Frontiers in Public Health最新文献

A novel automatic framework is proposed for global sexually transmissible infections (STIs) and HIV risk prediction. Four machine learning methods, namely, Gradient Boosting Machine (GBM), Random Forest (RF), XG Boost, and Ensemble learning GBM-RF-XG Boost are applied and evaluated on the Demographic and Health Surveys Program (DHSP), with thirteen features ultimately selected as the most predictive features. Classification and generalization experiments are conducted to test the accuracy, F1-score, precision, and area under the curve (AUC) performance of these four algorithms. Two imbalanced data solutions are also applied to reduce bias for classification performance improvement. The experimental results of these models demonstrate that the Random Forest algorithm yields the best results on HIV prediction, whereby the highest accuracy, and AUC are 0.99 and 0.99, respectively. The performance of the STI prediction achieves the best when the Synthetic Minority Oversampling Technique (SMOTE) is applied (Accuracy = 0.99, AUC = 0.99), which outperforms the state-of-the-art baselines. Two possible factors that may affect the classification and generalization performance are further analyzed. This automatic classification model helps to improve convenience and reduce the cost of HIV testing.

Background: Hypertensive heart disease (HHD) is a significant form of end-organ damage caused by hypertension, with profound impacts on global health and quality of life. Temperature anomalies driven by climate change, particularly extremes of heat and cold, are increasingly recognized as major contributors to the cardiovascular disease burden, notably impacting HHD. However, the specific spatiotemporal trends and gender-based differences in the burden of non-optimal temperatures on older adults HHD patients remain insufficiently explored. This study aims to evaluate the regional, gender-specific trends in the burden of HHD attributed to non-optimal temperatures among the older adults from 1990 to 2021, and to project future trends in HHD burden under climate-induced temperature anomalies from 2022 to 2050.

Methods: Data were sourced from the Global Burden of Disease Study (GBD 2021), which provides estimates of mortality and disability-adjusted life years (DALYs) at global, regional, and national levels. Age-standardized rates (ASR) and estimated annual percentage changes (EAPC) were analyzed. Future burden projections were modeled using age-period-cohort (APC) and Bayesian APC models to assess temperature impact by gender and age differences. Data analysis was conducted using R and STATA, examining the variations in temperature effects by gender and age.

Results: Between 1990 and 2021, cold-related HHD burden among the older adults significantly exceeded that of heat-related burden. However, heat-related HHD burden demonstrated a marked upward trend, projected to continue rising over the next two decades, particularly in low-income and tropical regions. Gender-specific analysis revealed that cold-related HHD burden was more pronounced in women, while heat-related burden was notably higher in men. Additionally, male heat-related HHD mortality rates have shown a substantial increase over the past 30 years, whereas female rates have exhibited a comparatively modest decline.

Conclusion: Although cold remains the dominant non-optimal temperature factor, rising global temperatures suggest an increasing burden of heat-related HHD among the older adults. Efforts should prioritize strengthening resilience in vulnerable regions and populations, with targeted interventions to mitigate future health risks associated with temperature extremes.

Objective: The purpose of this study was to analyze police officers' exercise participation behavior and influencing factors in order to better promote physical exercise participation and improve the health status of the police force.

Methods: Police officers (n = 3,682) were recruited from 16 district public security substations in a city in eastern China to investigate their physical exercise participation and influencing factors, and logistic regression analysis was used to investigate three aspects: exercise behavior, health cognition, and influencing factors.

Findings: The physical exercise behavior of police officers showed long duration of time, but low frequency and intensity. The exercise programs were diverse but mainly involved running. The exercise motivation was mainly to keep fit and for stress relief. Logistic regression analysis indicated that source of police entry (OR = 1.467, 95% CI: 1.338-1.609), exercise conditions in the workplace (OR = 1.069, 95% CI: 1.051-1.088), exercise conditions near home (OR = 1.123, 95% CI: 1.047-1.205), high volume physical labor during work resulting in little time for exercise (OR = 1.372, 95% CI: 1.038-1.813), lack of organization (OR = 1.415, 95% CI: 1.164-1.720), economic condition constraints (OR = 1.439, 95% CI: 1.114-1.858), and weather restrictions (OR = 2.929, 95% CI: 2.418-3.548) were the main factors influencing police physical exercise behavior.

Conclusion: Various influencing factors and the nature of actual police work presented barriers to police officers' participation in physical exercise. Interventions to increase physical exercise participation would promote the physical health of police officers.

Introduction: This study investigates the impact of industrial synergistic agglomeration on residents' health levels in China. It explores how green and traditional industry agglomeration models influence residents' health levels outcomes and identifies the underlying mechanisms driving these effects.

Methods: Using panel data from 283 prefecture-level cities and above in China from 2003 to 2020, the study applies the Generalized Spatial Two-Stage Least Squares (GS2SLS) method. This approach allows for a systematic analysis of both direct and spatial spillover effects, focusing on the comparative impacts of green and traditional industrial agglomeration models.

Results: (i) Spatial Effects: Residents' health levels exhibits a significant positive spatial effect, with public health improvements in one city positively influencing neighboring cities.(ii) Industrial Agglomeration: Industrial synergistic agglomeration has a stronger positive impact on residents' health levels compared to single-industry agglomeration.(iii) Mechanisms: The effect of industrial synergistic agglomeration on residents' health levels operates through three primary mechanisms:- Population Agglomeration Effects: Enhanced population clustering contributes to better public health services.- Media Dissemination Effects: Improved information dissemination raises public health awareness.- Income Growth Effects: Increased income levels drive better access to healthcare and lifestyle improvements.(iv) Model Comparison: Green industry synergistic agglomeration proves more beneficial for residents' health levels improvement than traditional industry agglomeration.

Discussion: The findings highlight the critical role of industrial synergistic agglomeration, particularly in green industries, in promoting residents' health levels. Policymakers are encouraged to prioritize strategies fostering green industry clustering and to leverage the identified mechanisms to amplify public health benefits across regions.

Background: Anxiety is widespread among adolescents, and research has shown that this condition can profoundly affect their mental, emotional, and physical well-being. The purpose of this study was to analyze gender differences in anxiety levels among adolescents and to explore the influencing factors and pathways.

Methods: A total of 3601 adolescents were included in this study (age: 15.14±1.97 years; male: 48.76%). Gender, age, school category, grade, duration of sleep, duration on Internet, anxiety and several social factors were investigated by online questionnaire. Teachers were responsible for organizing students to fill out the questionnaire. The Generalized Anxiety Disorder (GAD-7) was applied to measure participants' anxiety levels over the past 2 weeks. An Ordinal Logistic Regression measured risk factors of anxiety, while a path analysis was used to estimate the structural relationship between risk factors and anxiety.

Results: The severity of anxiety in female was higher. Approaching graduation, lack of sleep, poor peer relationships, poor ability to complete tasks, and unwillingness to seek help when in a bad mood were risk factors for anxiety in both male and female adolescents. Among female, prolonged Internet access is a risk factor for anxiety. The fit indices for the modified models were appropriate (male: GFI=0.999, IFI=0.996, TLI=0.976, CFI=0.995, AGFI=0.990, RMSEA=0.021, SRMR=0.016; female: GFI=0.997, IFI=0.990, TLI=0.971, CFI=0.990, AGFI=0.990, RMSEA=0.020, SRMR=0.018).

Conclusion: The female adolescents might have higher levels of anxiety, that academic stress, sleep, peer relationships, competence, and level of social support might be influence factors on anxiety in adolescents, and that "daily duration on Internet" might not be the risk factor in male adolescent.

Existing studies have established a linear relationship between urban environments and adolescent health, but the combined impacts of subjective and objective environments on multi-dimensional health status (including physical and mental health) have not been fully explored. Furthermore, while some studies have examined the non-linear relationship between urban environments and adult health, research specifically focusing on adolescents is sparse. Using Kunming, China, as a case study, we employ Random Forest model to examine the non-linear relationship between subjective/objective neighborhood environments and adolescent physical/mental health. The results indicate that the objective environment plays a more significant role in influencing physical and mental health in adolescents. There are generally non-linear correlations and threshold effects between neighborhood environment variables and adolescents' health status. Specifically, the effects of distance to subway station, ratio of traffic safety facilities, and greening view index on adolescent physical and mental health differ. Additionally, subjective environments characterized by community management, community image, and community capital tend to positively influence adolescents' health status. This study provides valuable insights for the planning of healthy communities, environmental interventions, and health promotion in specific dimensions among adolescents.

Introduction: Due to the rapid aging of the global population, new approaches are required to improve the quality of life of older people and to reduce healthcare system expenditures. One of the approaches that can be used is value-based healthcare. This article describes a value-based solution for older people who have suffered a myocardial infarction.

Methods: This solution combines the work of healthcare professionals and informal caregivers and the use of modern and user-friendly technologies to support the achievement of patients' values. Patients older than 65 years who have suffered a myocardial infarction will be divided into control and intervention groups within a pre-post-controlled design research study. Members of the intervention group will be provided with a personalized plan developed by healthcare professionals and based on the results from the baseline questionnaire.

Discussion: Two ValueCare digital solution components will be developed: a mobile application for the participants and a web platform for the professionals, researchers, and informal caregivers. Together with smartwatches, which will track important health aspects, and applications, this approach would enable older people to improve their health through correct lifestyle choices and their professional and informal caregivers to track their progress. With the use of the described technology and the multidisciplinary approach, the unmet needs and values of participants could be achieved. Using this approach, it could be possible to reduce overall healthcare expenses through the active involvement of both older people and their informal caregivers through a shared decision-making process with healthcare professionals.

Clinical trial registration: The ISRCTN registry number is 25089186. The date of trial registration is 16/11/2021.

Enterprise innovation investment is influenced by the actions of innovation subjects, whereas regulating shareholders' equity pledge behavior facilitates innovation investment and finance but also carries dangers and affects enterprise innovation investment. Methods:This paper builds an unbalanced panel model to empirically analyze the impact of controlling shareholders' equity pledges on corporate innovation and its heterogeneous characteristics. It also looks at the moderating role of corporate financing constraints and the mediating role of equity incentives, using data from A-share listed companies in China's pharmaceutical manufacturing industry from 2015 to 2022. Innovation investment is substantially inversely correlated with controlling shareholders' equity pledge; that is, firms' creative behavior and intensity are inhibited by equity pledge. Results and conclusions:The results also show that controlling shareholders' equity commitments have a more pronounced negative impact on enterprises' ability to innovate than non-state-owned and decentralized equity firms. The relationship between company innovation and the equity pledge of controlling shareholders is somewhat mediated by equity incentives. The relationship between controlling shareholders' equity promises and enterprises' innovation is negatively moderated by financing limitations, which also reduces R&D expenditure and stifles innovation.

Background: The prevalence of lymphedema is rising, necessitating accurate diagnostic and treatment information for affected patients. Short video-sharing platforms facilitate access to such information but require validation regarding the reliability and quality of the content presented. This study aimed to assess the reliability and quality of lymphedema-related information on Chinese short video-sharing platforms.

Methods: We collected 111 video samples addressing the diagnosis and treatment of lymphedema from four platforms: TikTok, Bilibili, WeChat, and Microblog. Two independent surgeons evaluated each video for content comprehensiveness, quality (using the Global Quality Score), and reliability (using the modified DISCERN tool). The videos from different sources were subsequently compared and analyzed.

Results: Out of 111 videos analyzed, 66 (59.46%) were uploaded by medical professionals, including breast surgeons, vascular surgeons, plastic surgeons, physical therapists, and gynecologists, while 45 (40.54%) were shared by non-medical professionals such as science bloggers, medical institutions, and lymphedema patients. Patient-uploaded videos received the highest engagement, with median likes of 2,257 (IQR: 246.25-10998.25) and favorites of 399 (IQR: 94.5-1794.75). 13 videos (11.71%) contained inaccuracies. Medical professionals' videos generally showed higher content comprehensiveness, particularly those by plastic surgeons, compared to non-medical professionals. The GQS and modified DISCERN tool were used to assess video quality and reliability respectively, with medical professionals scoring higher on both metrics (z = 3.127, p = 0.002; z = 2.010, p = 0.044). The quality and reliability of recommendations provided by plastic surgeons surpassed that of other medical professionals (χ ² = 16.196, p = 0.003; χ ² = 9.700, p = 0.046). No significant differences in video quality and reliability were found among the three categories of non-medical professionals (χ ² = 3.491, p = 0.175; χ ² = 2.098, p = 0.350).

Conclusion: Our study shows that lymphedema-related videos on short video platforms vary widely in quality. Videos by medical professionals are generally more accurate and of higher quality than those by non-professionals. However, patient-uploaded videos often get more engagement due to their relatability. To ensure public access to reliable information, establishing basic standards for this content is essential.