Objective To analyze the operational performance of the Guangzhou Student Health Monitoring System and evaluate its early warning effectiveness, thereby providing an evidentiary basis for the further optimization of the system's predictive capabilities. Methods An analysis was conducted on the characteristics of the alert signals generated by the Guangzhou Student Health Monitoring System and its efficacy in the early warning of infectious disease-related public health emergencies on school campuses. Furthermore, a cross-correlation analysis was employed to investigate the time-lag relationship between two data sources: the early warning signals produced by the student monitoring system and the corresponding case reports from the statutory infectious disease reporting system. Results From January 2023 to July 2024, the system generated a total of 61 555 early warning signals, achieving a timely response rate of 97.54% (60 041/61 555), a signal accuracy rate of 98.25% (60 480/61 555), and an overall positive predictive value of 28.15% (17 325/61 555). For campus-based infectious disease public health emergencies, the system demonstrated a sensitivity of 90.59% (77/85) and a timeliness rate of 87.06% (74/85). At a weekly aggregation level, the warning signals and the corresponding reported infectious disease data exhibited a significant positive correlation (P<0.01). The cross-correlation analysis revealed that alert signals for rash-related symptoms and Hand, Foot, and Mouth Disease demonstrated a temporal precedence, enabling the detection of fluctuations in the incidence of these target diseases 1 to 3 weeks in advance. Conclusion The Guangzhou Student Health Monitoring System demonstrates substantial concordance with the statutory notifiable infectious disease reporting system, providing a robust foundation for the early identification and warning of infectious disease outbreaks among the school-aged population. System performance may be further enhanced by strategically adjusting parameters such as warning thresholds and improving the quality of data reporting to increase the positive predictive value of the alerts.

Objective To analyze the survival status of children living with HIV in Zhaojue County and to investigate the factors associated with their survival time. Methods A retrospective cohort study was conducted, compiling follow-up data for pediatric HIV patients residing in Zhaojue County between 1996 and 2022. The observation endpoint was December 31, 2022. The life table method was utilized to calculate cumulative survival rates. Differences in survival times across various subgroups were compared using the log-rank test, and a Cox proportional hazards regression model was employed to perform the survival analysis. Results The study cohort comprised 925 children living with HIV, with a mean observation time of 66.0 months (95% CI: 63.3-68.7). The cumulative survival rates at 6 months, 1 year, 5 years, 10 years, and 15 years were 95%, 92%, 87%, 80%, and 73%, respectively. Multivariate Cox proportional hazards regression analysis indicated that the period of case diagnosis (1996-2008: HR=0.331, 95% CI: 0.125-0.878; 2009-2017: HR=1.742, 95% CI: 1.074-2.825), treatment status (untreated or lost to follow-up: HR=51.254, 95% CI: 32.221-81.531), and WHO Clinical Stage III of HIV infection (HR=9.527, 95% CI: 3.430-26.462) were statistically significant predictors of survival time. Conclusion It is imperative to prioritize the expansion of antiretroviral therapy (ART) coverage for children living with HIV, especially those diagnosed between 2009 and 2017, those who are treatment-naïve, and those who have advanced to WHO Clinical Stage III. Expediting the restoration of patients' immune function is critical to prolonging their survival.

Objective To investigate the epidemiological characteristics and spatiotemporal distribution patterns of other infectious diarrheal diseases in Lincang City from 2019 to 2023, thereby providing a scientific basis for the formulation of precise and efficacious prevention and control strategies. Methods Surveillance data on other infectious diarrheal diseases in Lincang City from 2019 to 2023 were extracted from the Chinese Information System for Disease Control and Prevention, based on the date of onset. Descriptive epidemiological methods were employed to analyze the distribution by person, place, and time. Global and local spatial autocorrelation analyses were performed on township-level reported incidence rates, supplemented by a spatiotemporal cluster analysis. Results A total of 6 962 cases of other infectious diarrheal diseases were reported in Lincang City from 2019 to 2023, corresponding to an average annual reported incidence rate of 57.67 per 100 000 population. The reported incidence was significantly higher in males than in females (P<0.01), with children under the age of five constituting the largest proportion of cases (6 161/6 962, 88.49%). The incidence exhibited distinct seasonal peaks; while the epidemic trend was generally consistent across months annually, the peak periods varied slightly, primarily occurring between February and April. The three counties (districts) with the highest average annual reported incidence rates were Linxiang District (139.01/100 000), Fengqing County (78.01/100 000), and Yun County (53.40/100 000). The rate of laboratory specimen collection and testing was 64.00% (4 456/6 962). Among the tested specimens, the three most frequently detected pathogens were rotavirus (89.03%, 3 967/4 456), adenovirus (5.27%, 235/4 456), and norovirus (4.71%, 210/4 456). A significant spatial aggregation in disease incidence was identified. High-High (H-H) clusters were predominantly located in 5 to 11 townships within Linxiang District, Fengqing County, and Yun County, with these clusters demonstrating a progressive year-on-year reduction in size. Low-Low (L-L) clusters were primarily situated in 3 to 12 townships in Gengma County and its contiguous areas; over time, these clusters also diminished in scope and migrated from the southwest towards the central and northwestern regions. The findings of the spatiotemporal scan analysis were highly concordant with those of the spatial autocorrelation analysis. Conclusion The reported incidence of other infectious diarrheal diseases in Lincang City from 2019 to 2023 exhibited a clustered spatiotemporal distribution. It is imperative to enhance health education for key populations during high-risk seasons and in high-incidence regions, and to develop scientific, precise, and context-specific prevention and control strategies.

Objective To analyze the dose-response relationship between Body Mass Index (BMI), waist circumference, and the prevalence of dyslipidemia, in order to provide a scientific basis for the comprehensive prevention and control of dyslipidemia. Methods From May to June 2024, a multi-stage cluster random sampling method was employed to conduct a questionnaire survey, physical examinations, and laboratory tests on residents aged 18 and older in the Chao'an District. An unconditional logistic regression model was used to analyze the association between BMI, waist circumference, and dyslipidemia. A logistic regression model based on restricted cubic splines (RCS) was utilized to analyze the dose-response relationship between BMI, waist circumference, and the prevalence of dyslipidemia. Results The prevalence of dyslipidemia among residents of Chao'an District was 34.00%, with an overweight/obesity rate of 30.74% and a central obesity rate of 23.86%. The risk of dyslipidemia was higher in residents with overweight/obesity (OR=2.18, 95% CI: 1.87-2.55) and central obesity (OR=2.13, 95% CI: 1.81-2.52) compared to residents with normal weight. Referencing the normal weight population, individuals with combined overweight/obesity and central obesity had a higher risk of developing dyslipidemia (OR=2.76, 95% CI: 2.27-3.36) than those with only overweight/obesity (OR=1.85, 95% CI: 1.49-2.29) or only central obesity (OR=1.70, 95% CI: 1.28-2.28). The restricted cubic spline model indicated a non-linear dose-response relationship between both BMI and waist circumference and the prevalence of dyslipidemia (both P<0.05). Conclusion BMI and waist circumference are associated with the prevalence of dyslipidemia, exhibiting a clear, monotonically increasing dose-response relationship.

Objective To evaluate the level of disease burden in patients with vestibular migraine and to investigate its association with psychiatric comorbidities, thereby providing a basis for the formulation of individualized treatment strategies. Methods A total of 388 patients diagnosed with vestibular migraine were recruited from a specialized vestibular clinic between October 2024 and April 2025 to form the case group. Concurrently, 388 patients with typical migraine without vestibular symptoms were enrolled as the control group. General demographic data and clinical characteristics were compared between the two groups. Patient assessments were conducted using the Migraine Disability Assessment (MIDAS), the Generalized Anxiety Disorder-7 (GAD-7) scale, the Patient Health Questionnaire-9 (PHQ-9), and the Migraine-Specific Quality of Life Questionnaire (MSQOL). Patients in the case group also completed the Dizziness Handicap Inventory (DHI). The study analyzed the exacerbation of disease burden in vestibular migraine and its relationship with psychiatric comorbidities. Results Of the 388 vestibular migraine patients, 13 were excluded due to invalid questionnaires, resulting in a final case group of 375 participants. Among the 388 patients with typical migraine, 18 were excluded due to invalid questionnaires or voluntary withdrawal, yielding a final control group of 370 participants. Multivariate logistic regression analysis revealed that attack frequency (OR=6.129) and MSQOL score (OR=0.543) were significant influencing factors for anxiety alone in patients with vestibular migraine (all P<0.05). Similarly, attack frequency (OR=5.249) and MSQOL score (OR=0.576) were identified as significant factors for depression alone (all P<0.05). The influencing factors for comorbid anxiety and depression in this population were age (OR=8.232), gender (OR=6.571), attack frequency (OR=9.952), MIDAS score (OR=5.796), DHI score (moderate disability OR=9.138, severe disability OR=11.816), direct medical expenditure (OR=1.002), and MSQOL score (OR=0.421) (all P<0.05). Psychiatric comorbidities were found to exert a partial mediating effect on the relationship between disease burden and quality of life, accounting for 20.00% of the total effect. Conclusion This study indicates that factors such as attack frequency and quality of life are significantly associated with psychiatric comorbidities in patients with vestibular migraine. Furthermore, psychiatric comorbidities partially mediate the relationship between disease burden and quality of life, providing a crucial evidence base for the development of personalized therapeutic approaches.

Objective To investigate the concentration levels of nonylphenol (NP) and bisphenol A (BPA) in the drinking water of four Chinese provinces and to assess the associated health risks. Methods From June to August 2022, samples of source water, finished water, and tap water were collected from 49 municipal water supplies across four provinces. The concentrations of NP and BPA were determined using solid-phase extraction coupled with ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). A non-carcinogenic health risk assessment was subsequently conducted for NP. Results The detection frequencies for NP and BPA were 65.31% and 44.90%, respectively, with median detected concentrations of 5.09 ng/L and 0.04 ng/L. The concentration of NP was significantly higher than that of BPA (z=-4.27, P<0.01). Significant inter-provincial variations were observed: the median NP concentration in Province D (164.00 ng/L) was the highest, followed by Province C (58.24 ng/L), Province A (5.17 ng/L), and Province B (0.04 ng/L) (χ²=40.90, P<0.01). For BPA, the median concentration in Province A (10.02 ng/L) was highest, followed by Province C (3.07 ng/L), Province D (0.04 ng/L), and Province B (0.04 ng/L) (χ²=56.84, P<0.01). The median NP concentration was significantly higher in surface water (9.86 ng/L) compared to groundwater (1.50 ng/L) (z=-3.09, P<0.01). The median BPA concentration in source water (4.80 ng/L) was significantly higher than in finished water (0.04 ng/L) and tap water (0.04 ng/L) (χ²=9.26, P<0.01). A significant positive correlation was identified between NP and BPA concentrations (P<0.01), as well as between NP concentration and water temperature (P<0.01). The non-carcinogenic risk from NP ingestion via direct drinking was higher for children than for adults, with the highest hazard quotient observed for male toddlers aged 1 to<2 years, calculated as 1.34×10⁻² and 4.47×10⁻¹ based on Danish and Australian reference values, respectively. Conclusion Trace quantities of NP and BPA, at the ng/L level, were detected in the drinking water of the four provinces. BPA concentrations were all below the regulatory limit set by China's drinking water standards (GB 5749-2022). The non-carcinogenic risk associated with NP was below the threshold of 1, indicating an acceptable level.

Objective To investigate the latent profiles of internet addiction among vocational college students and identify its influencing factors, thereby providing a basis for the development of differentiated intervention strategies. Methods A cross-sectional study was conducted between June and October 2024, utilizing convenience sampling to recruit students from three vocational colleges in Sichuan Province. Data were collected through a general demographic questionnaire, the Internet Addiction Scale, the Psychological Quality of Life Assessment Questionnaire, and the General Self-Efficacy Scale. Latent Profile Analysis (LPA) was employed to identify distinct profiles of internet addiction, and multinomial logistic regression was used to examine the associated factors. Results A total of 1 037 valid questionnaires were analyzed. Three distinct profiles of internet addiction were identified: a "No Internet Addiction" group (42.1%), a "Moderate Internet Use" group (40.2%), and a "High-Risk Internet Addiction" group (17.7%). Multinomial logistic regression analysis indicated that psychological quality of life, general self-efficacy, frequency of physical exercise, communication with parents, and whether the student held a position as a class cadre were significant factors influencing the latent profile membership. Specifically, students with higher scores in psychological quality of life (Moderate Internet Use vs. No Internet Addiction: OR=0.971; High-Risk Internet Addiction vs. No Internet Addiction: OR=0.930), higher general self-efficacy (OR=0.133), and highter physical exercise frequency (OR=0.476) were more likely to be classified in the "No Internet Addiction" group. Conversely, students who communicated less frequently with their parents (OR=1.887), had lower psychological quality of life (OR=1.044), lower general self-efficacy (OR=1.860), and hold a class cadre position (OR=0.556) were more likely to belong to the "High-Risk Internet Addiction" group (all P<0.05). Conclusion Internet addiction among vocational college students manifests in three distinct latent profiles. It is imperative for administrators to formulate and implement targeted intervention strategies based on the specific characteristics of these different groups to effectively prevent and mitigate problematic internet use.

Objective To analyze the trends in rabies incidence and mortality in China from 1990 to 2019 across different temporal points, as well as by age, period, and cohort, to provide evidence for optimizing rabies prevention and control strategies. Methods Data from the Global Burden of Disease Study 2019 (GBD 2019) were utilized. A Joinpoint regression model was employed to analyze the trends in the age-standardized incidence and mortality rates of rabies in China from 1990 to 2019 at various nodes. An Age-Period-Cohort (APC) model was used to assess the effects of age, period, and cohort on these standardized rates. Results The Joinpoint regression analysis indicated that from 1990 to 2019, the age-standardized incidence rate of rabies in the total population of China decreased by an average of 2.994% annually, and the age-standardized mortality rate decreased by an average of 3.029% annually. The APC model results revealed that the age-standardized incidence and mortality rates of rabies in China exhibited a bimodal trend with increasing age, first decreasing and subsequently increasing. The age-standardized incidence rate for the total population reached its initial peak in the 5-9 age group (0.197 per 1 000 000) and a second peak in the 70-74 age group (0.162 per 1 000 000). The age-standardized mortality rate for the total population showed its first peak in the<5 age group (0.195 per 1 000 000) and a secondary peak in the 70-74 age group (0.185 per 1 000 000). For the period effect, using 2000-2004 as the reference group (RR=1), the risk of incidence and mortality was lower in 1990-1999 and peaked in 2005-2009. For the cohort effect, with the 1960-1964 birth cohort as the reference group (RR=1), the risk increased for birth cohorts from 1905 to 1994. The incidence and mortality risk for the 2015-2019 birth cohort was the lowest (RR=0.395、0.458). Conclusion Although the overall age-standardized incidence and mortality rates of rabies in China demonstrated a downward trend from 1990 to 2019, children and the elderly remain at high risk, with males exhibiting a higher risk than females. It is recommended that comprehensive intervention measures, including canine immunization, activity management, and sterilization, be strengthened. Targeted health education should be conducted for high-risk groups such as children, the elderly, and males to increase awareness of post-exposure prophylaxis.

Objective To describe the incidence and mortality of prostate cancer in China and countries with varying levels of the Human Development Index (HDI). Methods Data pertaining to prostate cancer were extracted from the GLOBOCAN 2022 database. Spearman rank correlation analysis was employed to examine the associations between the HDI and the standardized incidence rate (SIR), standardized mortality rate (SMR), and the mortality-to-incidence (M/I) ratio. Descriptive epidemiological methods were utilized to analyze the epidemiological characteristics within each HDI stratum and for China. Results In 2022, the global SIR for prostate cancer was 29.4 per 100 000, and the SMR was 7.3 per 100 000. For China, the SIR was 9.7 per 100 000, and the SMR was 3.3 per 100 000. The SIRs for prostate cancer in countries or regions with very high, high, medium, and low HDI were 57.7, 18.6, 9.9, and 22.9 per 100 000, respectively; the corresponding SMRs were 9.1, 5.6, 4.7, and 14.0 per 100 000, respectively. Both China's SIR (9.7 per 100 000) and SMR (3.3 per 100 000) were lower than the averages for the high-HDI stratum to which it belongs. The M/I ratio exhibited an increasing trend across the very high, high, medium, and low HDI strata. China's M/I ratio (0.36) was higher than that of its high-HDI group (0.32). A positive correlation was observed between the HDI and the prostate cancer SIR (r_s=0.45,P<0.01), whereas negative correlations were found with the SMR (r_s=-0.22,P<0.01) and the M/I ratio (r_s=-0.84,P<0.01). Conclusions ignificant disparities exist in the incidence and mortality of prostate cancer among countries with different HDI levels. Although China exhibits a relatively low SIR and SMR, its elevated M/I ratio necessitates the development of targeted screening and control strategies.

Objective To compare the composition of plasma bacteria and phages between healthy individuals and individuals with HIV infection, and to investigate the differential correlations between phages and bacteria within these two cohorts. Methods Blood samples were collected from a cohort of HIV-infected individuals and a control group of healthy individuals. Nucleic acids were extracted for metagenomic sequencing. Bioinformatic pipelines were utilized to identify bacterial and phage compositions and to predict phage-host relationships. Alpha diversity analyses were conducted to assess microbial diversity and richness. Spearman's rank correlation was employed to analyze the interrelationships between phages and bacteria. Results This study enrolled 61 individuals with HIV infection and 15 healthy controls. In the healthy cohort, 267 bacterial species, 146 genera, and 91 families were identified, whereas the HIV-infected cohort presented 294 bacterial species, 165 genera, and 103 families. The two groups shared 9 families, 8 genera, and 6 species. Alpha diversity analysis revealed no significant difference in plasma bacterial diversity (Shannon index, P=0.081) between the groups; however, bacterial richness (Chao1 index) was significantly higher in the healthy controls compared to the HIV-infected individuals (P=3.7×10⁻⁶). Phages were detected in all healthy controls, with 165 phage species and 102 genera identified. Conversely, phages were detected in only 46 of the 61 HIV-infected participants (75.41%), comprising 61 phage species and 34 genera. Alpha diversity metrics for the plasma phageome were significantly higher in the healthy cohort in terms of both diversity (Shannon index, P=1.8×10⁻⁸) and richness (Chao1 index, P=9.1×10⁻⁹). The three most abundant phages in both groups were identified as those associated with the genera Rhodoferax, Cronobacter, and Cutibacterium. In the HIV-infected cohort, phages associated with Cronobacter, Rhodoferax, and Flavobacterium demonstrated significant negative or positive correlations with plasma levels of Lactobacillus, Cupriavidus, and Citrobacter, respectively (all P<0.05). These correlations, however, were attenuated or exhibited an opposite trend in the healthy control group. Conclusion Marked differences exist in the plasma microbial composition of healthy individuals versus those with HIV infection, particularly concerning the diversity, richness, and bacterium-phage correlations of the phageome. HIV infection may substantially reshape the plasma phage community, thereby potentially affecting the stability of the blood micro-ecosystem.

Objective To investigate the distribution patterns and concentration levels of 16 rare earth elements (REEs) in 22 species of medicinal and edible homologous Chinese herbal medicines from the Guangxi. Methods The concentrations of REEs were determined utilizing microwave digestion followed by inductively coupled plasma tandem mass spectrometry (ICP-MS/MS). The distribution patterns of these elements were subsequently explored through a combination of correlation analysis,cluster analysis, and principal component analysis (PCA). Results The results indicated that among the 487 samples across 22 species, the mean total REE concentrations in Ganoderma lucidum (2.570 mg/kg), Sophorae Flos (2.569 mg/kg), and Houttuynia cordata (2.265 mg/kg) were significantly elevated compared to other species (all P<0.05). Statistically significant variations in REE content were observed among samples from different geographical origins (P<0.05). Furthermore, principal component analysis revealed that light rare earth elements (LREEs),notably Lanthanum (La) and Cerium (Ce), were the principal contributors to the total variance (explaining 65.13%). Conclusion It was concluded that rare earth elements are ubiquitously present in the medicinal and edible homologous herbal materials from Guangxi. Both the species and the geographical provenance were found to be significant determinants of REE content. This underscores the necessity of establishing a differentiated regulatory framework, including specific maximum permissible limits, based on both species and origin.

Objective To investigate the association between early-life exposure to air pollutants (PM_2.5, PM₁₀,SO₂, NO₂) and the risk of autism spectrum disorder (ASD) in children. Methods A nested case-control study was conducted based on a birth cohort from the Foshan Maternal and Child Health Information System between 2019 and 2021. A total of 725 children diagnosed with ASD at designated diagnostic centers were enrolled as the case group. For each case, two healthy children from the same birth cohort were selected as controls, matched 1∶2 using propensity score matching, resulting in 1 445 control subjects. Multivariable conditional logistic regression models were employed to analyze the association between exposure to various air pollutants during five critical windows—the first, second, and third trimesters, the entire pregnancy, and the first year of life—and the risk of developing ASD. Results After adjusting for a range of confounding factors, including maternal gestational diabetes mellitus, the regression analysis revealed a significant positive association between ASD risk and exposure to PM_2.5 (OR=2.37, 95% CI:1.44-3.90) and PM₁₀ (OR=1.80, 95% CI:1.07-3.04) throughout the entire gestational period. Furthermore, exposure to PM_2.5 (OR=1.68, 95% CI:1.13-2.51) and NO₂ (OR=1.58, 95% CI:1.27-1.97) during the first year of life was also significantly associated with an elevated risk of ASD(all P<0.05). Stratified analysis by exposure window further indicated that the associations were particularly prominent for exposure to PM_2.5 (OR=2.75, 95% CI:1.22-6.21) and PM₁₀ (OR=3.26, 95% CI:1.40-7.63) during the first trimester (all P<0.05). Conclusion Exposure to PM_2.5, PM₁₀, and NO₂ during the prenatal period and the first year of life may increase the risk of ASD in children. The first trimester of pregnancy appears to be a critical sensitive window for the adverse effects of particulate matter exposure on neurodevelopment.