=0.63-0.78, 3 studies); mercury exposure increased the risk of overweight/obesity (OR=1.42, 95%CI=1.14-1.76, 2 studies) and abdominal obesity (OR=1.99, 95%CI=1.45-2.73, 2 studies) in children; the group with the highest concentration of arsenic in urine had a lower risk of developing obesity compared to the group with the lowest concentration (OR=0.39, 95%CI=0.23-0.65, 1 study), and the group with the highest concentration of aluminum in urine had a lower risk of obesity compared with the group with the lowest concentration (OR=0.52, 95%CI=0.31-0.86, 1 study)(all P < 0.05).

Heavy metal exposure may be a risk factor for overweight and obesity in children and adolescents, but the conclusions are inconsistent and need to be validated in further high-quality prospective cohort studies.

To investigate the indoor fine particulate matter (PM_2.5) pollution and its influencing factors in children's bedrooms using solid fuel, so as to provide evidence for effective strategy to reduce PM_2.5 pollution.

From December 2019 to November 2020, 198 households (108 in the north, 90 in the south) from two pilots in the north(Jiamusi in Heilongjiang Province) and south of China (Mianyang in Sichuan Province) were selected, and status of solid fuels using were obtained through home visits, dynamic changes in PM_2.5 concentrations in children's bedrooms were monitored by using real-time online instruments, and the influencing factors of PM_2.5 pollution were analyzed by using a mixed-effects model.

During the monitoring period, the daily PM_2.5 concentrations in the northern and southern pilot were 78.33 (40.50, 154.80) and 38.54(26.20, 58.46) μg/m³, respectively, exceeding standard rates of 44.57% and 33.22%. During the heating period, the daily PM_2.5 concentrations in the northern and southern pilot were 212.50(133.60, 244.10) and 104.42(73.97, 134.90) μg/m³, respectively, with over standard rates of 96.75% and 86.96%. The mixed-effects model analysis results showed that children's bedroom PM_2.5 concentrations were associated with solid fuel usage duration, window opening time, room layout (shared entrance door between kitchen and bedroom), indoor smoking, indoor humidity, and solid fuel use in the bedroom (β=0.19, -0.05, 1.20, 0.43, 0.02, 0.35, all P < 0.05).

Solid fuel combustion significantly comtributes to PM_2.5 pollution in children's bedrooms, with more pronounced impacts observed in northern China compared to southern regions.

To investigate the association between medium- to long-term PM_2.5 exposure around school areas and overweight/obesity among primary and secondary school students in Guangxi, providing data support and theoretical foundations for scientifically addressing overweight and obesity in primary and secondary school students.

From September to November 2023, a stratified cluster random sampling method was employed to select 251 183 students aged 7-18 years (grade 1 to grade 12) from 14 prefecture level cities (111 districts and counties) in Guangxi. PM_2.5 mass concentration data were obtained from the Tracking Air Pollution in China (TAP) dataset. Preliminary comparative analysis was conducted using the Mann-Whitney U test, while binary Logistic regression models were applied to quantify the relationship between PM_2.5 exposure and overweight/obesity. Restricted cubic spline analysis was further utilized to examine the nonlinear association between PM_2.5 concentration and overweight/obesity risk.

The detection rate of overweight/obesity among Guangxi students in 2023 was 19.5%. The median PM_2.5 concentration in the year prior to the study was higher in the overweight/obesity group (23.22 μg/m³) compared to the non-overweight/obesity group (22.63 μg/m³) (Z=-15.66, P < 0.01), and consistent trends were observed across gender (male/female) and educational stage (primary/junior/senior high school) subgroups (all P < 0.01). Binary Logistic regression revealed that for every 10 μg/m³ increase in the annual average PM_2.5 concentration, the risk of overweight/obesity increased by 12% (OR=1.12, 95%CI=1.09-1.15, P < 0.01). Restricted cubic spline analysis indicated a nonlinear relationship between monthly PM_2.5 levels and overweight/obesity risk (P_trend < 0.01). Below 22.68 μg/m³, PM_2.5 exposure showed no significant association with obesity risk; above the threshold, the risk increased with rising PM_2.5 levels.

Medium- to long-term PM_2.5 exposure around school environments is significantly associated with overweight/obesity among primary and secondary school students.

To examine the relationship among physical education core literacy, exercise self-efficacy, physical self-esteem and subjective exercise experience among middle school students, and to analyze the latent classes of exercise self-efficacy, so as to provide evidence for enhancing adolescents' subjective exercise experience.

Using stratified cluster random sampling, 2 569 students from 12 provinces, autonomous regions or municipality directly under the central govement (Jiangxi, Guangdong, Hunan, Guizhou, Henan, Guangxi, Yunnan, Chongqing, Sichuan, Shandong, Hubei, Hebei) were surveyed from September to November in 2024 with Core Competency Scale of Physical Education, Subjective Exercise Experiences Scale, Exercise Self-Efficacy Scale, and Physical Self-esteem Scale. Pearson correlation analysis was conducted to explore the relationships among physical education core literacy, exercise self-efficacy, physical self-esteem, and subjective exercise experience. Mediation models with Bootstrap testing were employed to examine the mediating roles of exercise self-efficacy and physical self-esteem in the relationship between physical education core literacy and subjective exercise experience. Latent profile analysis (LPA) of exercise self-efficacy was performed using Mplus 8.3.

Pearson correlation analysis revealed positive associations between physical education core literacy and exercise self-efficacy (r=0.21), physical self-esteem (r=0.38), and subjective exercise experience (r=0.40); exercise self-efficacy was positively correlated with physical self-esteem (r=0.25) and subjective exercise experience (r=0.45); and physical self-esteem was positively correlated with subjective exercise experience (r=0.34) (all P < 0.01). Mediation analysis indicated that physical education core literacy positively predicted subjective exercise experience (β=0.41, P < 0.05), with exercise self-efficacy and physical self-esteem serving as partial mediators (effect size=0.14, P < 0.01), accounting for 34% of the total effect. LPA identified three latent classes of exercise self-efficacy: low (14.71%, n=378), moderate (65.51%, n=1 683), and high (19.78%, n=508) exercise self-efficacy groups.

Adolescents' exercise self-efficacy demonstrates heterogeneity, and both exercise self-efficacy and physical self-esteem mediate the relationship between physical education core literacy and subjective exercise experience.

To understand the influence of the concept of movement education on the fundamental motor skills of preschool children aged 3-6, so as to provide a reference for improving the quality of preschool education and promoting the all-round development of preschool children.

From August 2022 to June 2023, 592 normally developing preschool children aged 3-6 in a certain kindergarten in Qingdao were selected as the research objects by convenience sampling. They were randomly divided into the intervention group (physical education activities designed based on the concept of movement education) and the control group (original teaching plan). The intervention lasted for 24 weeks (twice a week, 40 minutes each time). Test of Gross Motor Development-2 (TGMD-2) was used to evaluate the children's gross motor skills, and repeated-measures analysis of variance was used to analyze the data of the two groups before and after the intervention.

Except for running and kicking, the group main effects (F_group=18.78-104.77), time main effects(F_time=243.23-3 003.19), and other interactive effects between group and time (F_group×time=14.01-322.91) were of statistical significances for gross motor, movement motor, manipulative motor and each sub-indicator between intervention group and control group. Further simple effect analysis results showed that, before intervention, there were no statistically significant differences in the total scores of gross motor (48.95±10.65, 45.87±10.98), movement motor (25.93±7.31, 23.46±7.32) and manipulative motor (23.15±4.40, 22.40±4.69) between the intervention group and the control group (F=3.69, 2.94, 1.90, P > 0.05); and two goups were also found of no statistical significance in the each sub-indicator of movement and manipulative motor (F=0.01-3.58, P > 0.05); after intervention, the total scores of gross motor, movement motor, and manipulative motor in the intervention group (75.92±9.48, 38.12±5.40, 37.80±4.92) were all better than those in the control group (59.52±12.12, 30.71±7.47, 28.81±5.54) (F=168.15, 97.58, 210.71), and the total indicators of both goups had better scores than those before the intervention (F_intervention=3 498.90, 1 438.27, 2 431.24; F_control=545.58, 309.18, 283.29)(all P < 0.01); after intervention, the intervention group had better scores in all sub-indicators (except for running and kicking) than the control group (F=43.57-297.71), and the each sub-indicator of both goups had better scores than those before the intervention (F_intervention=300.58-858.65; F_control=12.28-135.64)(all P < 0.01).

Physical education activities designed based on the concept of movement education could better promote the development of children's fundamental motor skills.

To explore the potential classification of 24-hour activity time allocation among college students in Yinchuan and its association with active health levels, so as to provide references for optimizing activity time allocation to enhance active health levels.

From November 18 to December 6, 2024, a stratified cluster random sampling method was used to select 2 422 first- and second-year college students from full-time undergraduate institutions in Yinchuan. The Chinese College Students' 24-hour Movement Behaviors Questionnaire (24 h MBQ) and Active Health Behavior Scale were used to assess 24-hour activity time allocation and evaluate active health levels. Latent profile analysis (LPA) was employed to categorize activity types, and a binary Logistic regression analysis was conducted to analyze the relationship between active health levels and activity types.

A total of 1 087 students (44.9%) were found of meeting active health standards, and significant statistical differences were found in active health levels across different genders, grades, academic qualities, sources of origin and academic categories (χ²=22.03, 7.65, 25.50, 10.12, 43.44, all P < 0.01). Moreover, significant statistical differences could also be found among college students' 24-hour activity time across different genders, ages, grades, sources of origin, academic qualities, and academic categories (t/Z/H/F=-5.70-111.39, P < 0.05).The 24-hour activity time allocation was classified into four types: academic high (6.9%), low activity rest (8.8%), light activity (67.8%), and high activity dynamic (16.4%). Significant statistical differences were observed in activity time allocation categories across different ages, academic qualities and academic categories (χ²=15.52-108.46, all P < 0.05). Using the high activity dynamic type as a reference, the light activity type (OR=0.39, 95%CI=0.31-0.50), low activity rest type (OR=0.10, 95%CI=0.06-0.15), and academic high type (OR=0.03, 95%CI=0.02-0.07) had lower active health levels among college students (all P < 0.01).

There is a significant difference in 24-hour activity time allocation among college students in Yinchuan, and different activity types are associated with active health levels.

To investigate the impact of extracurricular physical activity on heart rate variability (HRV) among primary and secondary school students in Chengdu City, so ao to provide references for scientific exercise prescription.

Using a convenient sampling method, 1 323 primary and secondary students were enrolled from central Chengdu who underwent physical fitness assessments at Sichuan Provincial Institute of Sports Science from September 2020 to January 2022. According to the standards of the National Physical Fitness Monitoring Center, boys and girls were divided into groups with and without extracurricular physical exercise habits. HRV was monitored using the SA-3000P device. Key HRV parameters were evaluated separately by gender, including standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (rMSSD), total power (TP), low-frequency power (LF) and high-frequency power (HF). Statistical analyses were employed by t-test, Mann-Whitney U-test and Chi-square test.

lgSDNN, lgrMSSD, TP, LF and HF in the group without extracurricular physical exercise habit [boys: (1.67±0.13)ms, (1.59±0.20)ms, (7.34±0.73)ms², (6.11±0.74)ms², (6.05±0.87)ms²; girls: (1.67±0.13)ms, (1.59±0.19)ms, (7.35±0.60)ms², (6.06±0.69)ms², (6.12±0.87)ms²] were lower than those in the group with extracurricular physical exercise habit [boys: (1.75±0.13)ms, (1.72±0.18)ms, (7.69±0.62)ms², (6.41±0.76)ms², (6.44±0.79)ms²; girls: (1.73±0.13)ms, (1.68±0.20)ms, (7.60±0.65)ms², (6.26±0.86)ms², (6.36±0.90)ms²] (t=-8.24, -8.75, -6.54, -5.35, -6.33;-5.10, -4.90, -4.47, -2.71, -2.93, all P < 0.01). Only the group of boys without extracurricular physical exercise habits showed a decrease in lgLF/HF [0.04(-0.19, 0.27)] compared to the group with extracurricular physical exercise habits [-0.03(-0.25, 0.20)] (Z=-2.01, P < 0.05). When the score classes of autonomic nerve activity, stress index and fatigue index were compared between boys and girls groups without and with extracurricular physical exercise habits, the proportion of boys normal and above scores increased from 79.3%, 84.1%, 71.8% to 91.4%, 95.7%, 87.3%, respectively, and the differences were statistically significant (χ²=47.42, 63.66, 38.28); the proportion of girls normal score and above increased from 79.8%, 85.7%, 75.0% to 85.4%, 92.1%, 79.4%, and the differences were statistically significant (χ²=48.31, 22.18, 22.22) (all P < 0.01).

The primary and secondary school students who have the habit of extracurricular physical exercise have enhanced compliance in indicators related to HRV, showing more complex heart rate variability.

To explore the relationship between positive parenting styles and academic emotions in junior high school students, as well as the chain mediation effects of parent-child communication and peer relationships, providing a theoretical basis for family education interventions.

Using stratified cluster random sampling, 1 063 students from four junior high schools in a city in Anhui Province were selected for questionnaire surveys, form March to April, 2025. Core variables were measured using the Short-form Parenting Style Scale, Adolescent Parent-Child Communication Scale, Peer Relationship Scale, and Adolescent Academic Emotion Questionnaire. Group comparison was conducted using t-test or analysis of variance, and Pearson correlation analysis was used to examine the correlation between positive parenting styles, peer relationships, parent-child communication and positive academic emotions. Multiple linear regression analysis was used to examine the effects of positive parenting styles, peer relationships and parent-child communication on positive academic emotions. A mediation effect model and Bootstrap method were employed to test the chain mediation effects.

Students who were class leaders, had parents with higher education levels, or came from intact families scored significantly higher on positive academic emotions (t/F=7.23, 13.73, 10.67, 4.45, all P < 0.01). Positive parenting styles, peer relationships, and parent-child communication were all positively correlated with positive academic emotions (r=0.45, 0.41, 0.38), and all three positively predicted positive academic emotions (β=0.24, 0.23, 0.12) (all P < 0.01). Further analysis showed that positive parenting styles directly predicted positive academic emotions (β=0.40) and also indirectly influenced academic emotions through parent-child communication (β=0.07), peer relationships (β=0.05), and the chain mediation path of "parent-child communication → peer relationships" (β=0.04) (all P < 0.05), with the total indirect effect accounting for 40.55%.

Positive parenting styles enhance junior high school students' academic emotions through the chain mediation path of "parent-child communication → peer relationships", providing theoretical support for interventions within the educational ecosystem.

To explore the association between peer victimization and psychotic-like experiences (PLEs) among junior high school students, so as to provide a scientific basis for preventing adolescent PLEs.

In January 2024, a method of combining convenient sampling with cluster sampling was used to survey 2 760 students from two ordinary junior high schools in southern Anhui Province (Susong Country, Anqing City). The Community Assessment of Psychic Experiences (CAPE) and the Adolescent Peer Bullying Scale were employed to assess PLEs with different symptoms and peer victimization (verbal, physical, relational, and cyberbullying). Multivariate Logistic regression models analyzed the associations of different types peer victimization and PLEs with different symptoms.

The prevalence of PLEs was 17.5%, with delusional (15.4%) and hallucinatory (7.4%) symptoms being most common. Peer victimization was reported by 51.3% of students (49.6% victims, 19.5% perpetrators), with verbal victimization being most frequent (42.4% victims, 15.5% perpetrators) and cyberbullying least frequent (6.0% victims, 1.9% perpetrators). Compared to students without bullying, students exposed to bullying showed significantly higher rates of delusional (χ²=29.09-127.22), hallucinatory (χ²=27.23-72.29), and overall PLEs (χ²=34.32-127.25) (all P < 0.01). After adjusting for relevant confounding factors, the multiple Logistic regression model revealed verbal victimization increased risks of delusions (OR=1.59, 95%CI=1.22-2.09), hallucinations (OR=1.94, 95%CI=1.33-2.84), and overall PLEs (OR=1.62, 95%CI=1.26-2.09); relational victimization was associated with delusions (OR=1.83, 95%CI=1.40-2.39) and PLEs (OR=1.65, 95%CI=1.28-2.13); physical victimization correlated with hallucinations (OR=1.64, 95%CI=1.12-2.40) and PLEs (OR=1.41, 95%CI=1.06-1.87) (all P < 0.05).

Specific types of peer victimization are differentially associated with PLEs, with relational victimization demonstrating the strongest association.

To explore the core features of trait aggression in children and adolescents, so as to provide a theoretical basis for behavioral interventions targeting the central psychological characteristics of aggression in children and adolescents.

From March to May 2020, a simple random convenience sampling method was employed to recruit 39 165 students from grades 4 to 12 in Sichuan, Chongqing, Guizhou, and Shandong. Data were collected via online questionnaires, with all participants completing the Chinese Version of the Aggression Questionnaire. Psychometric network analysis was utilized for data processing.

Trait aggression among Chinese children and adolescents was at a moderately low level. The core nodes of the network structure included physical aggression [if someone intentionally causes trouble for me, I will hit them severely (AGG6); if someone hits me, I will retaliate (AGG11)] and self-aggression [When I am very irritable, I think of hurting myself (AGG5); when I am in a bad mood, I engage in behaviors that harm my health, such as overeating (AGG25)]. Across grade levels, core nodes primarily originated from the anger dimension [When I'm angry, I feel like a powder magazine that could explode at any moment (AGG13); I can't control my temper (AGG18); I am prone to getting angry when I see things that are not pleasing to the eye (AGG23); I will get angry for no reason (AGG27)]. Except for grades 7 and 9, core nodes in other grades included the verbal aggression dimension [I am prone to arguments with people (AGG22)]. Before grade 8, core nodes incorporated the self-aggression dimension (AGG 5, AGG 25); after grade 8, core nodes included the physical aggression dimension [AGG 6, AGG 11, I fight slightly more than others (AGG16), and if people around me make things difficult for me to a certain extent, I will fight with them (AGG26)]. No statistically significant differences were found in the trait aggression network structures across grades, genders, or within-gender comparisons of different grades.

These findings broaden our understanding of aggression in children and adolescents, suggesting that behavioral interventions can effectively reduce aggressive behaviors in this population.

To explore differences in the factors influencing parents' and teachers' assessments of preschool children's mental health using the Strengths and Difficulties Questionnaire (SDQ), so as to provide reference for promoting children's mental health.

A retrospective analysis was conducted on the SDQ survey data of 14 763 middle and senior kindergarten children in Nanshan District, Shenzhen, from March to June 2023. Chi-square χ² tests were used to analyze differences in mental health assessments between parents and teachers. Multivariate Logistic regression was employed to examine the factors influencing parental assessments, and Kappa coefficients were used to evaluate the consistency between parent and teacher evaluations.

The positive rate of mental health problems reported by parents (7.2%) was significantly higher than that reported by teachers (6.2%) (χ²=254.27, P < 0.01). Gender differences revealed that parents reported a lower positive rate for boys (7.9%) compared to teachers (8.5%), whereas for girls, the parental positive rate (6.4%) was higher than that reported by teachers (3.8%) (χ²=163.59, 81.26, all P < 0.01). Age-related differences showed that parental positive rates for 4, 5, and 6-year-olds (8.5%, 7.4%, 5.8%) were consistently higher than teachers' assessments (6.3%, 6.7%, 5.4%) (χ²=41.23, 157.53, 63.67, all P < 0.05). Univariate analysis of parental assessments indicated higher positive rates among boys (7.9%), 4-year-olds (8.5%), mothers aged 20-35 (6.6%), mothers with high school education or below (9.8%), fathers aged 23-40 (6.4%), fathers with high school education or below (10.3%), and children exposed to secondhand smoke (7.9%) (χ²=23.56-235.24, all P < 0.01). Multivariate Logistic regression identified lower parental education levels and exposure to secondhand smoke as significant risk factors for abnormal SDQ assessments by parents (χ²=2.05, 1.62, 3.15, all P < 0.05). The Kappa coefficients for parent-teacher agreement across SDQ subscales and total difficulties ranged from 0.04 to 0.12 (all P < 0.01).

Parental education level and exposure to secondhand smoke are significant factors influencing preschool children's mental health. Differences exist between parental and teacher assessments of children's mental health, and incorporating teacher evaluations can provide a more comprehensive understanding of preschoolers' psychological well-being.

To analyze the longitudinal relationship between cumulative multiple risks and depressive emotions in primary and secondary school students, and to examine the mediating role of executive function in the association, so as to provide scientific evidence for preventing and alleviating depressive emotions in adolescents.

Using convenience sampling, 946 students from Shandong and Hunan provinces were tracked for one year (December 2023 to December 2024) regarding their exposure to multiple risks, executive function, and depressive emotion. Pearson correlation analysis was employed to examine variable relationships, while mediation modeling with Bootstrap testing (5 000 iterations) was conducted to verify the mediating effect.

At baseline, the prevalence of survival risks was relatively low, with 37.98% of primary school students and 30.87% of middle-school students reporting no exposure to such risks. In contrast, developmental risks and harmful risks showed substantially higher prevalence, with 63.20% of primary school students and 69.63% of middle-school students experiencing two or more risk factors in developmental risks, and 44.81% of primary school students and 71.60% of middle-school students experiencing two or more harmful risks. After controlling for gender, age, baseline executive function and depressive emotions: higher cumulative developmental risks (β=0.06, P < 0.01) and hazardous risks (β=0.08, P < 0.01) predicted elevated depressive emotion, while survival risks showed no significant prediction (β=0.03, P>0.05). Executive function significantly mediated the effects of both developmental risks (Effect=0.02, 95%CI=0.01-0.04) and hazardous risks (Effect=0.02, 95%CI=0.01-0.04) on depressive emotion (both P < 0.05).

Increased exposure to developmental and hazardous risks predicts poorer executive function, which subsequently exacerbates depressive emotions in students.

To explore the influence of social support and school connectedness on the developmental trajectory of self-efficacy in adolescents and analyze its subgroup effects, so as to provide a basis for enhancing adolescents' self-efficacy.

Using a cluster random sampling method, 930 first-year middle school students from four schools in Xiangxi Autonomous Prefecture, Hunan Province, were selected for three longitudinal surveys in October 2023 (T1), April 2024 (T2), and October 2024 (T3). The General Self-efficacy Scale (GSES), Social Support Scale (SSS), and School Connectedness Scale (SCS) were administered. Latent growth mixture modeling (LGMM) was used to identify different developmental trajectories of self-efficacy in early adolescence. Multivariate Logistic regression was employed to examine the associations of self-efficacy trajectories with social support and school connectedness in adolescents.

The developmental trajectory of self-efficacy in adolescents was classified into three categories: category 1 was low efficacy-rapid growth group (53 students, 6.6%), category 2 was moderate efficacy-stable growth group (793 students, 84.1%), and category 3 was high efficacy-rapid decline group (84 students, 9.3%). Using the low efficacy-rapid growth group as the reference, students with higher social support were more likely to belong to the moderate efficacy-stable growth group (OR=1.06, 95%CI=1.03-1.08) and the high efficacy-rapid decline group (OR=1.06, 95%CI=1.03-1.09), students with higher school connectedness were more likely to belong to the high efficacy-rapid decline group (OR=1.10, 95%CI=1.03-1.18) (all P < 0.05). Subgroup analysis revealed significant effects for boarding status (low efficacy-rapid growth group at T1, t=2.10; high efficacy-rapid decline group in social support, t=-2.15) and only-child status (moderate efficacy-stable growth group at T2, t=2.05) (all P < 0.05).

The developmental trajectory of self-efficacy in adolescents exhibits group heterogeneity, with boarding status and only-child status showing subgroup effects. Enhancing social support and school connectedness can help improve self-efficacy in adolescents.

To analyze the association between each regional fat mass and total body bone mineral density (BMD) in children and adolescents aged 7-17 years in Beijing, so as to provide theoretical basis and practical guidance for implementing interventions.

From September to December 2020, a stratified cluster random sampling method was used to select 1 423 children and adolescents aged 7-17 years in Tongzhou District, Beijing. Dual-energy X-ray absorptiometry (DXA) was employed to measure regional body composition and total body BMD. Multiple linear regression was used to analyze the association between regional fat mass and total body BMD.

The median (interquartile range) fat mass values for total body, upper limbs, abdomen, hips, and thighs were 13.51(8.84, 19.21), 1.59(1.08, 2.23), 0.73(0.39, 1.29), 2.32(1.46, 3.26), 5.29(3.59, 7.21)kg, respectively. After adjusting for covariates, the results of multiple linear regression analysis showed that total body fat mass (β=0.010), abdominal fat mass (β=-0.100), and hip fat mass (β=0.104) were significant associations with total body BMD (all P < 0.01). Sex-stratified analysis revealed that in boys, total body fat mass (β=0.008) and hip fat mass (β=0.058) were positively associated with BMD, while thigh fat mass (β=-0.038) showed a negative association with total body BMD (all P < 0.05). In girls, total body fat mass (β=0.013), hip fat mass (β=0.163), and thigh fat mass (β=0.023) were positively associated with total body BMD, whereas abdominal fat mass (β=-0.196) showed a negative association with total body BMD (all P < 0.05). Among children and adolescents with body fat percentage below the standard range, within the standard range and above the standard range, total body fat masses were positively associated with total body BMD (β=0.021, 0.016, 0.015); among children and adolescents with body fat percentage within the standard range while upper limb (β=-0.042), abdominal (β=-0.067), and thigh fat mass (β=-0.018) showed negative associations with total body BMD, and hip fat mass demonstrated a positive association with total body BMD (β=0.082) (all P < 0.05).

Regional fat distribution is associated with total body BMD in children and adolescents, with the nature of these associations varying by sex and body fat percentage.

To investigate the mental health status and related factors among primary and secondary school students in western Yunnan Province, so ao to provide scientific evidences for advancing mental health education.

In June 2024, a stratified cluster sampling method was employed to select 4 584 students from 18 schools across Diqing Tibetan Autonomous Prefecture, Lincang City and Baoshan City three regions in western Yunnan Province. The Mental Health Test (MHT) was used for assessment. Latent class analysis (LCA) and Logistic regression were applied for data classification and related factor analysis respectively.

The overall positive detection rate of MHT was 11.81%, with a mean total score of 40.50±19.25. The predominant issues were learning anxiety (58.4%), hypersensitivity tendency (31.1%), and self-blame tendency (23.1%). LCA categorized students into four groups: severe psychological problems group (74.4% detection rate), learning anxiety-hypersensitivity group (16.4%), learning anxiety-physical symptoms group (9.2%), and healthy group (0). Logistic regression revealed that compared with the healthy group, the severe problems group showed higher risks among females (OR=3.01), junior/senior high school students (OR=1.88/4.02), and those with authoritarian parenting (OR=3.54); the anxiety-hypersensitivity group had higher risks for females (OR=1.87), senior high students (OR=1.54), boarders (OR=1.31), and authoritarian parenting recipients (OR=1.85); the anxiety-physical symptoms group demonstrated increased risks among females (OR=2.22), senior high students (OR=2.58), and authoritarian parenting recipients (OR=2.74), while lower risks were observed for students with parent/grandparent guardians (OR=0.38) and non-only children (OR=0.58) (all P < 0.05).

Mental health problems are prominent among students in western Yunnan, with gender, grade level, boarding status, guardian type, and parenting style being key determinants. Recommendations include strengthening mental health education, prioritizing left-behind children's psychological well-being and promoting healthy development.

To investigate the impact of preschool children's aquatic motor skill (AMS) acquisition on their fundamental motor skill (FMS) development and the correlation between AMS and FMS development, so ao to provide a scientific basis for early childhood education and physical education teaching.

From April to June 2024, 60 children, recruited by random sampling from a kindergarten in Taiyuan, were stratified randomly divided into an experimental group (n=30) and a control group (n=30). The experimental group were further divided into five classes of six each. They received AMS practice interventions twice weekly, 40 minutes per session, over eight weeks (16 sessions total) at a designated swimming center. The control group maintained their usual routine. Children's FMS and AMS were assessed pre- and post-intervention using the Test of Gross Motor Development-3rd (TGMD3) and Actual Aquatic Skills Test (AAST), respectively. Before and after test comparisons within and between groups employed t-tests, Wilcoxon signedrank tests, ANCOVA (including ranktransformed ANCOVA), and Cohen's d effect sizes were calculated for standardized mean differences. Spearman rank correlation was used to analyze relationships between FMS and AMS.

After the aquatic learning, the experimental group scored significantly higher than the control group on locomotor skills (F=20.47, P < 0.01, η²=0.26), FMS (F=4.59, P=0.04, η²=0.08), and AMS (F=109.71, P < 0.01, η²=0.79). The experimental group's improvement in locomotor skills 5.0(3.8, 7.3) versus the control group (2.8±2.5) yielded a medium effect size (Cohen's d=0.71); AMS gains in the experimental group versus controls showed a very large effect size (Cohen's d=4.73) (both P < 0.01). Among preschool children, AMS acquisition was positively correlated with locomotor skills (r=0.39) and overall FMS (r=0.43)(both P < 0.05). Skill specific assessments revealed lower proficiency in headfirst entry (immersion), treading water, and sagittalplane rotation.

Preschool children's acquisition of AMS has a positive effect on their FMS, with mutual facilitation between the two, especially in locomotor abilities.

To investigate the timing of puberty onset among primary school students, so as to provide the reference data for early identification of children with suspected precocious puberty.

A study was conducted from October 23 to November 7, 2023, involving 10 225 students(5 412 boys, 4 813 girls) from grade 1 to 6 of four campuses in Meiling Primary School in Yangzhou. Breast development in girls and external genitalia in boys was assessed via visual inspection and palpation, with pubertal stages classified using the Tanner staging method. Puberty onset timing was determined based on age/sex reference values from Chinese Han children's pubertal milestone indicators. Descriptive analysis was performed using SPSS 26.0.

The median age for testicular volume reaching 4 mL in boys was 10.49 years, while the median age for breast development onset in girls was 9.70 years. Among boys with testicular volume ≥4 mL, 16.6%(n=217) were identified as suspected early puberty cases; among girls with Tanner stage Ⅱ and Ⅲ, 123(9.4%) and 165(18.5%) showed earlier breast development than the reference range. Overall, 14.4% of students exhibited suspected precocious puberty.

The onset age of puberty for girls in primary schools of Yangzhou aligns with findings from other regions, while boys show earlier pubertal initiation.

To investigate the relationship between relative grip strength and hyperuricemia (HUA) levels in university freshmen, and to explore the potential value of muscle function indicators in HUA prevention among young populations, so as to provide new scientific evidences for HUA control in the demographic.

Utilizing health examination data from 1 744 freshmen enrolled in a Shaanxi Province university in September 2024, absolute grip strength was measured using CAMRY electronic dynamometers, with relative grip strength subsequently calculated. Spearman correlation analysis was employed to examine relationships between student characteristics and relative grip strength, and binary Logistic regression models assessed the association strength between relative grip strength and HUA.

The overall HUA detection rate among freshmen was 29.8%, with significant gender differences (male: 43.1%; female: 24.0%; χ²=64.62, P < 0.01). Correlation analysis revealed significant associations between relative grip strength, body weight, height, body mass index (BMI) and HUA in both genders (boys: r=-0.27, 0.54, 0.11, 0.53; girls: r=-0.18, 0.33, 0.08, 0.33, all P < 0.05). Binary Logistic regression demonstrated that each standard deviation increase in relative grip strength reduced HUA risk by 77% in males (OR=0.23, 95%CI=0.14-0.37) and 80% in females (OR=0.20, 95%CI=0.11-0.36) (both P < 0.01).

Relative grip strength represents a significant factor associated with HUA in university students. Incorporating muscle strength training into HUA prevention programs and establishing muscle function-based HUA risk warning systems should be considered.

To investigate the correlation between sleep fragmentation and body composition/blood pressure in female students of middle school, so as to provide theoretical guidance for preventing health risks associated with sleep fragmentation.

From September 2022 to December 2023, 505 female students aged 12-15 years in Nanyang City were selected through stratified cluster random sampling and conducted Pittsburgh Sleep Quality Index(PSQI) survey. Participants were divided into Q1-Q4 groups based on sleep fragmentation index (SFI) quartiles. Body composition and blood pressure measurements were measured by adopting body composition analyzer and traditional mercury sphygmomanometer, and data were analyzed using χ² tests and linear regression.

Significant intergroup differences for Q1-Q4 were observed with increasing SFI levels for body mass index(BMI), fat percentage, muscle mass, bone mass, trunk fat percentage, systolic blood pressure, diastolic blood pressure, and PSQI total scores (F=15.25, 7.33, 8.38, 5.97, 11.24, 16.85, 6.87, 15.73, all P < 0.05). SFI showed positive correlations with BMI, fat percentage, trunk fat percentage, and blood pressure(β=0.37, 0.45, 0.34, 0.42, 0.38), but negative correlations with muscle mass and bone mass(β=-0.35, -0.48) (all P < 0.05). The χ² trend test revealed a significant increase in hypertension detection rates with elevated SFI (χ²=42.75, P < 0.05). The χ² testing demonstrated statistically significant differences in hypertension incidence among different quartiles groups (χ²=14.16, P < 0.05). After adjusting the significance level, hypertension incidence differences remained significant between Q1and Q4 (χ²=10.77), Q2 and Q4 groups (χ²=6.28) (both P < 0.008 3).

Sleep fragmentation correlates significantly with body composition and blood pressure indicators in female students of middle school. Implementing sleep fragmentation interventions is essential for safeguarding female students' health in middle school.

To understand classroom environmental conditions and their association with spinal curvature abnormalities among students of primary and secondary schools in Guizhou Province, so as to provide a basis for formulating school health policies and scientific prevention and control measures for abnormal spinal curvature in students.

Using a stratified random sampling method, 471 schools (2 811 classrooms) were selected annually across the province from 2022 to 2024 in order to monitor and evaluate classroom environment according to national standards. Spinal examinations were conducted for 196 606 (2022), 194 876 (2023), and 195 048 (2024) students, and χ² test was used to analyze the correlation of desk and chair compliance with student spinal curvature abnormalities.

The qualified rates of classroom blackboard illuminance uniformity (85.41%) and the blackboard size (82.24%) were the highest in primary and secondary schools in Guizhou Province, while the average blackboard surface illumination qualified rate (20.10%) was the lowest. The average desk illumination (50.11%-58.63%), desk illumination uniformity (61.92%-72.27%) and qualified noise rate (50.04%-51.94%) increased significantly in 3 years; in addition, the compliance rate of desks and chairs decreased from 25.00% to 13.52%, and the differences were all statistically significant (χ²=42.48, 80.93, 46.09, 129.72, all P < 0.05). Middle school classrooms outperformed primary schools in terms of per capita area, average blackboard illuminance, blackboard illuminance uniformity, average desktop illuminance, desktop illuminance uniformity, and noise compliance (χ²=311.55, 12.41, 20.64, 40.76, 10.25, 52.47), but had lower compliance for blackboard size and reflectance (χ²=537.29, 7.59) (all P < 0.01). Urban schools had higher compliance than suburban schools for per capita area, average blackboard illuminance, average desktop illuminance, and desktop illuminance uniformity (χ²=73.71, 17.68, 29.30, 36.03), but lower compliance for desk-chair suitability, blackboard size, and blackboard reflectance (χ²=4.72, 26.02, 5.43) (all P < 0.05). The spinal curvature abnormality detection rate was 0.83%. A significant association was found between abnormality detection and desk-chair non-compliance (χ²=223.85, P < 0.01).

Classroom environment hygiene in Guizhou schools is suboptimal. Strengthening school environmental hygiene infrastructure and greater attention to its impact on student's health are essential.

To analyze the prevalence and determinants of comorbid overweight/obesity and elevated blood pressure among primary and secondary school students in Yangzhou City, and to explore the association between sleep patterns, eating behavior and the comorbidity of overweight/obesity and elevated blood pressure, so as to provide reference for developing prevention strategies targeting common comorbidities in students.

By using stratified cluster random sampling, a total of 8 735 primary and secondary school students were selected from 36 schools in six counties of Yangzhou from October to November 2023. Students underwent physical examinations and a questionnaire survey was conducted using the questionnaire on students' health status and influencing factors. The Chi-square test was used to compare the detection rate of comorbid overweight/obesity and elevated blood pressure in different groups of primary and secondary school students. The Logistic regression model was used to explore the association between sleep and dietary behaviors and their combined effects and coexistence.

The detection rate of comorbid overweight/obesity and elevated blood pressure among primary and secondary school students in Yangzhou was 9.85%, which was higher among boys (12.14%) than girls (7.59%)(χ²=50.86, P < 0.01). After controlling for gender, residence, educational stage, parental education, smoking, drinking, and moderate to vigorous exercise, multivariate Logistic regression analysis showed that irregular breakfast consumption and inadequate daily sleep were associated with a higher risk of comorbidities compared with regular breakfast consumption and adequate daily sleep among overall and primary school students (overall: OR=1.52, 95%CI=1.18-1.96, primary school students: OR=2.79, 95%CI=1.61-4.82)(both P < 0.05). From the perspective of primary school students of different genders, the risk of comorbidities in girls who consumed breakfast irregularly and had inadequate daily sleep was 3.59 times higher than that in girls who consumed breakfast irregularly and had inadequate daily sleep (95%CI=1.65-7.82, P < 0.01).

The sleep patterns and breakfast behaviors of primary and secondary school students are found to be associated with comorbid overweight/obesity and elevated blood pressure, especially in primary school girls.

To investigate the relationship between serum alanine transaminase (ALT) and carotid intima-media thickness (cIMT) in adolescents, providing evidence for early prevention and control strategies for cardiovascular structural abnormalities in adolescents.

Data were obtained from the third follow-up survey (from October to November 2023) of the "Huantai Children Cardiovascular Health Cohort", including 1 153 healthy adolescents with complete information. Analysis of variance (ANOVA) was used to compare cIMT across different ALT level groups, and multiple linear regression was employed to analyze the relationship between serum ALT levels and cIMT.

Significant differences in cIMT were observed among Q1, Q2, and Q3 ALT level groups [(0.56±0.04) (0.57±0.04) (0.59±0.04)mm, respectively; F=3.61, P < 0.01]. After adjusting for covariates, multiple linear regression revealed a positive correlation between ALT levels and cIMT (β=0.18, P < 0.01). Gender subgroup analysis showed similar results in males (β=0.19, P < 0.01), but no statistically significant association was found in females (β=0.07, P=0.54).

Elevated serum ALT levels are associated with an increased risk of vascular structural damage in adolescents, especially in boys. Early detection and control of abnormal serum ALT levels can help to reduce early vascular structural damage and further reduce the risk of adverse cardiovascular events.

To understand the epidemiological characteristics of abnormalities spinal curvature among children and adolescents in Karst landform in Guizhou Province, so as to provide a scientific basis for targeted comprehensive intervention.

From September to December 2023, 194 875 children and adolescents aged 6-18 were selected from all countieldistricts of 9 cities (prefectures) in Guizhou Province by stratified random cluster sampling method according to the proportion of Karst landform area in Guizhou Province for carrying out spinal curvature abnormality screening, and a questionnaire survey was conducted on 139 449 students in the fourth grade and above of primary school. Binary Logistic regression was used for multivariate analysis.

The detection rate of abnormal spinal curvature among children and adolescents aged 6-18 in Guizhou Province was 1.13%. The detection rates of abnormal spinal curvature in areas with a high proportion of Karst landform, areas with a low proportion of Karst landform, intercalation areas, and non-Karst landform areas were 1.10%, 2.00%, 0.90%, and 0.60%, respectively. Among them, the detection rates of abnormal spinal curvature in female students (2.40%, 1.60%, 0.90%) in areas with a low proportion of Karst landform, intercalation areas and non-Karst landform were higher than those in male students (1.60%, 0.10%, 0.30) (χ²=12.66, 112.69, 30.22, all P < 0.05). The detection rates of abnormal spinal curvature among senior high school students (2.00%, 4.30%, 1.40%, 1.30%) in different Karst landform distributions were successively higher than those among junior high school students (1.40%, 3.20%, 1.00%, 0.60%) and primary school students (0.70%, 0.80%, 0.60%, 0.30%) (χ²=306.11, 175.80, 14.24, 39.57, all P < 0.05). The results of multivariate Logistic regression analysis showed that the detection rates of abnormal spinal curvature in both high-proportion and low-proportion Karst landform areas were higher than those in non-Karst landform areas [OR(95%CI)=1.84(1.05-2.25), 1.60(1.23-2.09), both P < 0.05].

The detection rate of abnormal spinal curvature in children and adolescents aged 6-18 in Guizhou Province is related to the distribution of Karst landform, so it is necessary to strengthen screening and appropriate comprehensive interventions.

To analyze the characteristics and safety risks of preservatives and sweeteners in beverages sold near schools in Anshun City, so as to provide a evidence for formulating targeted regulatory strategies in campus.

From December 2023 to July 2024, 834 beverage samples were collected from sales points near primary and secondary schools in Xixiu District and four surrounding townships of Anshun City by a stratified random sampling method. High-performance liquid chromatography was used to detect three preservatives (sorbic acid, benzoic acid and dehydroacetic acid) and four sweeteners (sodium saccharin, acesulfame-K, aspartame, and neotame). Differences were analyzed using the Chi-square test.

The overall exceedance rate of preservative was 8.6% (72 samples), with dehydroacetic acid showing the highest exceedance rate (7.0%, 58 samples), significantly higher than sorbic acid (0.6%, 5 samples) and benzoic acid (0.4%, 3 samples) (χ²=90.85, P < 0.01). The overall exceedance rate of sweetener was 10.4% (87 samples), with sodium saccharin having the highest exceedance rate (6.2%, 52 samples), significantly higher than neotame (2.8%, 23 samples), acesulfame-K (0) and aspartame (0) (χ²=262.04, P < 0.01). Potential risks were identified due to the co-occurrence of multiple additive exceedances, including 0.7% (6 samples) for mixed preservatives and 1.6% (13 samples) for mixed sweetener. No statistically significant differences were found in preservative (7.2%, 26 samples) or sweetener (12.3%, 44 samples) exceedance rates between micro-enterprises and large, medium and small enterprises (χ²=2.67, 5.16, both P>0.05).

Systemic misuse risk of food additives in beverages sold near school necessitates a risk-traceability-based regulatory framework, with emphasis on standardizing enterprise production practices and strengthening oversight of sales outlets near campuses.