Objective In this study,a risk prediction model for Alzheimer's disease(AD)was constructed based on Alzheimer's disease neuroimaging initiative(ADNI)database to provide a theoretical basis for a better understanding of AD,as well as to provide a reference basis for the rational allocation of health resources and the development of preventive and control strategies.Methods The ADNIMERGE,UPENNBIOMK,ADNINIGHTINGALELONG and DXSUM datasets from the ADNI database were downloaded and random forest algorithm was used for the missing values imputation.Variable screening was performed by LASSO regression.Borderline-1 SMOTE resampling was used to adjusted for intergroup balance,and the variables were incorporated into base classifiers including XGBoost,random forest,bagging,AdaBoost,and support vector machine.Enhanced integrated classifiers were then constructed based on voting and Stacking strategies.Youden index,area under curve(AUC),F-score,G-mean,accuracy,Matthews correlation coefficient(MCC)and Kappa on the validation set were used to evaluate and compare the model efficacy.Results The performance of the classifiers based on balanced data were improved for both base and enhanced integrated classifiers.The performance of stacking and voting enhanced integrated classifiers constructed based on advantageous base classifiers have better performance compared to the base classifiers.After data balancing,the XGBoost performed better in the base classifiers(AUC:0.9090,accuracy:0.9091)and voting algorithm performs better in enhanced integrated classifiers(AUC:0.9178,accuracy:0.9179).Conclusion After Borderline-1 SMOTE resampling adjusted,the performance of both base classifiers and the enhanced integrated classifiers were all improved.For balanced data,XGBoost classifier and the voting enhanced integrated classifier can effectively assist in clinical prediction of Alzheimer's disease progression.

Allergic diseases pose an increasingly significant threat to children's health,with environmental pollutants playing a crucial role.Indoor and outdoor air pollution(such as particulate matter,nitrogen oxides,sulfur oxides,ozone,etc.),chemical contamination(such as persistent organic pollutants,heavy metals,etc.),and other environmental exposure factors(such as green spaces,viruses,meteorological conditions,diet,etc.)are all significant risk factors for allergic diseases in children.Particularly during the early life stages from the fetal period to infancy,exposure to environmental pollutants has a profound impact on the development of the immune system and the risk of future allergic diseases in children.It is worth noting that during these early life stages,certain specific dietary components(such as specific fatty acids,microorganisms,vitamins,etc.)and breastfeeding can provide some protection for children,reducing the incidence of allergic diseases.However,the mechanisms by which emerging persistent organic pollutants(such as chlorinated paraffins and perfluoroalkyl substances)interact with allergic diseases in children have not yet been fully elucidated.Additionally,the potential health impacts of green spaces and their components,as well as the relationship between household pet ownership and allergic diseases in children,remain key areas for future research.This article reviews the recent research progress on the correlation between environmental pollutants and allergic diseases in children,analyzes the mechanisms by which different environmental factors affect children's health,and aims to explore the impact of environmental pollutants on children's health in depth.It also provides a scientific basis for the prevention and treatment of allergic diseases in children.

Objective:To analyze the transition patterns of anal sex and unprotected anal intercourse (UAI), estimate the transition intensity and probability, and identify factors influencing the transition patterns in men who have sex with men (MSM) in Shandong Province.Methods:In August 2019, MSM aged ≥18 years old were recruited as subjects from 11 cities in Shandong Province. The baseline survey were completed in December 2019, and followup surveys were conducted once every 3 mouths from June 2020 to March 2021. Time-continuous, state-discrete multi-state reversible Markov model was constructed based on the status of MSM's sexual behaviors with different types of sexual partners [anal sex occurred or not (S1=No, S2=Yes) and UAI occurred or not (S1=No,S2=Yes)] to analyze the transition patterns and the influencing factors.Results:A total of 735 MSM were included. The transition intensity of starting anal sex with stable and casual partners was 1.935 times and 0.595 times higher than that of discontinuing this behavior, respectively. While the transition intensity to start UAI with stable and casual partners was 0.430 times and 0.169 times higher than that of discontinuing it, respectively. During the follow-up, the transition probabilities of anal sex and UAI with both stable and casual partners increased first and then stabilized. For stable partners, the transition probability of starting anal sex was higher than that of discontinuing it at the same period, for casual partners, it was just the reverse. For both stable and casual partners, the transition probabilities of discontinuing UAI were higher than starting it at the same time. The results of multivariate analysis showed that participants who received intervention materials ( HR=1.47), had an associate degree ( HR=1.77) or a bachelor's degree and above ( HR=1.47) were at higher risk of starting anal sex with stable partners. Those who received intervention materials ( HR=1.39) were at higher risk of discontinuing anal sex with stable partners, while participants identified themselves as non-male gender ( HR=0.49) were at lower risk of discontinuing anal sex with stable partners. Participants received intervention materials ( HR=1.75) were at higher risk of starting UAI with stable partners. Those who lived apart, divorced, or widowed ( HR=3.22) were at higher risk of starting UAI with casual partners, whereas had a bachelor's degree and above ( HR=0.58) were at lower risk of starting UAI with casual partners. Participants identified themselves as non-male gender ( HR=0.45) at lower risk of discounting UAI with casual partners. Conclusions:The transition patterns of homosexual behavior in MSM are different. Marital status, gender identity, educational level and other factors are the influencing factors of sexual behavior status transitions. Future researches should develop targeted interventions for different types of sexual partners and characteristics of MSM.

Objective:This study aims to analyze the focus and existing shortcomings of informal elderly care policy in China,and to provide references for policy system optimization.Methods:A two-dimensional analysis framework of"policy instruments-participating actors"was constructed and a content analysis method was applied to quantitatively analyze 34 relevant policy texts on informal elderly care(2011-2025),aiming to reveal the structural features and evolution logic of the policy system.Results:The policy evolution has undergone three stages,including institutional initiation,regulated development,and systematic deepening.In terms of policy tools,supply-side,environmental,and demand-side tools accounted for 39.6%,33.6%,and 26.8%,respectively,with the structure transitioning from a"supply-dominated"to a diversified synergistic model of"supply optimization+environmental empowerment+demand stimulation".In terms of participating actors,government departments(27.7%)played a dominant role,technology enterprises showed increased participation(20.6%),while family members remained underrepresented(9.2%).Conclusion:It is necessary to further optimize the structure of policy tool,strengthen social participation and family support systems,promote the deep integration of technology and humanistic care,and enhance the systematicness and effectiveness of the policy system.

Objective:To investigate the self-perceived cognitive decline status in the community population,and to explore the association between different dietary habits and self-perceived cognitive decline.Methods:A cross-sectional study was carried out in 11 879 community residents in the three regions of Weifang,Jining,and Zoucheng in Shandong Province.The Ascertain Dementia-8 and dietary habits information questionnaire were used to assess self-perceived cognitive decline and dietary habits,and their association were analyzed using single factor and multivariate logistic regression.Results:The detection rate of self-perceived cognitive decline was 21.4％.Lo-gistic regression showed that smoking in the past was positively associated with self-perceived cognitive decline(OR=1.40,95％CI:1.14-1.73).However,intake of fruits(often,OR=0.70,95％CI:0.52-0.94;everyday,OR=0.60,95％CI:0.44-0.81),nuts(daily,OR=0.62,95％CI:0.44-0.88),mushrooms(often,OR=0.74,95％CI:0.57-0.92)and high tryptophan foods(sometimes,OR=0.79,95％CI:0.68-0.91;everyday,OR=0.54,95％CI:0.34-0.87)were negatively associated with self-perceived cognitive decline.Conclusion:Smoking history might be a risk factor for self-perceived cognitive decline,and high frequency intake of fruits,nuts,mush-rooms,and high tryptophan foods might protective factors for it.

Objective:To investigate the symptom network structure of subjective cognitive decline(SCD)and its associated factors in middle-aged and older adults.Methods:A cross-sectional study was conducted among 8,262 community residents aged 45 years and over in Shandong Province(Jining,Weifang,and Zoucheng).SCD was assessed using the 8-item Ascertain Dementia(AD8)questionnaire,while mental health status was evaluated with Patient Health Questionnaire-9 and General Anxiety Disorder-7.SPSS and R were applied to construct the SCD symptom network model and examine its association with psychological factors.Results:The prevalence of SCD was 24.53％."Difficulty using household appliances"emerged as the core symptom,with the strongest connections to"forgetting appointments"(edge=2.13)and"declining daily memory and thinking ability".Additionally,"poor self-rated mental health"was most strongly linked to"loss of interest,change in hobbies and reduced activities"(edge=0.38).Conclusion:SCD symptoms in middle-aged and older adults exhibits strong interconnections and are closely linked to the individual's mental health condition.

Objective:To investigate the comorbidity rate of chronic diseases and prevalence of depressive symptoms among the middle-aged and elderly population,and explore the association between comorbidity with-chronic disease and depressive symptoms in middle-aged and older people.Methods:A cross-sectional study was conducted in Shandong Province.A total of 9 535 middle-aged and older people aged 45 years and over were recrui-ted.General information questionnaire,the chronic disease information questionnaire and Patient Health Question-naire were used for face-to-face interview to screen symptoms and collect information.Univariate analysis and mult-ivariate logistic regression analysis were employed to explore the association between comorbidity with chronic dis-ease and depressive symptoms.Results:The prevalence of depressive symptoms among middle-aged and older peo-ple was 8.7％,while among those with comorbid chronic diseases,the prevalence of depressive symptoms was 29.6％.Respectively,demonstrating an increasing trend with the number of chronic diseases(P＜0.001).Multiva-riate analysis revealed that comorbid chronic disease(OR=1.47,95％CI:1.22-1.78)were risk factors of depres-sive symptoms.Conclusion:Middle-aged and older people with multiple chronic conditions are more likely to be di-agnosed with depressive symptoms,and the detection rate of these symptoms increases with the number of comorbid chronic conditions.Therefore,it is recommended to strengthen mental health interventions for those with multiple chronic conditions.

Objective To construct a nomogram prediction model for predicting hemoglobin A1c(HbA1c)failure in type 2 diabetes mellitus(T2DM)patients.Methods A total of 936 inpatients with T2DM admitted to the Department of Endocrinology of the Affiliated Hospital of Shandong Second Medical University from January 2021 to January 2022 were selected as the research objects and divided into the non-standard group(HbA1c≥7%,n=801)and the standard group(HbA1c<7%,n=135).Univariate analysis was used to screen the related factors of HbA1c failure.Logistic regression multivariate model was used to analyze the influencing factors of HbA1c failure in T2DM patients.The R language was used to construct a nomogram,and the area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the predictive ability of the model.The C-index and Hosmer-Lemeshow test were used to evaluate the discrimination and calibration of the model.Results There were statistically significant differences in triglyceride(TG),low-density lipoprotein cholesterol,direct bilirubin,urinary albumin/creatinine ratio(UACR),self-monitoring of blood glucose(SMBG),meat and vegetable pairing,hot pot,whole grain and animal viscera consumption between the two groups(P<0.05).Logistic regression analysis showed that TG(OR 1.699,95%CI 1.298～2.222),UACR(OR 1.003,95%CI 1.001～1.005),SMGB(OR 0.480,95%CI 0.313～0.735),more meat and less vegetables(OR 1.432,95%CI 1.062～1.931)were the influencing factors of HbA1c failure.The AUC of the nomogram prediction model based on the influencing factors was 0.711,with C-index 0.710(95%CI 0.663～0.758)and good calibration(χ2=11.185,P=0.191).Conclusions The nomogram prediction model for HbA1c failure in T2DM patients established based on TG,UACR,SMGB,meat and vegetarian mix has good discrimination and calibration,which can provide certain reference value for warning of poor blood glucose control.

AIM:To study the effect of nicotinamide mononucleotide(NMN)on renal fibrosis in mice with Al-port syndrome(AS)through TGFβ/Smad3 pathway.METHODS:SPF grade female X-linked AS(COL4A5 KI)mice were divided into model group(AS group)and model drug administration group(AS+NMN group).while female C57BL/6 mice served as the wild-type(WT)group,with 7 to 8 mice in each group.The mice in the administration group were given oral administration at 8 weeks of age for 8 weeks to 16 weeks of age.The remaining mice were given saline intragastric ad-ministration.The ratio of urinary microalbumin to urinary creatinine(UACR)was measured by biochemical method.After sampling,the renal fibrosis was analyzed by Masson staining.The expression levels of desmin and α-smooth muscle actin(α-SMA)were detected by immunohistochemistry.The expressions of fibrosis-related proteins desmin,α-SMA,trans-forming growth factor β(TGFβ),Smad3,p-Smad3,and fibronectin were detected by Western blot.RESULTS:Com-pared with the model group,UACR(13 weeks,P＜0.01;15 weeks,P＜0.01)and fibrosis-related protein expression(P＜0.05)in AS mice were significantly decreased after NMN treatment.CONCLUSION:Treatment with NMN attenuates renal fibrosis in AS mice through TGFβ/Smad3 signaling pathway.

This study reviews Japan's interactions with WHO concerning topic setting,staffing,and financing,and summarizes its key characteristics and experiences:First,under the guidance of its national strategies,Japan concentrate its resources and promote multi-level cooperation with the WHO.Second,Japan establishes benchmarks based on its advantages and experience,to lead global discussions and actions on critical health topics.Third,Japan builds a win-win cooperation partnership with WHO.The study also discuss Japan's possible future cooperation with the WHO,and offers recommendations for China's collaboration with the WHO in the future.