Objective To analyze the status and influencing factors of depression in Chinese elderly aged ≥60 years, to provide a reference for the formulation of depression prevention and control policy. Methods Based on the survey data of the China Health and Retirement Longitudinal Survey in 2020, the related data of behavior and life habits, health status, and life function of the elderly aged ≥60 years were selected. The multivariate stepwise logistic model was used to analyze the influencing factors of depression, and the MLP neural network model was constructed to rank the importance of the influencing factors. Results A total of 8 337 elderly people aged ≥60 years were included, and the prevalence of depression was 41.05%. The Logistic regression results showed that women (OR=1.79), agricultural household registration (OR=1.52), current address in rural areas (OR=1.28), married and separated (OR=1.33), divorced/widowed (OR=1.36), illiterate (OR=1.41), primary education level (OR=1.36), per capita monthly household expenditure<1 500 yuan (OR=1.32), sleep time<6 hours (OR=1.85), combined with≥2 chronic diseases (OR=1.46), high BADL score (OR=1.19), and high IADL score (OR=1.06) had a higher probability of depression in elderly people aged≥60 years. The probability of depression in elderly people aged ≥60 years who had quit smoking (OR=0.83), moderate to high intensity physical activity (OR=0.76), high health satisfaction (OR=0.53, 0.27), high life satisfaction (OR=0.24, 0.15), and high child satisfaction (OR=0.62, 0.47) was lower. The MLP neural network model showed that the relative importance ranking of the influencing factors for depression was from high to low, followed by life satisfaction, divorced/widowed, sleep time<6 hours, health satisfaction, current address in rural areas, sleep time>8 hours, child satisfaction, moderate to high intensity physical activity, married and separated, and current address in the urban-rural fringe. Conclusion The prevalence of depression in Chinese elderly aged ≥60 years is relatively high, and the mental health of the elderly should be promoted by advocating smoking cessation, regular exercise, maintaining proper sleep, and maintaining satisfaction with life.

Objective To establish an evaluation index system for insurance compensation for vaccine adverse events in Guangdong Province. Methods The index system was initially formulated by referring to literature review and policy documents of other pilot regions and other similar insurance products, and the indicators were selected by collecting experts' scores through three rounds of questionnaires using the Delphi method, and the weights of each indicator were calculated using the percentage weighting method. Results A total of 24 experts participated in the survey evaluation, including 7 experts from national and provincial CDCs, 5 experts from provincial health administration departments, and 12 experts from higher education institutions; 9 experts with senior titles, 8 experts with associate titles, and 7 others. The areas of expertise involved epidemiology (n=9), health policy (n=7), insurance (n=6), pharmacology (n=1), and health toxicology (n=1). The participation rate of experts in the three rounds was 95.80%, 100.00%, and 95.80%, respectively. The average coefficient of expert authority was 0.79, among which the average coefficient of expert judgment was 0.76 and the average coefficient of familiarity was 0.82. Following three rounds of expert consultations, an evaluation index system for insurance compensation for vaccine adverse events in Guangdong Province was established, which included five primary indicators (pilot results, pre-planning, implementation, post-analysis, and support work), 12 secondary indicators (number of insured, policy formulation, insurance fund raising, etc.), and 34 tertiary indicators (number of insured vaccine companies, number of insured persons vaccinated, policy integrity, etc.). Conclusion The evaluation index system established in this study has a high degree of authority and coordination of expert opinions, and can be used for the specific evaluation of the work on compensation insurance for vaccine adverse events in Guangdong Province.

Objective To analyze the epidemiological characteristics and spatiotemporal distribution features of dengue fever in Shantou City from 2011 to 2020,to provide a reference basis for formulating precise prevention and control strategies. Methods Data on dengue fever outbreaks in Shantou City from 2011 to 2020 were collected. Descriptive epidemiology,spatial autocorrelation analysis,and spatiotemporal scan statistic were used to analyze the patterns of dengue fever. Results From 2011 to 2020,a total of 1 271 cases of dengue fever were reported in Shantou City,with an average annual incidence rate of 2.23/100 000. Among them,there were 1 153 local cases（90.72%）. Dengue fever cases were reported in all seven districts of Shantou City,and the number of local cases was positively correlated with the number of imported cases （r_s=0.83,P<0.05）. The results of spatial autocorrelation analysis indicated that the local cases showed significant spatial clustering in 2014 and 2019,16 "hot spot" areas were identified,with no "cold spot" areas in the city. A total of four local case cluster areas were detected by spatiotemporal scanning：the first type of cluster area involving 17 streets （towns） in Jinping District and Longhu District,with the clustering period from July to September 2019;the other three cluster areas were distributed in Chaonan District （two） and Chaoyang District （one）. Conclusions The dengue fever epidemic in Shantou City has obvious spatiotemporal clustering characteristics,with a correlation between local cases and imported cases in terms of spatial and temporal clustering. Targeted prevention and control measures should be taken before the epidemic season and in high-incidence streets （towns）.

Objective To explore the relationship between Chinese visceral adiposity index （CVAI） and new-onset stroke in a large sample cohort of middle-aged and elderly individuals. Methods A Cox regression model was established using data from the China Health and Retirement Longitudinal Study （CHARLS） conducted between 2011 and 2018,to investigate the relationship between CVAI and new-onset stroke. Restricted cubic spline model was used to examine potential non-linear relationships,while subgroup analyses explored the moderating effects of social,demographic,and economic factors. Results A total of 6 902 participants were included in this study,among whom 398 （5.76%） experienced new-onset stroke. The median CVAI at baseline was 93.26 （63.21,123.96）,and the CVAI in new-onset stroke patients was higher than that in non- new-onset stroke patients （P<0.01）. Cox regression model results showed that after adjusting covariates,the risk of new-onset stroke increased by 67.2% for every one quartile increase of CVAI （60.75） （P<0.01）. Compared with CVAI Q₁ group （< 63.21）,CVAI Q₂,Q₃,and Q₄ groups （63.21 - <93.26,93.26- <123.96,and ≥123.96） had an increased risk of new-onset stroke by 78.5%,96.7%,and 184.2%,respectively （all P < 0.01）. The risk of new-onset stroke increased with increasing CVAI （P_trend < 0.001）. Restricted cubic spline regression analysis showed that there was a dose-response relationship between CVAI and new-onset stroke （P<0.01）,and the relationship was linear （P_nonliner =0.53）. Subgroup analysis showed that age may have a moderating effect on the relationship between the two groups （P_interaction <0.05）,and the lower age group was more affected. Conclusions The CVAI is closely associated with new-onset stroke,showing a dose-response relationship. Younger individuals with high CVAI should be particularly vigilant about their risk for developing strokes.

Objective To understand the prevalence of ground glass nodules （GGN） in health examination population in Shanghai and explore its correlation with metabolic diseases. Methods A total of 10 403 health examinees were selected for the survey,and the prevalence of GGN and metabolic indicators in this population were analyzed. Univariate and multivariate analyses were used to examine the impact of metabolic diseases on GGN. Results The prevalence of GGN in health examination population of the region was approximately 35.90% （3 735/10 403）,with females accounting for 38.87% （1 703/4 381） and males accounting for 33.74% （2 032/6 022）,with a statistically significant difference （P<0.05）. There was a statistically significant difference in the prevalence of GGN among patients with different metabolic diseases （P<0.05 or P<0.01）. Hypertension （OR=1.168） was a risk factor for GGN in the population. In addition to hypertension,high levels of low-density lipoprotein cholesterol （LDL-C） （OR=1.287） was a risk factor for GGN in females. For males,diabetes （OR=1.234）,impaired glucose regulation （OR=1.342）,and low levels of high-density lipoprotein cholesterol （HDL-C） （OR=1.315） were risk factors for GGN,while fatty liver （OR=0.858） was found to be a protective factor. Conclusions The prevalence of GGN is relatively high in health examination population in Shanghai. The prevalence of GGN in females is affected by hypertension and high levels of LDL-C,while the prevalence of GGN in males is related to hypertension,diabetes,impaired glucose regulation,low levels of HDL-C,and fatty liver.

Objective To understand the usage of condoms and related factors among young students engaging in non-regular sexual partner behaviors in Guangdong Province. Methods The research was conducted in 16 universities, technical schools, and vocational colleges in Guangdong Province. The convenient sampling method of non-probability sampling was used to collect information from young students, and their adherence to condom usage during non-regular sexual partner behaviors and related factors were analyzed by logistic regression analysis. Results A total of 1 013 young students engaging in non-regular sexual partner behaviors were surveyed, of them 44.42% （450/1 013） were 16 to 19 years old, 74.73% （757/1 013） were males, 56.76% （575/1 013） reported consistent condom usage during non-regular sexual partner behaviors. The differences in condom usage during non-regular sexual partner behaviors were statistically significant across different genders, school types, average monthly living expenses, only child status, living arrangements on campus, self-reported sexual orientation, stages of AIDS-related health education, AIDS awareness, age of first sexual encounter, use of psychoactive substances during sexual activity in the past year, engaging in regular sexual behaviors and condom usage during such behaviors in the past year （P < 0.05 or P < 0.01）. logistic regression analysis revealed that being an only child （OR=0.623）, use of psychoactive substances during sexual activity in the past year （OR=0.350）, and failure to consistently use condoms during regular sexual partner behaviors in the past year （OR=0.159） were associated with a lower likelihood of using condoms during non-regular sexual partner behaviors; consistently use condoms during regular sexual partner behaviors in the past year （OR=6.845） was associated with a higher likelihood of using condoms during non-regular sexual partner behaviors. Conclusions The proportion of condom usage in non-regular sexual partner behaviors remains low among young students in Guangdong Province. Attention should be paid to only children, those who have used psychoactive substances during sexual activity in the past year, and those engaging in regular sexual partner behaviors but not consistently using condoms. Targeted measures such as propaganda and intervention should be strengthened to enhance their risk awareness and reduce unsafe sexual behavior.

Objective To analyze the influencing factors of carotid plaque formation and stability in patients with ischemic cerebrovascular disease based on secondary prevention. Methods A questionnaire survey and carotid artery color ultrasound examination were conducted on patients diagnosed with ischemic cerebrovascular disease who were admitted to a hospital in Beijing from January 2019 to December 2022 and had been recorded in the hospital medical record management system. The descriptive analysis method was used to analyze the formation and stability of the carotid plaque in the patients, and univariate and multivariate analysis methods were used to analyze the factors influencing carotid plaque formation and stability. Results A total of 2 050 patients with ischemic cerebrovascular disease were divided into 359 patients with plaque formation and 1 691 patients without plaque formation. Among the 359 patients with plaque formation, the plaque stability test showed that 162 patients had stable plaques and 197 patients had unstable plaques. The results of multivariate logistic regression analysis showed that age≥80 years old （OR=4.495）, concomitant hypertension （OR=2.199）, concomitant hyperhomo‐cysteinemia （OR=3.235）, and intracranial and extracranial artery stenosis （OR=2.807） were risk factors for the formation of carotid plaques in patients with ischemic cerebrovascular disease; Following medical advice to use antiplatelet drugs （OR=0.276） and a reasonable diet （OR=0.358） were protective factors in reducing the formation of carotid plaques in ischemic cerebrovascular disease. Age≥80 years old （OR=2.804） and concomitant hyperhomo‐cysteinemia （OR=2.707） were risk factors for the stability of carotid plaques in patients with ischemic cerebrovascular disease; Following medical advice to use antiplatelet drugs （OR=0.366） was a protective factor for the stability of carotid plaques in ischemic cerebrovascular disease. Conclusion Based on the secondary prevention analysis, it is found that the elderly and intracranial and extracranial artery stenosis are the risk factors affecting the formation and stability of carotid plaque in patients with ischemic cerebrovascular disease, and following medical advice to use antiplatelet drugs is a protective factor.

Objective To analyze the willingness and influencing factors of taking post-exposure prophylaxis （PEP） among young students in Guangzhou. Methods A cross-sectional study was conducted among five universities in Guangzhou from September to November 2021. Using PEP as predictive variable, logistic regression model, Decision Tree algorithm model, as well as Random Forest algorithm model were constructed respectively. ROSE algorithm was used to handle data imbalance problems. Evaluated the predictive performance of the three models through AUC （area under ROC curve） and confusion matrix. Results A total of 7 346 valid questionnaires were collected, during which 67.63% reported ever heard of PEP, 92.49% reported willing to take PEP and 7.51% reported unwilling. Based on the results of the three models, the willingness to take PEP was affected by individual factors （gender, age）, school factors （school type, major）, HIV-related factors （HIV knowledge, testing knowledge, attitude of testing, acceptance period of HIV education, sexual behavior）, and economic conditions etc. The predictive performance AUC （95% CI） for logistic regression, Decision Tree, and Random Forest model were 0.77 （0.75-0.79）, 0.74（0.72-0.76）, and 0.90 （0.89-0.92）, respectively, among which Random Forest algorithm model showed the best prediction than the other two models. Conclusions Knowledge of PEP among young students in Guangzhou still need to be strengthened. The willingness to take PEP is mainly affected by PEP knowledge, individual factors, school factors, HIV-related factors, economic conditions and so on. The Random Forest algorithm model is suitable for predicting the willingness to take PEP among young students.

Objective To analyze the correlation between condom use in the first sexual behavior and the occurrence of sexual behavior and condom use in the past year among students in technical and vocational schools, and to provide reference for targeted sexual health education and HIV/AIDS prevention and control measures. Methods Based on the survey of HIV/AIDS knowledge, behavior and self-testing service needs of young students in Guangdong Province in 2022, an anonymous survey was conducted among students from 10 technical and vocational schools in Guangdong Province. The information about condom use in the first sexual behavior and sexual behavior in the past year was collected. Univariate and multivariate unconditional logistic regression analysis were used to analyze the situation of condom use in the first sexual behavior and the dependent variables. Results A total of 2 173 students who had sexual experience were included in this study. Among them, 1 573 （72.4%） students used condoms at their first sexual intercourse. A total of 1 895 （87.2%） students had penetrative sex in the past year, and the rate of condom use was 69.9% （1 325/1 895）. After adjusting for demographic factors, multivariate analysis showed that students who used a condom for the first sexual behavior were less likely to use substance abuse （OR=0.23）, and were more likely to engage in sexual activity in the past year （OR=1.72） and engage in sexual activity with a regular partner （OR=1.72）. And, they were more likely to use condoms every time they had sex （OR=10.10）, with a regular partner （OR=12.06）, with a casual partner （OR=8.95）, and with a commercial partner （OR=8.76） in the past year. Conclusions The rate of condom use in the first sexual behavior among technical and vocational school students in Guangdong Province is higher than that of the young students in the whole country, but still lower than that of school students in our province. Good first sexual behavior habits can promote students to choose regular sexual partners and adopt safety measures. Technical and vocational schools need to provide higher quality sexual health education to protect students’ sexual health.

Objective To analyze the epidemiological status of tobacco and factors affecting smoking behavior at colleges and universities in Zhaoqing City. Methods Stratified proportional sampling method was used to investigate students in 4 colleges and universities in Zhaoqing City, Chi‐square test and logistic regression were used to analyze the influencing factors of smoking behavior. Results Among 827 freshmen to juniors in Zhaoqing City, the average age was （20.00±1.53） years old, the male accounted for 43.41% and the female accounted for 56.59%, respectively. The smoking rate was 18.02% （149/827）, and the continuous smoking rate was 11.73% （97/827）. logistic regression analysis showed that male students （OR=2.710）, students believed that offering cigarettes was a social necessity （OR= 1.622）, students in their second year of school （OR=1.695）, those with parents who smoked （OR=2.305）, roommates who smoked in the dormitory （OR=2.509）, and students who were encouraged to smoke at classmate parties （OR=1.707） were more likely to smoke. Moreover, significant differences of smoking dose were found in the distribution of factors such as tobacco dependence, the impact of smoking on life, and the choice of tobacco type among students engaging in continuous smoking behaviors（P<0.05 or P<0.01）. Conclusions The smoking behaviors of college students in Zhaoqing City are related to factors such as gender, cognition of cigarette offering, school age, smoking behaviors of parents or roommates, and persuasion to smoke at classmate parties. We advocate building a smoke‐free environment between home and school, and carry out tobacco control intervention according to the psychological, behavioral, and environmental characteristics of college students at different school ages.

Objective To analyze the association between insufficient sleep at different time periods and overweight/obesity among children and adolescents in Guangdong Province,and to provide scientific basis for the prevention and control of overweight and obesity. Methods A multi‐stage stratified random sampling method was used to select children and adolescents aged 6-17 years from 13 cities and counties in Guangdong Province for questionnaire survey and physical measurement. logistic regression was used to analyze the association between insufficient sleep at different time periods and overweight/obesity among children and adolescents. Results A total of 431 cases of overweight/obesity were detected among 3 575 children and adolescents,with a prevalence rate of 12.06% （among which 6.80% were overweight and 5.26% were obesity）. The reported rates of insufficient sleep were 47.50%,54.41% and 24.17%,respectively,on weekdays,school days and weekends. logistic regression analysis showed that insufficient sleep during both school days and weekends was associated with overweight and obesity in children and adolescents（OR=1.45）. Stratified analysis found that girls （OR=1.63）,primary school students （OR=1.53）,and rural students （OR=2.52） were at increased risk of overweight and obesity when they had insufficient sleep during both school days and weekends. Conclusions Insufficient sleep is common among children and adolescents in Guangdong Province. More attention should be paid to girls,primary school students,and rural students,and ensuring sufficient sleep time during both school days and weekends can help reduce the occurrence of overweight and obesity.

Objective To investigate the knowledge, attitude, and practice （KAP） regarding medication among residents in Ningde City, and analyze the relevant factors that affect the risk of medication safety behavior among residents. Methods The convenience sampling method was employed to carry out a KAP questionnaire survey on medication safety behavior risks among residents in Ningde City during June 2021. Descriptive analysis was utilized to examine the medication-related KAP of residents, while exploring the interrelationship between knowledge, attitude, and practice. Univariate and multivariate analyses were conducted to investigate the influencing factors affecting knowledge, attitude, and practice. Results Among the 768 participants, there were 289 males （37.63%） and 479 females （62.37%）, aged 19-78 years. The mean medication knowledge score was （74.49 ± 21.72）, with an excellent rating of 203 individuals （26.43%） and a good rating of 323 individuals （42.06%）. The average attitude score was （32.56 ± 5.58）, with an excellent rating for only 36 participants （4.69%） and a good rating for 241 participants （31.38%）. As for medication behavior, the average score was found to be （63.29 ±11.73）, with an excellent rating received by187 individuals （24.35%） and a good rating by 373 individuals （48.57%）. The results of the multivariate analysis revealed that several independent factors significantly influenced medication knowledge, including gender （β’=-0.073）, age （β’=0.092）, place of residence （β’=0.074）, education level （β’=-0.121）, medical security situation such as commercial insurance, self-funded medical care, and others （β’=0.164, 0.118, 0.127 respectively）, occupational status as a freelancer （β’=0.166）, and work status as retired or none/unemployed individuals （β’=0.140, 0.163 respectively）. Furthermore, various independent factors were found to influence medication attitudes including medical security through commercial insurance coverage （β’=0.150）, occupational status as a teacher （β’=0.105）, and medication knowledge levels （β’=0.729）. Moreover, the study identified several independent factors affecting medication practices including gender （β’= -0.141）, medical security situation such as commercial insurance, self-funded medical care, and others （β’=0.222, 0.132, 0.130 respectively）, occupational status as a freelancer （β’=0.099）, work status as retired （β’=0.111）, medication knowledge levels （β’=1.572）, and medication attitudes （β’=1.983）. Conclusions The KAP regarding medication safety behaviors among residents in Ningde City demonstrates an overall positive trend. However, it is crucial to prioritize the medication safety risks among the elderly population and individuals with limited education or unstable employment, and the medication education for residents needs to be further strengthened.

Objective To understand the medication adherence of pulmonary tuberculosis patients in Huizhou City,and explore its influencing factors. Methods A survey questionnaire was developed based on the Information-Motivation-Behavioral skills model （IMB）. Convenience sampling was utilized to recruit participants from Huizhou Tuberculosis Prevention and Control Research Institute from March to April 2022 to examine their medication adherence during treatment. A logistic regression model was employed to analyze the factors influencing medication adherence. Results Among the 269 participants,the mean age was （46.64±16.47） years old,with 171 males （63.6%） and 98 females （36.4%）. The medication adherence rate was 83.6% （225/269）. The results of the multivariate logistic regression analysis revealed that a higher level of knowledge regarding treatment information （OR = 1.19） and self-efficacy （OR = 2.91） were associated with improved medication adherence among patients. Conversely,a higher level of perceived barriers （OR = 0.76） was linked to poorer medication adherence in patients. Conclusions The medication adherence of pulmonary tuberculosis patients in Huizhou City is good overall,and the main influencing factors are the level of knowledge regarding treatment information,self-efficacy,and perceived barriers. In the future,interventions such as health education and doctor-patient communication can be strengthened to improve patients' medication adherence.

Objective To examine the concentration of trihalomethanes （THMs） in drinking water in Longgang District,Shenzhen,and to evaluate the potential risk of THMs to human health. Methods The concentration of THMs in the municipal water supply of Longgang District,Shenzhen was monitored from 2019 to 2023. An evaluation of the health risk associated with THMs exposure through drinking water and bathing in Longgang District,Shenzhen was conducted using a health risk assessment model. Results The detection rates of trichloromethane （TCM） were all 100.00%. The detection rates of bromo-dichloromethane （DCBM） were over 97.00%,and the detection rates of dibromo-chloromethane （DBCM） ranged from 76.34% to 95.83%. The lowest detection rate was found for tribromomethane （TBM）. The carcinogenic risk of THMs through drinking water exceeded that through skin exposure,while the carcinogenic risk of THMs through skin exposure was below 1.0×10^-6. Additionally,the carcinogenic risk of THMs exposed to peripheral water through drinking water was greater than 1.0×10^-6 but less than 1.0×10^-4. Furthermore,the non-carcinogenic risks of THMs in different exposure paths,various water sample types,and diverse water collection periods were found to be <1. Conclusions The carcinogenic risk values of TCM,DCBM,and DBCM in drinking water exceed the recommended levels set by USEPA,indicating a certain level of health risk within an acceptable range. The carcinogenic risk of exposure through drinking water is higher than that through bathing skin.

Objective To understand the prevalence and influencing factors of screening myopia combined with overweight/obesity in children and adolescents from 2019 to 2021 in Xi'an City,and to provide a reference for the co-prevention of myopia and overweight/obesity. Methods Students from 12 schools monitored for common diseases in Xi'an from 2019 to 2021 were selected for this study,and stratified cluster sampling was carried out in grades 4 to 6 of primary school,junior high school,and senior high school. To describe the status quo of screening myopia combined with overweight/obesity,χ² test and multiple logistic regression were used to analyze the influencing factors of comorbidity. Results From 2019 to 2021,a total of 5 768 children and adolescents were included,including 1 877 （32.54%） in grades 4 to 6 of primary school,1 928 （33.43%） in junior high school,and 1 963 （34.03%） in senior high school. The co-incidence rates of screening myopia and overweight/obesity from 2019 to 2021 were 27.4% （985/3 601）,16.1% （168/1 041）,and 27.4% （308/1 126）,respectively,with a J-shaped curve. The 3-year total co-incidence rate was 25.3% （1 461/5 768）. The co-incidence rate was higher in urban area than in suburban county,higher in boys than in girls,and increased with phase of studying （all P<0.01）. Video time ≥2 h/d was a risk factor for screening myopia combined with overweight/obesity in grades 4 to 6 of primary school students （OR=2.111）. Outdoor activity time ≥2 h/d was a protective factor for screening myopia combined with overweight/obesity in grades 4 to 6 of primary school students and junior high school students （OR=0.531,0.544）. Conclusions Reducing video time and increasing outdoor time can reduce the incidence of screening myopia combined with overweight/obesity in children and adolescents.

Objective To understand the sleep status and influencing factors of children and adolescents in Shenzhen,and provide theoretical basis for promoting their sleep health. Methods In 2021,multi‐stage stratified cluster random sampling method was adopted to select elementary and secondary school students in Shenzhen for physical examination and questionnaire survey. Chi‐square test and logistic regression analysis method were used to analyze the sleep status and influencing factors of elementary and secondary school students in Shenzhen. Results The average sleep duration of 4 534 children and adolescents was （9.23±1.01） h,with 54.67% having insufficient sleep and 35.64% having sleep disorders. Grades 4-6 （OR=1.656）,high school （OR=0.797）,graduating class （OR=1.899）,mother's education level was high school/vocational school/technical school （OR=0.744）,and mother's education level was junior high school or below （OR=0.613） were influencing factors for insufficient sleep among children and adolescents. High school （OR=2.753） and screen time≥2 h/d （OR=1.290） were influencing factors for sleep disorders among children and adolescents. Conclusions There are many sleep problems among children and adolescents in Shenzhen. School period,mother's education level,and screen time are the main influencing factors. Parents and schools should give comprehensive intervention according to the influencing factors of sleep to improve the sleep status of children and adolescents.

Objective To construct a fecal microscopy image dataset of intestinal parasite eggs and establish a corresponding deep learning image recognition model, so as to provide technical support for the auxiliary diagnosis of intestinal parasitic diseases. Methods Microscopic images of 12 intestinal parasite eggs were collected using a microscope and a digital camera, pre-processed and labelled with the categories and locations of the eggs to form an image dataset. A masked region convolutional neural network deep learning model was used as a framework to train the bounding box regression, classification, and mask generation, and its performance was evaluated. Results The fecal microscopy image dataset was constructed with a total of 6 299 images, including 10 944 egg images. After testing, the deep learning model achieved an overall recognition accuracy of 90.20%. The recognition accuracy for the 12 types of eggs ranged from 58.65% （Spirometra mansoni egg） to 100.00% （Pinworm egg）. Conclusion Constructing a microscopy image dataset of intestinal parasite eggs and establishing an image recognition model using convolutional neural networks provide technical support for the auxiliary diagnosis of parasitic diseases.

Objective To analyze the knowledge, attitude, and practice of secondary prevention in patients with ischemic stroke in Shangqiu City, as well as their influencing factors. Methods Convenient sampling method was used to select patients with stable ischemic stroke who were diagnosed and treated in two hospitals in Shangqiu City from June 2022 to June 2023 for this study. The knowledge, attitude, and practice of secondary prevention were investigated, and the influencing factors were analyzed. Results A total of 1 530 patients with stable ischemic stroke were investigated, of which 1 483 were effectively investigated, aged 18-76 years old, with a higher proportion of ≥61 years old. The sex ratio of male to female was 1.328∶1. The total average scores of secondary prevention knowledge, attitude, and practice were （30.03±5.88）, （40.63±7.62）, and （38.73±8.22）, respectively. Multiple linear regression analysis showed that age （β′= 0.184, 0.115, 0.187）, combined with underlying diseases （β′= 0.253, 0.266, 0.221）, family history of ischemic stroke （β′= 0.195, 0.071, 0.204）, receiving publicity/lectures on ischemic stroke （β′= 0.256, 0.189, 0.217）, social support （β′= 0.319, 0.613, 0.375）were the common influencing factors on the scores of prevention and control knowledge, attitude, and practice （all P <0.05）. Educational level （β′= 0.263, 0.394）, marital status （β′= 0.152, 0.148）, and resident manner （β′= 0.176, 0.261）were the influencing factors of prevention and control knowledge and practice （all P<0.05）. Disease duration （β′= 0.284）was the influencing factor of prevention and control attitude （P<0.05）. According to Pearson correlation analysis, there was a significant positive correlation （all P<0.05）between knowledge and attitude （r=0.449）, knowledge and practice （r=0.621）, and attitude and practice （r=0.635）. Conclusions The levels of knowledge, attitude, and practice of secondary prevention in patients with stable ischemic stroke in Shangqiu City are generally low. Active measures can be taken to improve the levels of knowledge, attitude, and practice of secondary prevention in patients through age, complicated underlying diseases, family history of ischemic stroke, receiving publicity/lectures on ischemic stroke, and social support.

Objective To understand the change of rubella incidence before and after the expanded program on immunization （EPI） in Hebei Province and give short‐term and long‐term evaluation of its preventive effect. Methods The incidence of rubella report in Hebei Province from 2004 to 2022 was collected,and a multiple linear regression model was established by interrupted time series analysis. According to the slope and coefficient,the effect of the EPI was evaluated. Results From 2004 to 2022,a total of 25 690 cases of rubella were reported,the reported annual average incidence was 1.925/100 000,accounting for 1.00% of the reported incidence of Class C infectious diseases. Results of interrupted time series regression model analysis indicated an increasing incidence of rubella reports before EPI in 2004-2008 （β₁=0.004 3,P<0.05）. In 2009,for the first year after the EPI,the short‐term intervention worked well,reported a decrease in incidence from previously. A decrease in incidence was reported in the post‐EPI phase from 2009 to 2022 （β₃=-0.005 6,P<0.05）. There was an overall downward trend in reported incidence after EPI （β₁+β₃=-0.001 3）. The reported annual average incidence decreased from 3.938/100 000 before EPI to 1.206/100 000 after EPI. Conclusions The use of interrupted time series regression model to evaluate the efficacy of rubella before and after the implementation of EPI can be extruded to other infectious diseases or diseases. It can provide new methods and ideas for professionals.

Objective To analyze the epidemiological characteristics and spatial‐temporal clustering of intestinal infectious diseases in Yunfu City from 2013 to 2022. Methods The reported data of intestinal infectious diseases in Yunfu City from 2013 to 2022 were collected. Descriptive epidemiological methods, spatial autocorrelation analysis, and spatial‐temporal scanning statistics were used to analyze the reported incidence of intestinal infectious diseases. Results From 2013 to 2022, Yunfu City reported eight kinds of notifiable intestinal infectious diseases, with a total of 93 334 cases reported, with an annual reported incidence of 10.45 per 10 000 to 56.76 per 10 000, and an annual reported incidence of 39.16 per 10 000. The reported intestinal infectious diseases were mainly hand, foot and mouth disease and other infectious diarrheal diseases, accounting for 97.39% of the reported intestinal infectious diseases, and the annual reported incidence was 33.18 per 10 000 and 4.95 per 10 000, respectively. The reported incidence rate showed a decreasing trend （trend c²=65.837, P<0.01）. The incidence was seasonal, with bimodal distribution （May‐July and September‐October）, and at a low level from December to March. Cases were reported in all age groups, among which the group of 0-4 years old reported the most cases （77 118 cases, accounting for 82.63%）. The results of spatial autocorrelation analysis showed that the incidence of intestinal infectious diseases reported in Yunfu City from 2013 to 2022 showed a spatial positive correlation at the street （town） scale （global Moran's I was 0.592, Z=7.439, P<0.05）, with spatial clustering. Hand, foot and mouth disease had different “hot spots” with high incidence. Spatial‐temporal scanning analysis showed that there were obvious spatial‐temporal clusters of intestinal infectious diseases in Yunfu City from 2013 to 2022, with one cluster area of class Ⅰ and one cluster area of class Ⅱ and one cluster season （May to October）. Hand, foot and mouth disease and other infectious diarrhea diseases had different cluster areas and cluster seasons （months）. Conclusions The intestinal infectious diseases reported in Yunfu City showed obvious spatial‐temporal clustering from 2013 to 2022. Targeted prevention and control measures should be taken in pre‐epidemic season and high‐risk streets （towns）.

Objective To explore the pollution levels of polycyclic aromatic hydrocarbons （PAHs） in atmospheric PM_2.5 in Zhuhai City, and to assess the health risks to the population via inhalation exposure. Methods In 2022, from the 10th to the 16th of each month, PM_2.5 samples were collected in three districts of Zhuhai City. The mass concentration of PM_2.5 was measured using the gravimetric method, while the concentrations of 16 types of PAHs were detected using liquid chromatography. Additionally, the carcinogenic and non-carcinogenic health risks resulting from inhaling PAHs were evaluated. Results In 2022, the concentration of atmospheric PM_2.5 in Zhuhai City was 7.00-80.00 μg/m³, with a median of 19.00 μg/m³ and an annual average of 23.85 μg/m³. The overall concentration of 16 PAHs ranged from 0.43 to 17.99 ng/m³, with a median of 0.68 ng/m³. The median HQ of naphthalene was 4.33×10^-5 and P₉₅ was 1.20×10^-4. The median HQ for benzo [a]pyrene （BaP） was 0.01 and P₉₅ was 0.24. The carcinogenic equivalent concentration of 16 PAHs were calculated using BaP as the reference toxic equivalent factor, the total lifetime excess carcinogen risk （ECR） calculated by P₉₅ was 6.64×10^-7, which was lower than the acceptable level of 1×10^-6. Conclusions The overall concentration of PAHs in atmospheric PM_2.5 in Zhuhai City is relatively low. Besides, both the non-carcinogenic and carcinogenic risks posed to the population by exposure to atmospheric PAHs are within acceptable risk thresholds.