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In this study 3307 samples of 24 vegetables and fruits from 18 regions of Henan Province, China, were collected in 2021 with the aim of assessing the levels of pesticide residues and analysing the differences between different sources in Henan Province. Thirteen kinds of pesticides were analysed by gas chromatography-mass spectrometry (GC-MS) and detection rates were compared by the chi-square test. In all samples, except ginger, pimento, edible fungi and yam, pesticide residues were detected. The detection rates of difenoconazole, acetamiprid, carbendazim, procymidone, emamectin benzoate, lambda-cyhalothrin, cypermethrin and dimethomorph in supermarkets and traditional farmers' markets were different. The difenoconazole group and the dimethomorph group were both statistically different (P < 0.05). This study showed common vegetables and fruits to contain pesticide residues in Henan Province and provided a scientific basis for their evaluation. Different sources take different regulatory measures to control pesticide residues to ensure food safety. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the recent prevalence and the distributions of morphological subtypes of anaemia in the rural population. Design: Anaemia was defined according to the WHO and the Chinese criteria, and the morphological subtypes of anaemia were classified based on the erythrocyte parameters. The age-standardised prevalence was calculated according to the data of the Population Census 2010 in China. Setting: A cross-sectional study in Henan Province. Participants: 33 585 subjects aged 18–79 years old. Results: The standardised prevalence of anaemia across the WHO and the Chinese definitions was 13·63 % and 5·45 %, respectively. Regardless of which criteria was used, the standardised prevalence of anaemia was higher among women than among men and that increased with age in men, while markedly decreased after menopause in women. There were shifts in morphological patterns of anaemia using the WHO and the Chinese criteria that the standardised prevalence of microcytic anaemia was 3·74 % and 2·97 %, normocytic anaemia was 9·20 % and 2·34 %, and macrocytic anaemia was 0·75 % and 0·14 %, respectively. Besides, there were differences in the influencing factors of anaemia according to different criteria or gender. However, age, education level and renal damage were consistently significantly associated with anaemia in all participants. Conclusions: Anaemia may still be a serious health problem in rural China. It is necessary to reformulate prevention and management strategies to reduce the disease burden of anaemia. [ABSTRACT FROM AUTHOR]

This cross-sectional study aimed to investigate differences in skin surface lipids (SSL) and explore related metabolic pathways among females of different ages in Henan Province. Ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) was used to determine the lipid composition of the skin surface of 58 female volunteers who were divided into three age groups. Statistical analysis was performed using Progenesis QI, Ezinfo, and MetaboAnalyst. Multivariate and enrichment analysis were used to identify the different SSL among the groups. A total of 530 lipid entities were identified and classified into eight classes. Among these, 63 lipids were significantly different between the groups. Lower levels of glycerolipids (GLs) and sphingolipids (SPs) were observed in the middle-aged group, while higher levels of GLs were found in the elder group. GLs belonged to the largest and statistically significant enrichment of lipid metabolic pathways, and the lipid individuals enriched to the sphingoid bases metabolism were the most and statistically significant. These findings suggest that there are differences in hand SSL among females of different ages, which may be related to GLs and sphingoid bases metabolism. [ABSTRACT FROM AUTHOR]

It is worth paying attention to the level of worry and fear of students during the normalization of the epidemic. We conducted the cross‐sectional study that included 182,991 high school students using an online survey to assess worry and fear levels and its influencing factors in three cities in Henan Province, China, from May 21 to May 27, 2021. Worry and fear levels were measured using a five‐item Likert‐type scale. Multinomial logistic regression was used to analyze the risk factors. Approximately 65.42% of students reported being high worry about the coronavirus disease 2019 (COVID‐19) epidemic, and about 41.44% of students reported being high fear about the COVID‐19 epidemic. In addition, compared with female, male had lower odds of suffering from a high worry, and compared with senior high school students, junior high school students were more likely to suffer from a high worry. Students lived in rural had highest odds increased likelihood of high worry. Similar results in fear levels. During the normalization period of the COVID‐19 epidemic, many students have high levels of worry and fear. This study has implications for potential influencers of worry and fear levels in follow‐up work. Practitioner Points: Approximately 65.42% of students reported being high worry about the coronavirus disease 2019 (COVID‐19) epidemic, and about 41.44% of students reported being high fear about the COVID‐19 epidemic.Students lived in rural had highest odds increased likelihood of high level of worry and fear.Compared with senior high school students, junior high school students were more likely to suffer from a high worry. [ABSTRACT FROM AUTHOR]

Objective: Food-away-from-home (FAFH) is one of the leading dietary patterns in Chinese families. However, the relationship between FAFH and dyslipidemia remains unclear, especially in the rural adult population. This study explored the relationship of FAFH frequency with serum lipid levels and dyslipidemia in rural Chinese adults. Methods: A total of 12,002 men and 17,477 women aged 18–79 were included from the Henan rural cohort. Serum lipid levels were measured by enzyme colorimetry. Information on FAFH frequency was collected using a validated questionnaire. The associations of FAFH frequency and serum lipid levels were assessed through multiple linear regression modeling. Logistic regression was performed to explore the linkages of the FAFH frequency to dyslipidemia and its four parameter types. Mediation analysis examined whether body mass index (BMI) acted as a mediator between the FAFH frequency and dyslipidemia. Results: After adjusting for potential confounders, the adjusted odds ratio (OR) and 95% confidence interval (CI) of the groups with 8–11 FAFH times/week for dyslipidemia were 1.991 (1.569, 2.526) in men compared with 0-frequency subgroup. Participants who consumed 8–11 FAFH times/week had a higher risk of high total cholesterol (TC), high triglycerides (TG), high LDL-cholesterol (LDL-C), and low HDL-cholesterol (HDL-C) with the OR and 95% CI of 1.928 (1.247, 2.980), 1.723 (1.321, 2.247), 1.875 (1.215, 2.893), and 1.513 (1.168, 1.959), respectively. In addition, the interaction effect between FAFH and gender was significantly associated with dyslipidemia and lipid levels (P < 0.001). BMI played a fully mediating effect between FAFH frequency and dyslipidemia in men, and the Sobel test showed the significance of the mediating effect (z = 4.2158, P < 0.001). Conclusion: In rural Chinese adults, FAFH was significantly associated with a higher risk of dyslipidemia, which indicated the importance of FAFH reduction and dietary intervention in patients with dyslipidemia and cardiovascular disease, especially in clinical practice. Trial Registration: The Henan Rural Cohort Study has been registered on the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15,006,699). [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate whether dietary patterns were associated with the risk of type 2 diabetes mellitus (T2DM) or pre-diabetes in adults of rural area in Henan. Design: Cross-sectional study. Principal component analysis was used to identify dietary patterns, while multivariate logistic regression analysis and restricted cubic spline regression models were used to analyse the association between dietary patterns and both pre-diabetes and T2DM. Setting: Rural area of Henan province, China. Participants: A total of 38 779 adults aged 18–79 years were recruited from the Henan rural cohort study as the subjects. Results: The prevalence of pre-diabetes and T2DM in rural Henan was 6·8 % and 9·4 %, respectively. A total of three dietary patterns were assessed in the present study. Dietary pattern I with a high intake of red meat and white meat; dietary pattern II with a high intake of grains, nuts, milk and eggs and dietary pattern III with a high intake of vegetables, staple food and fruits. The highest quintile (Q5) of pattern III could reduce 32·7 % risk of pre-diabetes. The Q5 of pattern II showed a 15·5 % decreased risk of T2DM, in a U-shaped dose–response manner; meanwhile, the Q5 of pattern III was significantly associated with reduced risks of T2DM (OR: 0·582, 95 % CI (0·497, 0·682)). Conclusions: Pattern III is beneficial for reducing risk of pre-diabetes or T2DM. Though a higher consumption of 'grains-nuts-egg' may associate with a reduced risk of T2DM, excessive intakes should be avoided. This study may provide a reference for the prevention of diabetes on dietary precautions. [ABSTRACT FROM AUTHOR]

Background: The increasing menace of the COVID-19 epidemic led to an atmosphere of anxiety around the world, however the evidence among Chinese students aged 12 to 18 years has been limited.Methods: A total of 373216 junior and senior high school students were recruited using a cluster sampling method in Zhengzhou, Xinxiang, Xinyang city of Henan Province, China, during February 4-12, 2020. Presence of anxiety symptoms was determined by Generalized Anxiety Disorder tool (GAD-7). Multiple logistic regression was performed to estimate the potential risk factors.Results: Among the participants, junior and senior high school students were found to have anxiety symptoms, producing an overall prevalence of 9.89%. The prevalence was lower in female than in male (9.66% vs. 10.11%) and the prevalence was higher for junior high school students than senior high school students (13.89% vs. 12.93%). The prevalence of anxiety symptoms was highest among rural students and lowest among urban students (11.33% vs. 8.77%). The cognitive level was negatively associated with the prevalence of anxiety symptoms. After adjusting for potential confounders, age, gender, residential location, worried level, fear level and behavior status were found to be associated with anxiety symptoms.Limitations: Prevalence may be skewed by assessing anxiety symptoms using self-reported scales rather than clinical interviews.Conclusions: This large-scale study assesses the prevalence of anxiety symptoms and its potential influencing factors in junior and senior high school students. These findings suggest that governments need to pay more attention to the mental health of young people in combating COVID-19. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to evaluate the validity and reproducibility of a thirteen-item FFQ regarding identification of dietary conditions in a rural population in China.Design: A reproducibility study repeated the first FFQ (FFQ1) approximately 4 weeks later (FFQ2). A validity study evaluated the mean of three consecutive 24 h diet recalls as the reference measure.Setting: Cross-sectional study.Participants: Residents of a rural area in Henan Province, which is located in the central region of China.Results: A total of 295 individuals participated in the reproducibility study. In addition, 123 people agreed to participate in the validity study. Spearman's correlation coefficients between the two FFQ ranged from 0·06 (vegetables) to 0·58 (eggs). Spearman's correlation coefficients between the two methods of collection ranged from 0·01 for cereal to 0·49 for staple foods. The mean of the intraclass correlation coefficients of the two FFQ (FFQ1 v. FFQ2) was 0·19. Bland-Altman analysis indicated good agreement for most food groups across the range of intake for the two studies.Conclusions: The study demonstrated that our FFQ design could be used as a representative tool to conduct a dietary evaluation of a rural population. [ABSTRACT FROM AUTHOR]

Since neonicotinoids (NNIs) are widely used around the world, they are extensively distributed in the environment and frequently occurred in humans. This study was conducted to assess the risk of NNIs residues in vegetables and fruits in Henan province, and evaluate the associations of NNIs single and mixed exposure with glucose metabolism, and further explore whether testosterone mediated these relationships in Henan rural population. The data of vegetables and fruits were collected from Henan Province in 2020–2021, and participants were drawn from the Henan Rural Cohort study. Hazard quotient (HQ) and hazard index (HI) were used to assess the risk of exposure to the individual and combined NNIs through vegetables or fruits intake. Relative potency factor (RPF) method was utilized to normalize each NNIs to imidacloprid (IMI RPF). Generalized linear models were used to explore the effects of each NNIs and IMI RPF on glucose metabolism. Weight quartile sum (WQS) regression and Bayesian kernel machine regression (BKMR) model were applied to estimate the effect of NNIs mixtures on glucose metabolism. Mediation analysis was employed to explore whether testosterone mediated these relationships. The HQs and HI in both vegetables and fruits were much lower than 1, which indicated that NNIs in vegetables and fruits were not expected to cause significant adverse effects. However, plasma natural logarithm nitenpyram (Ln_NIT), Ln_thiacloprid-amid (Ln_THD-A), and Ln_IMI eq were positively associated with type 2 diabetes mellitus (T2DM) (odds ratio (OR) (95% confidence interval (CI)): 1.12 (1.05, 1.19), 1.21 (1.10, 1.32), and 1.48 (1.22, 1.80)). Both WQS regression and BKMR models observed significantly positive associations between NNIs mixture exposure and T2DM. Testosterone partially mediated these associations among women (PE = 6.67%). These findings suggest that human NNIs exposure may impair glucose metabolism and could contribute to rising rates of T2DM, and it's necessary to regulate the use of pesticides in rural areas. [Display omitted] • Expose to neonicotinoids (NNIs) through intake of vegetables or fruits posed a low risk to population health. • NNIs mixture exposure was positively associated with type 2 diabetes mellitus (T2DM). • Both nitenpyram and thiacloprid-amid exposure were positively associated with T2DM. • Testosterone partially mediated the association of NNIs mixture with T2DM in women. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between mask wearing practice and the risk of anxiety symptoms during the COVID-19 epidemic among Chinese students aged 12-18 years old.Methods: Totally, 386,432 junior and senior high school students were recruited using a cluster sampling method across three cities of Henan Province in China during February 4-12, 2020. Mask wearing practice was defined according to its type and the behavior exhibited in relation to wearing a mask. Presence of anxiety symptoms was determined by Generalized Anxiety Disorder tool (GAD-7). Multiple logistic regression was performed to estimate the association between mask wearing and anxiety symptoms.Results: Among the participants, compared with students who completely adhered to the all the mask wearing practice, students who did not adhere to all the mask wearing practice had 1.97 times more likely to suffer from anxiety symptoms (adjusted odds ratio (aOR) = 1.97; 95% confidence interval (CI): 1.74-2.22). Furthermore, compared with students who did not know the proper type of mask, students who knew the proper type of mask had a lower risk of anxiety symptoms (aOR = 0.78; 95%CI: 0.76-0.80). Students who adhered to proper behavior of mask wearing was associated with 34% decreased odds for anxiety symptoms (aOR = 0.68; 95%CI: 0.62-0.74).Conclusions: To conclude, proper mask wearing may be an important attribute that play a significant role in reducing the risk of anxiety symptoms among junior and senior school student. However, since this study is a cross-sectional study, prospective studies are needed to further verify. [ABSTRACT FROM AUTHOR]

• This was a large sample study of 538,500 individuals to investigate the prevalence of anxiety in students. • The prevalence of anxiety symptoms among chinese primary school students was higher at 13.4%. • After adjusting for potential confounders, school location, knowledge and protective practices of COVID-19 were found to be associated with anxiety symptoms. • Good knowledge of COVID-19 was associated with a lower prevalence rate, which was higher in rural areas, but there was little difference between levels of protection practice. This study was conducted on elementary school students in Henan Province, China, from February 4th to 11th, 2020, during the coronavirus disease 2019 (COVID-19) epidemic. The purpose of the study was to examine the prevalence of anxiety among students and identify the related risk factors contributing to anxiety. Demographic information and psychological status were assessed by using self-reported measures. The generalized anxiety disorder tool (GAD-7) and a multiple logistic regression model were used to assess anxiety and identify potential influencing factors. Cross-sectional data indicated that the overall anxiety prevalence was 13.4%. The prevalence of anxiety symptoms was highest among rural primary school students and lowest among city students. Three groups of students in different regions were surveyed, and the prevalence of anxiety symptoms was significantly higher among students with poor knowledge of COVID-19 than among students with good knowledge of COVID-19. After adjusting for potential confounding factors, it was found that location, knowledge, and practice were related to anxiety. This study showed that the prevalence of anxiety symptoms was higher among Chinese primary school students. The influencing factors found in this study may help relevant staff improve the mental health of children during the epidemic. [ABSTRACT FROM AUTHOR]

Background: Depression is one of the most prevalent mental health challenges that affect all groups of persons. This study examines the association between type 2 diabetes and depressive symptoms (using PHQ-2) in a rural population. Other risk factors of depressive symptoms are examined.Methods: Data from 30,001 participants from the Henan rural cohort was analyzed. Multivariable logistic regression analyses were performed to examine the associations between depressive symptoms (DS) and type 2 diabetes and other risk factors. Adjusted odds ratios (aOR) with confidence intervals (CI) at 95% are reported.Results: The prevalence of DS in the study population is 5.86%, 6.69% in women, 4.74% in men, 5.80% in persons without diabetes and 6.81% in persons with diabetes (diagnosed and undiagnosed). DS prevalence was highest in persons with previously diagnosed diabetes (8.27%). No association was found between DS and diabetes (aOR = 0.95, CI at 95% 0.61-1.48; p=0.836). DS was associated with poor glycemic control (aOR=1.43, CI at 95% 1.04- 1.98; p= 0.034) in persons with previously diagnosed diabetes, persons with elevated triglycerides (aOR=1.19, CI at 95% 1.08-1.30; p<0.001), household income (aOR= 0.78, CI at 95% 0.63-0.97; p=0.027), marital status (aOR=1.37, CI at 95% 1.01-1.88, p=0.049) and hypertension treatment with medication (aOR=1.94, CI at 95% 1.48-2.55; p<0.001).Limitations: DS was assessed through self-report and may suffer recall or information bias.Conclusions: DS was not associated with diabetes in our study population. The association between poor glycemic control and DS calls for the integration of screening for depression among patients with diabetes. [ABSTRACT FROM AUTHOR]

Smoking has toxic effects on the skin and can damage it. However, few studies have focused on the lipid profile changes of facial skin surface lipids (SSL) by passive smoking. A cross-sectional analytical study was conducted on middle-aged females volunteered from Henan, China to participate in the study. A total of 20 passive smoking females and 20 non-passive smoking females were recruited for this study. The components of skin surface lipids were measured by ultra-performance liquid chromatography quadrupole time of flight mass spectrometry (UPLC-QTOF-MS). Multivariate data analysis and enrichment analysis were used to investigate the differences in facial SSL between passive and non-passive smoking females. There were 1247 lipid entities identified in facial SSL between passive and non-passive smoking females. Significant differences in composition of facial SSL were observed between the two groups. After multivariate data analysis suggested, 28 significantly different lipids were identified and classified into four classes in SSL of the female cheeks. As well as 32 significantly different lipids were obtained in SSL of the female foreheads, which included three classes of lipids. Subsequent analysis revealed that the content of fatty acids (FA) in passive smoking females was significantly reduced and the content of glycerolipids (GL) and sphingolipids (SP) increased, compared with the control group. These results indicated that an increase in GLs and SPs of facial lipids and a decrease in FAs in passive smoking females. These changes in lipids might be associated with oxidative stress and interference with signaling pathways by substances in smoke. And passive smoking affected facial SSL and changed the content and metabolism of skin lipids. • There were 1247 lipid entities identified in facial SSL between passive and non-passive smoking females. • There are good separation and significant differences in facial SSL between passive and non-passive smoking females. • This study found that GLs and SPs of facial lipids were increased and FAs were decreased in passive smoking females. • This study provides the basis for research on skin care and raises female's awareness of the harms of passive smoking. [ABSTRACT FROM AUTHOR]

• Higher residential greenness was associated with better sleep quality in rural China. • The association was stronger in males and participants with higher household income. • The association was stronger in participants with higher educational attainment. • Exposure to air pollution modified the association of greenness with sleep quality. Epidemiological studies on the association of residential greenness with sleep quality are limited in China. This study aims to investigate the association of long-term exposure to residential greenness with sleep quality in rural China. In our study, 27,654 rural residents were selected from 4 counties of Henan Province by a multi-stage stratified cluster sampling method. Participants' sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), two satellite-derived vegetation indexes, were used to assess the level of residential greenness. Long-term greenness exposure was defined as the averages of NDVI and EVI during the three years prior to the baseline survey. The relationship between sleep quality and greenness was assessed using the mixed-effect linear regression models. Among 27,654 rural residents, the mean age was 55.89 years (standard deviation, SD = 12.22) and 60.18% of them were female. In the crude model, the PSQI score decreased with per interquartile range (IQR) increase in EVI and NDVI [ΔPSQI score (95% confidence interval, 95%CI): −0.073 (−0.115, −0.030) and −0.047 (−0.089, −0.002)]. After controlling potential confounders, ΔPSQI scores and 95%CIs were −0.055 (−0.095, −0.012) and −0.090 (−0.151, −0.025) associated with per IQR increment in EVI and NDVI. The results of stratified analyses showed the effect of residential greenness on sleep was stronger among males and individuals with higher household income and educational attainment than females and those with lower household income and educational attainment. Moreover, the modification effect of air pollution was observed in the greenness-sleep association. Our study indicated that higher residential greenness was significantly associated with better sleep quality in Chinese rural population, which highlights the significant effect of green space on human health. [ABSTRACT FROM AUTHOR]

• Higher PM 1 , PM 2.5 , NO 2 exposure concentrations were associated with increased odds of type 2 diabetes. • Higher levels of PM 1 , PM 2.5 , NO 2 exposure were associated with an elevated fasting blood glucose levels. • Males and populations aged 65 years or older may susceptible to air pollution. To evaluate the associations between long-term exposure to particulate matter with an aerodynamic diameter ≤1.0 μm and ≤2.5 μm (PM 1 and PM 2.5), nitrogen dioxide (NO 2) and type 2 diabetes prevalence and fasting blood glucose levels in Chinese rural populations. A total of 39, 259 participants were enrolled in The Henan Rural Cohort study. Questionnaires and medical examination were conducted from July 2015 to September 2017 in rural areas of Henan province, China. Three-year average residential exposure levels of PM 1 , PM 2.5 , NO 2 for each subject were estimated by a spatiotemporal model. Logistic regression and linear regression models were applied to estimate the associations between PM 1 , PM 2.5 , NO 2 exposure and type 2 diabetes prevalence and fasting blood glucose levels. The mean 3-year residential exposure concentrations of PM 1 , PM 2.5 and NO 2 was 57.4 μg/m3, 73.4 μg/m3 and 39.9 μg/m3, respectively. Higher exposure concentrations of PM 1 , PM 2.5 , NO 2 by 1 μg/m3 was positively related to a 4.0% (95%CIs: 1.026, 1.054), 6.8% (1.052, 1.084) and 5.0% (1.039, 1.061) increase in odds of type 2 diabetes in the final adjusted models. Besides, a 1 μg/m3 increase of PM 1 , PM 2.5 and NO 2 was related to a 0.020 mmol/L (95%CIs: 0.014, 0.026), 0.036 mmol/L (95%CIs: 0.030, 0.042) and 0.030 mmol/L (95%CIs: 0.026, 0.034) mmol/L higher fasting blood glucose levels. Higher exposure concentrations of air pollutants were positively related to the increased odds of type 2 diabetes, as well as higher fasting blood glucose levels in Chinese rural populations. [ABSTRACT FROM AUTHOR]