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Background Existing research has extensively explored the relationship between government trust and compliance behaviour, but significant controversies exist. Some studies suggest a strong positive correlation between the two. Other studies have found that government trust hinders compliance behaviour. However, during the pandemic, the effectiveness of public health policies largely depends on the public’s compliance with these policies. To examine the aforementioned controversies, this study utilizes survey data on the Chinese population during the COVID-19 period to explore the relationship between compliance with public health policies and government trust. Methods The study conducted a questionnaire survey of 1,395 individuals from 25 provinces in China from mid-November to mid-December 2022. Firstly, we categorized the public’s compliance behaviour with public health policies based on the results of factor analysis. Subsequently, we examined the impact of government trust and professional trust on compliance behaviour with public health policies by constructing a structural equation model. Results Based on the results of factor analysis, we classified public adherence to public health policies into protective compliance and restrictive compliance. Results from the structural equation model show a positive correlation between the public’s trust in the government and both protective and restrictive compliance, with a stronger influence on protective compliance. Government trust also exerts a positive impact on restrictive compliance behaviour through professional trust. Additionally, the study indicates a significant positive correlation between the public’s professional trust and restrictive compliance, while it does not significantly affect protective compliance. Moreover, the public from rural areas demonstrates a greater willingness to adhere to both types of public health policies. Married individuals exhibit a stronger inclination toward protective compliance, while females show a stronger tendency toward restrictive compliance. Conclusion The study revealed a significant positive impact of government trust and professional trust on compliance behaviour with public health policies during the COVID-19 pandemic, refuting any negative correlation between government trust and compliance behaviour. Normative motivations for compliance behaviour had a substantial impact on adherence. These findings offer valuable insights for future public health crisis management and public policy formulation.

The classical Grothendieck compactness principle states that every norm-compact subset of a Banach space lies in the closed convex hull of a norm null sequence. Replacing the norm topology by the weak topology yields a characterization of Banach spaces with the Schur property. In the present paper, we establish an extension of this principle to the framework of super weakly compact sets. Specifically, we prove that for a Banach space X with the weak Banach–Saks property, every super weakly compact subset of X is contained in the closed convex hull of a uniformly weakly null sequence if and only if X has the Schur property. In addition, we demonstrate that every Banach space failing the Schur property contains a weakly null sequence which is not uniformly weakly null.

Previous studies on public compliance with policies during pandemics have primarily explained it from the perspectives of motivation theory, focusing on normative motivation (trust in policy-making institutions) and calculative motivation (fear of contracting the disease). However, the social amplification of a risk framework highlights that the media plays a key role in this process. This study aims to integrate the motivation theory of compliance behavior and the social amplification of risk framework to uncover the \"black boxes\" of the mechanisms by which normative motivation and calculative motivation influence public policy compliance behavior through the use of media. During the COVID-19 pandemic, we conducted a web-based survey of 2309 Chinese citizens from December 4, 2022, to March 21, 2023. We treated the public's policy compliance behavior during the pandemic as the dependent variable. Media use, specifically the use of authoritative media and \"we-media,\" that is, personal social media accounts and media platforms operated by individuals, was set as the independent variable. Trust in government, representing normative motivation, and risk perception, representing calculative motivation, were included as mediating variables. A structural equation model was constructed and analyzed using Stata. First, the mediation effect of trust in government indicates that the use of authoritative media can enhance trust in government, which significantly increases individuals' policy compliance behavior (β coefficient=0.108, 95% CI 0.080-0.135; P<.001). Second, the mediation effect of risk perception shows that the use of we-media heightened individual risk perception, thereby significantly enhancing policy compliance behavior (β coefficient=0.012, 95% CI 0.002-0.021; P=.02). Third, the study revealed the \"paradox of trust\": the chain mediation effect in which authoritative media increased trust in government and reduced risk perception, ultimately decreasing policy compliance behavior (β coefficient=-0.005, 95% CI -0.009 to -0.001; P=.008). By combining the motivation theory of compliance behavior with the social amplification of risk framework in risk communication, we found that trust in government, as a normative motivation, operates through authoritative media, while risk perception, as a calculative motivation, promotes compliance behavior through we-media. In addition, in major crises, the public's use of authoritative media can lead to the paradox of trust: on the one hand, trust in the government increases policy compliance; on the other hand, this trust reduces risk perception, thereby decreasing compliance behavior. Authoritative institutions need to balance providing authoritative information with maintaining the public's risk perception.

Epigenetic modifications are plausible molecular sources of phenotypic heterogeneity across schizophrenia patients. The current study investigated biological heterogeneity in schizophrenia using peripheral epigenetic profiles to delineate illness subtypes independent of their phenomenological manifestations. We applied epigenome-wide profiling with a DNA methylation array from blood samples of 63 schizophrenia patients and 59 healthy controls. Non-negative matrix factorization (NMF) and k-means clustering were performed to identify DNA methylation-related patient subtypes. The validity of the partition was tested by assessing the profile of the T cell receptor (TCR) repertoires. The uniqueness of the identified subtypes in relation to brain structural and clinical measures were evaluated. Two distinct patterns of DNA methylation profiles were identified in patients. One subtype (60.3% of patients) showed relatively limited changes in methylation levels and cell composition compared to controls, while a second subtype (39.7% of patients) exhibited widespread methylation level alterations among genes enriched in immune cell activity, as well as a higher proportion of neutrophils and lower proportion of lymphocytes. Differentiation of the two patient subtypes was validated by TCR repertoires, which paralleled the partition based on DNA methylation profiles. The subtype with widespread methylation modifications had higher symptom severity, performed worse on cognitive measures, and displayed greater reductions in fractional anisotropy of white matter tracts and evidence of gray matter thickening compared to the other subtype. Identification of a distinct subtype of schizophrenia with unique molecular, cerebral, and clinical features provide a novel parcellation of the schizophrenia syndrome with potential to guide development of individualized therapeutics.

Protecting groundwater from nitrogen contamination is an important public-health concern and a major national environmental issue in China. In this study, we monitored water quality in 29 wells from 2009 to 2010 in a village in Shanghai city, whick belong to typical rural-urban continuum in China. The total N and NO(3)-N exhibited seasonal changes, and there were large fluctuations in NH(4)-N in residential areas, but without significant seasonal patterns. NO(2)-N in the water was not stable, but was present at high levels. Total N and NO(3)-N were significantly lower in residential areas than in agricultural areas. The groundwater quality in most wells belonged to Class III and IV in the Chinese water standard, which defines water that is unsuitable for human consumption. Our health risk assessments showed that NO(3)-N posed the greatest carcinogenic risk, with risk values ranging from 19×10(-6) to 80×10(-6), which accounted for more than 90% of the total risk in the study area.

Adolescence is a susceptible period to establish health-risk behaviors, which may have an impact on academic performance. The aim of this study was to investigate the association between health-risk behaviors (HRBs) and perceived academic performance (PAP) of adolescents in Shanghai, China. The data of the present study included three-round Shanghai Youth Health-risk Behavior Survey (SYHBS). This cross-sectional survey investigated multiple HRBs of students involved in dietary behaviors, physical activity and sedentary behaviors, intentional and unintentional injury behaviors, and substance abuse behaviors, as well as PAP by using self-reported questionnaire. Using a multistage random sampling method, 40,593 middle and high school students aged 12 to 18 years were involved. Only participants with complete data on HRBs information, academic performance and covariates were included. A total of 35,740 participants were involved in analysis. We used ordinal logistic regression to analyze the association between each HRB and PAP adjusting for sociodemographic, family environment and duration of extracurricular study. The results showed that students who did not eat breakfast or drink milk everyday were more likely to have a lower PAP, with a decreased odds of 0.89 (95%CI: 0.86–0.93, P <0.001) and 0.82 (95%CI: 0.79–0.85, P <0.001), respectively. The similar association was also found in students who did exercise ≥60 minutes for less than 5 days/week, spend time on watch TV beyond 3 hours/day and other sedentary behaviors. Most intentional and unintentional injuries, and ever smoked were associated with a lower PAP. Our finding suggests that multiple HRBs negatively associated with PAP of adolescents. It needs to raise public health concerns with HRBs in adolescents, and to develop and implement comprehensive interventions on HRBs.

Background Preserved ratio impaired spirometry (PRISm) is a distinct pulmonary function abnormality characterized by a diminished forced expiratory volume in one second (FEV1) while maintaining a normal FEV1/forced vital capacity ratio. Although PRISm is associated with cardiovascular disease (CVD), its correlation with CVD subtypes and multiple CVDs is unclear. This study aims to investigate the association between PRISm and single and multiple CVDs using data from the National Health and Nutrition Examination Survey (NHANES) 2007–2012 and explore the heterogeneity of this association in specific CVD subtypes, including coronary heart disease, heart failure, stroke, angina, and heart attack. Method We included 8258 participants aged ≥ 20 years from NHANES 2007–2012. We utilized multivariable logistic regression to adjust for confounders in four stages (demographic factors, lifestyle factors, and metabolic diseases) to analyze the association between PRISm and the number of CVDs (1, ≥ 2, and ≥ 3) and specific subtypes (coronary heart disease, heart failure, stroke, angina, and heart attack). Additionally, we performed subgroup and sensitivity analyses. Result The prevalence of PRISm was 13.99%. Participants with PRISm were older and exhibited a higher prevalence of obesity, hypertension, and diabetes ( p < 0.001). Upon complete adjustment, PRISm was significantly associated with multiple CVDs (≥ 2) (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.27–3.78), CVDs (≥ 3) (OR: 2.10, 95% CI: 1.06–4.16) and exhibited the most pronounced association with heart failure (OR: 2.60, 95% CI: 1.40–4.86); however, not with stroke ( p = 0.670). Subgroup analyses revealed that the risk of heart failure was higher in men and in participants with a body mass index < 30 kg/m 2 (OR: 4.19 and 3.40, respectively). Conclusion PRISm is independently associated with multiple CVDs, particularly heart failure. Clinicians may consider cardiovascular risk monitoring in PRISm patients given this robust association

Background Growing evidence suggests that circadian misalignment may adversely affect adolescent health, yet environmental determinants such as air pollution remain understudied. This study aimed to investigate the associations between ambient fine particulate matter (PM 2.5 ) and nitrogen dioxide (NO 2 ) exposure and sleep chronotype among adolescents. Methods A total of 14,594 students were enrolled from the 2023 Shanghai Students' Common Diseases and Health Influencing Factors Surveillance. Sleep chronotype was assessed using the Morningness-Eveningness Questionnaire 5 (MEQ-5), categorizing participants into morning (M), evening (E), or neither (N) types. Air pollution data were obtained from the China National Environmental Monitoring Centre, and exposure was averaged at 7, 30, 90, 180, and 365 days prior to the survey. Generalized linear mixed models were applied to estimate associations between air pollution exposure and chronotype categories. Results Of the participants, 57.0% were classified as N type, 24.3% as M type, and 18.7% as E type. In single-pollutant models, higher exposure to PM 2.5 and NO 2 was associated with increased odds of N or E types. In two-pollutant models, NO 2 exposure was significantly associated with increased risk at 180 days (OR = 1.19, 95% CI: 1.04–1.38), 90 days (OR = 1.07, 95% CI: 1.00–1.15), and 7 days (OR = 1.16, 95% CI: 1.04–1.33). When interaction terms were included, both PM 2.5 (OR = 1.39, 95% CI: 1.00–2.00) and NO 2 (OR = 2.03, 95% CI: 1.10–4.06) exhibited stronger associations at the 30-day exposure window. Stratified analyses indicated that girls and junior high school students were more susceptible. Conclusions Exposure to PM 2.5 and NO 2 was associated with a shift toward later sleep chronotypes among adolescents. Given the potential health impacts of circadian disruption, targeted public health interventions to reduce air pollution exposure—particularly among vulnerable subgroups such as girls and younger students—are warranted to promote healthy sleep patterns during adolescence.

Objective: We aimed to examine the longitudinal associations between lifestyle behaviors, academic achievement, and physical diseases in adolescents. Study Design: Longitudinal cohort study. Methods: We recruited participants (n = 4330; mean age of 14.0 (SD = 1.51) years at the first time point and 16.0 (1.51) years at the second time point) from 16 districts in Shanghai, China, who completed a survey in 2021 (T1) and 2023 (T2). We employed a cross-lagged panel network model to explore the interconnected relationships among lifestyle behaviors, academic achievement, and physical condition (i.e., obesity, high blood pressure, high myopia, depressive symptoms). Results: Among the cross-lagged associations, the predictive effects of T1 obesity on T2 high blood pressure (OR = 2.39), T1 breakfast skipping on T2 TV screen time (OR = 1.49), (in cross-domain relationships) T1 symptoms of depression on T2 low fruit and vegetable consumption (OR = 2.43), T1 obesity on T2 TV screen time (OR = 1.53), and T1 computer time on T2 high BP (OR = 1.31) were particularly prominent. Nonetheless, the observed cross-lagged effect sizes were small. Based on the sum of expected influence on their connecting nodes, obesity, depressive symptoms, and breakfast skipping demonstrated their paramount roles in the network metrics. We found breakfast skipping showed the strongest bridging effect among all factors in association with coexisting conditions and academic performance in children. Conclusions: Our findings identified breakfast skipping as the pivotal bridge node with the highest centrality within the network of modifiable lifestyle factors. Although this does not imply direct causality, its prominent bridge effect highlights its essential role in maintaining network stability and mediating interactions across distinct variable clusters.

This study aimed to assess the accuracy of body mass index (BMI) percentile, waist circumference (WC) percentile, waist-height ratio, and waist-hip ratio for identifying cardiometabolic risk factors in Chinese children and adolescents stratified by sex and BMI categories. We measured anthropometric indices, fasting plasma glucose, lipid profile and blood pressure for 15698 participants aged 6-17 in a national survey between September and December 2013. The predictive accuracy of anthropometric indices for cardiometabolic risk factors was examined using receiver operating characteristic (ROC) analyses. The DeLong test and Z test were used for the comparisons of areas under ROC curves (AUCs). The prevalence of impaired fasting glucose, dyslipidemia, hypertension and cluster of risk factors were 2.9%, 27.3%, 10.5% and 5.7% respectively. The four anthropometric indices showed poor to fair discriminatory ability for cardiometabolic risk factors with the AUCs ranging from 0.53-0.72. Each index performed significantly better AUCs for dyslipidemia (0.59-0.63 vs. 0.56-0.59), hypertension (0.62-0.70 vs. 0.55-0.65) and clustered risk factors (0.70-0.73 vs. 0.60-0.64) in boys than that in girls. BMI percentile performed the best accuracy for hypertension in both sexes; WC percentile had the highest AUC for dyslipidemia and BMI percentile and waist-height ratio performed similarly the best AUCs for clustered risk factors in boys while BMI percentile, WC percentile and waist-height ratio performed similar and better AUCs for dyslipidemia and clustered risk factors in girls; whereas waist-hip ratio was consistently the poorest predictor for them regardless of sex. Though the anthropometric indices were more predictive of dyslipidemia, hypertension and clustered risk factors in overweight/obese group compared to their normal BMI peers, the AUCs in overweight/obese group remained in the poor range below 0.70. Anthropometric indices are not effective screening tools for pediatric cardiometabolic risk factors, even in overweight/obese children.