Objective: To evaluate the classroom environmental management and CO 2 volume concentration in primary and secondary schools from Liaoning, Tianjin, and Shanghai, thereby providing a scientific basis for developing targeted strategies to improve classroom air quality. Methods: From December 16 to 26, 2024, by using stratified random cluster sampling method, the questionnaire survey was conducted in 72 primary and secondary schools (24 each of primary, junior high, and regular high schools) across Liaoning, Tianjin and Shanghai. Information on heating, ventilation and other classroom environmental management was collected. Additionally, 108 classrooms were selected for on site microclimate measurements, including temperature, humidity, wind speed and CO 2 volume concentration. Univariate analysis and multiple linear regression models were employed to explore related factors of classroom CO 2 volume concentration. Results: Among the three provinces/municipalities, 20.8% of schools regularly monitored the microclimate. The overall compliance rate for classroom CO 2 volume concentration was 17.6%. Multiple linear regression analysis showed that CO 2 volume concentration in regular and junior high school classrooms were higher than in primary school classrooms ( β=0.067, 0.046, 95%CI =0.036-0.099, 0.013-0.080); classrooms ventilated regularly in the morning and afternoon had higher CO 2 volume concentration than those ventilated during every break between classes ( β=0.043, 95%CI = 0.007- 0.080); both temperature ( β=0.010, 95%CI =0.004-0.016) and humidity ( β=0.003, 95%CI =0.002-0.004) were positively correlated with CO 2 volume concentration (all P <0.05). Conclusions Excessive CO 2 volume concentration in primary and secondary school classrooms is a prominent issue, and ventilation frequency is a key intervenable factor for controlling CO 2 levels. It is recommended to promote ventilation during every break between classes as a core management measure and to emphasize air quality supervision in regular high school classrooms.

Objective:To explore the association between healthy lifestyle and co-morbidity of overweight/obesity and myopia in adolescents.Methods:Based on the Shanghai Municipal Dynamic Cohort of Student Common Diseases, we used the group-based trajectory model (GBTM) to establish a model for the development of adolescents' healthy lifestyle trajectories aged 11-14 years and the Cox proportional hazard regression model to assess the effects of different healthy lifestyles on the co-morbidity of overweight/obesity and myopia in adolescents.Results:A total of 2 331 adolescents were included in the analysis. The average follow-up time was 1.87 years, with age of (11.44±0.45) years at the initial follow-up, among 1 106 boys and 1 225 girls. During the 2-year follow-up period, the incidence rates of overweight/obesity, myopia, and co-occurrence of overweight/obesity and myopia were 25.9%, 77.0%, and 13.7%, respectively. GBTM identified 3 healthy lifestyles: the unhealthy group (7.3%), the relatively healthy group (50.2%), and the healthy group (42.5%). The risk of overweight/obesity was lower in the relatively healthy group than in the unhealthy group ( HR=0.694, 95% CI: 0.508-0.947). There was no statistically significant association between the GBTM lifestyle subgroups and myopia ( P>0.05). The risk of co-occurrence of overweight/obesity and myopia was lower in both relatively healthy group and healthy group than in the unhealthy group (relatively healthy group: HR=0.515, 95% CI: 0.348-0.763; healthy group: HR=0.571, 95% CI: 0.384-0.849). Sensitivity analyses showed this result to be stable for myopia, overweight/obesity and myopia co-morbidities. Conclusion:Persistent unhealthy lifestyle increases the risk of overweight/obesity and myopia co-occurrence in adolescents.

Objective:To analyze the association between moderate-to-vigorous-physical activity (MVPA) and obesity, poor sleep quality, as well as multimorbidity in 7- to 8-year-old children in Shanghai City.Methods:From September to November 2023, a cluster sampling method was used to select second-grade students from four primary schools in Jinshan District, Shanghai. Three-axis acceleration motion sensors (GT3X+, Acti-graph) were used to monitor daily physical activity for seven consecutive days. A multivariate logistic regression model was used to analyze the association between MVPA duration characteristics and obesity, poor sleep quality and multimorbidity in school-age children.Results:Of the 937 study participants, 512 (54.64%) were boys and 425 (45.36%) were girls. Among them, 89 (9.50%) were obese and 782 (83.46%) had poor sleep quality. A total of 77 cases (8.22%) were affected by obesity and poor sleep quality. The average daily MVPA time was (45.97±15.87) minutes, and the MVPA attainment rate was 17.18%. The multivariate logistic regression model analysis showed that, after adjusting for covariates, the daily average MVPA time was negatively associated with the risk of obesity ( OR=0.982, 95% CI: 0.968-0.997), as well as multimorbidity ( OR=0.981, 95% CI: 0.965-0.997). The risk of obesity, poor sleep quality and multimorbidity in <1 d was 2.228 ( OR=2.228, 95% CI: 1.398-3.549), 1.702 ( OR=1.702, 95% CI: 1.141-2.540) and 2.150 ( OR=2.150, 95% CI: 1.310-3.528) times higher than that in ≥1 d. Conclusion:Obesity, poor sleep quality and multimorbidity of school-age children are closely related to the level of moderate-to-vigorous physical activity.

Objective:To explore the association between healthy lifestyle and co-morbidity of overweight/obesity and myopia in adolescents.Methods:Based on the Shanghai Municipal Dynamic Cohort of Student Common Diseases, we used the group-based trajectory model (GBTM) to establish a model for the development of adolescents' healthy lifestyle trajectories aged 11-14 years and the Cox proportional hazard regression model to assess the effects of different healthy lifestyles on the co-morbidity of overweight/obesity and myopia in adolescents.Results:A total of 2 331 adolescents were included in the analysis. The average follow-up time was 1.87 years, with age of (11.44±0.45) years at the initial follow-up, among 1 106 boys and 1 225 girls. During the 2-year follow-up period, the incidence rates of overweight/obesity, myopia, and co-occurrence of overweight/obesity and myopia were 25.9%, 77.0%, and 13.7%, respectively. GBTM identified 3 healthy lifestyles: the unhealthy group (7.3%), the relatively healthy group (50.2%), and the healthy group (42.5%). The risk of overweight/obesity was lower in the relatively healthy group than in the unhealthy group ( HR=0.694, 95% CI: 0.508-0.947). There was no statistically significant association between the GBTM lifestyle subgroups and myopia ( P>0.05). The risk of co-occurrence of overweight/obesity and myopia was lower in both relatively healthy group and healthy group than in the unhealthy group (relatively healthy group: HR=0.515, 95% CI: 0.348-0.763; healthy group: HR=0.571, 95% CI: 0.384-0.849). Sensitivity analyses showed this result to be stable for myopia, overweight/obesity and myopia co-morbidities. Conclusion:Persistent unhealthy lifestyle increases the risk of overweight/obesity and myopia co-occurrence in adolescents.

Objective:To analyze the association between moderate-to-vigorous-physical activity (MVPA) and obesity, poor sleep quality, as well as multimorbidity in 7- to 8-year-old children in Shanghai City.Methods:From September to November 2023, a cluster sampling method was used to select second-grade students from four primary schools in Jinshan District, Shanghai. Three-axis acceleration motion sensors (GT3X+, Acti-graph) were used to monitor daily physical activity for seven consecutive days. A multivariate logistic regression model was used to analyze the association between MVPA duration characteristics and obesity, poor sleep quality and multimorbidity in school-age children.Results:Of the 937 study participants, 512 (54.64%) were boys and 425 (45.36%) were girls. Among them, 89 (9.50%) were obese and 782 (83.46%) had poor sleep quality. A total of 77 cases (8.22%) were affected by obesity and poor sleep quality. The average daily MVPA time was (45.97±15.87) minutes, and the MVPA attainment rate was 17.18%. The multivariate logistic regression model analysis showed that, after adjusting for covariates, the daily average MVPA time was negatively associated with the risk of obesity ( OR=0.982, 95% CI: 0.968-0.997), as well as multimorbidity ( OR=0.981, 95% CI: 0.965-0.997). The risk of obesity, poor sleep quality and multimorbidity in <1 d was 2.228 ( OR=2.228, 95% CI: 1.398-3.549), 1.702 ( OR=1.702, 95% CI: 1.141-2.540) and 2.150 ( OR=2.150, 95% CI: 1.310-3.528) times higher than that in ≥1 d. Conclusion:Obesity, poor sleep quality and multimorbidity of school-age children are closely related to the level of moderate-to-vigorous physical activity.

Objective: To understand the prevalence and influencing factors of scoliosis among primary and middle school students in Shanghai, so as to provide reference for the prevention and control strategies of scoliosis in children and adolescents. Methods: From September to December 2021, a total of 4 531 students from grade four of primary school to grade three of junior high school from 16 primary and middle schools in 4 districts of Shanghai were selected by multi stage stratified cluster sampling to carry out scoliosis screening and questionnaire survey. Independent sample t-test, Chi-squared test, Fisher s exact probability method and nonparametric Mann Whitney U-test were used for statistical analysis, and multivariate Logistic regression was used to analyze the influencing factors of scoliosis. Results: The on the spot detection rate of scoliosis abnormality was 7.4% and the prevalence was 2.2%, mainly for thoracolumbar scoliosis (60.4%) and the scoliosis angle of 10° -<20°(88.1%). The results showed that the detection rate of scoliosis in boys was 1.6% and in girls was 3.3%, with a statistically significant difference ( χ 2=11.84, P < 0.01). There were significant differences in weight and BMI between scoliosis students and students with negative initial screening( t = -3.77, -5.30, P <0.01). And there was a statistically significant difference in the detection rate of scoliosis with different frequency of classroom seating arrangements ( Z =2.02, P <0.05). The results of multivariate Logistic regression showed that the risk of scoliosis in girls was higher than that in boys ( OR =1.87, 95% CI =1.21-2.88). BMI ( OR =0.89, 95% CI =0.83-0.95) and frequency of classroom seating arrangements ( OR =0.49, 95% CI =0.25-0.93) were correlated with lower rate of scoliosis. After stratification by sex, the frequency of classroom seating arrangements ( OR =0.26, 95% CI =0.10-0.67) in boys and the educational stage ( OR =2.35, 95% CI =1.26-4.41) in girls ( P <0.05) was correlated with higher rate of scoliosis, while BMI ( OR =0.86, 95% CI =0.79-0.94) in girls were correlated with lower rate of scoliosis. Conclusion Regular screening of scoliosis is an effective method for early detection of scoliosis. Girls in junior high school and low BMI should be paid close attention to. According to the occurrence and influencing factors of scoliosis, comprehensive prevention and control based on family, school, society, and other aspects can be carried out.

ObjectiveTo explore the sensory processing characteristics of preschool children with autism spectrum disorder （ASD）， and to provide a theoretical basis for early screening and intervention training of ASD. MethodsA total of 215 preschool children with ASD and170 typically developed （TD） children were investigated with a basic situation questionnaire and sensory processing measure （SPM）. The two groups were stratified according to age and gender， and the differences of scores in sensory domains were compared to analyze the sensory processing characteristics of preschool children with ASD. ResultsThe scores of social participation， vision， hearing， touch， taste and smell， body awareness， balance and motion， planning and ideas， and total sensory system in children with ASD were all higher than those in children with TD （all P<0.01）. The highest degree of abnormality was found in hearing and the lowest degree in taste and smell in children with ASD. The results of Spearman correlation analysis showed that in the 4-year-old and 5-year-old children with ASD， the scores of vision （r_s=-0.200， P= 0.033） and hearing （r_s=-0.194， P=0.040） decreased with age. There was no correlation between the scores of other developmental quotients and age （all P>0.05）. Boys and girls with ASD had higher scores in all developmental quotients than TD children （P<0.01）. However， there was no significant gender difference in any developmental quotients of ASD children （all P>0.05）. ConclusionSensory processing abnormalities are common in preschool children with ASD， which are different from those of TD children in multiple sensory domains. Sensory processing abnormalities may be used as an indicator for early screening of ASD， and it is necessary to conduct corresponding intervention training for sensory processing abnormalities in children with ASD.