Objective To investigate the relationship between cyberbullying and suicidal ideation in college students, and explore the mediating role of rumination and the regulatory effect of uncertain psychological stress, and to provide scientific basis for prevention and intervention of suicidal ideation in this population. Methods A convenience sampling method was used to survey on the cyberbullying experiences, rumination, suicidal ideation, and uncertain psychological stress among undergraduate students in 12 full-time ordinary universities in Xuzhou during September to October 2023. A latent variable structural equation model was constructed to analyze the mediating effects and moderating effects. Results Significant differences in suicidal ideation scores were observed across gender, sexual orientation, and annual family income (P<0.01). Significant positive correlations were found among cyberbullying, rumination, and suicidal ideation. The latent variable structural equation modeling demonstrated significant direct effects of cyberbullying on both suicidal ideation (β=0.428, P<0.05) and rumination (β=0.579, P<0.05). Rumination mediated the relationship between cyberbullying and suicidal ideation (indirect effect β=0.183, P<0.01), accounting for 30% of the total effect. Uncertain psychological stress significantly moderated this mediation model (P<0.01), with the cyberbullying-suicidal ideation association being stronger under high stress conditions (β=0.366, P<0.001) than under low stress conditions (β=0.247, P<0.001). Conclusions Both cyberbullying and rumination significantly predict suicidal ideation, with rumination functioning as a partial mediator. Uncertain psychological stress moderates this relationship, demonstrating that the associations between cyberbullying and suicidal ideation strengthens with increasing stress levels. Therefore, targeted interventions for cyberbullied college students should prioritize rumination reduction while implementing stress management training to mitigate uncertain psychological stress, which is crucial for preventing suicidal ideation development.

Objective To investigate the associations between hobbies/interests and mental health issues, including depression, anxiety, and stress among adolescents in Fujian. Methods A cross-sectional survey was conducted using a multi-stage stratified cluster random sampling method to examine their hobbies/interests as well as mental health issues including depression, anxiety, and stress in Fujian. The χ2 tests were utilized to compare the distribution differences in depression, anxiety, and stress, while logistic regression analysis was applied to explore the associations between hobbies/interests and depression/anxiety. Results A questionnaire survey was conducted among 58 174 students from 110 secondary schools across 55 counties (cities, districts) in 6 prefecture-level cities of Fujian. Among them, 33 972 (58.4%) were junior high school students and 24 202 (41.6%) were senior high school students. The results showed that 18.5% of the students exhibited varying levels of depressive symptoms, while 21.9% reported varying levels of anxiety symptoms. Regression analysis indicated that having positive and beneficial hobbies served as protective factors against depression (OR= 0.756, 95%CI: 0.711-0.803), anxiety (OR=0.730, 95%CI: 0.689-0.774) and stress (OR=0.680, 95%CI:0.626-0.739). Conclusions Engaging in hobbies and interests is correlated with adolescent depression, anxiety, and stress, among other psychological conditions. Schools can help safeguard and enhance students’ mental health by fostering positive and beneficial interests.

Objective To investigate the prevalence and changing trends of myopia and high myopia among children and adolescents in Sichuan from 2021 to 2024, and to provide a basis for policy formulation. Methods From 2021 to 2024, 183 districts (counties) in 21 cities (prefectures) of Sichuan were designated as monitoring sites. Nine schools (kindergartens, primary and secondary schools) were selected in each district, and seven in each county, with a stratified cluster sampling method. At least 80 students from each grade of each school were enrolled for vision screening. The myopia and high myopia rate were analyzed using Chi-square tests for changing trend. Results During this period, the detection rates of myopia among children and adolescents in Sichuan were 51.4%, 47.8%, 47.4%, and 46.7%, respectively, showing a significant downward trend (χ2=1 294.893, P<0.001), with an average annual percent change range of -1.6. The detection rates of high myopia were 4.8%, 4.4%, 3.8%, and 3.9%, respectively, showing a downward trend (χ2=413.033, P<0.001), with an average annual percent change range of -0.3. In both genders, stratified analysis revealed consistent downward trends of myopia (Male: χ2=604.863, P<0.001; Female: χ2=711.790, P<0.001), with an average annual percent change range of -1.5 and -1.6, and girls exhibited higher myopia rate than that among boys in each year (χ2=1 004.078, 1 321.610, 1 244.378, 1 307.335, all P<0.001), as well as the high myopia (Male: χ2=149.029, P<0.001;Female: χ2=272.354, P<0.001), with an average annual percent change range of -0.2 and -0.4, and girls exhibited higher high myopia rate than that among boys in each year (χ2=71.301, 69.574, 54.266, 31.521, all P<0.001). Stratified analysis by educational stage showed that the detection rate of myopia in preschool, primary school and junior high school stages showed a downward trend (χ2=181.504, 186.019, 224.029, all P<0.001), while it showed an increasing trend in the senior high school (χ2=204.661, P<0.001). The average annual percent changes were -1.4,-0.8,-1.2 and +1.0, respectively. The detection rates of high myopia in preschool, primary school, and junior high school showed a fluctuating downward trend (χ2=6.779, 27.538, 52.228, all P<0.01), with an average annual percent change range of -0.02, -0.02, -0.17, respectively, while no statistically significant differences were observed in the senior high schools (χ2=0.114, P=0.736). Conclusion Although overall myopia prevalence in Sichuan’s children and adolescents has declined, the rising trend among senior high school students warrants urgent attention.

Objective To understand the mental health status and influencing factors of college students during the normalized COVID-19 prevention and control period. Methods From March to May 2024, a cross-sectional survey was conducted using a stratified cluster sampling method among students from four universities in Xuzhou. A self-designed questionnaire, combined with the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) was used to collect data. Univariate and multivariate ordinal logistic regression were applied to identify influencing factors. Results A total of 789 valid questionnaires were collected. Of the respondents, 27.5% and 37.77% exhibited varying degrees of anxiety and depression, respectively. Urban residence (OR=0.656, 95%CI：0.469-0.918) and medical major (OR=0.677, 95%CI：0.484-0.948) were protective factors against anxiety, while having sequelae (OR=2.069, 95%CI：1.411-3.034) and holding negative attitudes (OR=2.277, 95%CI：1.623-3.196) were risk factors. Similarly, medical major (OR=0.659, 95%CI：0.482-0.901) was a protective factor against depression, whereas sequelae (OR=1.539, 95%CI：1.103-2.147) and holding negative attitudes (OR=2.010, 95%CI：1.478-2.729) were risk factors. Conclusions A certain proportion of college students experience anxiety and depression. Particular attention should be paid to the psychological status of students who are non-medical majors, from rural areas, have sequelae, or hold negative attitudes.

Objective To learn the epidemiological characteristics of male homosexual transmission of Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) among young students in Liaoning Province, so as to provide a scientific basis for reducing the risk of HIV infection among young students and formulating targeted prevention and control measures. Methods Through the "China Disease Prevention and Control Information System", HIV/AIDS information of students aged 15-24 years for the period from January 1, 2015 to December 31, 2024 in Liaoning Province was collected. Epidemiological analyses were conducted on the male-to-male sexual transmission of HIV/AIDS among young male students, and the trend of change can be analyzed based on the Annual Percent Change (APC) and the Average Annual Percent Change (AAPC). Results From 2015 to 2024, a total of 916 new cases of HIV/AIDS among male students aged 15-24 years through homosexual transmission were reported in Liaoning Province. The number of reported cases decreased overall each year (AAPC=-9.11%,P<0.001). The main reporting cities were Shenyang with 315 cases (34.4%) and Dalian with 304 cases (33.2%). The majority of these cases were aged 19-24 (718 cases, 78.4%), Han ethnicity (756 cases, 82.5%) and associate degree or above (772 cases, 84.3%). With the increase in years, the proportion of cases in the 15-<19 ages group showed an upward trend (χ2trend=5.836, Ptrend=0.016; AAPC=5.54%, P=0.062). The proportion of patients with four or more same-sex sexual partners showed a monotonically decreasing trend (χ2trend=27.249, Ptrend<0.001; AAPC=-8.73%, P=0.013). The proportion of cases detected through testing and counseling showed an upward trend from 2015 to 2017 (APC=25.74%, P<0.01), but a downward trend from 2017 to 2021 (APC=-16.70%, P<0.001). The proportion of patients from Sexually Transmitted Disease (STD) clinics showed a downward trend from 2015 to 2017 (APC=-30.09%, P<0.001), but an upward trend from 2017 to 2020 (APC=44.43%, P<0.001). The proportion of patients from other medical visits (AAPC=13.19%, P<0.01) and other sources (AAPC=-10.28%, P<0.01) showed a monotonically increasing and decreasing trend, respectively. Conclusions From 2015 to 2024, the reported cases of HIV/AIDS transmitted through male-to-male sexual contact among young students in Liaoning Province showed a general decline, and the composition characteristics changed. The proportion of young students in the younger age group increased, indicating that further efforts are needed to strengthen health education on AIDS prevention for young students of this age group. The proportion of HIV/AIDS detected in patients visiting STD clinics and other medical institutions increased, suggesting that the detection efforts in key medical institutions such as STD clinics should be strengthened. At the same time, it is necessary to pay closer attention to changes in the source of samples and make targeted adjustments to the key areas of AIDS prevention and control.

Objective To learn the prevalence and influencing factors of scoliosis, myopia, and their comorbidity among primary and secondary school students of Nantong in 2024, and to provide reference for formulating scientific and effective prevention and control measures. Methods From September to November 2024, a stratified random cluster sampling method was used to select 15 179 primary and secondary school students from 7 districts in Nantong for screening scoliosis and myopia. A questionnaire survey was conducted on 11 292 students in grade 4 and above. A total of 11 171 valid questionnaires were collected, with an effective recovery rate of 98.9%. The χ2 test was applied to compare the differences between the groups of scoliosis, myopia and their comorbidity. Multivariate logistic regression was applied to analyze the influencing factors of scoliosis, myopia, and their comorbidity. Results In 2024, the detection rates of scoliosis, myopia, and their comorbidity were 3.81%, 68.36%, and 3.16%, respectively. The comorbidity rate of senior high school students (8.18%) was higher than that of junior high school students (3.79%) and primary school students (0.06%) (χ2= 60.52, 423.67, 126.65, all P<0.001). Multivariate logistic regression analysis showed that an increase in school stage (junior high school, OR=2.02, 95%CI: 1.55-2.64; senior high school, OR=1.93, 95%CI: 1.27-2.95), as well as daily indoor sedentary time > 8 hours in the past week (OR=1.33, 95%CI: 1.01-1.75) increased the risk of scoliosis, myopia, and their comorbidity among primary and secondary school students. Meanwhile, daily daytime outdoor activity time > 2 hours in the past week (OR=0.65, 95%CI: 0.45-0.94) and average daily sleep duration > 8 hours (OR=0.49, 95%CI: 0.36-0.62) reduced the comorbidity risk. Conclusion The prevalence of scoliosis, myopia, and their comorbidity among primary and secondary school students in Nantong is relatively serious. An increase in school stage and sedentary sitting are the risk factors of comorbidity, and sleep for more than 8 hours per day is the protective factor. Further measures should be taken to reduce the academic burden on students, encourage students to increase their weekly outdoor activities, reduce indoor sedentary time, and ensure sufficient sleep time, thereby preventing the occurrence and progression of scoliosis, myopia, and their comorbidity.

Objective To explore the association between recent life stress events, health literacy and depression/anxiety symptoms among college students, and to provide basis for the prevention and control of depression and anxiety symptoms in college students. Methods A total of 7 617 freshmen from two universities in Jiangsu and Anhui were enrolled with a cluster sampling method. Recent life stress events, health literacy and depression/anxiety were evaluated by the Adolescent Life Events Self-Assessment Scale (ASLEC), the Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ), the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7). Spearman correlation and hierarchical regression were conducted to explore variable relationships. Results The detection rates of depression and anxiety symptoms among college students were 49.9% and 34.9%, respectively. Correlation analysis revealed that recent life stress events were positively correlated with depressive and anxiety symptoms (r=0.62, 0.59, both P<0.001), while health literacy was negatively correlated with both (r=-0.42, -0.37, both P<0.001). Hierarchical regression analysis indicated that the interaction term between life stress events and health literacy had a significant negative predictive effect on depression and anxiety symptoms (β=-0.33, -0.40, both P<0.001). Conclusion Recent life stress events are risk factors for depression and anxiety, and health literacy can mitigate the adverse impact of recent life stress events on depression and anxiety in college students.

Objective To investigate the growth levels and patterns of vital capacity among primary and secondary school students aged 6-17 years in Changzhou in 2024, and to establish growth curves and percentile reference values of vital capacity in healthy children and adolescents. Methods In 2024, a total of 13 276 primary and secondary school students in Changzhou were enrolled to measure the vital capacity, with a stratified random cluster sampling method. Correlations between vital capacity and age were analyzed by Spearman’s rank correlation. Gender differences of vital capacity across different age groups were analyzed by t-test or Wilcoxon rank sum tests. The LMS method was employed to build percentile reference values and growth curves of vital capacity by gender and age, and comparisons were made with data from other regions. Results The measured P50 values of vital capacity for boys and girls aged 6-17 in Changzhou ranged from 1 068.50 to 4 286.00 mL and 996.00 to 2 984.00 mL, respectively. Vital capacity increased with age in both genders (all P<0.01). Vital capacity in boys was higher than that in girls across all age groups (all P<0.01). The constructed growth curves of vital capacity for boys and girls had similar shapes, showing gender differences. The peak growth period of vital capacity occurred at 12-14 years in boys and 9-11 years in girls. Conclusion The percentile curves and reference values of vital capacity constructed by LMS method in this study can provide reference for evaluating the growth levels of vital capacity among healthy children and adolescents in Changzhou.

Objective To explore the characteristics and trends of mortality among primary and secondary school students in Wulong from 2015 to 2024, and to provide a scientific basis for implementing effective interventions to reduce mortality. Methods Data on deaths occurring between January 1, 2015, and December 31, 2024, were retrieved from the mortality surveillance system. Descriptive analysis, χ2 test, and Joinpoint regression analysis were employed to examine mortality patterns among students aged 6-18 years, including gender-, age group-, and cause-specific mortality rates, monthly distribution of deaths, and the Average Annual Percentage Change (AAPC). Results The average mortality rate among students aged 6-18 years in Wulong (2015-2024) was 25.40 per 100 000, with boys showing significantly higher rates (29.80/100 000) than girls (20.74/100 000) (χ2=4.040, P=0.044). Injury-related mortality (16.48/100 000) exceeded disease-related mortality (8.93/100 000) (χ2=9.820, P=0.002). The highest mortality rate was observed in the 15-18-year age group (36.27/100 000), while the lowest was in the 6-<10-year age group (19.30/100 000). Annual mortality rates fluctuated during 2015-2024, with an AAPC of -4.27%, though the trend was not statistically significant. Among injury-related deaths, drowning was the leading cause (mortality rate: 7.32 per 100 000), with male drowning mortality (10.68 per 100 000) being 2.83 times that of females (3.77 per 100 000). The leading disease-related cause of death was malignant tumors (2.72 per 100 000). The highest proportional mortality occurred in January, July, and November, accounting for 45.05% of all deaths. Conclusions Injuries, particularly drowning, were the leading causes of death among students aged 6-18 years in Wulong. Prevention efforts should prioritize drowning control through enhanced safety measures along water bodies and targeted water safety education for students. Parents should strengthen supervision, while relevant authorities should promote life-value education and increase awareness of healthy living and safety precautions among students.

Objective To analyze the epidemiological characteristics, development trends, and influencing factors of injury-related behaviors among primary and secondary school students in Liaoning from 2020 to 2023, and to provide scientific strategies and basis for the further prevention and control of injury-related behaviors. Methods A multi-stage stratified cluster sampling approach was employed to investigate the prevalence of injury-related behaviors among students enrolled in Liaoning during 2020 to 2023.Rigorous analyses were carried out for the distribution characteristics, development trends, and the influencing factors. Results From 2020 to 2023, the overall reporting rate of injury-related behaviors among primary and secondary school students in Liaoning was 24.5%. The reporting rate of daily unintentional injuries was 16.9% (including 16.0% for walking violations and 0.9% for non-safe swimming). The reporting rate of family bullying/violence, serious injuries, school bullying was 9.0%, 2.2%, and 1.3%, respectively. Multivariate analysis revealed that for serious injuries, rural areas (OR=0.92, 95%CI: 0.87-0.98, P=0.010) and female (OR=0.59, 95%CI: 0.55-0.62, P<0.001) were protective factors, while higher grades (junior high school: OR=1.16, 95%CI: 1.08-1.25, P<0.001; senior high school: OR=1.65,95%CI: 1.52-1.78, P<0.001) were identified as risk factors. Regarding school bullying, female (OR=0.71, 95%CI: 0.66-0.77, P<0.001) and non-boarders (OR=0.74, 95%CI: 0.67-0.82, P<0.001) were protective factors, while higher grades (junior high school: OR=1.2, 95%CI: 1.13-1.38, P<0.001; senior high school: OR=1.43, 95%CI: 1.29-1.59, P<0.001) were risk factors. For walking violations, female (OR=0.84, 95%CI: 0.82-0.86, P<0.001) was a protective factor, while non-boarders (OR=1.20, 95%CI: 1.15-1.24, P<0.001) and higher grades (junior high school: OR=1.16, 95%CI: 1.13-1.20, P<0.001; senior high school: OR=1.30,95%CI: 1.26-1.34, P<0.001) were risk factors. For non-safe swimming, female (OR=0.66, 95%CI: 0.60-0.72, P<0.001), non-boarders (OR=0.66, 95%CI: 0.58-0.75, P<0.001), and junior high school (OR=0.87, 95%CI: 0.78-0.98, P=0.017) were protective factors. For family bullying/violence, female (OR=0.82, 95%CI: 0.79-0.84, P<0.001) and higher grades (junior high school: OR=0.78,95%CI: 0.76-0.81, P<0.001; senior high school: OR=0.40, 95%CI: 0.39-0.42, P<0.001) were protective factors, while non-boarders (OR=1.46,95%CI: 1.38-1.55, P<0.001) was a risk factor. Conclusions Injury-related behaviors among students in Liaoning showed a downward trend from 2020 to 2023.Males, urban areas, and primary schools were the primary at-risk groups, with daily unintentional injuries being the most prevalent. In response to the factors influencing the prevalence of these injuries, corresponding prevention, control, and intervention measures should be prioritized to safeguard the healthy growth of students.

Objective To investigate the current status of influenza vaccination and the monitoring of Adverse Events Following Immunization (AEFI) after vaccination in Fuzhou from 2021 to 2023, and to provide a scientific basis for influenza prevention and control and optimization of immunization strategies. Methods Data of influenza vaccination from the Fujian Provincial Immunization Program Information Management System (2021-2023), and AEFI case information reported after influenza vaccination in the National Immunization Program Information System were collected. The population data from the same period, a statistical analysis was conducted for influenza vaccination rate and AEFI reporting incidence rate in Fuzhou City. Results From 2021-2023, the average reported influenza vaccination rate of population was 1.86%, showing an upward trend year by year (χ²=28 327.63, P<0.05). During the three years, the average vaccination rate was the highest in Taijiang District (4.82%) , while the lowest was in Minqing County (1.12%). The vaccination rate in different age groups exhibited significant significance (χ²=1 726 452.40, P<0.05), with the highest rate in the 6 months to <3 years old group, followed by the 3 to <7 years old group, and the lowest in the 18 to <60 years old group. Totaling 60 AEFI cases were reported during 2021-2023, with the majority being general reactions (98.3%). The AEFI reporting incidence rates in all counties (cities/districts) remained at a relatively low level (1.35/10 000 doses), with no statistically significant differences among 12 counties/city/districts (χ²=15.72, P=0.15). The reported incidence of AEFI showed an upward trend year by year(χ²=6.74, P<0.05). Conclusion The influenza vaccination rate in 2021-2023 in Fuzhou was low, showing a slow upward trend, and the AEFI reporting incidence rate of the vaccine was low.

Objective To develop a standardized and clinically feasible semi-structured play-based assessment protocol for the Childhood Autism Rating Scale (CARS) tailored to the psychological and behavioral characteristics of Chinese children and outpatient practice settings, and to validate its reliability and validity in children with Autism Spectrum Disorder (ASD). Methods Based on the diagnostic criteria for ASD outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and the assessment items of CARS, core play-based evaluation dimensions were identified. Game types, toy selections, and operational protocols were designed with reference to play-setting guidelines and the Autism Diagnostic Observation Schedule (ADOS). Content validity was assessed via expert panel reviews. From September 2020 to December 2024, 713 ASD children aged 2-6 years were recruited across five clinical centers to evaluate the reliability and validity of the developed semi-structured play-based CARS protocol. Results The semi-structured play-based assessment protocol was established under the iterative reviews by 10 experts. The results demonstrated a good internal consistency (Cronbach’s α=0.73) and inter-rater reliability (Kappa=0.85). Kruskal-Wallis tests revealed statistically significant differences in CARS total scores across diagnostic severity levels (P<0.05). Conclusion The semi-structured play-based CARS protocol exhibits strong reliability and validity for ASD assessment in clinical settings, supporting its broader implementation in practice.

Objective To investigate the depression, anxiety, and stress status among students in Guangzhou’s technical school, and provide references for technical school to carry out psychological intervention among students. Methods A stratified random cluster sampling method was applied to select 2 087 students from 10 technical schools of Guangzhou in October 2022.The questionnaire survey was conducted using the depression-anxiety-stress scale (DASS-21). The survey focused on the depression, anxiety, and stress status and the influencing factors among students in the past week. Results The scores of depression, anxiety, and stress among technical school students were 2(0.00, 6.00), 2(0.00, 6.00) and 2(0.00, 10.00), respectively. The detection rates of depression, anxiety, and stress were 18.5%, 21.08%, and 10.21%, respectively. The logistic regression analysis showed that students with monthly disposable expenses≥2 000 yuan, those from poor or fair family atmosphere and smokers exhibited higher levels of depression (OR=1.172, 2.741, 1.448, and 1.388, respectively). Similarly, students from poor or fair family atmosphere and smokers had higher anxiety levels (OR = 4.670, 1.877 and 2.037, respectively), as did those with monthly disposable income≥2 000 yuan, poor or fair family atmosphere, and smokers (OR=1.516, 5.406, 1.755, and 2.177, respectively). Third-year students showed lower stress levels (OR=0.625). Conclusions The detection rates of depression and stress among students in technical schools of Guangzhou are relatively low, while the detection rate of anxiety is relatively high. Psychological interventions for these students should prioritize groups such as those from urban areas, families with poor family atmosphere, those with higher monthly disposable income, and smokers.

Objective To investigate the current status of myopia and the trends in refractive error among primary and secondary school students in Yancheng, Jiangsu, and to provide references for myopia prevention and control. Methods From 2019 to 2023, a cluster sampling method was adopted to select 33 923 students who had participated in vision examinations for four consecutive years for a myopia follow-up survey. A myopia tracking survey was conducted to calculate the myopia detection rates in different age groups and to analyze the changes in spherical equivalent (SE) and the severity of myopia across these age groups. Results The myopia detection rates among the 33 923 students from 2019 to 2023 were 48.03%, 61.62%, 69.63%, and 76.45%, respectively (P<0.001). The rates for male students were 45.90%, 58.87%, 66.59%, and 73.40%, while those for female students were 50.42%, 64.70%, 73.03%, and 79.87%. In the initial age group of 6-8 years, the myopia detection rates in the 2022-2023 academic year were 4.57 times (age 6), 3.35 times (age 7), and 2.49 times (age 8) those of the 2019-2020 academic year. In the initial age group of 6-11 years, the high myopia detection rates in the 2022-2023 academic year were at least four times those of the 2019-2020 academic year. Students aged 6-9 years exhibited the fastest progression of myopia, with the most rapid progression observed in 8-year-old students, whose SE increased annually by -0.49 D (right eye) and -0.47 D (left eye), and in 9-year-old students, whose SE increased annually by -0.49 D (right eye) and -0.45 D (left eye). Conclusion The progression of myopia among students aged 6-9 has significantly accelerated, highlighting the need for increased attention to the critical window period for myopia prevention and control in this age group.

Objective To explore the associations between dietary patterns and stress, anxiety, and depression among undergraduates and to provide reference for promoting mental health in this targeted population. Methods Using the convenience sampling method, from February to May in 2024, the Depression-Anxiety-Stress Scale (DASS) and a Semi-quantitative Food Frequency Questionnaire were used to collect data on stress, anxiety, depression, and dietary intake among undergraduates at a medical university in Ningxia. Factor analysis was used to extract dietary patterns, and logistic regression was performed to analyze the associations between different dietary patterns and stress, anxiety, and depression. Results A total of 250 undergraduates were surveyed, with a mean age of (20.58 ± 1.68) years; 38.40% were male, 64.00% had normal BMI, 40.40% were sophomores, 86.80% were enrolled in medical majors, 77.20% were non-only children, mean nighttime sleep duration was (7.34±0.96) hours, and mean weekly exercise time was (9.38±9.33) hours. The detection rates of stress, anxiety, and depressive symptoms were 19.60%, 41.60%, and 29.50%, respectively. Six dietary patterns were identified: “staple food-dominant pattern” “balanced pattern” “meat-alcohol-beverage pattern” “processed food pattern” “mushroom-vegetable pattern” and “offal-potato pattern.” After adjusting for confounders, the “meat-alcohol-beverage pattern” was positively associated with stress (OR=5.27, 95%CI: 1.97-14.12), anxiety (OR=2.25, 95%CI: 1.05-4.81), and depression (OR=2.95, 95%CI: 1.35-6.46). The “processed food pattern” was positively associated with anxiety (OR=3.33, 95%CI: 1.53-7.27) and depression (OR=4.02, 95%CI: 1.72-9.39). The “mushroom-vegetable pattern” was negatively associated with anxiety (OR=0.44, 95%CI: 0.21-0.84). The Q3 level of the “staple food-dominant pattern” was negatively associated with stress (OR=0.24, 95%CI: 0.09-0.68) and anxiety (OR=0.38, 95%CI: 0.17-0.83). Both the Q2 level (OR=0.35, 95%CI: 0.15-0.79) and Q3 level (OR=0.25, 95%CI: 0.11-0.60) of the “staple food-dominant pattern” were negatively associated with depression. Conclusions The meat-alcohol-beverage pattern and processed food pattern are risk factors for stress, anxiety, and depression among undergraduates, whereas the mushroom-vegetable pattern and appropriate staple food-dominant pattern are protective factors. Attention to dietary patterns may be an effective approach to promoting mental health in undergraduates.

Objective To analyze the status and influencing factors of cigarette smoking initiation among secondary school students in Nanping, and to provide a scientific basis for targeted cigarette control interventions among students. Methods From August to October 2023, students from six junior- and senior-high schools in Nanping were enrolled with a multi-stage stratified random cluster sampling method and surveyed with questionnaires, covering topics such as smoking behaviors and secondhand smoke exposure. Statistical software SPSS 19.0 was conducted for univariate and binary logistic regression analyses on the influencing factors of students’ cigarette smoking initiation. Results A total of 828 secondary school students were surveyed. The cigarette smoking initiation rate of secondary school students in Nanping was 16.91% (140/828), with boys (20.56%) higher than that of girls (11.45%). The cigarette smoking initiation rate in junior-, senior-, and vocational- high school students was 13.20%, 16.67% and 29.60%, respectively, while the rates were 13.62% for students under 16 years old and 21.73% for those aged 16 years and older, showing statistically significant differences (all P<0.05). Multivariate logistic regression analysis showed that vocational high school (OR=2.35, 95%CI:1.33-4.16), secondhand smoke exposure in indoor public places other than the home (OR=1.79, 95%CI:1.14-2.79), having seen someone smoking in the movie or video within 30 d (OR=1.67, 95%CI:1.07-2.62), having close friend smoking (OR=3.58, 95%CI:2.26-5.67), having teachers who smoke (OR=2.21, 95%CI:1.31-3.74), believing that smoking makes young people more attractive (OR=2.37, 95%CI:1.04-5.40), and believing that they will use tobacco within the coming year (OR=5.66, 95%CI:1.42-22.52) were risk factors for cigarette smoking initiation among secondary school students (P<0.05). Believing that smoking makes young people less attractive (OR=0.61, 95%CI:0.38-0.97), believing that quitting smoking is definitely difficult (OR=0.60, 95%CI:0.37-0.99), and feeling more uncomfortable smoking in social situations (OR=0.55, 95%CI:0.33-0.93) were factors that reduced the risk of cigarette smoking initiation among secondary school students (P<0.05). Conclusions The rate of smoking initiation among secondary school students in Nanping is relatively high in Fujian, which is influenced by factors such as the type of school and secondhand smoking exposure. Targeted measures need to be taken to strengthen tobacco control health education and to guide secondary school students to establish a correct perception of staying away from tobacco.

Objective To analyze the factors influencing HIV-related knowledge awareness and casual sexual behaviors among young students in Chongqing from 2020 to 2024 based on the sentinel surveillance data, and to provide a reference for formulating the HIV prevention and control measures for young students in Chongqing. Methods Continuous cross-sectional surveys were conducted from 2020 to 2024.A multi-stage stratified sampling method was used to select young students in Chongqing for anonymous questionnaire surveys, collecting socio-demographic information, HIV knowledge, and sexual behavior data. Logistic regression analysis was applied to identify influencing factors associated with casual sexual behaviors. Results A total of 10 410 participants were surveyed from 2020 to 2024.The majority were young students aged 20-24 years, registered locally, and of Han ethnicity. Approximately 40% of the surveyed subjects were freshmen each year. The sample was primarily composed of undergraduates and postsecondary specialized college students. The awareness rate of HIV-related knowledge among young students ranged from 91.9% to 97.1% during the study period. The proportion of students engaging in casual sexual behaviors in the past year decreased from 18.4% in 2020 to 13.0% in 2024.Multivariate analysis showed that, compared to male students, females were less likely to engage in casual sexual behaviors (aOR=0.31, 95%CI: 0.21-0.42). Compared to the 22-year-old and above age group, students aged 18-<22 years had a lower risk of engaging in casual sexual behaviors (aOR=0.41, 95%CI: 0.27-0.63; aOR=0.53, 95%CI: 0.37-0.77). Students with HIV-related knowledge had a lower risk of engaging in casual sexual behaviors (aOR=0.32, 95%CI: 0.21-0.50). Compared to freshmen, students in other grades were more likely to use condoms during casual sexual behaviors (aOR=2.87, 95%CI: 1.32-6.47). Students with HIV knowledge were more likely to use condoms compared to those without (aOR=3.45, 95%CI: 1.35-8.62). Conclusions The overall awareness rates of HIV-related knowledge among young students in Chongqing remain relatively high from 2020 to 2024, but the HIV-related knowledge structure is uneven. The incidence of casual sexual behaviors reveal no significant decline, and gaps in condom use persist. Male gender, aged 22 years and above, and lack of HIV knowledge are the risk factors for engaging in casual sexual behaviors. Freshmen and students lacking HIV knowledge are more likely to engage in unprotected casual sexual behaviors. It is recommended to strengthen behavioral interventions for key populations such as male students and freshmen, and to improve educational approaches to facilitate the translation of protective knowledge into practice.

Objective To investigate the current status of screened myopia (referred to as myopia) in lower-grade primary school students in Miluo, Hunan and analyze its association with dietary food groups, and to provide scientific evidence for myopia prevention and control among primary school students. Methods A cluster random sampling method was used to select six primary schools in Miluo City, Hunan Province, in September 2024. Uncorrected visual acuity and refractive error were examined in 789 first- and second-grade students without cycloplegia. Dietary intake and diversity were assessed using the Chinese Dietary Quality Questionnaire, and physical activity was evaluated using the International Physical Activity Questionnaire-Short Form. The myopia rate was calculated, and logistic regression models were used to explore the association between myopia and dietary food groups. Results Among the 789 first- and second-grade students, 157 were diagnosed with myopia, yielding a myopia detection rate of 19.90%. The myopia rates for boys and girls were 21.17% and 18.26%, respectively, with no statistically significant difference (P>0.05). Compared with the normal vision group, myopic students had a lower proportion of poultry and fish and seafood intake (P<0.05). Multivariate logistic regression analysis showed that poultry intake was a protective factor for myopia (OR= 0.57, 95%CI: 0.36-0.90), while intake of unprocessed red meat (non-ruminant) was a risk factor for myopia (OR= 2.03, 95%CI: 1.14-3.59). Conclusions Myopia is a serious issue among lower-grade primary school students in Miluo City. Intake of poultry food might be a protective factor against myopia in primary school students, while intake of non-ruminant meat could be a risk factor.

Objective To explore the association between weekly Physical Education (PE) class frequency and depressive symptoms among middle school students, and to inform the development of evidence-based policies for promoting adolescent mental health. Methods A stratified random cluster sampling method was employed to survey 71 987 junior and senior high school students in Hubei Province in October 2022. Depressive symptoms were assessed using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regression and Restricted Cubic Spline (RCS) models were employed to analyze associations, with subgroup analyses stratified by gender, grade level, and sleep duration. Results Among the participants, a total of 22 579 (31.3%) were detected with depressive symptoms. Compared with students attending 1 PE class per week, those attending 2, 3, or more classes per week showed 11% (OR=0.89, 95% CI: 0.86-0.93);15% (OR=0.85, 95% CI: 0.80-0.89);12% (OR=0.88, 95% CI: 0.81-0.96) reductions in depressive symptom risk, respectively. There was a nonlinear dose-response relationship between weekly PE class frequency and depressive symptoms (χ2=33.78, P<0.01). Stratified analyses revealed that attending ≥2 PE classes per week was associated with reduced depressive symptom risk across subgroups stratified by gender, school stage, and sleep duration. Conclusions The frequency of weekly PE classes (≥2 sessions/week) is nonlinearly associated with depressive symptoms in middle school students. Policy interventions optimizing PE curriculum scheduling may serve as a feasible strategy for adolescent depression prevention.

Objective To compare the prevalence and demographic factors of poor vision among primary and secondary school students in Nanjing between 2005 and 2021, and to provide evidence for the prevention and control of poor vision. Methods Data on vision examinations of 4 374 urban and rural students in Nanjing were collected through cluster sampling during September-October 2005 and September-October 2021. Changes in poor vision prevalence and demographic factors were analyzed. Results The overall detection rates of poor vision and severe poor vision exhibited a significant increasing trend from 2005 to 2021 (χ2=7.430, χ2=27.431, both P<0.01 ). From primary to senior high school, the detection rates of poor vision showed a consistently increasing trend in both years (χ2trend=340.416, χ2trend=255.846, both P<0.01). Females consistently exhibited higher detection rates than males (χ2=20.382, χ2=5.742, both P<0.01 ). Urban students had higher detection rates than rural peers in 2005 (χ2=8.251, P<0.01), and no statistical significance was observed in 2021. Notably, rural junior high students in 2021 showed significantly higher detection rates than urban counterparts (χ2=7.861, P<0.01). Conclusions The detection rates of poor vision among primary and secondary school students in Nanjing have increased in recent years. Females, rural students, and junior high school students should be prioritized in future prevention and control efforts.

Objective To investigate the health literacy level and its influencing factors among secondary school students in Guangdong Province, and to provide a scientific basis for targeted health education interventions. Methods From October to November 2022, a total of 18 230 secondary school students in Guangdong Province were selected using a multistage stratified cluster random sampling method for a health literacy survey. The possession rates of overall and six-dimensional health literacy (growth and development & adolescent health-care, healthy behaviors and lifestyles, disease prevention, mental health, safety emergency &risk avoidance, medical knowledge & rational medical health-care) were calculated and compared among students with different characteristics. Multivariate logistic regression was employed to identify the independent influencing factors related to students’ health literacy. Results The overall possession rates of health literacy among secondary school students in Guangdong Province was 28.8%. The possession rates of six-dimensional health literacy, from high to low, were safety emergency & risk avoidance (63.2%), healthy behaviors and lifestyles (44.4%), disease prevention (43.0%), mental health (41.9%), growth and development & adolescent health-care (19.9%), and medical knowledge & rational medical health-care (9.1%). Multivariate logistic regression analysis showed that being in senior high school, female gender, being an only child, parental education level of junior college/bachelor’s degree or above, and receiving health education ≥3 times per month were positively correlated with the overall health literacy level of secondary school students (P<0.05). Schools located in non-Pearl River Delta regions (Eastern, Western, and Northern Guangdong), vocational school students, and daily use of mobile electronic devices for more than 4 hours were negatively correlated with the overall health literacy level of secondary school students (P<0.05). Conclusions The overall health literacy level among secondary school students in Guangdong Province is suboptimal and unevenly distributed across dimensions, influenced by multiple factors at the individual, family, and school levels. It is recommended that relevant authorities strengthen education in underdeveloped areas, such as growth and development & adolescent health-care, and medical knowledge & rational medical health-care, and formulate differentiated intervention strategies guided by the aforementioned influencing factors.

Objective To investigate the influenza vaccination coverage and the occurrence of post-vaccination adverse reactions among children aged 6 months to 15 years in Xuzhou from 2019 to 2024, and to provide a reference basis for the development of influenza vaccination. Methods Influenza vaccination data (2019-2024) and suspected Adverse Events Following Immunization (AEFI) reports were sourced from the “Jiangsu Comprehensive Immunization Service Management Information System” and “China Disease Prevention and Control Information System”, respectively. The vaccination coverage and AEFI situation were analyzed. Joinpoint regression analysis was applied to model the trend in vaccination rates. Results From 2019 to 2024, a total of 245 892 children aged 6 months to 15 years received 301 576 doses of influenza vaccinations in Xuzhou, with an average annual vaccination rate of 2.08% (range:0.87%-3.13% annually). No significant temporal trend was observed (AAPC=20.832%, 95%CI: -0.114-46.166, P=0.051). The vaccination rate of girls was higher than that of boys, with a statistically significant difference (χ2=511.51, P<0.01). The vaccination rates for the age groups of 6 months to <3 years, 3 to <6 years, 6 to <12 years, and 12 to 15 years were 6.41%, 4.43%, 1.25%, and 0.27%, respectively. The different age groups demonstrated a declining trend in vaccination rates (χ2trend=218 537.02, P<0.01), showing statistically significant differences annually (all P<0.01). Geographic disparities showed significant differences (all P<0.01): 3.01% (urban districts), 1.43% (county-level cities), and 1.63% (counties). A total of 189 AEFI cases were reported, with an overall incidence rate of 62.67 per 100 000 doses. Among these, 185 cases were general reactions accounting for 97.88%. The incidence was highest in the 6 months to <3 years age group (73.72 per 100 000 doses), followed by the 3 to <6 years age group (72.58 per 100 000 doses). Conclusions The influenza vaccination rate is relatively low among children aged 6 months to 15 years in Xuzhou, and AEFI monitoring indicates a favorable safety profile for the influenza vaccine. It is necessary to strengthen the popularization of science, actively lead the parents to pay attention to influenza vaccination, and improve the influenza vaccination rate of children to achieve the effect of influenza epidemic prevention and control.

Objective To explore the correlations among psychological help-seeking, adverse childhood experiences, and smartphone addiction in medical students, and to provide empirical evidence for students’ mental health research for the targeted population. Methods A stratified cluster sampling was used to conduct a questionnaire survey from April to June 2024 among 704 medical students in a medical university in Ganzhou City. Data were collected with the Attitude Toward Seeking Professional Psychological Help Short Form (ATSPPH-SF), Adverse Childhood Experiences Questionnaire, and the Propensity to Mobile Phone Addiction Scale for College Students (MPATS). Results There was a positive correlation between adverse childhood experiences and smartphone addiction (r=0.239, P<0.01). Psychological help-seeking attitudes among medical students showed significant negative correlations with both adverse childhood experiences (r=-0.175, P<0.01) and smartphone addiction (r=-0.276, P<0.01). The mediating effect of smartphone addiction accounted for 22.195% of the total effect [effect value=-0.182, 95%CI(-0.274, -0.105)], and adverse childhood experiences could negatively predict medical students’professional psychological help-seeking attitudes and indirectly affect the attitudes through smartphone addiction. Conclusions Smartphone addiction partially mediates the impact of professional help-seeking attitudes and adverse childhood experiences. It is recommended that universities should prioritize individualized strategies and implement targeted interventions.

Objective To analyze the influencing factors of myopia among primary and secondary school students in Yancheng City, construct a myopia risk prediction tool based on the random forest model, and to provide a scientific basis for formulating targeted intervention strategies. Methods Based on the physical examination and questionnaire survey data of 13 235 primary and secondary school students in Yancheng in 2023, univariate analysis was applied to screen significant influencing factors. The random forest model was then employed to rank the importance of variables, and the model performance was evaluated using the ROC curve. Results The detection rate of myopia among primary and secondary school students in Yancheng was 77.8%. The ranking results of the importance of each variable in the random forest model were as follows: Age, school stage, duration of doing homework or reading/writing after school, whether parents have myopia, mother’s education level, reading or using electronic screens while lying or prostrate, duration of outdoor activities during the day in the past week, father’s education level, frequency of moderate-to-high-intensity exercise per day during holidays, reading or using electronic screens while walking or riding in a vehicle, number of times sugar-sweetened beverages were consumed in the past 7 days, turning off the lights when using electronic screens after dark, number of times fried foods were eaten in the past 7 days, gender, urban/rural residence, whether parents restrict watching TV or playing computer, daily sleep duration, location of activities during break time, and frequency of eye exercises per day. The area under the ROC curve of the random forest model was 0.679 2, with a 1-specificity of 42.40% and a sensitivity of 67.35%. Conclusions Myopia among primary and secondary school students is jointly influenced by genetic, behavioral, and family environmental factors, requiring comprehensive interventions. The random forest model has certain value in predicting myopia risk, but its discriminatory ability is limited. Future studies need to optimize the model and expand the sample size to improve the predictive efficacy.

Objective To explore the associations between parent-child interaction levels and cognitive development in children and adolescents. Methods Data were derived from the 2014 China Family Panel Studies (CFPS), including 1 394 children and adolescents aged 10-15 years. Participants were divided into low- (P1-P33), medium- (P34-P67), and high-level (P68-P100) parent-child interaction groups based on tertiles. Multiple linear regression analysis was conducted to explore the associations between parent-child interaction levels and the cognitive ability of chillren and adolescents. Restrictive cubic spline model was performed to evaluate the dose-response relationships between parent-child interaction levels and cognitive development. Results Increasing tertiles levels of parent-child interaction levels were associated with higher cognitive performance in mathematics (10.45, 10.90, and 11.08), vocabulary (21.17, 21.56, and 22.47), and standardized cognition (0, 0.08, and 0.16), showing an upward trend (all P<0.001). After adjusting for potential covariates, multiple linear regression analysis indicated a positive correlation between the high-level group and the cognitive ability of children and adolescents compared to the low-level parent-child interaction group: mathematics: (β=0.631, 95%CI: 0.139-1.123), vocabulary (β=1.296, 95%CI: 0.483-2.109), and standardized cognition (β=0.159, 95%CI: 0.065-0.252). Restrictive cubic spline analysis confirmed a positive linear relationship (P <0.05) between parent-child interaction levels and cognitive ability in children and adolescents. Conclusions Higher parent-child interaction levels are positively associated with the cognitive development in children and adolescents, exhibiting a positive linear relationship. Enhancing the level of parent-child interaction levels may help to promote the development of cognitive abilities in children and adolescents.