Objective:To investigate the mediating effects of medical inquiry ability and attitudes toward aging on the relationship between socioeconomic status and mental health among the elderly.Methods:Utilizing data from the 2021 China General Social Survey(CGSS), a sample of 957 individuals aged 60 years and older was selected for analysis.The influence of each variable was assessed through regression analysis, and the mediating effects were evaluated using the Bootstrap method.Results:The study samples ranged in age from 60 to 95 years, including 479 females and 478 males.Socioeconomic status significantly positively influenced mental health( β=0.208, P<0.001).Additionally, socioeconomic status had a notable positive effect on medical inquiry ability( β=0.244, P<0.001)and attitudes toward aging( β=0.163, P<0.001)among the elderly population.Furthermore, medical inquiry ability positively affected both attitudes toward aging( β=0.158, P<0.001)and mental health( β=0.139, P<0.001).The attitude toward aging also had a significant positive impact on mental health( β=0.216, P<0.001).Notably, both medical inquiry ability and attitudes toward aging served as significant mediators between socioeconomic status and mental health in the elderly, with a total indirect effect value of 0.091(95% CI: 0.063-0.123).The chain mediating effect of medical inquiry ability and pension mentality was also significant, with an effect size of 0.010(95% CI: 0.005-0.017). Conclusions:Enhancing the socioeconomic status of older adults can foster their medical inquiry ability, positively influence their attitudes toward aging, and ultimately contribute to the promotion of their mental health.

Objective:This study aims to investigate the impact of socioeconomic status on cognitive function in older adults, while analyzing the mediating role of health-related social determinants.The findings will provide a foundation for the implementation of an active aging strategy.Methods:Utilizing data from the China Health and Retirement Longitudinal Study(CHARLS)2020, this study employed multiple linear regression analysis to investigate the relationship between socioeconomic status and cognitive function among older adults.A multiple mediation model was applied to evaluate the mediating effects of health-related social determinants on the association between socioeconomic status and cognitive function, with these mediation effects assessed using the Bootstrap method.Results:The results of the multiple linear regression analysis indicated that socioeconomic status significantly positively influences cognitive function in older adults.Factors such as younger age, male gender, Han ethnicity, and urban residence were associated with higher cognitive scores.The mediation analysis demonstrated that, of the total effect of socioeconomic status on cognitive function, health status accounted for 1.564%, individual lifestyle for 14.820%, social support networks for 2.719%, living conditions for 1.632%, and other social structural factors for 1.496%.In the multiple mediation model, a total of 17.945% of the effect of socioeconomic status on cognitive function in older adults was jointly mediated by health-related social determinants.Conclusions:Socioeconomic status is a critical determinant of cognitive impairment among older adults in China.To address this issue, comprehensive interventions should be implemented to promote the equitable distribution of economic and social resources, reduce socioeconomic disparities, and mitigate health inequalities, thereby enhancing the overall cognitive function of disadvantaged groups.Preventive measures and strategies aimed at improving health status, encouraging healthy lifestyle choices, strengthening social support networks, enhancing living conditions, and optimizing social structural factors could serve as essential intervention points to improve the cognitive function of older adults with lower socioeconomic status.

Objective To explore related factors of intra-amniotic infection(IAI)during the delivery period in pregnant women with gestational diabetes mellitus(GDM),and to analyze the predictive value of these related factors for IAI.Methods A retrospective study was conducted on 360 GDM pregnant women,including 120 cases with IAI(IAI group)and 240 pregnant women with GDM who did not develop IAI(control group).Clinical data,fetal monitoring during labor,placental pathology,pregnancy outcomes and glycosylated hemoglobin(HbA1c)results were collected for both groups.Multivariate Logistic regression was used to investigate influencing factors of IAI.The predictive value of combined HbA1c levels,parity and rupture time for IAI was evaluated using receiver operating characteristic(ROC)curves,and the area under the curve(AUC)was calculated.Results In the IAI group,the proportion of primigravida,first-time delivery,artificial rupture of membranes,oxytocin use,rupture time and HbA1c levels were significantly higher than those in the control group(P＜0.05).The IAI group had a smaller gestational age at delivery,higher rates of forceps-assisted delivery,cesarean section and amniotic fluid contamination(P＜0.05).In the IAI group,the proportion of abnormal intrapartum baseline fetal heart rate and the incidence of late decelerations were higher than those in the control group(P＜0.05),while the incidence of variable deceleration and the proportion of category Ⅱ fetal heart rate monitoring were lower in the IAI group than those in the control group(P＜0.05).There were no significant differences in baseline variability or acceleration of fetal heart rate between the two groups(P＞0.05).The proportions of mild neonatal asphyxia and neonatal transfer to intensive care were high in the IAI group than those of the control group(P＜0.05).Multivariate Logistic regression showed that elevated HbA1c levels(OR=3.342,95%CI:1.539-7.257)and prolonged rupture time(OR=1.001,95%CI:1.000-1.001)were independent risk factors for IAI in GDM pregnant women,while multiparity was a protective factor(OR=0.113,95%CI:0.046-0.278).The AUC for predicting IAI during labor by combining HbA1c,parity and rupture time was 0.819(95%CI:0.772-0.865),with a sensitivity of 0.742 and specificity of 0.767.Conclusion HbA1c levels,rupture time and parity are independent influencing factors for IAI during labor in pregnant women with GDM.The combination of these three factors has high clinical value in predicting IAI in GDM patients.

Objective To explore related factors of intra-amniotic infection(IAI)during the delivery period in pregnant women with gestational diabetes mellitus(GDM),and to analyze the predictive value of these related factors for IAI.Methods A retrospective study was conducted on 360 GDM pregnant women,including 120 cases with IAI(IAI group)and 240 pregnant women with GDM who did not develop IAI(control group).Clinical data,fetal monitoring during labor,placental pathology,pregnancy outcomes and glycosylated hemoglobin(HbA1c)results were collected for both groups.Multivariate Logistic regression was used to investigate influencing factors of IAI.The predictive value of combined HbA1c levels,parity and rupture time for IAI was evaluated using receiver operating characteristic(ROC)curves,and the area under the curve(AUC)was calculated.Results In the IAI group,the proportion of primigravida,first-time delivery,artificial rupture of membranes,oxytocin use,rupture time and HbA1c levels were significantly higher than those in the control group(P＜0.05).The IAI group had a smaller gestational age at delivery,higher rates of forceps-assisted delivery,cesarean section and amniotic fluid contamination(P＜0.05).In the IAI group,the proportion of abnormal intrapartum baseline fetal heart rate and the incidence of late decelerations were higher than those in the control group(P＜0.05),while the incidence of variable deceleration and the proportion of category Ⅱ fetal heart rate monitoring were lower in the IAI group than those in the control group(P＜0.05).There were no significant differences in baseline variability or acceleration of fetal heart rate between the two groups(P＞0.05).The proportions of mild neonatal asphyxia and neonatal transfer to intensive care were high in the IAI group than those of the control group(P＜0.05).Multivariate Logistic regression showed that elevated HbA1c levels(OR=3.342,95%CI:1.539-7.257)and prolonged rupture time(OR=1.001,95%CI:1.000-1.001)were independent risk factors for IAI in GDM pregnant women,while multiparity was a protective factor(OR=0.113,95%CI:0.046-0.278).The AUC for predicting IAI during labor by combining HbA1c,parity and rupture time was 0.819(95%CI:0.772-0.865),with a sensitivity of 0.742 and specificity of 0.767.Conclusion HbA1c levels,rupture time and parity are independent influencing factors for IAI during labor in pregnant women with GDM.The combination of these three factors has high clinical value in predicting IAI in GDM patients.

Objective:To investigate the mediating effects of medical inquiry ability and attitudes toward aging on the relationship between socioeconomic status and mental health among the elderly.Methods:Utilizing data from the 2021 China General Social Survey(CGSS), a sample of 957 individuals aged 60 years and older was selected for analysis.The influence of each variable was assessed through regression analysis, and the mediating effects were evaluated using the Bootstrap method.Results:The study samples ranged in age from 60 to 95 years, including 479 females and 478 males.Socioeconomic status significantly positively influenced mental health( β=0.208, P<0.001).Additionally, socioeconomic status had a notable positive effect on medical inquiry ability( β=0.244, P<0.001)and attitudes toward aging( β=0.163, P<0.001)among the elderly population.Furthermore, medical inquiry ability positively affected both attitudes toward aging( β=0.158, P<0.001)and mental health( β=0.139, P<0.001).The attitude toward aging also had a significant positive impact on mental health( β=0.216, P<0.001).Notably, both medical inquiry ability and attitudes toward aging served as significant mediators between socioeconomic status and mental health in the elderly, with a total indirect effect value of 0.091(95% CI: 0.063-0.123).The chain mediating effect of medical inquiry ability and pension mentality was also significant, with an effect size of 0.010(95% CI: 0.005-0.017). Conclusions:Enhancing the socioeconomic status of older adults can foster their medical inquiry ability, positively influence their attitudes toward aging, and ultimately contribute to the promotion of their mental health.

Objective:This study aims to investigate the impact of socioeconomic status on cognitive function in older adults, while analyzing the mediating role of health-related social determinants.The findings will provide a foundation for the implementation of an active aging strategy.Methods:Utilizing data from the China Health and Retirement Longitudinal Study(CHARLS)2020, this study employed multiple linear regression analysis to investigate the relationship between socioeconomic status and cognitive function among older adults.A multiple mediation model was applied to evaluate the mediating effects of health-related social determinants on the association between socioeconomic status and cognitive function, with these mediation effects assessed using the Bootstrap method.Results:The results of the multiple linear regression analysis indicated that socioeconomic status significantly positively influences cognitive function in older adults.Factors such as younger age, male gender, Han ethnicity, and urban residence were associated with higher cognitive scores.The mediation analysis demonstrated that, of the total effect of socioeconomic status on cognitive function, health status accounted for 1.564%, individual lifestyle for 14.820%, social support networks for 2.719%, living conditions for 1.632%, and other social structural factors for 1.496%.In the multiple mediation model, a total of 17.945% of the effect of socioeconomic status on cognitive function in older adults was jointly mediated by health-related social determinants.Conclusions:Socioeconomic status is a critical determinant of cognitive impairment among older adults in China.To address this issue, comprehensive interventions should be implemented to promote the equitable distribution of economic and social resources, reduce socioeconomic disparities, and mitigate health inequalities, thereby enhancing the overall cognitive function of disadvantaged groups.Preventive measures and strategies aimed at improving health status, encouraging healthy lifestyle choices, strengthening social support networks, enhancing living conditions, and optimizing social structural factors could serve as essential intervention points to improve the cognitive function of older adults with lower socioeconomic status.

Objective:To investigate the mediating effect of social interaction on the relationship between internet use and the health status of the elderly.The findings of this research can potentially contribute new insights into improving the health status of the elderly population.Methods:Based on the data from the Chinese General Social Survey(CGSS)in 2021, a total of 2 675 elderly individuals aged 60 and above were included in the study.The researchers analyzed the linear regression relationship between Internet use, social interaction, and the health status of the elderly using a hierarchical regression model.Additionally, a mediation effect test was conducted using the Bootstrap test.Furthermore, heterogeneity analysis of the mediation effect was performed considering factors such as gender, place of residence, working conditions, and physical exercise among the elderly participants.Results:The total effect value was 0.170.The direct effect of Internet use on the health status of older adults was 0.160(95% CI: 0.078-0.240), accounting for 93.66% of the effect value.The indirect effect of social interaction was 0.011(95% CI: 0.003-0.021), accounting for 6.34% of the effect value.The mediating effect of social interaction on the health status of older adults varied among different groups.Among female elderly, rural elderly, elderly who are currently unemployed, and those who are physically active, the mediating effects were 5.16%, 7.86%, 10.18%, and 9.91%, respectively. Conclusions:The impact of internet use and social interaction on the health status of the elderly is notably positive.Additionally, social interaction partially mediates the relationship between internet use and the health status of the elderly.

Objective:To analyze the disparity in the prevalence of chronic comorbidities between the urban and rural elderly populations, providing scientific evidence to tailor health management strategies and policies.Methods:Data from 9, 252 participants aged 60 years and older, drawn from the 2020 China Health and Retirement Longitudinal Study(CHARLS, 2020), were analyzed.The urban-rural disparity in chronic comorbidities prevalence and the associated factors were examined using logistic regression analysis and Fairlie decomposition.Results:Of the 9, 252 participants, the rate of chronic comorbidities was 66.10%, with a higher prevalence observed in the urban population compared to the rural population(68.52% vs.64.86%, =12.421, P<0.001).Logistic regression analysis indicated that among the urban population, chronic comorbidities were less prevalent in participants who reported more than 6 hours of sleep, were employed, and assessed their health as good.Conversely, a higher prevalence was noted in individuals aged 65 and older.In the rural population, the rate of chronic comorbidities was lower in participants who reported more than 6 hours of sleep, were employed, had annual incomes exceeding RMB 10, 000, assessed their health as good, and reported higher life satisfaction.Utilizing the Fairlie decomposition method, it was found that the differences in the prevalence of chronic comorbidities between urban and rural elderly populations were primarily attributable to employment status and sleep duration( P<0.05), with contribution rates of 69.22% and 6.92%, respectively. Conclusions:In the context of global aging, this study examined the factors influencing the prevalence of comorbidity among elderly populations in urban and rural settings.The findings demonstrate that enhancing sleep quality, promoting employment opportunities, fostering community engagement, and encouraging family interaction may contribute to reducing the health disparities between urban and rural areas, thereby supporting healthy aging.

Objective:To analyze the disparity in the prevalence of chronic comorbidities between the urban and rural elderly populations, providing scientific evidence to tailor health management strategies and policies.Methods:Data from 9, 252 participants aged 60 years and older, drawn from the 2020 China Health and Retirement Longitudinal Study(CHARLS, 2020), were analyzed.The urban-rural disparity in chronic comorbidities prevalence and the associated factors were examined using logistic regression analysis and Fairlie decomposition.Results:Of the 9, 252 participants, the rate of chronic comorbidities was 66.10%, with a higher prevalence observed in the urban population compared to the rural population(68.52% vs.64.86%, =12.421, P<0.001).Logistic regression analysis indicated that among the urban population, chronic comorbidities were less prevalent in participants who reported more than 6 hours of sleep, were employed, and assessed their health as good.Conversely, a higher prevalence was noted in individuals aged 65 and older.In the rural population, the rate of chronic comorbidities was lower in participants who reported more than 6 hours of sleep, were employed, had annual incomes exceeding RMB 10, 000, assessed their health as good, and reported higher life satisfaction.Utilizing the Fairlie decomposition method, it was found that the differences in the prevalence of chronic comorbidities between urban and rural elderly populations were primarily attributable to employment status and sleep duration( P<0.05), with contribution rates of 69.22% and 6.92%, respectively. Conclusions:In the context of global aging, this study examined the factors influencing the prevalence of comorbidity among elderly populations in urban and rural settings.The findings demonstrate that enhancing sleep quality, promoting employment opportunities, fostering community engagement, and encouraging family interaction may contribute to reducing the health disparities between urban and rural areas, thereby supporting healthy aging.

Objective:To construct a porcine model of ischemia with non-obstructive coronary artery (INOCA) and explore the diagnostic value of a one-stop noninvasive method including CT myocardial perfusion imaging (CT-MPI) and coronary CT angiography (CCTA).Methods:Twelve swines were divided into the experimental group (9) and the normal group (3). Coronary microvascular dysfunction (CMD) porcine model was constructed in the experimental group by inducing diabetes mellitus, chronic kidney disease, and hypercholesterolemia. Invasive coronary angiography (ICA) and functional examination were performed on all 7+3 trial swines to clarify the INOCA diagnosis after completion of the modeling. Then, CT-MPI and CCTA were performed on all individuals to explore the CT-MPI and CCTA characteristics of INOCA porcine models. CT-MPI parameters, including myocardial blood flow (MBF), and myocardial blood volume (MBV) in rest and stress conditions, and CCTA parameters, including severity of stenosis and CAD-RADS, were analyzed.Results:ICA and functional tests showed that all swines in the experimental group met the diagnostic criteria for INOCA, which meant that INOCA porcine model was constructed successfully. CCTA results confirmed that there was no obstructive coronary stenosis in all 10 swines which were examined, which was consistent with ICA findings. CT-MPI results demonstrated that the mean MBF values, as well as the mean MBV values, in the rest and stress condition of each swines in the experimental group were lower than those of the control group. In contrast to the control group, the mean MBF and MBV values of swines in the experimental group in stress condition were generally lower than those in resting condition.Conclusions:In this study, a porcine model of CMD is successfully constructed by inducing hypercholesterolemia+diabetes mellitus+chronic kidney disease. ICA and invasive functional tests show that this CMD model meet the diagnostic criteria for INOCA. It has been confirmed that one-stop CT multimodality examination including CT-MPI and CCTA can be used for the diagnosis of INOCA as a noninvasive diagnostic method.