To investigate the association between bedtime screen use and sleep health among fourth- and fifth-grade primary school students, so as to provide evidence to support interventions for improving sleep quality.

From April to June 2024, a survey was conducted among 4 232 fourth- and fifth-grade students from nine primary schools in a district of Beijing. A self-designed questionnaire assessed bedtime screen use behavior and sleep health indicators. Generalized linear models and Logistic regression were used to analyze the associations.

Among the surveyed students, 28.3% reported bedtime screen use. Mean sleep duration every day was (9.31±0.90) hours on school days and (10.08±1.36) hours on weekends. Compared to non-users, students with bedtime screen use exhibited every day: later bedtimes on school days (10.18 min delay, 95%CI=6.88-13.47) and weekends (22.09 min delay, 95%CI=17.33-26.85) (P < 0.05); later weekend wake times (7.97 min delay, 95%CI=1.78-14.16, P < 0.05); reduced sleep duration on school days (-9.82 min, 95%CI=-13.62 to -6.03) and weekends (-14.12 min, 95%CI=-20.24 to -8.00) (P < 0.05); greater weekend-school day bedtime discrepancy (β=1.15, 95%CI=1.08-1.23, P < 0.01). Additionally, they had lower odds of falling asleep within 20 minutes (OR=0.62, 95%CI=0.54-0.72), daytime alertness (OR=0.66, 95%CI=0.56-0.77), and subjective sleep satisfaction (OR=0.57, 95%CI=0.49-0.66)(P < 0.01).

Bedtime screen use is associated with adverse effects on multiple dimensions of sleep health in primary school students. Reducing screen exposure before bed may help improve their sleep quality.

To explore the relationship between sleep characteristics, physical activity patterns, with depressive and anxiety symptoms in college students, so as to provide reference for student mental health promotion.

From September to November 2023, a convenience sampling method was used to select 7 954 college students aged 18-22 years from 9 universities in Shanghai, Hubei, and Jiangxi. Assessments were conducted using the International Physical Activity Questionnaire Short-Form (IPAQ-SF), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI) to evaluate physical activity, depressive and anxiety symptoms, and sleep quality, respectively. Logistic regression analysis was employed to explore the impact of sleep characteristics and physical activity patterns on depressive and anxiety symptoms and their comorbidity among college students.

The detection rates for depressive symptoms, anxiety symptoms, and comorbid depression and anxiety symptoms were 25.67%, 35.39%, and 23.15%, respectively. Factors such as gender, grade, household registration, parental education level, annual family income, family structure, and dietary habits were all associated with the detection rates of depressive and anxiety symptoms and their comorbidity (χ²=4.41-118.39, P < 0.05). Physical activity patterns, sleep duration, sleep quality, and sleep-wake characteristics were also associated with the occurrence of depressive and anxiety symptoms and their comorbidity (χ²=9.66-627.70, P < 0.05). Logistic regression analysis showed that college students who stayed up late and slept less than 7 had the highest risk of depressive and anxiety symptoms and their comorbidity (OR=1.93, 1.85, 1.88, P < 0.05). Compared to regular physical activity patterns, insufficient physical activity patterns were associated with an increased risk of depressive and anxiety symptoms (all OR=1.18, P < 0.05). Further stratified analysis results showed that the risk of depression, anxiety and their comorbidity increased in college students who stayed up late and slept less than 7 h, went to bed before midnight and slept less than 7 h, or went to bed before midnight and slept more than 7 h but did not have sufficient physical activity (P < 0.05).

Sleep characteristics and physical activity patterns significantly affect depressive and anxiety symptoms in college students. Universities should strengthen sleep management and implement flexible physical activity interventions to help students establish healthy lifestyles.

To investigate the effects of poor sitting postures on muscle fatigue in school-age children, so as to provide evidence for developing healthy sitting guidelines.

In May 2024, 30 children aged 6-12 were recruited from Changping District in Beijing. A combination of surface electromyography (sEMG) and psychophysical scales were used to assess muscle fatigue at varying deviation angles under four sitting postures (forward head tilt, lateral head tilt, uneven shoulder height, and forward trunk inclination). One-way ANOVA and LSD post hoc multiple comparisons were employed to analyze the differences in electromyographic (EMG) data among various deviation angles under different sitting postures.

The mean integrated electromyography (I_EMG) of representative muscles showed statistically significant differences (P < 0.05) across deviation angles in all postures, with muscle fatigue worsening as deviation angles increased. Forward head tilt: significant I_EMG differences were observed in the left/right sternocleidomastoid and left/right splenius capitis (F=13.74, 13.21, 5.43, 6.11, P < 0.05). Lateral head tilt: significant differences were found in the right sternocleidomastoid muscle (SCM), right splenius capitis, and left trapezius (F=5.13, 4.73, 12.13, P < 0.05). Uneven shoulder height: significant differences occurred in the right SCM, bilateral splenius capitis, and left trapezius (F=12.46, 12.56, 32.49, 5.98, P < 0.05).Forward trunk inclination, significant differences were identified in the left/right SCM, left/right splenius capitis, and left/right lumbar muscles (F=4.45, 9.84, 14.49, 26.44, 8.02, 18.34, P < 0.01). Temporal analysis revealed varying fatigue onset times across postures: severe fatigue occurred earlier in lateral head tilt and forward trunk inclination, while excessive forward head tilt, lateral head tilt, and uneven shoulder postures predominantly induced mild to moderate fatigue.

Under different sitting postures, both the integrated I_EMG of relevant muscles and subjective evaluations in school-aged children increase with greater postural deviattion. Head tilt and trunk-leaning postures require particular intervention, with emphasis on uneven-shoulder alignment and trunk inclination control.

To explore the dynamic association and gender difference among body dissatisfaction, weight bias internalization and eating disorders in junior high school students, so as to provide the reference for the rational implementation of relevant intervention activitites.

From June to December 2023, a cluster sampling method was used to select 698 students from a middle school in Fuzhou for three follow-up surveys for a period of 6 months (T1:June 2023, T2:September 2023, T3:December 2023). The Eating Disorders Inventory-Body Dissatisfaction (EDI-BD), the Chinese Version of the Weight Bias Internalization Scale for Mainland Chinese Children and Adolescents (C-WBIS), and the Chinese Version of the Eating Disorder Examination Questionnaire (C-EDE-QS) were used for investigation. Analysis of variance, t test, Pearson correlation analysis and cross-lagged analysis were used for statistical analysis.

T1 there were statistically significant differences in body dissatisfaction scores among junior high school students of different grades and with or without left-behind experience (t=-3.25, 2.12, P < 0.05). There were statistically significant differences in weight bias internalization (t=-3.03, -2.43, 2.43) and eating disorders (t=-4.64, -2.04, 2.63) among junior high school students of different genders, grades and with or without left-behind experience (P < 0.05). Cross-lagged analysis showed that body dissatisfaction was a predictor of weight bias internalization (β_T1-T2=0.22, β_T2-T3=0.12) and eating disorders (β_T1-T2=0.09, β_T2-T3=0.17, P < 0.01). Eating disorders could predict body dissatisfaction (β_T1-T2=0.15, β_T2-T3=0.13) and weight bias internalization (β_T1-T2=0.14, β_T2-T3=0.23, P < 0.01). The mutual predictive effect of body dissatisfaction, weight bias internalization and eating disorders varied with gender. T2 weight bias internalization in girls had a predictive effect on T3 body dissatisfaction (β=0.11). T1 and T2 eating disorders in girls had a predictive effect on T2 and T3 weight bias internalization (β_T1-T2=0.26, β_T2-T3=0.21) (P < 0.01).

Body dissatisfaction, weight bias internalization, and eating disorders of the junior high school students are interconnected. And there is a certain two-way correlation and gender difference between body dissatisfaction, weight bias internalization and eating disorders in junior high school students.

To investigate the efficacy of interpersonal synchronous intervention on improving social behavioral deficits in children with autism spectrum disorder (ASD), in order to provide effective guidance for optimizing social intervention programs for ASD children.

From September 2022 to March 2023, 84 ASD children aged 7-12 years were recruited from the Children and Adolescents Mental Health Medical Center of Inner Mongolia Autonomous Region Mental Health Center. The test subjects were randomly divided into an intervention group (42 cases) and a control group (42 cases). A 7-month social interactive game intervention plan was implemented in the intervention group, with an average of 2 times per week, each lasting 70 minutes, for a total of 56 interventions; the control group only participates in routine social activites such as daily communication and cooperation. And tests were conducted on communication behavior indicators (language expression, language comprehension, and cognitive speaking) and maladaptive behavior indicators (action characteristics, emotional expression, and social communication) of two groups of ASD children before and after intervention, and the differences in various social behavior indicators between the two groups of ASD children before and after intervention were compared through paired sample t-test.

Before the intervention, there were no significant differences in language expression, language understanding and cognitive oral scores of children with ASD between the intervention and control groups (t=1.43, 1.65, 1.67, P>0.05). The language expression (76.29±2.34) and cognitive speaking (84.24±2.13) scores of the intervention group before intervention were lower than those after intervention (79.28±3.16, 88.39±2.35) (t=-4.17, -4.66), and the language understanding score (85.64 ± 2.30) was higher than that after intervention (83.33±1.28) (t=5.41)(P < 0.05). Before intervention, there were no statistically significant differences in non adaptive behavior factors (motor characteristic, emotional expression, and social communication)between groups (t=1.05, 1.46, 1.69, P>0.05). After intervention, the intervention group had higher scores in motor characteristics (79.55±3.32), emotional expression (73.20±3.21), and social communication (78.22±4.05) compared to the control group (72.24±3.43, 69.33±4.18, 76.21±3.14) (t=7.10, 5.51, 4.24, P < 0.05).

The interpersonal synchronous intervention program has shown good improvement in the treatment of social behavior disorders in children with ASD.

To investigate the trends in disease burden due to childhood asthma in China from 1990 to 2021 and to project the disease burden from 2022 to 2035, so as to provide insights into formulation of the control interventions for childhood asthma in China.

The prevalent case, age-standard prevalence, disability-adjusted life years (DALYs) and age-standard DALYs rate of children with asthma at ages of 0 to 14 years and their 95% uncertainty interval (UI) in China from 1990 to 2021 were extracted from the Global Burden of Disease (GBD) database. The temporal trends in the disease burden of childhood asthma were evaluated with estimated annual percentage change (EAPC) and its 95% confidence interval (CI), and the disease burden due to asthma was projected among children at ages of 0 to 14 years in China using a Bayesian age-period-cohort (BAPC) model from 2022 to 2035.

There were 9.368 3 million (95%UI=6.410 7 million to 14.026 1 million) prevalent cases of asthma among children at ages of 0 to 14 years in China in 2021, contributing to 0.387 9 million (95%UI=0.216 1 million to 0.668 8 million) DALYs loss. The prevalent cases and DALYs of asthma decreased by 37.28% and 52.55% among children at ages of 0 to 14 years in China in 2021 compared with 1990, and the age-standardized prevalence [EAPC=-0.70%, 95%CI=-1.26% to-0.13%)] and DALY rates [EAPC=-1.71%, 95%CI=-2.32% to-1.10%)] also appeared a tendency towards a decline. From 1990 to 2021, the prevalent cases, prevalence, DALYs and DALYs rate of asthma were all higher among male children than among female children, and the disease burden of asthma was higher among children at ages of 5 to 9 years than at other age groups. BAPC model predicted a decline in both prevalent cases and DALYs of asthma among children at ages of 0 to 14 years in China from 2022 to 2035, with 6.759 6 million prevalent cases and DALYs of 0.228 4 million person-years in 2035, while the prevalence and DALYs rates were projected to rise to 5 143.35/10⁵ and 173.75/10⁵ in 2035.

Despite a reduction in the disease burden of asthma among children at ages of 0 to 14 years in China from 1990 to 2021, the prevalence remained high. The disease burden due to asthma is projected to appear a decline among children at ages of 0 to 14 years in China from 2022 to 2035; however, the prevalence and DALYs rates still rise. Intensified control measures and targeted interventions are required to reduce the disease burden of childhood asthma.

To explore the prospective association between multidimensional sleep indicators and the risk of newly-onset dental caries, providing a reference for children's oral health-related sleep intervention.

In October 2021, 1 417 students in grades 1 to 4 (aged 6 to 11) from two elementary schools in Bengbu, Anhui Province, were selected by cluster sampling method. Surveys and follow-up visits were conducted at baseline (T1), November 2022 (T2), May 2023 (T3), and November 2023 (T4), respectively, including parental questionnaires, oral health and physical examination. Bedtime, sleep duration, sleep midpoint, social jet lag, weekend catch-up sleep, and sleep habits were collected and calculated. A multifactorial Cox proportional risk regression model was used to analyze the association between multidimensional sleep indicators and newly-onset caries in school-aged children after 2 years.

The prevalence of dental caries in children was 65.1% at baseline, and the prevalence was 59.0% at the end of the 2-year follow-up. Cox proportional risk regression model showed that for every 1-point increase in the children's bedtime resistance, nocturnal awakenings, parasomnias, and daytime sleepiness scores, the risk of newly-onset caries increased by 12% (HR=1.12, 95%CI=1.08-1.15), 22% (HR=1.22, 95%CI=1.15-1.29), 12% (HR=1.12, 95%CI=1.08-1.17), and 15% (HR=1.15, 95%CI=1.12-1.19), respectively; the risk of newly-onset caries increased by 23% for each 1 h increase in the length of weekend catch-up sleep (HR=1.23, 95%CI=1.14 -1.33); compared with children who went to bed before 21:00 on school days, those who went to bed later than 22:00 had a 57% higher risk of newly-onset caries (HR=1.57, 95%CI=1.22-2.03). Compared to children who slept adequately (≥9 h/d), those with insufficient sleep had a 67% higher risk of new caries (HR=1.67, 95%CI=1.43-1.95) (P < 0.01).

These findings suggest a significant association between sleep patterns/sleep disorders and the development of childhood dental caries. Incorporating sleep behavior optimization and sleep quality improvement into comprehensive caries prevention and oral health management protocols may represent a promising intervention strategy to enhance children's oral health outcomes.

To analyze the latent tuberculosis infection and preventive treatment in the school tuberculosis epidemic, so as to provide theoretical and technical support for tuberculosis prevention and control in schools.

Information on latent infection, preventive treatment and tuberculosis incidence were collected from five tuberculosis outbreaks in schools in Hunan Province from January to December 2023. Statistical analysis was conducted by using Chi-square test and Fisher's exact test.

The prevalence of tuberculosis patients in close contacts (7.69%) and the latent infection rate of Mycobacterium tuberculosis (31.87%) were higher than those in non-close contacts (0.12%, 6.29%), and the differences were statistically significant (P < 0.01). The subsequent incidence of close contacts with latent infection was higher (8.62%) than that of non-close contacts (0), the rate of close contacts receiving prophylactic treatment (63.30%) was higher than that of non-close contacts (47.37%), and the proportion of close contacts receiving prophylactic treatment (68.12%) was higher than that of non-close contacts (45.56%), and the differences were statistically significant (P < 0.05). The latent infection rate of Mycobacterium tuberculosis in college students (13.58%) was higher than that in middle school students (7.08%) (χ²=37.77, P < 0.01). The proportion of college students receiving preventive treatment (100.00%) was higher than that of middle school students (40.34%), and the subsequent incidence of latent infection (6.67%) was higher than that of middle school students (0.54%); the rate of middle school students who should receive preventive treatment (70.41%) was higher than that of college students (30.77%), and the rate of middle school students who received preventive treatment (100.00%) was higher than that of college students (62.50%), and the differences were statistically significant (P < 0.01). Among the latent infected persons, 144 who completed preventive treatment did not get sick, and 10 of the 177 who did not complete preventive treatment got sick, with an incidence rate of 5.65%. The incidence rate of close contacts (19.23%) was higher than that of non-close contacts (0) (P < 0.01). There was no significant difference in the incidence of pulmonary tuberculosis between university (8.18%) and middle school (1.49%) among latent infected persons who did not complete preventive treatment (P=0.09).

Actively promoting preventive treatment for latent infections, especially among close contacts, and ensuring that all eligible individuals receive treatment can reduce tuberculosis incidence in schools and help control the scale of school tuberculosis outbreaks.

To explore the muscle mass index (MMI) among adolescents in Xinjiang's agricultural and pastoral areas and its association with cardiovascular risk factors, providing references and basis for the prevention and intervention of cardiovascular diseases among adolescents in these regions.

From March to July 2023, a total of 1 842 students aged 13-18 years from four middle schools in Yili agricultural and pastoral areas of Xinjiang were selected using cluster random sampling. Measurements of muscle mass, physical indicators, questionnaires, and blood samples were conducted and analyzed. Statistical analyses were performed using one-way analysis of variance, Kruskal-Wallis H test, Mann-Whitney U test, and Logistic regression analysis.

There were significant differences in weight, body mass index (BMI), waist circumference, muscle mass, systolic blood pressure, diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol and fasting blood glucose among adolescents with severe, insufficient, good, and sufficient MMI in Xinjiang's agricultural and pastoral areas(F=326.78, 634.76, 261.67, 134.56, 80.14, 16.78, 5.84, 21.67, 3.42, P < 0.01). Logistic regression analysis showed that, after adjusting age and BMI, the risk of cardiovascular risk factors aggregation in adolescents with good (OR=0.55-0.62) and adequate (OR=0.52-0.57) MMI were lower than that in adolescents with insufficient MMI (P < 0.05). After gender stratification, the risk of cardiovascular risk factors aggregation in adolescents with good MMI for boys (OR=0.48-0.62) and with good MMI for girls (OR=0.61) were also lower than that in adolescents with insufficient MMI (P < 0.05).

MMI in adolescents from agricultural and pastoral areas of Xinjiang are positively correlated with cardiovascular health. Future efforts should focus on muscle strength training for adolescents in these areas, as improving MMI can play a positive role in promoting cardiovascular health in adolescents.

To analyze the incidence of statutory and key-monitored infectious diseases among school students in Beijing from 2016 to 2020, so as to provide a reference for developing the prevention and control of infectious diseases in schools.

A descriptive statistical analysis was conducted on student cases aged 6-22 years in Beijing from 2016 to 2020 selected from the China Disease Surveillance Information Reporting Management System. Rate comparisons were performed using the χ² test and trend χ² test.

From 2016 to 2020, the overall incidence of statutory and key-monitored infectious diseases among students in Beijing showed an upward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=582.42), the incidence rates of Category B and other infectious diseases exhibited a downward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=82.71, 18.34), while Category C infectious diseases demonstrated a significant upward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=911.75) (P < 0.01). Among Category B infectious diseases, scarlet fever, bacillary dysentery, tuberculosis, and HIV/AIDS were predominant, with annual average incidence rates of 61.33/100 000, 35.38/100 000, 13.88/100 000, and 3.78/100 000, respectively. Except for HIV/AIDS, the reported incidence rates of other infectious diseases showed a declining trend. Among Category C infectious diseases, influenza, other infectious diarrhea, hand-foot-mouth disease, and mumps were predominant, with annual average incidence rates of 956.13/100 000, 114.39/100 000, 111.37/100 000, and 28.24/100 000, respectively. Influenza showed a significant upward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=1 508.30), while the other infectious diarrhea, hand-foot-mouth disease, and mumps exhibited a downward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=13.84, 25.78, 6.13) (P < 0.05). Among other infectious diseases, varicella was predominant (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=17.47, P < 0.05). Scarlet fever, influenza, hand-foot-mouth disease, and mumps had higher incidence rates among primary and middle school students; other infectious diarrhea and varicella were more prevalent among high school students; tuberculosis and bacillary dysentery were more common among high school and college students; and HIV/AIDS had higher incidence rates among college and high school students.

From 2016 to 2020, the incidence of Category B infectious diseases among students in Beijing showed a declining trend, while influenza, a Category C infectious disease, exhibited a significant upward trend.