This paper is an evaluation of seasonal influenza vaccination hesitancy (IVH) and its determinants among community HCWs in Chongqing, a city in southwest China. Methods: A cross-sectional survey of 1030 community HCWs with direct or indirect patient contact was conducted from July to September 2021 using a self-administered electronic questionnaire. Possible factors for IVH among community HCWs were investigated by multivariable logistic regression to yield adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Overall, 46.2% of community HCWs were vaccinated in the 2020–2021 season, while 65.8% of community HCWs had IVH. “Don’t know the coverage in China” (OR: 1.46, 95% CI: 1.01–2.11; 40-year-old group OR: 3.02, 95% CI: 1.92–4.76), “complacency” (OR: 4.55, 95% CI: 3.14–6.60) were positively related with having IVH. The community HCWs that had a history of influenza vaccination (OR: 0.67 95% CI: 0.48–0.95) and groups with confidence and convenience (OR: 0.08, 95% CI: 0.06–0.12; OR: 0.34, 95% CI: 0.23–0.52, respectively) were more likely to completely accept vaccination. Conclusions: Measures such as improving the awareness and knowledge of influenza and vaccination and expanding the free vaccination policy, combined with improving the convenience of the vaccination service, will promote increased seasonal influenza vaccination-coverage in community HCWs in Chongqing.

The Three Gorges Dam in China is the world’s largest hydro-electric scheme in the contemporary world. After the construction of the Dam, great changes took place on the residents’ lifestyles characterized by reduced physical activity due to the loss of arable land and a series of psychological problems caused by resettlement, which might be regarded as contributing factors to the development of diabetes in Three Gorges Reservoir Region (TGRR). However, there is no study that has been conducted targeting large population samples with the aim of determining the prevalence of diabetes in TGRR. This study purposed to estimate the prevalence of diabetes and impaired fasting glucose (IFG) in the adult population ≥18 years in TGRR and to evaluate the associated risk factors. A total of 3721 randomly selected adults, aged ≥18 years and having lived in TGRR for at least one year, participated in questionnaire-based interview from April to May 2013 and had their physical examinations and standard glucose taken. 75 g oral glucose tolerance test (OGTT) was conducted on the subjects with fasting glucose levels being ≥ 5.6 mmol/L. Diabetes and IFG were defined according to WHO 1999 criteria. The age-standardized prevalence of diabetes and IFG were 7.6% (7.9% among men and 7.4% among women) and 9.0% (9.1% among men and 8.9% among women), respectively. Among the identified cases of diabetes in this study, 54.46% (171/314) were newly diagnosed. The prevalence of diabetes cases rose with age (4.0%, 4.5%, 8.1%, 11.2%, 12.4% and 12.9% among persons who were 18 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69 and ≥ 70 years of age, respectively). The results of multivariate logistic-regression analyses showed that the diabetes was significantly linked to age, family history of diabetes, central obesity, educational level and hypertension for both men and women. In addition, smoking was significantly associated with diabetes in men. Diabetes has become a major public health problem in the TGRR with a large number of the cases undiagnosed. These results suggest that regular population-based diabetes screening should be conducted to identify early-stage diabetes and integrated strategies aimed at the prevention and treatment of diabetes initiated.

The aim of our study was to examine the relationship between age at menarche (AM) and hypertension and to evaluate whether different dietary patterns have an effect on associations between AM and hypertension in a large-scale Han Chinese population in southwest China. A cross-sectional study was performed that included 44,900 participants from 17 districts in southwest China from September 2018 to January 2019. The study comprised 23,805 individuals in the final analysis. Logistic regression and multivariable linear regression were applied to estimate the dietary pattern-specific associations between AM and hypertension or systolic/diastolic blood pressure (SBP/DBP). Restricted cubic spline regression was utilized to calculate the shape of the relationship between AM and the odds ratio of hypertension. After adjusting for multiple variables, women who had a history of AM > 14 years were associated with an increased risk of hypertension (OR 1.12, 95%CI 1.04–1.19) and elevated levels of SBP (β 0.90, 95%CI 0.41–1.38) compared with those with AM ≤ 14 years among the total population, and this association was still statistically significant when we further adjusted for body mass index (BMI). In participants with AM > 14 years, the odds ratio values of hypertension increased with increasing menarche age. After stratification by age at recruitment, the positive association between menarche age and hypertension only remained in the middle-aged group, and this association was not found in the young and old groups. After stratification by the Dietary Approaches to Stop Hypertension (DASH) score among the total population, the positive association between AM and hypertension was presented only in the low DASH score group; however, this association was not found in the high DASH score group. Women who have a history of AM > 14 years should pay close attention to blood pressure levels and incorporate the DASH diet more in order to achieve the early prevention of hypertension, especially middle-aged women.

Although the association between particulate matter(PM_2.5) exposure and congenital heart disease (CHD) has been widely reported, the component-specific effects, critical exposure window period, and multicomponent synergistic effects remain unknown. This study used a case-control design. In our study, we assessed PM_2.5 and its components exposure concentrations during preconception and first trimester of 9152 pregnancies collected from the Chongqing Municipal Birth Defects Surveillance System. Multivariate logistic regression was used to analyse the effect of PM_2.5 and its components on offspring CHD prevalence. A quantile-based g-computation was also used to analyse the risk of mixed exposure to the components. For all participants, mean daily PM_2.5 exposure was 31.26 and 32.59 μg/m³ during preconception and first trimester, respectively. Black carbon (BC),and unspeciated matter (UM) were significantly associated with overall CHD, Septal Defects (SPD), and Patent Ductus Arteriosus (PDA) risk in the single-pollution model. Sulfates(SO₄^2-), and organic matter (OM) specifically increased the risk of PDA during preconception and first-trimester, respectively. During the first trimester, co-exposure to PM_2.5 components was associated with a 17 % increase (OR = 1.17, 95 % CI: 1.03-1.33) in the overall risk of CHD, a 22 % increase (OR = 1.22, 95 % CI: 1.00-1.50) in SPD, a 29 % increase (OR = 1.29, 95 % CI: 1.05-1.59) in PDA, and a 33 % increase (OR = 1.33, 95 % CI: 1.03-1.72) in other CHD subtypes. In the preconception period, the risk of PDA increased by 38 % (OR = 1.38, 95 % CI: 1.07-1.78). The Marginal Mixture Odds Ratios (MM-ORs) for the combined effects of components during both the preconception and first-trimester periods were higher than those for PM_2.5 alone, highlighting the importance of considering component mixtures. This study suggests that the toxicity of PM_2.5 may be driven by the synergistic effects of its components. BC, SO₄^2-, OM, and UM may interfere with offspring cardiac development through distinct mechanisms during both preconception and the first trimester of pregnancy. These results advocate for component-specific air quality regulations to mitigate CHD risk.

Background: Wastewater-based epidemiology (WBE) is a cornerstone of post-pandemic SARS-CoV-2 surveillance, yet the environmental covariates and spatiotemporal heterogeneities of viral signals remain poorly characterized. Methods: We conducted a 35-month longitudinal study across 19 sites in Chongqing, China, quantifying SARS-CoV-2N gene concentrations via RT-qPCR to assess the value of WBE and the correlation between viral concentrations and meteorological fluctuations. We employed Gaussian generalized additive models with REML estimation to quantify seasonal dynamics and lagged effects of diurnal temperature range (DTR). Results: A total of 2,520 wastewater samples with complete data were obtained, with an overall N gene detection rate of 62.02%, a median flow-population normalized viral load of 8.40 log10 gc/day per 1,000 inhabitants, and median 1-day, 3-day and 7-day lagged DTR of 6.05 °C, 6.05 °C and 5.67 °C, respectively. Our results demonstrate a surveillance lead time for wastewater signals relative to clinical notifications. WBE detected a 2025 resurgence 2 months earlier than official reports. Wastewater SARS-CoV-2 circulation exhibited a distinct seasonal pattern, characterized by a primary peak in June and two secondary peaks in March and August. The spatiotemporal distribution patterns revealed by monthly heatmaps were highly consistent with the city-wide seasonal trends, and significant spatial heterogeneity was observed. The 7-day moving average DTR exhibited a complex nonlinear relationship with viral loads, initially decreasing, then increasing to a peak at 7–8 °C before declining again. Conclusion: These findings indicate that WBE serves as a useful population-level proxy for infection burden and trends, complementing clinical surveillance. The statistical association between DTR and viral dynamics offers a predictive framework for refining early-warning systems and informs targeted interventions in complex urban environments.