Objective: To investigate the status of heat illness, knowledge awareness and adaptive behaviors of heat wave knowledge among food delivery riders, so as to provide a basis for optimizing heat wave response measures for food delivery riders. Methods: In November 2022, food delivery riders from a large food delivery platform in Ningbo City, Zhejiang Province were selected as survey subjects using a cluster sampling method. A self-designed electronic questionnaire was used to select demographic information, work status, lifestyle behaviors and disease history, heat illness status, knowledge awareness and adaptive behaviors of heatwave. Results: A total of 911 questionnaires were distributed, and 830 valid questionnaires were recovered, resulting in a valid response rate of 91.11%. Among the respondents, 796 (95.90%) were male, and 818 (98.55%) worked full-time. The mean age was (27.75±8.00) years. A total of 470 respondents (56.63%) had a work tenure of less than 1 year. The primary working hours were 8-<12 hours, with 504 people accounting for 60.72%. There were 108 cases of heatstroke, with an occurrence rate of 13.01%. And 286 people reported heat-related symptoms, with an occurrence rate of 34.46%. The overall awareness rate of heat wave knowledge was 73.22%, while the awareness rate of heat warning signal classification was relatively low at 9.04%. The heat wave cognition score was (5.86±1.31) points. There were statistically significant differences in heat wave cognition scores among food delivery riders of different ages, educational levels, family annual income, work tenures, and work durations (all P<0.05). Regarding positive adaptive behaviors, the number of riders paying attention to weather forecasts and actively learning about preventive measures was higher (734 people each, accounting for 88.43%). Regarding negative adaptive behaviors, the number of riders who often drank ice-cold beverages was higher (509 people, accounting for 61.33%). The heat wave adaptive behavior score was (6.88±1.77) points. There were statistically significant differences in adaptive behavior scores among riders with different educational levels, family annual income, work tenures, and smoking frequency (all P<0.05). Conclusions The occurrence rates of heatstroke and heat-related symptoms among food delivery riders are relatively high. The knowledge awareness and adaptive behaviors regarding heat wave are at a moderate level. It is suggested to strengthen health education, reinforce risk cognition of heat wave, and promote positive adaptive behaviors among food delivery riders.

Objective:To identify the risk factors for postoperative cognitive dysfunction (POCD) in elderly patients undergoing hip fracture surgery.Methods:In this case-control study, 6 differentially expressed genes were screened through gene expression database analysis and protein-protein interaction network analysis: cytochrome c oxidase subunit 7C (COX7C), ubiquinol-cytochrome c reductase complex III subunit VII (UQCRQ), cytochrome c oxidase subunit 7A2 (COX7A2), translocase of outer mitochondrial membrane 7, ubiquinone oxidoreductase subunit S5, and ribosomal protein L31. Elderly patients who underwent hip fracture surgery at Anhui No. 2 Provincial People′s Hospital from April 2022 to April 2024 were recruited. Based on the results of the Mini-Mental State Examination, the patients were divided into POCD group ( n=51) and non-POCD (NPOCD) group ( n=53). The expression of differentially expressed genes in the peripheral blood was detected using the fluorescent quantitative real-time polymerase chain reaction. The 6 differentially expressed genes were subjected to a difference test, and genes with P<0.05 were included in the binary logistic regression analysis to screen for risk factors for POCD. Results:The expression of COX7C, UQCRQ and COX7A2 was significantly down-regulated in POCD group compared with non-POCD group ( P<0.05). The results of logistic regression showed that the low-expression COX7C ( OR=1.926, 95% confidence interval [ CI] 1.604-5.264, P=0.022), UQCRQ ( OR=3.023, 95% CI 1.966-7.156, P=0.001), and COX7A2 ( OR=1.744, 95% CI 1.479-6.127, P=0.013) in peripheral blood were independent risk factors for the occurrence of POCD in elderly patients. Conclusions:Low-expression COX7C, UQCRQ and COX7A2 are risk factors for POCD in elderly patients undergoing hip fracture surgery.

Objective:To identify the risk factors for postoperative cognitive dysfunction (POCD) in elderly patients undergoing hip fracture surgery.Methods:In this case-control study, 6 differentially expressed genes were screened through gene expression database analysis and protein-protein interaction network analysis: cytochrome c oxidase subunit 7C (COX7C), ubiquinol-cytochrome c reductase complex III subunit VII (UQCRQ), cytochrome c oxidase subunit 7A2 (COX7A2), translocase of outer mitochondrial membrane 7, ubiquinone oxidoreductase subunit S5, and ribosomal protein L31. Elderly patients who underwent hip fracture surgery at Anhui No. 2 Provincial People′s Hospital from April 2022 to April 2024 were recruited. Based on the results of the Mini-Mental State Examination, the patients were divided into POCD group ( n=51) and non-POCD (NPOCD) group ( n=53). The expression of differentially expressed genes in the peripheral blood was detected using the fluorescent quantitative real-time polymerase chain reaction. The 6 differentially expressed genes were subjected to a difference test, and genes with P<0.05 were included in the binary logistic regression analysis to screen for risk factors for POCD. Results:The expression of COX7C, UQCRQ and COX7A2 was significantly down-regulated in POCD group compared with non-POCD group ( P<0.05). The results of logistic regression showed that the low-expression COX7C ( OR=1.926, 95% confidence interval [ CI] 1.604-5.264, P=0.022), UQCRQ ( OR=3.023, 95% CI 1.966-7.156, P=0.001), and COX7A2 ( OR=1.744, 95% CI 1.479-6.127, P=0.013) in peripheral blood were independent risk factors for the occurrence of POCD in elderly patients. Conclusions:Low-expression COX7C, UQCRQ and COX7A2 are risk factors for POCD in elderly patients undergoing hip fracture surgery.

Objective To evaluate the total and added effects of heatwaves on years of life lost(YLL)in Ningbo city.Methods We obtained data of mortality,population,meteorological and air quality from 2013 to 2019 in Ningbo city,and calculated the daily YLL rate.We defined 15 types of heatwaves by combining percentiles of daily maximum temperature with duration.Time series analysis and distributed lag non-linear model were used to estimate the total and added effects of heatwaves on YLL rate,and stratified analyses were conducted by gender and age(＜65 years,≥65 years).Results In the study period,the daily total YLL rate was(19.74±3.14)/105,which were higher in heatwave periods than in non-heatwave periods.The total effects of heatwave increased with higher temperature and longer duration.When heatwave was defined by daily maximum temperature≥95th(37.2℃)and the duration≥2 d,the total effect of heatwave in lag 0-10d was the greatest,with an increased total YLL rate of 3.77(95%CI:2.25,5.29)/105.The results of stratified analyses showed that heatwave had a larger effect on male and≥65 years old.The added effects of heatwave on male and≥65 years old were statistically significant(P＜0.05).Conclusion Heatwave could elevate the level of YLL rate,with greater impacts on male and elderly people.The added effects of heatwave may only occur in sensitive populations such as male and elderly people.

Objective:To explore the efficacy of central combined peripheral dual-target magnetic stimulation on Parkinson disease (PD) patients with freezing of gait (FOG).Methods:A total of 39 patients with FOG diagnosed at the Parkinson disease clinic of the Affiliated Hospital of Nantong University were included in the study from July 2022 to September 2023.They were randomly divided into observation group ( n=20) and control group ( n=19) by the random number table method. The patients in control group were treated with repetitive transcranial magnetic stimulation (rTMS), while the patients in observation group were treated with additional repetitive peripheral magnetic stimulation(rPMS) on the affected tibialis anterior muscle on the basis of the control group. Other clinical medical treatments were the same for both groups of patients.The timed up and go test (TUGT), 10 meter walk test (10MWT), and motor evoked potentials (MEP) were used to evaluate the efficacy before and after 2 weeks of treatment.The SPSS 25.0 software was used for statistical analysis. Independent sample t-test was used for comparison between the two groups, and paired sample t-test was used for comparison before and after treatment within group. Results:Before treatment, there were no statistically significant difference in TUGT time, 10MWT speed and MEP amplitude between the two groups( t=0.659, 0.514, 0.345, all P>0.05).After treatment, the TUGT time((7.87±1.74) s vs (9.31±1.57)s)and MEP amplitude((41.59±14.81)mV vs (58.26±19.26) mV)of the observation group were lower than those of the control group( t=2.723, 3.039, P=0.010, 0.004), while the 10MWT speed of the observation group was higher than that of the control group ((1.21±0.20) m/s vs (1.01±0.17)m/s, t=3.173, P=0.003).After treatment, the TUGT time and MEP amplitude of patients in the observation group and control group were all lower than before treatment (observation group: t=13.512, 7.126, both P<0.001; control group: t=6.535, 3.094, both P<0.05). The 10MWT speeds of patients in the observation group and control group after treatment were both higher than before treatment ( t=25.665, 6.750, both P<0.001). Conclusion:The combination of central and peripheral dual-target magnetic stimulation may improve the FOG of PD patients, and it is worthy of clinical promotion.

Objective: To evaluate the health risk of drinking water in Ningbo City, Zhejiang Province from 2021 to 2022, so as to provide insights into ensuring the safety of drinking water. Methods: The monitoring data of drinking water from 2021 to 2022 in Ningbo City were collected from the Chinese Disease Prevention and Control Information System. The routine indicators and disinfectant indicators (radioactivity indicators were excluded) of drinking water were evaluated according to the reference limits issued by Standards for Drinking Water Quality (GB 5749-2006), and the qualification rates were calculated. The indicators with detection rate higher than 50% were selected, and assessed the carcinogenic and non-carcinogenic risks via drinking water using the risk assessment model recommended by the United States Environmental Protection Agency. Results: A total of 1 678 samples were monitored in Ningbo City from 2021 to 2022. Sodium hypochlorite was the main disinfectant among 1 558 samples from centralized water supply (1 079 samples, 64.30%), and none of the 120 samples from decentralized water supply underwent disinfection treatment. The qualification rate of 88.38%, and the pollutants with a detection rate higher than 50% were nitrate, fluoride, trichloromethane and aluminum. The median carcinogenic risk value of trichloromethane was 2.964×10-6 (interquartile range, 3.909×10-6), and the median hazard quotient values of nitrate, fluoride, trichloromethane and aluminum were 1.631×10-2 (interquartile range, 1.361×10-2), 3.955×10-2 (3.164×10-2), 2.231×10-2 (2.942×10-2) and 2.136×10-4 (6.573×10-4), respectively. Conclusion The carcinogenic and non-carcinogenic risks through drinking water for 17 pollutants in drinking water of Ningbo City from 2021 to 2022 were at low levels.

Objective: To identify the most appropriate meteorological variable for forecasting the health risk of high temperatures. Methods: The surveillance on causes of death, meteorological data and surveillance on air quality among registered residents in Ningbo City, Zhejiang Province during the period between May and October from 2013 to 2019 were collected. The association models of daily minimum temperature, average daily temperature, daily maximum temperature, daily minimum heat index, average daily heat index, daily maximum heat index, average daily apparent temperature and torridity index with deaths and years of life lost (YLL) were created using time series analysis and distributed lag non-linear models, and the model fitting effect was evaluated using the minimum Akaike information criterion (AIC) procedure. The most appropriate meteorological variable for forecasting gender-, age- and mortality-specific health risks of high temperatures was identified. Results: A total of 120 628 deaths were reported during the study period, with daily deaths of 94 cases, and daily YLL rate of 19.74 person-years/105. Except for daily minimum heat index and torridity index, the exposure-response relationships between other six meteorological variables and deaths and overall YLL rate all appeared a “J” shape. The lowest AIC values and the optimal model fitting effects were measured for the association models between average daily temperature and whole populations, females, subjects at ages of 65 years and older, and deaths and YLL rates due to circulatory diseases and respiratory diseases. Conclusion High model fitting effects are observed between average daily temperature and deaths and YLL rates, which are more suitable for forecasting the health risk of high temperature.

Objective : To evaluate the excess mortality risk related to heat wave in Ningbo, Zhejiang from 2013 to 2018, so as to provide a basis for formulating coping strategies for heat wave. Methods : The data of daily mortality, meteorological and air quality from May to October in Ningbo from 2013 to 2018 were obtained from Ningbo Center for Disease Control and Prevention, Ningbo Meteorological Bureau and Environmental Monitoring Center of Ningbo, respectively. The generalized linear model ( GLM ) and distributed lag non-linear model ( DLNM ) were used to estimate the associations between heat wave and cause-specific mortality. Results : Among 1 104 days of the study period, 18 heat waves occured and lasted for 132 days, accounting for 11.96%. A total of 102 954 deaths were reported in the same period. The risks of mortality in circulatory system diseases ( RR=1.09, 95%CI: 1.03-1.16 ), respiratory system diseases ( RR=1.14, 95%CI: 1.04-1.25 ), digestive system diseases ( RR=1.38, 95%CI: 1.15-1.65 ), nervous system diseases ( RR=1.32, 95%CI: 1.08-1.61 ), mental disorders ( RR=1.51, 95%CI: 1.12-2.03 ) and accidental injury ( RR=1.18, 95%CI: 1.06-1.32 ) and all causes ( RR=1.10, 95%CI: 1.06-1.14 ) increased at lag 0-1 day of heat wave. The total excess death related to heat wave was 1 218 ( 95%CI: 731-1 705 ) . The excess deaths of circulatory system diseases, respiratory system diseases, accidental injury, digestive system diseases, nervous system diseases, mental disorders, urinary system diseases and endocrine system diseases were 313 ( 95%CI: 104-556 ), 206 ( 95%CI: 59-368 ), 164 ( 95%CI: 55-292 ), 122 ( 95%CI: 48-208 ), 69 ( 95%CI: 17-131 ), 56 ( 95%CI: 13-113 ), 18 ( 95%CI: -15-64 ) and 3 ( 95%CI: -51-72 ). The excess deaths of urinary system and endocrine system diseases was not statistically significant ( P>0.05 ). Conclusion Heat wave can increase the mortality risk on the day and after a day in Ningbo from 2013 to 2018. Circulatory system diseases, respiratory system diseases and accidental injury rank top three in excess deaths.

Objective:To describe the basic characteristics of clusters of coronavirus diseases 2019 (COVID-19) cases in Ningbo, Zhejiang province, and evaluate the generation time (Tg) and basic reproduction number ( R0) of COVID-19. Methods:The basic information and onset times of the clusters of COVID-19 cases in Ningbo were investigated, the inter-generational interval of the cases were fitted by using gamma distribution, and the R0 was calculated based on the SEIR model. Results:In the 15 clusters of COVID-19 cases, a total of 52 confirmed cases, 5 cases of nucleic acid-positive asymptomatic cases. The cases occurred from January 23 to February 4, the cases were mainly women. The incubation period was (6.11±3.38) days, and the median was 5 days. The Tg was (6.93±3.70) days. There were no significant differences in Tg between age group<60 years and age group 60 years and above, and between men and women ( P=0.551). According to the Tg calculated in this paper, the R0 of COVID-19 in Ningbo was 3.06 (95 %CI: 2.64- 3.51); according to the reported case transmission interval of 7.5 days in the literature, the R0 was 3.32 (95 %CI: 2.51-9.38). Conclusion:There is no age and gender specific differences in the Tg of clusters of COVID-19 cases in Ningbo, and COVID-19 has high infectivity and spreading power in early phase.

Objective: To explore the relationship between different temperature indicators and hospital admission for childhood pneumonia. Methods: The hospital admissions for pneumonia in children aged 0-14 years and meteorological data in Ningbo from 2015 to 2017 were collected. A distributed lag non-linear model combined with a generalized linear model was employed to analyze the exposure-response relationships between different temperature indicators（daily average,minimum and maximum temperature;the first percentile as low temperature and the 99th percentile as high temperature）and hospital admission for childhood pneumonia. Results: A total of 4 542 cases of childhood pneumonia were recruited. There were obvious seasonal fluctuations found in the inpatient volume of childhood pneumonia,which peaked in winter and bottomed in summer. After adjusting for potential confounding variables such as relative humidity,PM2.5,long term trend and seasonal trend,the results suggested that after exposed to whether low or high temperature,the inpatient volume of childhood pneumonia would increase. When the daily average temperature and daily minimum temperature were employed,the effect of high temperature on the increase of inpatient volume for childhood pneumonia was statistically significant and the cumulative relative risk for a lag of 0-7 days were 1.52（95%CI：1.04-2.23）and 1.59（95%CI：1.08-2.34）,respectively. When the daily maximum temperature was employed,the effect of low temperature on the increase of inpatient volume for childhood pneumonia was statistically significant and the cumulative relative risk for a lag of 0-7 days were 1.30（95%CI：1.02-1.66）. Conclusion Our findings suggested that an increased risk of hospital admission for childhood pneumonia was associated with both low and high temperature.