Search Results (5,220)

Youth drug abuse is a persistent public health concern in China. Community-based drug rehabilitation (CBDR), the final three-year stage of China’s official rehabilitation system, aims to help people who use drugs (PWUD) reintegrate into society, but reintegration remains limited, particularly among young PWUD. This study explores the social reintegration challenges faced by young PWUD aged 18 to 35 during the CBDR stage in Guangzhou, China. Semi-structured interviews were conducted with 16 participants and analyzed using reflexive thematic analysis (RTA). Three themes were identified: stigma and relational struggles, socioeconomic marginalization and daily life disruption, and limitations of the CBDR service model. These challenges were not separate but reinforced one another, with difficulties in one domain spilling into others and narrowing the space in which reintegration could occur. These findings suggest that addressing the reinforcing linkages between stigma, economic hardship, and service limitations requires a more coordinated approach to CBDR service provision, one that integrates vocational support into relapse prevention, builds flexibility into surveillance procedures, and provides participants and their families with realistic, evidence-based information about the prospects of recovery. Full article

Human papillomavirus type 53 (HPV53) is one of the most prevalent HPV genotypes in China, frequently detected in cervical intraepithelial neoplasia and cervical cancer, yet remains outside the coverage of all currently available prophylactic vaccines and is relatively understudied. This study performed a comprehensive analysis of HPV53 clinical infection profiles, genomic diversity, and T-cell epitopes to inform therapeutic vaccine development. Clinical analysis of 158 HPV53-positive patients showed that infections were most prevalent in women aged 40–59 years, with persistent infection identified in 13.3% participants and a subset of cases associated with cervical lesions. Genomic analysis of 134 HPV53 isolates identified four lineages (A-D, with lineage D further subdivided into four sublineages, and an overall nucleotide variability of 4.4%. E2 was the most variable protein while E7 was the most conserved. Immunoinformatic prediction identified 176 HLA class I-restricted T-cell epitopes across E6, E7, E1, and E2, from which 20 candidates were selected for experimental validation. Ten demonstrated strong HLA binding affinity in vitro, and murine immunization identified a E6 peptide VYNFAYTDL as an immunodominant epitope. Three validated epitopes exhibited sequence overlap with 12 to 13 of other 13 high-risk HPV genotypes, suggesting their potential as broadly cross-reactive targets. These findings clarify the genomic diversity and immunogenic epitope landscape of HPV53, providing a foundation for the rational design of therapeutic vaccines. Full article

A massive number of early-constructed small-to-medium-span bridges are collectively entering an “aging” phase in China. Meanwhile, vast amounts of unstructured bottom-level inspection texts remain underutilized. To address them, this paper proposes a data governance method. Large Language Models were leveraged to process unstructured defect data from 18,238 real-world bridges nationwide. The data were structurally cleaned and mapped into discrete features, revealing multidimensional vulnerabilities. On this basis, the Stable Contrastive Pattern Risk (SCPR) intelligent decision-making model was developed. The results demonstrate that, following robust filtration, 6 nationwide common risk rules were extracted from 2064 initial candidate combinations. These rules converge into three core risk patterns: the heavy-duty aging pattern, the substructure-dominated pattern, and the over-water small-span low-seismic-design pattern. Guided by these robust rules and specific damage enrichment characteristics, risk stratification and differentiated management strategies were further formulated for Class III bridges. This research facilitates a paradigm shift in bridge maintenance. It moves from reactive, post-event symptom characterization toward data-driven, proactive early warnings. This shift provides a substantive scientific foundation for optimizing resource allocation and enabling precise investment decisions at the road network level. Full article

Background: Adolescent tobacco, e-cigarette, and alcohol use are important public health concerns in China. However, the associations of specific types and cumulative exposure to childhood family violence with different substance use outcomes remain insufficiently understood. This study examined these associations among Chinese adolescents. Methods: We analyzed data from a cross-sectional school-based survey of 41,146 students aged 10–19 years conducted from October 2022 to March 2023 in a mountainous city in western Guangdong Province, China. Childhood family violence was assessed using the validated Chinese Family Violence Questionnaire and a cumulative exposure index. Descriptive analyses and logistic regression models were conducted, with adjustment for demographic and environmental factors. Results: The mean age of participants was 14.8 years, and 51.7% were female. Overall, 25.1% of adolescents reported at least one type of childhood family violence. Verbal insults (18.6%) and emotional neglect (16.3%) were the most frequently reported types and were consistently associated with tobacco, e-cigarette, and alcohol use (adjusted odds ratios [ORs] = 1.4–1.5, p < 0.001). A cumulative exposure pattern was also observed. Compared with adolescents reporting no childhood family violence, those exposed to three or more types had higher odds of tobacco use (OR = 3.81; 95% CI: 3.42–4.23), e-cigarette use (OR = 3.90; 95% CI: 3.39–4.48), and alcohol use (OR = 3.95; 95% CI: 3.59–4.35). Peer smoking and access to tobacco products were also significantly associated with substance use. Conclusions: Childhood family violence, particularly verbal insults and emotional neglect, was associated with adolescent tobacco, e-cigarette, and alcohol use. The findings highlight the importance of considering emotional maltreatment, cumulative adversity, peer influences, and access to tobacco products in future prevention research and practice. Full article

Background: Malaria and dengue continue to pose significant public health challenges in Asia, with differing temporal trends and regional distributions. However, comparative and long-term assessments of their disease burden and future trajectories remain limited. Methods: Using Global Burden of Disease Study 2021 data, we estimated age-standardized incidence rates (ASIR), disability-adjusted life years (DALYs-ASR), and estimated annual percentage changes (EAPCs) for global, Asian, and Chinese populations by age, sex, and socio-demographic index (SDI). Correlations with SDI and population density were analyzed, and an importation risk index for China was developed. Future trends to 2030 were projected using Bayesian age-period-cohort modeling. Findings: From 1990 to 2021, dengue ASIR increased globally and in China, particularly in middle-SDI regions, whereas malaria ASIR and DALYs-ASR declined substantially, with the most pronounced reductions observed in China. Dengue DALYs-ASR were highest among children under five, while incidence peaked in adolescents; malaria burden was concentrated in young children and young adults. Sex-specific differences were observed, with higher dengue incidence in females but greater DALY rates in males. Geographically, Southeast Asian countries contributed most to the estimated importation risk for both diseases. Projections indicate continued increases in dengue burden through 2030, alongside further declines in malaria. Conclusions: Malaria and dengue exhibit divergent epidemiological patterns across Asia, with declining malaria burden but rising dengue incidence. These findings highlight the need for differentiated control strategies, strengthened regional collaboration, and enhanced surveillance of cross-border transmission. Full article

Rapid population ageing in China urgently demands improved attention to elderly friendly community green space design. Despite national efforts toward community renovation and urban regeneration, existing projects often overlook the systematic optimisation of green spaces explicitly tailored to elderly residents, leading to environments that inadequately support their physical, psychological, and social needs. Given that home-based care remains the predominant preference for elderly populations in China, creating optimised community green spaces is essential to facilitate healthy ageing-in-place effectively. This study systematically investigates the discrepancies between elders’ observed usage patterns and their stated landscape design preferences in two residential communities in Suzhou, China. By integrating year-round observational data with subjective interviews, the research identifies critical mismatches between elderly individuals’ actual behaviours and expressed preferences, highlighting significant deficiencies in current landscape designs. Comparative analyses reveal that prioritising microclimate comfort, accessible pathways, and targeted seating arrangements significantly enhances elderly usage frequency and satisfaction. Ultimately, this study provides practical, policy-aligned recommendations for designing climate-adaptive, elderly centric community green spaces, effectively contributing to sustainable urban renewal and the Healthy China 2030 initiative. Full article

Background: Mild Cognitive Impairment (MCI) is a clinical state between normal aging and dementia. It may involve impairment in one or several cognitive domains. MCI offers a key window for maintaining cognitive function and studying how deficits develop in the elderly, making it of great research value. Measurement tools for screening MCI are not yet standardized in China. The accuracy of diagnostic criteria and threshold values needs improvement. Previous studies on the neural mechanisms of MCI have examined various aspects, but the changes in the white matter microstructure in older adults with MCI remain unclear. Most past studies used Fractional Anisotropy (FA) analysis to examine changes in white matter fiber orientation, often ignoring fiber density. As a result, findings are often contradictory or difficult to interpret. Therefore, it is necessary to assess cognitive function in MCI populations using more comprehensive and standardized measurement tools. It is also important to explore the association between changes in white matter microstructure and cognitive function in MCI by analyzing FA and Mean Diffusivity (MD). Methods: First, we assessed cognitive function using the Cognitive Function Measurement Scale for the Elderly, developed by Beijing Normal University, with diagnoses based on the NIA-AA (National Institute on Aging—Alzheimer’s Association) criteria. Second, we employed Diffusion Tensor Imaging (DTI) combined with Tract-Based Spatial Statistics (TBSS) to investigate alterations in the white matter fiber tract integrity in individuals with MCI. Based on the metrics used, this study was divided into two analytical approaches: Analysis Mode 1 utilized FA to explore changes in white matter fiber orientation in the MCI group. Analysis Mode 2 utilized MD to examine changes in white matter fiber density in the MCI group. Third, we further explored the association between alterations in the white matter fiber tract integrity and cognitive function in individuals with MCI. Specifically, FA and MD values from brain regions showing significant differences between the MCI and normal control groups were extracted and correlated with cognitive test scores. Results: According to the results of the community measurement survey, the prevalence of MCI among the elderly in Shenzhen is approximately 21.54%. Individuals with MCI exhibited functional decline in memory, attention, language, executive function, and spatial processing. DTI results indicated that (1) FA values across the brain’s white matter fiber tracts showed a decreasing trend in the elderly with MCI, with no areas exhibiting significantly higher FA values. Specifically, FA values were significantly lower in the corpus callosum, internal capsule, corona radiata, thalamic radiation, external capsule, superior fronto-occipital fasciculus, and cingulum (cingulate gyrus). (2) White matter fiber tracts with significantly reduced FA values also demonstrated significantly increased MD values. Additionally, MD values in the cingulum (hippocampus), inferior cerebellar peduncle, and corticospinal tract were significantly reduced in the MCI group. (3) Correlation analysis revealed that the significant differences in FA and MD values within the white matter fiber tracts of older adults with MCI were correlated with scores on several cognitive tests. Conclusions: In the present study, older adults with MCI tended to exhibit functional decline across multiple cognitive domains and relatively extensive microstructural white matter damage. Observations suggested that white matter fiber density may be informative regarding these microstructural alterations, indicating that diffusion biomarkers in key regions such as the cingulum (hippocampus) warrant further investigation. Full article

The humid coastal Lingnan region of South China, including the Chaoshan area of eastern Guangdong, is frequently exposed to disaster-prone weather conditions such as high humidity, typhoon-related winds, heavy rainfall, and salt-laden coastal air. These long-term environmental exposures may contribute to surface deterioration risks of architectural heritage. Located in Shantou, Yingchuan Shijia has shown five visible surface deterioration types—cracks, staining, saltpetering, plants, and spalling—under the combined influence of environmental exposure, material aging, previous disturbance, and insufficient maintenance. To address the limitations of manual inspection, this study explores a conservation-oriented intelligent workflow integrating YOLO-based detection, digital documentation, and screening-level conservation interpretation. Digital documentation used UAV imagery, mobile LiDAR scanning, measured drawings, and SketchUp-based three-dimensional modeling. The dataset was built in three stages: a 99-image preliminary dataset, where YOLOv8 showed only basic learning capability with low performance metrics, including Precision of 33.0 ± 3.0%, Recall of 28.0 ± 1.0%, mAP50 of 25.0 ± 1.0%, and mAP50-95 of 11.0 ± 1.0%; a 362-image non-augmented case-study dataset, where YOLOv8 still showed limited performance, with mAP50 of 20.0 ± 1.0% and mAP50-95 of 8.0 ± 1.0%; and a final YOLO-format case-study dataset of 2000 images after training-set-only augmentation using 11 geometric and photometric transformation methods. After augmentation, YOLOv8 mAP50 increased to 62.0 ± 2.0%. Under the same augmented-data condition, YOLOv13 showed Precision of 89.0 ± 1.0%, Recall of 77.0 ± 1.0%, mAP50 of 84.0 ± 1.0%, and mAP50-95 of 65.0 ± 1.0%, indicating relatively higher validation performance than YOLOv8. In the normalized confusion matrix, the background missed-detection values for cracks and saltpetering were 0.29 and 0.22, respectively, indicating that weak-feature and low-contrast deterioration types remained challenging. Based on YOLOv13, a mini program was developed to organize detection outputs and provide field-oriented preliminary conservation hints. Overall, this study provides a preliminary workflow linking digital collection, image-based deterioration detection, Grad-CAM visualization, and assisted field recording for the preventive conservation of Chaoshan overseas-Chinese residences in humid coastal heritage environments. Full article

This study targets biochar utilization in seasonally frozen Northeast China and addresses the insufficient research on aging characteristics and mechanisms of low-temperature wheat straw biochar under long-term freeze–thaw stress. A 60-day simulated freeze–thaw test with 12 h −20 °C freezing and 12 h 0 °C thawing per daily cycle was carried out on 300 °C wheat straw biochar (B300). We tracked dynamic shifts in pH and water absorption during aging, and comprehensively characterized particle size, micromorphology, pore structure, elemental composition and surface functional groups for fresh (CK-B300) and fully aged (FC-B300) biochar. Freeze–thaw cycling caused drastic aging: the average particle size dropped by 33.09%, specific surface area increased by 13.86%, while total pore volume and average pore size fell by 31.47% and 54.9%, respectively. Freeze–thaw oxidation raised the O/C ratio and enriched -OH, C=O functional groups; biochar pH declined by 12.94% alongside improved water absorption. This study confirms that biochar aging is jointly controlled by ice-crystal physical fragmentation and water-temperature oxidation, providing basic data and theoretical support for evaluating and applying biochar in cold freeze–thaw zones. Full article

Background/Objectives: Telomeres are critical biomarkers of biological aging, with shortened leukocyte telomere length strongly linked to all-cause mortality and age-related disease risk. Although exercise modulates telomere dynamics, the field’s evolution from descriptive measurements to mechanistic inquiries involving redox biology and epigenetics remains incompletely mapped. This study systematically characterized the global research landscape of telomere–exercise science over 25 years to establish a strategic evidence base for precision exercise prescription. Methods: A bibliometric analysis was conducted on 858 publications from the Web of Science Core Collection (2000–2025). CiteSpace and VOSviewer were used for keyword co-occurrence analysis, strategic thematic mapping, and citation burst detection to visualize global research trends and identify emerging frontiers. Results: Annual publication volume grew from 2 (2000) to 71 (2025), with a compound annual growth rate of 15.4%. China emerged as one of the leading global contributors. Thematic analysis revealed a paradigm shift from descriptive leukocyte telomere length studies toward mechanistic investigations of oxidative stress, mitochondrial homeostasis, and epigenetic clocks. Keyword network analysis confirmed oxidative stress and inflammation as central hubs, mediating telomere protection via redox regulation and non-canonical telomerase functions. Conclusions: Exercise preserves telomere integrity primarily through redox–mitochondrial homeostasis, hormesis-driven antioxidant upregulation, and non-canonical telomerase activation. For aging populations and individuals at metabolic risk, aerobic training and high-intensity interval training (HIIT) are recommended as first-line non-pharmacological interventions for healthspan extension. Leukocyte telomere length and telomerase activity should be integrated as biomarkers in preventive medicine practice. Future large-scale randomized controlled trials incorporating multi-omics approaches and sex-stratified analyses are warranted to establish individualized dose–response guidelines for precision exercise prescription. Full article

Background: Varicella remains a common vaccine-preventable disease in China. Although Anhui Province recommended a two-dose varicella vaccine (VarV) schedule in 2021, real-world evidence on the incremental benefit of the second dose is limited. Methods: A prospective cohort study among children aged 1–12 years was conducted in Anhui Province from July 2022 to August 2025. Children aged 1–3 years who had received one dose of the human diploid cell line-based (SV-1) VarV and children aged 4–12 years whose second dose was the SV-1 VarV were enrolled in the exposed group and were compared with children who had no history of VarV and those who had received only one dose of the VarV, respectively. Varicella cases were collected through active follow-up and surveillance systems. Vaccine effectiveness (VE) and incremental VE were estimated as [1 − relative risk (RR)] × 100%, where the RRs were calculated based on the incidence densities of breakthrough varicella. Results: Overall, 50,054 participants were finally enrolled, contributing 125,351.5 person-years and 105 valid cases. The VE in children aged 1–3 years was 79.1% (95%CI: 42.8–92.4%). Among children aged 4–12 years, the incremental VE was 65.0% (95%CI: 41.9–78.9%), with incremental VEs of 60.1% (95%CI: 22.3–79.5%) for ages 4–6 years and 72.7% (95%CI: 37.8–88.0%) for ages 7–12 years. Conclusions: One-dose SV-1 VarV provided substantial protection in young children, and a second dose conferred significant additional protection in children aged 4–12 years, supporting strengthened implementation of the two-dose strategy and catch-up vaccination among school-aged children. Full article

Objectives: To determine the prognostic value of the triglyceride-glucose (TyG) index, which serves as a surrogate for insulin resistance, for heart failure rehospitalization and all-cause mortality in older adults with chronic heart failure, and to evaluate its clinical utility in risk stratification and nursing care. Methods: In this single-center retrospective cohort study, 786 patients aged ≥65 years with chronic heart failure hospitalized at a tertiary referral hospital in Central China (January 2022–January 2025) were included and divided into low vs. high TyG index groups based on the median. Baseline data were extracted from medical records. Follow-up ended in December 2025. Associations between TyG index and adverse outcomes were examined using Kaplan–Meier curves, restricted cubic spline (RCS) regression, and multivariable Cox proportional hazards models. Results: The median TyG index was 8.35. In unadjusted analyses, the high-TyG group had significantly greater cumulative risks of heart failure rehospitalization (p < 0.001) and all-cause mortality (p = 0.028). After multivariable adjustment, the TyG index remained independently associated with heart failure rehospitalization (hazard ratio [HR] = 1.63), whereas its association with all-cause mortality was attenuated and no longer significant. Restricted cubic spline analysis revealed a nonlinear dose–response relationship between the TyG index and heart failure rehospitalization, and a linear relationship with all-cause mortality. Conclusions: In elderly patients with chronic heart failure, the TyG index independently predicted heart failure rehospitalization and demonstrated a nonlinear dose–response relationship; its independent association with all-cause mortality was not significant after full adjustment. The index may nonetheless aid in risk stratification and individualized nursing in this population. Full article

Excessive fluoride intake from drinking water remains a public health concern in geogenic high-fluoride regions, yet direct evidence linking environmental fluoride levels to internal exposure in remote high-altitude areas is limited. This study integrated environmental monitoring with human biomonitoring to assess fluoride exposure and health risks in the Taruo Lake region of the Tibetan Plateau. Surface water (n = 45 for Taruo Lake; n = 8 for its tributaries) and groundwater samples (n = 4) were collected and analyzed for fluoride concentrations, and blood ionic fluoride (BIF) levels were measured in 122 local residents (47 adults, 75 children). The results showed that fluoride concentrations in most surface water tributaries of Taruo Lake and groundwater sources were below China’s drinking water standard, whereas those in Taruo Lake exceeded this limit (routine monitoring mean 2.54 mg/L; multi-site mean 2.79 mg/L). BIF levels were significantly higher in adults (0.126 ± 0.041 mg/L) than in children (0.075 ± 0.032 mg/L) and showed a positive correlation with age (r = 0.533, p < 0.001). Notably, 23.4% of adults and 1.3% of children exceeded 0.15 mg/L, an empirical threshold typical for healthy populations in non-endemic areas. Based on the hazard quotient (HQ) model recommended by the US EPA, most drinking water sources posed acceptable non-carcinogenic risks (HQ < 1). In contrast, Taruo Lake water presented an elevated risk (HQ > 1) in 2024 primarily due to the regional geological background, and although not used for daily drinking, this finding offers an indicative reference for local water management and risk prevention. This preliminary monitoring and biomonitoring assessment provides baseline data for future studies and underscores the necessity of continuous surveillance and evaluation of total dietary fluoride intake to protect the health of this vulnerable high-altitude population. Full article

Objective: To evaluate the impact of urban–rural health insurance integration on the health outcomes and financial burden of rural older adults. Methods: Utilizing panel data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2013 to 2018, we employed a staggered difference-in-differences model coupled with propensity score matching (PSM-DID) for rigorous causal identification. Results: The policy significantly reduced out-of-pocket medical expenditures for rural households by approximately 5.6% (p = 0.034). Concurrently, significant improvements were observed in both physical health (a 0.092-point reduction in ADL impairment scores) and mental health (a 0.725-point reduction in CES-D depression scores). Mechanism analyses revealed that the integration did not significantly increase the probability of outpatient or inpatient visits—thereby ruling out supplier-induced demand and moral hazard—while effectively reducing the incidence of catastrophic health expenditure by 1.9% (p = 0.004). Heterogeneity analyses indicated that while the financial relief was universally distributed across varying educational levels, the policy dividends were predominantly captured by the younger-old demographic. Notably, the reduction in financial burden was not statistically significant for the oldest-old cohort (aged 75 and older). Conclusions: The urban–rural health insurance integration has achieved a dual dividend of financial protection and health enhancement without triggering the overutilization of medical services. Nevertheless, the unmet care expenses for older adults with severe disabilities underscore the urgent necessity for a secondary safety net, such as long-term care insurance. Full article

Sandstone-type uranium deposits are the main source of uranium in China. The Ordos Basin, one of the most typical Mesozoic intracontinental sedimentary basins in northern China, is a major uranium-bearing basin in China. The Hangjinqi area is a significant uranium-bearing region in the northern Ordos Basin, with favorable geological conditions and promising exploration prospects for mineralization, and the Lower Cretaceous Huanhe Formation is one of the uranium-bearing strata in this area. This study focuses on the Huanhe Formation in the Hangjinqi area to investigate the governing factors of uranium enrichment and mineralization in this stratum. U-Pb dating of detrital zircons from sandstones of the Huanhe Formation reveals dominant peak ages of 2370–2585 Ma, 214–320 Ma, and 1805–2325 Ma, and secondary peak ages of 340–506 Ma, 1598–1797 Ma, and 110–150 Ma. The age results of the selected detrital zircons indicate that the provenance of the Huanhe Formation is mainly derived from three sources: (1) the 2.6–2.5 Ga TTG gneisses and granulites in the Yinshan Block; (2) the Paleoproterozoic (2500–1800 Ma) khondalites and granitic gneisses in the Daqingshan–Wulashan–Jining area, as well as granites in the Yinshan area; and (3) large-scale intermediate–acidic intrusive rocks and volcanic rocks of the Yinshan orogenic belt, whose ages range from 110.9 to 505.9 Ma (predominantly Paleozoic). These source rocks may have provided a potential uranium source. The paleoclimate proxies, including Sr/Cu, Sr/Ba, V/Cr, Ni/Co, and Fe²⁺/Fe³⁺ ratios, combined with the Chemical Index of Alteration (CIA) and the Index of Compositional Variability (ICV), suggest that the Huanhe Formation was formed in a relatively arid and oxidized environment with a low degree of chemical weathering, which facilitated the migration of uranium-bearing ore-forming fluids. The sedimentary environment, provenance, and paleoclimate created favorable geological conditions for uranium enrichment in the Huanhe Formation of the northern Ordos Basin. Full article