Objective To understand the relationship between eating out and salt intake among residents of six provinces in China, and to provide a scientific basis for the development of relevant salt reduction strategies. Methods A questionnaire survey, physical measurements, and 24-hour urine collection were conducted in 12 counties in six provinces, namely Hebei, Sichuan, Heilongjiang, Qinghai, Jiangxi, and Hunan, using multistage cluster sampling to select residents aged 18-75 years. The Chi-square test was used to analyze the eating out and salt intake of different population groups, and the disordered multiple logistic regression model was used to analyze the correlation between residents' eating out and salt intake. Results A total of 2 428 subjects were included in the study, including 1 225 (50.45%) males, 1 171 (48.23%) urban residents, and 471 (19.40%) people who asked for less salt when eating out, with the total rate of eating out being 26.98%. There were 247 (10.17%) people in the moderate salt intake group, 1 575 (64.87%) in the mildly excessive group, and 606 (24.96%) in the severely excessive group. Compared with the severely excessive group and the moderate salt intake group, the risk of severely exceeding salt intake was higher in the frequent eating out group than in the non-eating out group (OR=1.868, 95% CI: 1.035-3.369, P=0.011). Conclusion High frequency eating out behavior is associated with high salt intake, and residents have weak awareness of asking for less salt when eating out.

Objective To analyze the mortality and the trends of probability of premature mortality due to four chronic diseases in Chancheng District, Foshan City during 2014-2021, and to predict the targets achievement of premature death probabilities for the years 2025 and 2030. Methods The death cases and population data of registered residents in Chancheng District during 2014-2021 were collected. The constituent ratio, crude mortality rate, standardized mortality rate, and the probability of premature mortality were calculated. Joinpoint regression model was used to calculate the average annual percent change (AAPC) and the predicted value of probability of premature mortality. Results During 2014-2021, the standardized mortality rate caused by chronic diseases in total population, males, and females showed decreasing trends, with AAPCs of -3.01%, -2.52%, and -3.66%, respectively (all P<0.01). The crude mortality rates and standardized mortality rates of diabetes and chronic respiratory diseases all showed decreasing trends (all P<0.01). The probability of premature mortality caused by four chronic diseases in total population decreased from 11.38% in 2014 to 9.93% in 2021, with the AAPC of -2.48% (P<0.05). The probability of premature mortality caused by four chronic diseases decreased from 7.51% to 6.20% for females, with the AAPC of -3.65% (P<0.05), while without statistically significant for males (P>0.05). The predicted probability of premature mortality in Chancheng District, Foshan City in 2025 and 2030 were 9.33% and 8.23%, respectively, which were lower than the target premature death probabilities of 9.88% and 8.65% in 2025 and 2030 in the "Medium- and Long-term Plan for Chronic Disease Control and Prevention in China (2017-2025) " and "Healthy China 2030" Planning Outline, respectively. Conclusions The probability of premature mortality caused by four chronic diseases in Chancheng District showed a decreasing trend from 2014 to 2021. We should continue to strengthen the control and prevention of chronic diseases, and strive to achieve a lower probability of premature mortality than the planned targets for 2025 and 2030.

Objective To construct prediction models of hospitalization risk and high medical cost for patients with hepatitis B cirrhosis, in order to improve the scientific nature of patient management and clinical decision-making. Methods The study samples were collected from patients diagnosed as hepatitis B cirrhosis in an infectious disease hospital in Guangzhou. The data were divided into a training set (70%) and a validation set (30%) by random sampling. In view of the class imbalance, SMOTE method was used to balance the training set, and the prediction models of hospitalization risk and high medical cost in the following year were established by the random forest algorithm combined with logistic regression. The models were then validated with class-balanced and validation datasets to evaluate its predictive effectiveness. Results This study included 7 022 patients with hepatitis B cirrhosis, of whom 602 (8.57%) were hospitalization in the following year, and 179 (2.55%) had high medical expenses in the following year. Random forest algorithm and logistic regression prediction models showed that hospitalization, abnormal total protein, and low albumin in the current year were risk factors for hospitalization and high cost in the following year (all OR 95% CI >1). Glutamic-pyruvic transaminase and entecavir use were protective factors for hospitalization and high costs in the following year (both OR 95% CI <1). In the class-balanced dataset, the AUC for the following year hospitalization risk prediction model was 0.944, and the AUC for the high medical cost prediction model was 0.962. In the validation dataset, the AUC of the following year hospitalization risk prediction model was 0.787, and the AUC of the high medical cost prediction model was 0.857, indicating good predictive performance. Conclusion The predictive models constructed in this study showed good performance in predicting the risk of hospitalization and high medical expenses in the following year of patients with hepatitis B cirrhosis, which are of great value for optimizing patient management, reducing medical costs, and improving the quality of medical services.

Objective The Bayesian kernel machine regression (BKMR) model is a new method developed rapidly in recent years. This study aims to introduce the application of the BKMR model in the study of the health effects of multi-pollutant exposure and R implementation. Methods Taking the dataset published by the National Institute of Environmental Health Sciences (NIEHS) as an example, we used BKMR model to analyze the impact of multi-pollutant on health, and introduced its implementation steps based on R language. Results Using on the "bkmr" package of R language, the BKMR model could analyze the univariate exposure-response relationship between the exposure and the health outcomes, the interactions among multiple exposures, and estimate the effect of single exposure and the joint effect of multi-pollutant exposure. Conclusion The BKMR model can analyze the exposure-response relationship and health effects of multi-pollutant exposure on health outcomes, which is a new analytical method for studying the health effect of combined environmental exposures.

Objective To investigate the incidence of non-suicidal self-injury ( NSSI ) among adolescents with depression in Nanjing, and to further explore its influencing factors. Methods Adolescents with depression who received treatment at four tertiary or higher-level hospitals in Nanjing from February 2023 to February 2024 were recruited. NSSI in the past year was evaluated according to the criteria stipulated by Diagnostic and Statistical Manual of Mental Disorders. Demographic information was collected using a self-designed questionnaire. The Loneliness Rating Scale (LRS), Barratt Impulsiveness Scale 11th version (BIS-11), Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the International Version of the Adverse Childhood Experiences Questionnaire (ACEIQ) were applied to evaluate loneliness, impulsivity, childhood trauma and family functions, respectively. Descriptive analysis was conducted to analyze the incidence of NSSI among adolescents with mental disorders. Univariate and multivariate analysis methods were utilized to identify risk factors for NSSI. Results Among the 2 012 adolescents with depression, 762 cases had NSSI, with an incidence rate of 37.87%. Of these, 420 cases had recurrent NSSI and 342 had occasional NSSI. The lower arm and wrist were the most common sites of self-injury (accounting for 39.90%) . Multivariate logistic regression analysis revealed that the depression severity (OR=4.683), exposure to school violence (OR=5.546), feelings of loneliness (OR=4.958), impulsivity (OR=5.562), childhood trauma (OR=5.181), and dysfunctional family environments during childhood (OR=5.333) were significant risk factors for NSSI among adolescents with depression (all P<0.05). Conclusions The prevalence of non-suicidal self-injury (NSSI) among adolescents with depression in Nanjing is relatively high. In particular, Patients with more severe depression, exposure to school violence, and heightened impulsivity are more likely to engage in NSSI. It is essential to pay close attention to these high-risk groups. Corresponding prevention and control measures should be formulated to reduce the incidence of NSSI.

Objective To investigate the status of personnel-position matching among grassroots medical staff in Guangdong Province and identify its influencing factors, to provide a foundation for enhancing the alignment of this workforce and improving work efficiency. Methods The research subjects comprised grassroots medical staff currently employed in Guangdong Province. An online survey was conducted utilizing a personnel-position matching scale, followed by an analysis of influencing factors through a multiple linear regression model. Results A total of 16 573 grassroots medical staff were included in the study, with a personnel-position matching score of (21.87±3.58) points (out of 30 points). The multiple linear regression model analysis indicated that a bachelor's degree (β=0.036), holding a deputy senior professional title (β=0.033), holding a senior professional title (β=0.024), 6-10 years of work experience (β=0.039), 11-15 years of work experience (β=0.074), 16 years or more of work experience (β=0.119), middle-level management (β=0.038), leadership team (β=0.042), majoring in preventive medicine (β=0.024), majoring in other medical specialties (β=0.053), no major (for high school and below degree) (β=0.034), and working as a technician in positions such as laboratory testing and imaging (β=0.035) were the main factors that improve personnel-position matching. Grassroots medical staff without professional titles (β=-0.044), non-regular staff (β=-0.030), and those working in public health positions (β=-0.071) had lower levels of personnel-position matching. Conclusions There remains significant potential for improvement in the personnel-position matching of grassroots medical staff in Guangdong Province. Particular attention should be directed towards groups such as those lacking professional titles or holding low-level titles, individuals with limited work experience, those occupying lower administrative positions, clinical medicine majors, and public health workers. Targeted intervention measures are recommended to enhance the state of personnel-position matching for these groups.

Objective To analyze the epidemic characteristics of hepatitis C in Zibo City from 2018 to 2023 and explore the distribution of hepatitis C clusters at the township (street) level in order to provide a scientific basis for the prevention and control of hepatitis C. Methods Data on reported cases of hepatitis C in Zibo City from 2018 to 2023 were collected. Descriptive epidemiological methods were used to analyze the temporal, spatial, and demographic characteristics. Spatial autocorrelation analysis and spatiotemporal scanning analysis were also conducted. Results A total of 1 130 cases of hepatitis C were reported in Zibo City from 2018 to 2023, with an average annual reported incidence rate of 4.28 per 100 000. The male-to-female ratio was 1.32∶1, and farmers, household workers, unemployed individuals, and retirees accounted for a total of 78.94% of cases. Spatial autocorrelation analysis revealed significant clustering with Moran's I values from 2018 to 2020 and 2023 being 0.203, 0.205, 0.210, and 0.115 (P<0.05 or P<0.01). Hot spots were identified in townships (streets) within Zichuan District, Huantai County, Yiyuan County, Linzi District, Boshan District, and Zhoucun District. The results of spatiotemporal aggregation analysis showed that from 2018 to 2023, there were 1 to 2 spatiotemporal aggregation regions with different aggregation times. In 2022 and 2023, the main aggregation regions were similar, and the regions with high incidence of hepatitis C were mainly concentrated in Zichuan District, Huantai County, and Yiyuan County. Conclusions The incidence of hepatitis C in Zibo City shows clear clustering within specific populations and at particular times and locations. It is important to pay special attention to males, middle-aged and elderly individuals, rural residents, as well as the hepatitis C epidemic situation in Zichuan District, Huantai County, Yiyuan County, and surrounding regions.

Objective To analyze the epidemiological characteristics and secular trend of other infectious diarrhea (OID) in Dongying City from 2010 to 2023, and provide evidence for OID control and prevention. Methods Through the China Disease Control and Prevention Information System, the data of OID surveillance in Dongying City from 2010 to 2023 was collected. Joinpoint regression model was established to analyze the epidemiological trend of OID. Results A total of 40 973 cases of OID were reported in Dongying City during 2010-2023, and the annual reported incidence rate was 136.86/100 000. The incidence rate was higher in males than in females (P<0.01), and the incidence ratio of male to female was 1.28: 1.00. Cases were reported in all age groups, mainly under 20 years old, with a total of 17 907 cases reported (43.70%). There were two incidence peaks for OID, from June to August in summer and December to January of the following year in winter. Joinpoint regression analysis showed that the reported incidence rate of OID in Dongying City showed an overall upward trend from 2010 to 2023 (AAPC=7.19%, P<0.05), males showed an overall upward trend but without statistical significance (P>0.05), while females showed an overall upward trend with statistical significance (P<0.05). The age group of 0 - <1 showed an overall slowly downward trend (P<0.05), while the age groups of 1 - <5, 5 - <10, 10 - <15, 20 - <25, 25 - <30, 40 - <45, 50 - <55, 60 - <65, 65 - <70, 75 - <80, and 80 - 99 showed an overall upward trend (P<0.05 or P<0.01). Conclusions The incidence of OID in Dongying City from 2010 to 2023 was still at a high level. It is imperative to pay attention to the age group of 0 - <20 years old and control the key seasonal periods, and actively take targeted prevention and control strategies for OID.

Objective To analyze the current status of healthcare workers' knowledge and attitudes regarding hospital-acquired infection prevention and control in psychiatric hospitals and explore its influencing factors, providing a reference for improving the level of infection prevention and control in psychiatric hospitals. Methods A simple sampling method was used. Healthcare workers from three psychiatric hospitals in Wuhu, Anhui Province were enrolled. A questionnaire survey on infection prevention and control and cognitive level assessment were conducted. Multiple linear regression analysis was employed to explore the influencing factors of healthcare workers' knowledge and attitudes in infection prevention and control. Results The survey results showed that regarding hospital-acquired infection prevention and control, the psychiatric medical staff had a high level of mastery of the basic knowledge, hand hygiene, cleaning and disinfection, and personal protection. However, the correct response rates for multi-drug-resistant bacteria prevention and control only ranged from 60% to 80%. The average score of 514 psychiatric healthcare workers in infection prevention and control cognition was (8.71±1.28), indicating a moderate level. Among them, 157 healthcare workers answered all questions correctly, with a complete correct response rate of 30.54%. Multiple linear regression analysis showed that years of psychiatric work experience (β′=0.074), frequency of training and education (β′=0.922), highest educational level (β′=0.078), and department leaders' emphasis on infection prevention and control (β′=0.076) were independent influencing factors of healthcare workers' cognitive level in hospital infection prevention and control (P<0.05). Conclusions The knowledge and attitudes of healthcare workers in psychiatric hospital regarding infection prevention and control still needs improvement. Years of psychiatric work experience, frequency of training and education, highest educational level, and department leaders' emphasis on infection prevention and control are independent influencing factors of healthcare workers' cognitive level in this area.

Objective To investigate the prevalence of comorbid myopia and overweight/obesity among primary and secondary school students, explore its influencing factors, and thereby provide a scientific basis for establishing a "co-morbidity, shared etiology, shared prevention" mechanism for common diseases in children and adolescents. Methods In 2023, a multi-stage stratified cluster sampling method was used to select 217 393 students from fourth grade in primary school to third grade in high school in 18 cities in Sichuan Province. These students underwent height and weight measurements, myopia screenings, and questionnaire surveys. Differences between groups were tested using the χ² test, and factors influencing the comorbidity of myopia and overweight/obesity were analyzed using a multivariate logistic regression model. Results A total of 213 609 primary and secondary school students were included, the myopia rate was 65.82% (140 593 cases), the overweight/obesity rate was 23.47% (50 132 cases), and the comorbidity rate of both conditions was 15.26% (32 596 cases). Fully meeting the 24-hour movement guideline was a protective factor for comorbid myopia and overweight/obesity (OR=0.858). Additionally, gender, ethnicity, school grade, economic region, and family structure also had significant impacts on the occurrence of comorbidity (all P<0.01). Conclusions The prevalence rates of myopia, overweight/obesity, and their comorbidity are relatively high among primary and secondary school students in Sichuan Province. Targeted interventions should be implemented based on gender, ethnicity, school grade, economic region, and family structure. Fully meeting the 24-hour movement guideline can reduce the incidence of comorbid myopia and overweight/obesity.

Objective To explore the correlation between the hospital-acquired infections (HAIs) safety culture and medical staff's compliance with infection prevention and control measures; and to identify strategies for enhancing compliance. Methods A cross-sectional study was conducted in seven tertiary medical institutions in Nantong, Jiangsu Province Medical staff from different clinical departments were enrolled through simple random sampling. Data were collected using questionnaires with self-completion method. Results A total of 1 707 medical staff participated in the investigation, most of whom were female (1 519 cases). Among them, 988 were under 30 years old, 719 were 30 years old and older. Most participants were nurses (1 587 cases). Clinical teachers (OR=1.883) and medical staff who had direct contact with patients with HAIs (OR=2.071) demonstrated better compliance with IPC measures. The score of Leadership Emphasis (OR=1.564), HAI event reporting (OR=1.219), IPC Improvement (OR=1.361), Management Incentives (OR=1.548), Education and Training (OR=1.486), Staffing (OR=1.618), and working environment (OR=1.262) were all positively correlated with better compliance with IPC measures (all P<0.05). Conclusion The formation of a hospital HAIs safety culture is closely related to medical staff's compliance with IPC measures.