Objective Based on the health ecological model (HEM), this study aims to explore the factors that affect cognitive impairment in the elderly, providing scientific basis for enhancing cognitive function and promoting healthy aging. Methods This study utilized data from 5 490 elderly people aged 60 and above from the China health and retirement longitudinal survey (CHARLS, 2018) . The presence of cognitive dysfunction was used as the dependent variable. Explanatory variables were incorporated based on the five dimensions of the HEM. A hierarchical multivariate logistic regression analysis was employed to evaluate the respective influence and contribution of each HEM dimension to cognitive impairment. Results The prevalence of cognitive impairment was 7.32%, with 402 affected individuals. The hierarchical multivariate logistic regression analysis revealed that at the individual characteristics level, disability was associated with increased odds of impairment (OR=1.314, 95% CI: 1.066-1.620). At the behavioral level, physical exercise was a protective factor (OR=0.669, 95% CI: 0.484-0.924). Within the interpersonal network dimension, marital status (OR=0.729, 95% CI: 0.559-0.952) and engagement in social activities (OR=0.735, 95% CI: 0.596-0.907) were associated with lower odds of impairment. At the work and life conditions level, a primary school education was associated with a higher risk (OR=1.913, 95% CI: 1.496-2.447), whereas a high school education or above was protective (OR=0.564, 95% CI: 0.345-0.922). At the policy environment level, enrollment in pension insurance (OR=0.439, 95% CI: 0.240-0.801) and medical insurance (OR=0.706, 95% CI: 0.512-0.975) were correlated with a reduced risk. The full HEM framework accounted for 41% of the variance in cognitive impairment (Pseudo R²=0.41), with the policy environment (ΔPseudo R²=0.10) and behavioral factors (ΔPseudo R²=0.08) emerging as the most significant contributors. Conclusions Determinants of cognitive impairment in older adults were identified across all five dimensions of the HEM. A holistic and multi-faceted approach, integrating comprehensive interventions at the individual, economic, environmental, and policy levels, is therefore warranted to enhance cognitive function, thereby improving the quality of life and subjective well-being of the aging population.

Objective To analyze the allocation and equity of human resources for health (HRH) in Shenzhen from 2014 to 2022. Methods Data pertaining to health technical personnel, licensed (assistant) physicians, registered nurses, geographical area, and resident population in Shenzhen for the period 2014-2022 were collected. Spatial analysis was employed to explore the geographical distribution of HRH, while agglomeration degree analysis was utilized to measure regional disparities in HRH allocation. Results A progressive increase in the stock of HRH in Shenzhen was observed from 2014 to 2022. Global spatial autocorrelation analysis indicated that the overall spatial disparity in the allocation of HRH per thousand population was not statistically significant in either 2014 or 2022 (both P>0.05). However, local spatial autocorrelation analysis identified low-low (L-L) clustering of health technical personnel, licensed (assistant) physicians, and registered nurses in Guangming District for both years. A similar L-L clustering pattern was observed for registered nurses in Bao'an District in 2022. No other significant changes in the spatial agglomeration patterns of HRH per thousand population were detected across other districts. In 2014 and 2022, the ratio of Health Resources Agglomeration Degree to Population Agglomeration Degree (HRAD/PAD) surpassed 1 for all categories of health professionals in Futian and Luohu Districts, signifying a relative abundance of HRH in relation to their population size. Conversely, the HRAD/PAD ratio was less than 1 in Bao'an, Longgang, Longhua, and Guangming Districts, indicating an insufficient allocation of HRH relative to their populations. Conclusions The total volume of HRH in Shenzhen is inadequate and characterized by geographical disparities. It is recommended that governmental initiatives not only augment investment in health and medical resources but also strategically prioritize the equity and accessibility of resource allocation to enhance the provision of medical services and health security.

Objective To identify subtypes of benefits from bariatric surgery among the obese population using latent class analysis and to analyze corresponding intervention strategies. Methods A retrospective study was conducted on 234 obese patients admitted to the Second Affiliated Hospital of Anhui Medical University from July 2022 to February 2024. The percentage of excess weight loss (%EWL) was followed up at 1 month (T1), 3 months (T2), 6 months (T3), and 12 months (T4) postoperatively. An unconditional latent class growth model (LCGM) was employed to analyze the trajectory subtypes of surgical benefits, and the influencing factors were investigated. Results The mean %EWL for the 234 patients after laparoscopic sleeve gastrectomy was (40.57±4.76)%, (54.57±6.12)%, (65.17±8.46)%, and (79.76±8.47)% at T1, T2, T3, and T4, respectively, with statistically significant differences across the four time points (P<0.01). Based on latent class analysis, three subtypes of surgical benefits were identified: a high-level benefit group (C1) with 138 cases (58.97%), a low-level benefit group (C2) with 34 cases (14.53%), and a medium-level benefit group (C3) with 62 cases (26.50%). Multivariate logistic regression analysis indicated that preoperative BMI classification (OR=3.970), anxiety/depression (OR=2.268), postoperative protein intake (OR=2.152), postoperative adverse eating behaviors (OR=2.765), and postoperative weekly exercise duration (OR=2.018) were significant factors associated with the surgical benefit trajectories (all P<0.05). Conclusions Bariatric surgery confers benefits to the obese population; however, a subset of patients exhibits low to medium levels of postoperative benefit. This may be associated with preoperative BMI classification, anxiety/depression, low postoperative protein intake, adverse eating behaviors, and weekly exercise duration of less than 150 minutes. Intervention strategies based on these factors should be implemented early to enhance the surgical benefits for this patient population.

Objective To investigate the utility of the Moving Epidemic Method(MEM) in establishing an epidemic warning model for various influenza virus subtypes in Yunfu, thereby providing an evidence-based reference for influenza prevention and control strategies. Methods Weekly virological surveillance data for influenza were collected from three national influenza sentinel hospitals in Yunfu, spanning from week 36 of 2014 to week 35 of 2023. The MEM was employed to construct models based on the nucleic acid detection positivity rates for influenza A(H1N1)pdm09 subtype, A(H3N2) subtype, and B(Victoria) lineage, respectively. Epidemic and intensity thresholds were subsequently established for each virus subtype. The resulting models were then utilized to assess the epidemic activity of these influenza subtypes during the 2023/2024 influenza season. Results The MEM-derived epidemic thresholds for the nucleic acid detection positivity rates of influenza A(H1N1)pdm09, A(H3N2), and B(Victoria) were determined to be 5.87%, 14.58%, and 6.67%, respectively. The A(H3N2) subtype exhibited the highest intensity thresholds across all levels, followed by the B(Victoria) lineage, whereas the A(H1N1)pdm09 subtype demonstrated the lowest intensity thresholds. Assessment of the 2023/2024 influenza season using these models indicated that the A(H1N1)pdm09 subtype reached a high level of epidemic activity, the A(H3N2) subtype remained at a low level, and the B(Victoria) lineage achieved a moderate level of epidemic activity. Conclusion The MEM is a viable tool for the epidemic surveillance and early warning of different influenza virus subtypes in Yunfu

Objective To investigate the distribution of the HARMS2-AF score within a general population cohort in Southern China and to identify the factors associated with this risk score. Methods Data were sourced from the baseline information (2018-2020) of the prospective cohort study on chronic non-communicable diseases in a general population of Southern China. A total of 53, 826 permanent residents from the survey sites were included as the study population. Data pertaining to demographic characteristics, lifestyle factors, and physical examinations were collected. The distribution of the HARMS2-AF score was analyzed for the entire cohort and across various subgroups, and its associated factors were subsequently explored. Results The HARMS2-AF scores within the Southern China general population cohort ranged from 0 to 12. The distribution was as follows: 24.5% of participants were in the first group (score of 0), 18.7% in the second group (scores 1-2), 28.1% in the third group (scores 3-5), and 28.7% in the fourth group (scores 6-12). Multivariate analysis indicated that an alternative marital status [Prevalence Ratio (PR)=1.39, 95% CI: 1.35-1.43)], moderate socioeconomic status (PR=1.25, 95% CI: 1.21-1.28), low socioeconomic status (PR=1.49, 95% CI: 1.44-1.54), sleep disorders (PR=1.08, 95% CI: 1.06-1.11), obesity (PR=1.57, 95% CI: 1.53-1.61), diabetes mellitus (PR=1.60, 95% CI: 1.56-1.65), and cardiovascular disease (PR=1.69, 95% CI: 1.63-1.75) were all associated with an increased risk of a high HARMS2-AF score. Conversely, individuals with low or high levels of physical activity exhibited a significantly lower risk of a high score compared to those with moderate activity levels (PR=0.93, 95% CI: 0.91-0.96 and PR=0.95, 95% CI: 0.92-0.97, respectively). Conclusions The overall HARMS2-AF scores in the general population of Southern China are relatively low. Public health interventions should prioritize high-risk populations, particularly individuals with low socioeconomic status and chronic diseases. The adoption of healthy lifestyle habits is crucial for mitigating the risk of atrial fibrillation.

Objective To investigate the multifactorial associations with occupational burnout among radiological professionals and to provide an evidence base for the formulation of psychological and human resource management strategies within medical institutions. Methods A multicenter, stratified random sampling method was employed between June and July 2024. Radiological professionals were recruited from the radiology departments of one Grade A Tertiary hospital and three Grade A Secondary hospitals, which were randomly selected from a pool of two Grade A Tertiary and five Grade A Secondary hospitals in Hengshui City. The Maslach Burnout Inventory-General Survey (MBI-GS) was utilized to assess the status of occupational burnout. A self-administered questionnaire was developed to gather occupational-related data. Descriptive statistics were used to summarize the prevalence of burnout. Subsequently, univariate and multivariate logistic regression analyses were conducted to identify influencing factors. Results The study included 1 014 radiological professionals, with an age range of 26 to 58 years (mean±SD: 42.25±7.69 years), comprising 620 males and 394 females. The mean scores for the dimensions of emotional exhaustion, depersonalization, and reduced personal accomplishment were 3.95±0.54, 2.72±0.19, and 5.05±1.08, respectively. The overall mean MBI-GS score was 3.92±1.68. The prevalence of occupational burnout was 82.94% (841), while 17.06% (173) did not exhibit burnout. The logistic regression analysis revealed that average monthly income (OR=0.537), average daily duration of radiation exposure (OR=3.787), overtime frequency (OR=3.257), level of organizational support (OR=0.493), positive and negative affectivity (OR=0.601), and the status of the psychological contract (OR=0.377) were significantly associated with occupational burnout (all P<0.05). Conclusions This study reveals a high prevalence of occupational burnout among radiological professionals. Factors including average monthly income, duration of radiation exposure, overtime work, organizational support, positive and negative affectivity, and the psychological contract were identified as significant correlates of burnout. These findings suggest that healthcare institutions could implement targeted interventions focusing on these areas to mitigate occupational burnout.

Objective To investigate the contamination status of quinolone veterinary drugs in foods of animal origin within the Pudong New District of Shanghai and to assess the associated dietary exposure and health risks for the population over 15 years of age. Methods Between 2021 and 2024, a total of 272 samples of animal-derived foods were collected from 36 administrative sub-districts (towns) in the Pudong New District. The samples were analyzed for ten quinolone compounds, including enrofloxacin, following Chinese national standard analytical methods. A risk assessment of dietary exposure to quinolones was conducted by integrating point estimation with Monte Carlo probabilistic simulation, utilizing established data on dietary consumption and body weight for Shanghai residents aged 15 and above. Results The overall detection rate of quinolones in the sampled foods of animal origin was 27.21%. The highest detection rates were observed for the sum of ciprofloxacin and enrofloxacin in fish (50.43%), shrimp (14.29%), poultry (10.26%), and eggs (3.41%), respectively. The highest median residual concentration was also for the sum of ciprofloxacin and enrofloxacin in fish, reaching 1.03 μg/kg. The hazard quotients (HQs) derived from the Monte Carlo simulation revealed that both the median and the 97.5th percentile HQs for quinolones across the four food categories were substantially lower than 1. Conclusion Although quantifiable levels and instances of non-compliance with maximum residue limits for quinolone veterinary drugs were identified in foods of animal origin in the Pudong New District, the health risk associated with dietary exposure for residents aged 15 and over is estimated to be low.

Objective This real-world study investigates the impact of treatment adherence on long-term visual prognosis among patients undergoing intravitreal injection therapy. It aims to identify key factors influencing adherence to inform the development of preventative strategies against visual impairment. Methods A retrospective analysis was conducted on patients receiving intravitreal injections at a hospital in Cangzhou City between April 2022 and March 2024. Based on their final visual acuity at the 12-month follow-up after initial treatment, patients were stratified into a poor prognosis group (n=72) and a good prognosis group (n=232). A logistic regression model was constructed to analyze the effect of treatment adherence on visual outcomes. Results The mean treatment adherence score in the poor prognosis group was significantly lower than that in the good prognosis group (5.58±0.86 vs. 6.26±0.72; t=5.977, P<0.01). The median adherence score for the entire cohort of 304 patients was 6.25. Patients were dichotomized based on this median score into a high-adherence group (Q1, n=156, score ≥6.25) and a low-adherence group (Q2, n=148, score <6.25). In an unadjusted model, the risk of poor visual prognosis was 2.640 times higher in the Q2 group compared to the Q1 group (OR=2.640, 95% CI: 1.516-4.597). After adjusting for confounding factors, the risk in the Q2 group remained significantly elevated at 2.894 times that of the Q1 group (OR=2.894, 95% CI: 1.064-7.875). These findings indicate a substantive association between diminished treatment adherence and an increased risk of adverse visual outcomes in this patient population. Conclusions Treatment adherence is a critical determinant of visual prognosis in patients receiving intravitreal injections. Non-adherence significantly elevates the risk of poor long-term visual outcomes. By identifying the factors that undermine adherence, targeted interventions can be designed for high-risk populations and critical deficiencies in care pathways, thereby enhancing treatment adherence and preserving long-term vision.

Objective To investigate the distribution and determinants of healthy aging among the elderly in the South China region, thereby providing a scientific basis for promoting healthy aging. Methods Utilizing baseline data from a prospective cohort study on chronic diseases in a natural population of South China, a multiple linear regression model was employed to explore the factors influencing healthy aging scores. Results The study included 23 837 elderly individuals aged 60-89 years, with a mean age of (67.3±5.5) years; males constituted 36.6% of the cohort. The distribution of healthy aging status was as follows: 4 623 (19.4%) were classified as unhealthy, 15 936 (66.9%) as moderately healthy, and 3 278 (13.8%) as optimally healthy. The multiple linear regression analysis revealed that older age (β'=0.280), female sex (β'=0.024), household size ≥3 persons (β'=0.015, 0.049), sleep duration <7 hours (β'=0.018) or >8 hours (β'=0.033), and higher BMI (β'=0.187) were associated with higher healthy aging scores. Conversely, higher educational attainment (β'=-0.050), annual income >30 000 RMB (β'=-0.057), unemployment/retirement (β'=-0.044), moderate-to-vigorous physical activity (both β'=-0.029), increased walking time (β'=-0.046), and low-frequency red meat consumption (β'=-0.016) were correlated with lower healthy aging scores (P<0.05). Conclusions The overall level of healthy aging is lower among females in the South China region. Modifiable factors such as moderate-to-vigorous physical activity, walking duration, sleep duration, dietary patterns, and BMI are significant determinants of healthy aging in this elderly population.

Objective To characterize the etiological spectrum of respiratory outbreaks in the northeastern suburbs of Beijing during the 2017-2024 surveillance period, to elucidate local epidemiological patterns of influenza viruses, and to investigate the molecular evolution of influenza B virus, thereby providing an evidence base for influenza prevention and control. Methods Respiratory specimens were collected from febrile and influenza-like illness cases associated with outbreaks between 2017 and 2024. Influenza viral RNA was detected by real-time quantitative PCR (qRT-PCR), and descriptive epidemiological methods were applied to delineate subtype-specific prevalence. Thirteen BV isolates were randomly selected and their hemagglutinin (HA) genes amplified by reverse-transcription PCR (RT-PCR) and sequenced. Together with homologous BV HA sequences retrieved from the GISAID database, maximum-likelihood phylogenies were constructed to infer genetic characteristics and evolutionary dynamics. Results Among 6 250 outbreak-associated specimens, 3 517 were positive for influenza virus, yielding an overall positivity rate of 56.27%. Across the surveillance period, subtype A/H3N2 predominated (55.90%), followed by A/H1N1 (26.81%), BV (13.14%), and B/Yamagata (4.15%). Co-circulation of A/H1N1 and influenza B viruses was observed in 2017-2018;alternating circulation of A/H1N1, A/H3N2, and BV in 2018-2019;exclusive dominance of A/H3N2 in 2019-2020;overwhelming predominance of BV in 2021-2022;joint dominance of A/H1N1 and A/H3N2 in 2022-2023;and alternating dominance of A/H3N2 and BV in 2023-2024. Phylogenetic analysis revealed that all 13 BV isolates clustered within the V1A clade. Relative to contemporary vaccine strains, outbreak isolates accumulated multiple amino-acid substitutions in critical antigenic regions of the HA protein, including the 120-, 150-, and 160-loops and the 190-helix. Conclusions From 2017 to 2024, influenza outbreaks in northeastern Beijing exhibited considerable subtype heterogeneity. Although BV outbreak strains maintained high overall homology with corresponding vaccine strains, they displayed increasing genetic diversity and acquired mutations at several pivotal HA antigenic sites. Continuous surveillance of both epidemiological trends and molecular evolution is therefore imperative to inform evidence-based respiratory-disease control strategies with emphasis on influenza.