Objective To analyze the disease burden of intestinal obstruction in China from 1990 to 2021, investigate its changing trends, and forecast the future disease burden for the period of 2022-2035. Methods Data on the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of intestinal obstruction in China from 1990 to 2021 were extracted and analyzed from the Global Burden of Disease (GBD) 2021 database. The Joinpoint regression model was employed to analyze trends in the disease burden, while the Autoregressive Integrated Moving Average (ARIMA) model was utilized to predict the disease burden from 2022 to 2035. Results In comparison to 1990, the year 2021 witnessed a 37.75% increase in the number of incident cases of intestinal obstruction in China, with a corresponding 13.90% rise in the incidence rate. The number of prevalent cases increased by 34.97%, and the prevalence rate rose by 11.60%. Conversely, the age-standardized incidence rate and age-standardized prevalence rate decreased by 9.70% and 9.96%, respectively. The number of deaths, mortality rate, and age-standardized mortality rate declined by 21.17%, 34.82%, and 64.98%, respectively. Furthermore, DALYs, the DALY rate, and the age-standardized DALY rate decreased by 64.75%, 70.85%, and 73.93%, respectively. When benchmarked against global and different Socio-Demographic Index (SDI) regions, China's age-standardized incidence and prevalence rates of intestinal obstruction were at a comparatively high global level. However, its age-standardized mortality and DALY rates were among the lowest globally. The Joinpoint regression model indicated a significant decreasing trend in the age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized DALY rate for intestinal obstruction in China from 1990 to 2021, with respective Average Annual Percent Changes (AAPCs) of -0.32%, -0.34%, -3.37%, and -4.22% (all P<0.001). The disease burden was higher in males than in females, and was particularly severe in the population aged 70 years and older. The ARIMA model forecasts an upward trend in the number of incident cases, prevalent cases, incidence rate, and prevalence rate of intestinal obstruction in China from 2022 to 2035. Conclusion The disease burden of intestinal obstruction in China remained at a high level between 1990 and 2021. Males and individuals aged 70 years and older represent high-risk populations. The burden of incident and prevalent cases of intestinal obstruction is projected to increase from 2022 to 2035. It is imperative to formulate targeted medical policies and implement necessary interventions, with a particular focus on enhancing prevention and intervention strategies for high-risk groups.

Objective To investigate the key risk factors for varicella (chickenpox) infection by integrating epidemiological survey data with social contact network analysis. Methods A retrospective field study was conducted following a varicella outbreak in May 2024 at a primary school. We utilized wireless wearable devices equipped with Ultra-Wideband (UWB) positioning technology to reconstruct the social contact network of the affected class. High-precision data on key parameters, including the number of contacts, contact frequency, and total contact duration, were systematically collected. Descriptive analysis was employed to characterize the distribution of student contact patterns. Subsequently, a Bayesian logistic regression model was constructed to identify critical risk factors associated with varicella incidence and transmission. Results The varicella attack rate during this primary school outbreak was 21.7% (10/46). A total of 14 009 contact instances were recorded among 45 students and one teacher. The median number of contacts per individual was 57. Of all single interaction events, 59.8% had a duration of less than one minute, and the median cumulative contact duration for 1 019 contact dyads was 28.1 minutes. The median duration of a single close-proximity (≤1 m) contact (6.6 minutes) was substantially longer than that of more distant (>1 m) contacts (1.5 minutes). The Bayesian multivariate logistic regression model indicated that varicella vaccination was a significant protective factor (OR=0.031, 95% CI: 0.003-0.236). Conversely, each standard deviation increase in the average duration of close-proximity contact (1.938 min) (OR=4.621, 95% CI: 1.485-18.922) and in degree centrality (9.968) (OR=3.910, 95% CI: 1.494-12.555) was associated with an increased risk of infection. Conclusion This study innovatively applied UWB technology to quantify the influence of social network centrality on varicella transmission. The findings demonstrate that vaccination significantly reduces the risk of infection, whereas prolonged duration of individual close-proximity contact and higher degree centrality within the network elevate infection risk. These results provide a scientific foundation for the development of precise, contact network-based early warning systems.

Objective To analyze the dynamic trends in the disease burden of tuberculosis in China between 1990 and 2021, explore the influence of key risk factors on this burden, and forecast future trajectories. Methods Data pertaining to the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of tuberculosis in China, along with their corresponding age-standardized rates (ASR), were sourced from the Global Burden of Disease (GBD) 2021 database. The Joinpoint regression model was utilized to analyze temporal trends, calculating the annual percent change (APC) and the average annual percent change (AAPC). Future trends in the tuberculosis burden from 2022 to 2035 were projected using the Norpred model. Results a significant decline was observed in the age-standardized incidence rate (ASIR) of tuberculosis in China, which decreased from 109.01 per 100 000 population in 1990 to 36.28 per 100 000 in 2021 (AAPC=-3.48%, 95% CI: -3.63% to -3.34%). Similarly, the age-standardized prevalence rate (ASPR) demonstrated a reduction from 31,445.76 per 100 000 to 30,557.45 per 100 000 (AAPC=-0.10%, 95% CI: -0.14% to -0.06%), while the age-standardized mortality rate (ASMR) experienced a substantial drop from 20.09 per 100 000 to 1.91 per 100 000 (AAPC=-7.42%, 95% CI: -7.78% to -7.07%). The age-standardized DALY rate (ASDR) also saw a considerable decrease from 719.42 per 100 000 to 76.22 per 100 000 (AAPC=-7.00%, 95% CI: -7.18% to -6.81%). The disease burden was found to be greater in males than in females. The primary attributable risk factors were identified as smoking and alcohol consumption, which were associated with 28.0% and 18.4% of mortality risk, and 28.0% and 18.8% of DALYs, respectively. Projections from the Norpred model suggest that the downward trends in ASIR, ASMR, and ASDR are expected to continue from 2022 to 2035. Conclusion China has achieved a notable reduction in the burden of tuberculosis. However, a higher burden persists in the male population, and smoking and alcohol consumption remain the principal modifiable risk factors. To further mitigate the disease burden of tuberculosis, it is imperative to refine prevention and control strategies and implement more targeted interventions for high

Objective To identify distinct frailty trajectories among middle-aged and older adults and to examine their association with the subsequent risk of incident cardiometabolic multimorbidity (CMM), utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) prospective cohort. Methods This study included 7 523 participants aged ≥45 years who were free of CMM at the 2011 baseline. Frailty was assessed using the Fried phenotype across three waves (2011, 2013, and 2015). Latent class growth curve modeling was employed to identify distinct frailty trajectories. The primary outcome was incident CMM, ascertained in 2018 and 2020. The association between frailty trajectories and incident CMM was analyzed using Kaplan-Meier curves and Cox proportional hazards regression models. Results Three distinct frailty trajectories were identified: low-stable (n=4 550, 60.48%), moderate-slowly increasing (n=2 241, 29.79%), and high-rapidly increasing (n=732, 9.73%). During follow-up, 1,728 (22.97%) participants developed incident CMM, with the highest incidence rate observed in the high-rapidly increasing group (P<0.05). The Kaplan-Meier cumulative incidence curves diverged significantly among the three groups starting from the second year of follow-up (log-rank χ²=714.698, P<0.01). Compared to the low-stable trajectory group, the multivariable-adjusted hazard ratios (HRs) for incident CMM were 1.871 (95% CI: 1.675-2.090) for the moderate-slowly increasing group and 4.718 (95% CI: 4.121-5.401) for the high-rapidly increasing group. Subgroup analyses indicated that this association was more pronounced among females and individuals aged ≥60 years. Conclusion Individuals exhibiting a trajectory of persistently worsening or rapidly progressing frailty face a significantly elevated risk of developing CMM. Consequently, dynamic monitoring of frailty trajectories may be a valuable strategy for mitigating the burden of CMM in middle-aged and older populations.

Objective To characterize the landscape of non-Expanded Program on Immunization (non-EPI) vaccine administration in Longgang District, Shenzhen, for the period of 2015-2024. Methods Data on non-EPI vaccine administration and the resident population were sourced from the Shenzhen Immunization Program Information Management System and the Longgang District Bureau of Statistics, respectively. Key metrics were calculated, including the total number of doses administered, average annual growth rate, doses per 10 000 population, substitution rate, and the age in months at primary immunization. Joinpoint regression was employed to analyze trends in the rate of doses administered per 10 000 population and the substitution rates. Concurrently, the Mann-Kendall test was utilized to assess temporal trends in the age at primary immunization for specific non-EPI vaccines. Results Between 2015 and 2024, a total of 8.867 2 million non-EPI vaccine doses were administered in Longgang District, accounting for 54.11% of all vaccine administrations and corresponding to a rate of 2 385 doses per 10 000 population. The three non-EPI vaccines with the highest average annual growth rates were the adult bivalent/quadrivalent/9-valent human papillomavirus (HPV) vaccine (133.99%), the adult recombinant/herpes zoster vaccine (RZV/HZV) (87.71%), and the pediatric 13-valent pneumococcal polysaccharide conjugate vaccine (PPCV13) (74.46%). A significant upward trend was observed in the administration rate of non-EPI vaccines per 10 000 population (AAPC=15.51%, 95% CI: 7.23%-24.56%, P<0.05). The aggregate substitution rate for substitutable non-EPI vaccines was 18.16%; notably, the substitution rate for DTaP-containing non-EPI vaccines increased from 9.08% to 41.76%. Statistically significant trends in the age at primary immunization were observed for all six evaluated non-EPI vaccines (all P<0.001). Specifically, the age for Haemophilus influenzae type b (Hib) and Varicella (VarV) vaccines followed a pattern of initial increase followed by a subsequent decrease, whereas the ages for Enterovirus 71 (EV71), Rotavirus (ORV1, ORV5), and PPCV13 vaccines exhibited significant downward trends. Conclusion The utilization of non-EPI vaccines in Longgang District, Shenzhen, demonstrates a consistent upward trajectory. This highlights the escalating importance of strengthening the surveillance and management of non-EPI vaccine programs in the future.

Objective To analyze surveillance data on adverse events following immunization (AEFI) associated with the Bacillus Calmette-Guérin (BCG) vaccine in Hubei Province from 2017 to 2023, and to evaluate the vaccine's safety profile. Methods Data on the number of BCG vaccine doses administered and individual AEFI cases from 2017 to 2023 were retrospectively collected from the Chinese Center for Disease Control and Prevention Information System and the Hubei Provincial Immunization Program Information System. A descriptive analysis was conducted to characterize the reported incidence and epidemiological features of AEFIs. Results A total of 313 BCG-associated AEFI cases were reported in Hubei Province from 2017 to 2023, with an average annual reported incidence of 10.07 per 100 000 doses. The reported incidences of common and abnormal reactions were 3.64 and 6.02 per 100 000 doses, respectively. The incidence rates for serious and non-serious AEFIs were 1.58 and 8.50 per 100 000 doses, respectively. AEFI cases were reported in all months, with a peak period observed from May to August (44.73%). Cases were reported in all prefectures of the province except for Ezhou City, with average annual reported incidences ranging from 3.19 to 35.03 per 100 000. The male-to-female ratio of cases was 1.93∶1, with the majority (70.61%) occurring in infants aged six months or younger. The onset of common reactions was primarily concentrated at ≥91 days (26.61%) and<1 day (23.38%) post-vaccination. Abnormal reactions predominantly occurred ≥8 days post-vaccination (91.98%). More specifically, BCG-associated lymphadenitis was most commonly observed ≥31 days post-vaccination (91.09%), whereas local abscesses were most frequent ≥8 days post-vaccination (92.11%). Conclusion The reported incidence of BCG-related AEFIs in Hubei Province exhibited an initial increase followed by a subsequent decline. Serious adverse events are exceedingly rare, indicating a favorable safety profile for the vaccine. It is imperative to enhance training and guidance in AEFI surveillance to improve the quality of investigation and diagnosis. Furthermore, conducting evaluative monitoring, establishing standardized treatment protocols for the prompt identification and management of severe BCG-related AEFIs, and implementing measures to reduce the incidence of abnormal reactions are warranted.

Objective To investigate the utilization of community health management services among migrant older adults in Luzhou City and to identify its influencing factors, thereby providing a scientific basis for enhancing service uptake. Methods A convenience sampling method was employed to recruit migrant older adults residing in the main urban districts of Luzhou City. Guided by the theoretical framework of social determinants of health, a binary logistic regression analysis was conducted to examine the factors associated with the utilization of community health management services. Results Among the 340 migrant older adults surveyed, the overall utilization rate of health management services was 57.9%. Specifically, 46.5% of participants utilized all 12 available services, whereas 16.8% utilized none. The services with the highest utilization rates were physical health examinations (72.6%), establishment of health records (72.4%), routine health guidance (72.4%), and family doctor contracts (70.3%). Conversely, the services with lower utilization rates included Traditional Chinese Medicine (TCM) health services (62.6%), follow-up appointments (63.2%), routine medication dispensing (64.4%), and physical examination/risk factor assessment (64.4%). Multivariate logistic regression analysis revealed that living with children (OR=0.550, 95% CI: 0.340-0.888) and being unmarried/divorced (OR=0.334, 95% CI: 0.146-0.767) were associated with significantly lower overall utilization of health management services. In contrast, adherence to a health-promoting lifestyle was associated with higher service utilization (OR=1.613, 95% CI: 1.124-2.314). Conclusion The overall utilization of community health management services among migrant older adults in Luzhou City is suboptimal and characterized by imbalanced use across different programs, with newer services exhibiting slightly lower uptake. To promote healthy aging, targeted interventions should focus on vulnerable subgroups, particularly migrant older adults who live with their children, are unmarried or divorced, or exhibit poor health-promoting lifestyle behaviors.

Objective To systematically analyze the current status of pre-hospital delay among patients with acute ischemic stroke and explore its multidimensional influencing factors within the framework of the Andersen model, thereby providing an empirical basis for intervention strategies. Methods A total of 186 patients were selected and dichotomized into a delay group and a non-delay group based on the thrombolytic time window (4.5 hours). Data were collected using a self-designed questionnaire. Multivariate logistic regression analysis was employed to identify influencing factors, supplemented by subgroup analyses and population attributable risk percentage (PAR%) calculations. Results Of the 186 questionnaires distributed, 180 were returned, yielding a valid response rate of 96.77%. The pre-hospital delay time for the 180 patients ranged from 45 to 720 minutes, with a mean of (312.67±215.93) minutes. Within this cohort, 128 patients experienced pre-hospital delay beyond the thrombolytic window, whereas 52 did not. Multivariate logistic regression analysis revealed that rural residence (OR=2.798), knowledge of <3 stroke symptoms (OR=3.326), non-utilization of emergency medical services (EMS, i.e., not calling 120) (OR=3.069), a high National Institutes of Health Stroke Scale (NIHSS) score (OR=2.520), and being unaccompanied by family at stroke onset (OR=3.298) were significant determinants of delay (P<0.05). Subgroup analysis indicated that for urban patients, being unaccompanied at onset (OR=6.666) and a high NIHSS score (OR=4.618) were significantly associated with delay (P<0.05). For rural patients, only knowledge of <3 stroke symptoms (OR=3.226) was significantly correlated with delay (P<0.05). Among patients who utilized EMS, a high NIHSS score (OR=3.492) was a significant predictor of delay (P<0.05). For those who did not utilize EMS, both knowledge of <3 stroke symptoms (OR=4.215) and a high NIHSS score (OR=2.217) were significantly associated with delay (P<0.05). The PAR% analysis demonstrated that insufficient stroke knowledge, non-utilization of EMS, and being unaccompanied at onset contributed 63.21%, 57.14%, and 41.69% to the risk of delay, respectively. Conclusion The rate of pre-hospital delay among patients with acute ischemic stroke is substantial. Key influencing factors include place of residence, level of stroke knowledge, utilization of emergency medical services, severity of neurological deficit, and the presence of family members at the time of stroke onset.

Objective This study, grounded in the health ecology model, aims to hierarchically analyze the prevalence and determinants of hypertension, diabetes, and dyslipidemia among residents of the Western Anhui region, thereby providing a reference for the research on the prevention, control, and management of chronic diseases. Method A multistage sampling methodology was employed to conduct a health survey among residents aged 18 and older across four counties in the Western Anhui region. The χ² test and binary logistic regression analysis were utilized to examine the determinants of hypertension, diabetes, and dyslipidemia. Results A total of 2 930 subjects were included in the study, with a male-to-female ratio of 1∶1.45. The mean age of the cohort was (55.55 ± 15.89) years, with 65.73% of participants aged over 45 years. The prevalence rates for hypertension, diabetes, and dyslipidemia were 46.55% (n=1 364), 11.50% (n=337), and 33.34% (n=977), respectively. Hierarchical regression analysis revealed a progressive improvement in the model's goodness-of-fit with the sequential addition of influencing factors across five models. Factors associated with an increased risk for these three conditions included being in the 45 to <60 age group (OR=1.989) or the ≥60 age group (OR=4.667), having a BMI classified as overweight (OR=1.739) or obese (OR=2.946), presenting with central obesity (OR=1.834), having a midday napping habit (OR=1.223), reporting fair (OR=1.455) or poor (OR=1.836) self-rated health, and possessing a college-level education or higher (OR=1.550). Conversely, being female (OR=0.557), having a BMI classified as underweight (OR=0.524), being married or cohabiting (OR=0.642), residing in a rural area (OR=0.783), and having medical insurance (OR=0.224) were identified as significant protective factors. Conclusion The prevalence of hypertension, diabetes, and dyslipidemia is notably high in the Western Anhui region. The determinants of these conditions are multi-level, multi-dimensional, and intricately interrelated. It is therefore imperative to strengthen prevention and management strategies for these cardiometabolic diseases across multiple ecological levels.

Objective To investigate the mediating role of plasma inflammatory markers in the association between dietary fatty acid intake and cognitive function. Methods This study recruited 1 074 Chinese adults aged 45-75 years from the Daxing District, Beijing, who were categorized into normal weight (NW), overweight (OW), and obese (OB) groups. The Montreal Cognitive Assessment (MoCA) was employed to evaluate the cognitive status of the participants. Gas chromatography was utilized to analyze erythrocyte membrane fatty acid profiles, which served as biomarkers for medium- to long-term dietary fatty acid intake. Levels of plasma inflammatory markers were quantified using enzyme-linked immunosorbent assays (ELISA). After adjusting for confounding variables, standard multiple linear regression and mediation analyses were conducted to examine the relationship between erythrocyte membrane fatty acids and cognitive function. Results Serotonin (5-HT) levels were significantly lower in the OW group compared to the NW group (P<0.05). In the NW and OB groups, alterations in Toll-like receptor 4 (TLR4) and lipopolysaccharide (LPS) were significantly predicted by total saturated fatty acid (SFA) levels (P<0.05). Polyunsaturated fatty acids (PUFAs) were associated with cognitive impairment in the OW group through the downregulation of Toll-like receptor 2 (TLR2) and Interleukin-12 (IL-12), with the mediating effects accounting for 8.76% and 7.24% of the total effect, respectively (P<0.05). Conversely, C20:5 n-3 (EPA) was associated with improved cognitive performance in the OB group by downregulating Interleukin-3 (IL-3), with the mediating effect constituting 7.32% of the total effect (P<0.05). Conclusion Dietary fatty acid intake may influence cognitive function by altering plasma inflammatory profiles. Interleukin-12, Toll-like receptor 2, and Interleukin-3 appear to function as negative modulators in the pathway linking fatty acid status to cognitive health.

Objective To develop and validate a risk prediction model for lung cancer incidence in a health screening cohort using electronic medical records and imaging data. Methods A retrospective study was conducted on 2 567 individuals who underwent computed tomography (CT) scans at Beijing Chest Hospital between January 2022 and June 2024, all of whom presented with pulmonary nodules and were suspected of having lung cancer. The cohort was randomly allocated into a training set (n=1 797) and a validation set (n=770) in a 7:3 ratio. Within the training set, participants were categorized into a cancer-positive group (n=247) and a cancer-negative group (n=1,550) based on the eventual diagnosis of lung cancer. Univariate analysis and LASSO-logistic regression were employed to screen for significant predictors, which were subsequently used to construct a nomogram model. The performance of the model was then validated. Results Multivariate analysis identified seven independent risk factors for lung cancer incidence (P<0.05): age ≥60 years (OR=5.081), history of smoking (OR=6.026), family history of lung cancer (OR=3.669), nodule maximum diameter of 5~<30 mm (OR=1.613、6.330), nodule types (OR=0.368、2.548), nodule margin (OR=2.526、10.175), and serum carcinoembryonic antigen (CEA) level ≥5.0 ng/mL (OR=5.044). The model demonstrated strong discrimination, with a Concordance Index (C-index) of 0.891 (95% CI: 0.867-0.915) in the training set and 0.865 (95% CI: 0.825-0.905) in the validation set. The area under the receiver operating characteristic curve (AUC) was 0.875 (95% CI: 0.851-0.899) for the training set and 0.863 (95% CI: 0.823-0.902) for the validation set. Calibration curves and decision curve analysis indicated good model fit and clinical utility. Stratification based on risk scores revealed that the incidence of lung cancer in the high-risk group (n=102) was significantly higher than that in the intermediate-risk (n=509) and low-risk (n=1 186) groups (P<0.01). Conclusion The nomogram, developed based on the seven aforementioned risk factors, exhibits excellent discrimination, calibration, and net clinical benefit. It serves as an effective tool for the early identification and stratified management of individuals at high risk for lung cancer.

Objective To investigate the seasonal characteristics of hand, foot, and mouth disease (HFMD) in Longgang District, Shenzhen, from 2014 to 2024, and to analyze the influence of the COVID-19 pandemic on these seasonal patterns, with the aim of providing a scientific basis for the early warning and prevention and control of HFMD. Methods Seasonal and Trend decomposition using Loess (STL), the seasonal index method, concentration analysis, and circular distribution were employed to analyze the seasonal characteristics of HFMD in Longgang District from 2014 to 2024. Results The annual incidence rate of HFMD in Longgang District between 2014 and 2024 ranged from 61.67/100 000 to 709.45/100 000. There was no statistically significant difference in the incidence of HFMD before and after the COVID-19 pandemic (χ²=1.36, P>0.05). Both the STL and seasonal index methods revealed a bimodal epidemic pattern for HFMD in Longgang District, with peaks occurring from May to July and from September to October. Prior to the COVID-19 pandemic, a bimodal distribution was predominant. However, during the pandemic (with the exception of 2021) and in the post-pandemic period, a unimodal distribution was primarily observed, and its intensity was greater than in previous years. Concentration analysis indicated a certain degree of seasonality in the incidence of HFMD from 2014 to 2024 (concentration value M=0.461). Upon exclusion of data from the COVID-19 period (2020-2022), a stronger seasonality was observed (concentration value M=0.501). Circular distribution analysis yielded r=0.08 and α=210.91°(Z=638.93>Z_0.001,P<0.001), with the epidemic peak day identified as June 15th and the peak period extending from April 11th to August 20th. Conclusion The incidence of HFMD in Longgang District, Shenzhen, exhibited distinct seasonal characteristics from 2014 to 2024, with a bimodal epidemic pattern in May-July and September-October. Nevertheless, the seasonal pattern shifted to a unimodal distribution following the COVID-19 pandemic. It is imperative to monitor this change in characteristics and its duration to facilitate the timely adjustment of corresponding prevention and control measures.

Objective Grounded in the Andersen model, this study aimed to analyze the utilization of Integrated Mental Health and Rehabilitation Services (Jingkang Services) and its determinants among community-dwelling patients with severe mental disorders (SMDs) in Foshan The findings are intended to provide an evidentiary basis for the promotion and dissemination of these services. Methods A cross-sectional questionnaire-based survey was conducted between October and December 2022. A multistage random sampling methodology was employed to recruit participants from the registry of community-dwelling patients with SMDs in Foshan. Descriptive statistical analysis was used to characterize the status of service utilization, while logistic regression analysis was performed to identify the influencing factors. Results A total of 1 034 patients were included in the final analysis. The cohort was predominantly female (n=535, 51.74%) and aged between 18 and 44 years (n=407, 39.36%). Of the participants, 679 (65.67%) had utilized the services, with health management services being the most frequently accessed category (49.71%). A substantial majority of patients (n=985, 95.26%) perceived a need for these services. The logistic regression results revealed that service utilization was significantly associated with patient's age (18-<45 years OR=2.138; 45-<60 years OR=3.317; ≥60 years OR=2.501), guardian's educational attainment (junior high/high school/vocational school OR=1.838), guardian's relationship to the patient (offspring OR=1.814), quality of life (moderate OR=1.952; high OR=1.451), service delivery location (village/neighborhood committee OR=2.773), duration of local service provision (>2 years OR=2.293), and satisfaction with the community-based mental health rehabilitation system (moderate OR=1.569; satisfied OR=2.251) (all P<0.05). Conclusion The utilization of Integrated Mental Health and Rehabilitation Services among community-dwelling patients with SMDs in Foshan is substantially lower than the perceived need. It is recommended that sub-district and township authorities implement tailored strategies based on the identified determinants—including patient and guardian characteristics, service point location, and program duration—to promote service uptake and ensure higher utilization rates.

Objective To investigate the risk and influencing factors of occupational exposure among staff in the Central Sterile Supply Department (CSSD), and to explore the association between psychological factors and occupational exposure. Methods A simple sampling method was used to select CSSD staff from three secondary and above hospitals in Shanghai for a questionnaire survey. The survey covered general demographic characteristics, occupational exposure, occupational exposure risk perception, knowledge‑attitude‑practice (KAP) regarding occupational protection, as well as psychological states including anxiety, depression, and job burnout. Descriptive statistics were used to analyze the current status of occupational exposure, and univariate and multivariate logistic regression were used to identify influencing factors. Results A total of 705 valid questionnaires were collected, of which 298 staff had experienced occupational exposure, with an incidence rate of 42.27%. Physical exposure was the most common type, followed by chemical and biological exposure. Occupational exposure was mainly concentrated in the decontamination area, sterilization area, and inspection/packaging area. In the decontamination area, sharp injuries and biological exposure predominated; in the sterilization area, high‑temperature burns and noise injuries were most common; and in the inspection/packaging area, sharp injuries were the main type. Multivariate logistic regression showed that working experience of 6 months to 1 year (OR=3.596, 95% CI: 2.298-5.626), working in the decontamination area (OR=2.388, 95% CI: 1.027-5.553), daily working hours >10 h (OR=5.016, 95% CI: 2.747-9.160), night shifts (OR=1.977, 95% CI: 1.235-3.166), and not receiving occupational protection training (OR=2.031, 95% CI: 1.358-3.039) were independent risk factors for occupational exposure (all P<0.05). Correlation analysis showed that anxiety, depression, and job burnout were positively correlated with the incidence of occupational exposure, and negatively correlated with occupational exposure risk perception and KAP scores regarding occupational protection (all P<0.01). Conclusion The incidence of occupational exposure among CSSD staff is relatively high. Working experience of 6 months to 1 year, working in the decontamination area, daily working hours >10 h, night shifts, and lack of protective training are important influencing factors. Anxiety, depression, and job burnout are closely associated with the occurrence of occupational exposure.

Objective To investigate the disease spectrum of chronic kidney disease (CKD), the current utilization of health services, and its associated determinants among adults in the Fuyang region. Methods A total of 1 014 patients with CKD, treated at various medical institutions in the Fuyang region between October 2021 and May 2025, were enrolled in this study. The investigation involved analyzing the characteristics of the disease spectrum and assessing health service utilization across three dimensions: screening and awareness, health-seeking behavior, and resource utilization. Univariate and multivariate analyses were subsequently employed to identify the factors influencing the rate of health service utilization for adult CKD in this locality. Results The disease spectrum of CKD in the Fuyang region was predominantly characterized by secondary nephropathy (89.4%), with diabetic nephropathy constituting the largest proportion (42.01%), followed by hypertensive nephropathy and hyperuricemic nephropathy. The majority of patients were in stage 3 of the disease (55.03%), and cardiovascular and cerebrovascular diseases were the most prevalent comorbidities (68.15%). Regarding health services, 84.42% of patients were aware of CKD-related services. The initial consultation typically occurred at county-level hospitals. The actual medical insurance reimbursement rate was ≥60% for 61.42% of patients, and the incidence of catastrophic health expenditure was 21.30%. Multivariate logistic regression analysis revealed that age (younger age, OR=1.688), annual family income (higher income, OR=2.954), educational attainment (higher level, OR=1.594), availability of community health services (available, OR=3.771), convenience of internet access (convenient, OR=2.118), level of social support (moderate/high, OR=4.809), and illness uncertainty (moderate/low, OR=4.068) were significant determinants of health service utilization among adults with CKD in the Fuyang region (all P<0.05). Conclusion The adult CKD population in the Fuyang region is primarily characterized by secondary nephropathy, mid-stage disease, and a high prevalence of comorbidities. While the overall utilization of health services is relatively favorable, issues such as insufficient awareness and delays in seeking medical consultation persist. The principal factors influencing health service utilization in this population include age, annual family income, educational attainment, availability of community health services, internet accessibility, social support, and the degree of illness uncertainty.