Comorbidity patterns and mortality among hospitalized patients with psychiatric disorders and COVID-19

Objectives: To examine the association between psychiatric and non-psychiatric comorbidity and 28-day mortality among patients with psychiatric disorders and COVID-19. Methods: Multicenter observational retrospective cohort study of adult patients with psychiatric disorders hospitalized with laboratory-confirmed COVID-19 at 36 Greater Paris university hospitals (January 2020-May 2021) (n=3,768). First, we searched for different subgroups of patients according to their psychiatric and non-psychiatric comorbidities through cluster analysis. Next, we compared 28-day all-cause mortality rates across the identified clusters, while taking into account sex, age, and the number of medical conditions. Results: We found five clusters of patients with distinct psychiatric and non-psychiatric comorbidity patterns. Twenty-eight-day mortality in the cluster of patients with mood disorders was significantly lower than in other clusters. There were no significant differences in mortality across other clusters. Conclusion: All psychiatric and non-psychiatric conditions may be associated with increased mortality in patients with psychiatric disorders and COVID-19. The lower risk of death among patients with mood disorders might be in line with the potential beneficial effect of certain antidepressants in COVID-19, but requires further research. These findings may help identify at-risk patients with psychiatric disorders who should benefit from vaccine booster prioritization and other prevention measures.

Effect of Spatial Contiguity on Learning Sequences of Positions / Efecto de la contigüidad espacial sobre el aprendizaje de secuencias de posiciones

Abstract Four conditions of spatial contiguity of positions were used to assess sequence learning. Two sequences of 16 and 25 positions presented in two matrices of 4x4 and 5x5 respectively were used. Within each matrix, 4 (in the 4x4 matrix) or 6 positions (in the 5x5 matrix) presented spatial contiguity. The place at the sequence in which contiguous positions occurred varied across groups. In this way, spatial contiguity of the 4 or 6 positions was presented at the beginning of the sequence (Group 1), in the middle part (Group 2), at the end of the sequence (Group 3) or it was presented a sequence in which all positions occurred without spatial contiguity (Group 4). 28 undergraduate students participated. Results showed no differences among groups in the number of trials required to reproduce the sequence correctly. Number of errors was lower when contiguous positions were presented at the beginning of the sequence. These findings are explained as a possible effect of accentuation of primacy given by the occurrence of contiguous positions at the beginning of the sequence.

Resumen Cuatro condiciones de contigüidad espacial de posiciones fueron empleadas para evaluar el aprendizaje de secuencias. Se emplearon dos secuencias de 16 y 25 posiciones presentadas en dos matrices de 4x4 y 5x5, respectivamente. Dentro de cada matriz, 4 (en la matriz de 4x4) o 6 posiciones (en la matriz de 5x5) presentaron contigüidad espacial. Entre grupos, se varió el punto de la secuencia en el que se presentaron las posiciones contiguas. De este modo, la contigüidad espacial de las 4 o 6 posiciones se presentó al inicio de la secuencia (Grupo 1), en la parte media (Grupo 2), al final de la secuencia (Grupo 3), o bien, se presentó una secuencia en la que todas las posiciones ocurrieron sin contigüidad espacial (Grupo 4). Participaron 28 estudiantes de licenciatura. Los resultados no mostraron diferencias entre grupos en cuanto al número de ensayos requeridos para reproducir la secuencia correctamente. El número de errores fue menor cuando las posiciones contiguas se presentaron al inicio de la secuencia. Los hallazgos se explican a partir de un posible efecto de acentuación de la primacía, dado por la ocurrencia de posiciones contiguas al inicio de la secuencia.

A Morphometric Study of Head in the Population of Young Chinese Adults / Estudio Morfométrico de la Cabeza en la Población de Adultos Jóvenes Chinos

SUMMARY: Due to the complexity of head shape, limited 1D or 2D head anthropometry fail to fully capture its shape characteristics. Currently, there is limited research on clustering analysis of head shape from a shape difference perspective, especially for the head shape of Chinese people. Head shape is influenced by factors such as race, sex, and age, making it imperative to create a head shape database for Chinese individuals. In this study, three-dimensional head data of 339 Chinese young adult were collected, and the head shapes were clustered into 7 clusters using an improved k-medoids algorithm. The differences between clusters and the average head shape were further analyzed. It can be foreseen that the head shape database for Chinese young adult constructed in this study has important reference value for the ergonomic design of head-related products and head morphology research, among other fields.

Debido a la complejidad de la forma de la cabeza, la antropometría limitada de ésta, en 1D o 2D, no logra capturar completamente sus características de forma. Actualmente, existen estudios limitados sobre el análisis de agrupamiento de la forma de la cabeza, desde una perspectiva de diferencia de forma, especialmente en el caso de la población china. La forma de la cabeza está influenciada por factores como la raza, el sexo y la edad, por lo que resulta imperativo crear una base de datos sobre la forma de la cabeza de los individuos chinos. En este estudio, se recopilaron datos tridimensionales de la cabeza de 339 adultos jóvenes chinos, y las formas de la cabeza se agruparon en 7 grupos utilizando un algoritmo k-medoids mejorado. Las diferencias entre los grupos y la forma promedio de la cabeza se analizaron a profundidad. Se puede prever que la base de datos sobre la forma de la cabeza de adultos jóvenes chinos construida en este estudio, tiene un valor de referencia importante para el diseño ergonómico de productos relacionados con la morfología de la cabeza, entre otros campos.

Clustering of cardiovascular disease risk factors among first-year students at the University of Ibadan, Nigeria: a cross-sectional study

ABSTRACT BACKGROUND: Cardiovascular disease (CVD) is the second leading cause of death in sub-Saharan Africa. Globally, there is substantial evidence that modifiable risk factors for CVD are increasing in adolescents. Unfortunately, there is a paucity of information on the prevalence and clustering of these risk factors in adolescents. OBJECTIVES: This study explores the modifiable risk factors for CVD among first-year students at the University of Ibadan, Nigeria. DESIGN AND SETTING: This cross-sectional study was conducted at the University of Ibadan, Nigeria. METHODS: A total of 546 newly admitted students at the University of Ibadan, Nigeria, were recruited using stratified random sampling. An interviewer-administered questionnaire was used to obtain information from study participants between January and February 2016. RESULTS: The mean age of respondents was 19 ± 2.2 years with a male-to-female ratio of 1:1. The reported risk factors for CVD were smoking (1.6%), abdominal obesity (3.3%), alcohol consumption (3.7%), overweight/obesity (20.7%), unhealthy diet (85.3%), and physical inactivity (94.5%). Clustering of ≥ 2 risk factors was reported in 23.4% of students. Female students were twice as probably overweight/obese as male students (adjusted odds ratio [AOR] = 2.2; confidence interval [CI] = 1.41-3.43). Students whose fathers were skilled workers were 3.5 times more likely to be physically inactive (AOR = 1.7; CI = 0.97-2.96). The clustering of ≥ 2 risk factors was significantly higher among women and Muslims in bivariate analysis, whereas no significant association was found in multivariate analysis. CONCLUSIONS: Public health strategies to prevent CVD risk factors should begin in schools and extend to the entire community.

Role of machine learning techniques in classification of peripheral pulse morphology

Recording of peripheral pulse serves as a very important and essential non-invasive tool used widely by doctors for the diagnosis of various diseases. The morphology of pulse is seen to vary as a function of time in a given individual and also from individual to individual. There are many variations in morphological patterns of peripheral pulse in different disease conditions, which lead to difficulty in accurate diagnosis. The peripheral pulse waveforms are extracted from radial arteries as time series data using a peripheral pulse analyzer which is designed on the principle of impedance plethysmography. It was first introduced by Nyober in the mid-nineteen hundreds and ameliorated further by Kubicek. It involves the recording of the instantaneous blood volume by the measurement of electrical impedance as a function of time. Therefore, the study of peripheral pulse morphology has gained much attention in the past few years among researchers. Physiological variability is one of the recent investigations added during the last two decades for the objective assessment of autonomic function and the assessment of prognosis in severe sicknesses namely myocardial infarction, diabetic neuropathy, etc. In addition to heart rate variability studied worldwide, few researchers have studied blood pressure variability and peripheral blood flow variability. In this computer era, artificial intelligence and machine learning techniques have become more important day-by- day, and different types of algorithms were used for the identification of hidden patterns from plethysmographic observations on the radial pulse such as support vector machine as well as crisp and fuzzy clustering. Eight patterns were classified with a yield of 80%–90% and helped with the diagnosis of disorders such as myocardial infarction, pulmonary tuberculosis, coronary artery disorders, cirrhosis of the liver, and bronchial asthma. This paper briefly describes the use of machine learning techniques for the classification of peripheral pulse morphologies.

Padrões espaciais e caracterização epidemiológica dos suicídios na microrregião de Chapecó, Santa Catarina: estudo ecológico, 1996-2018 / Patrones espaciales y caracterización epidemiológica de los suicidios en la micro-región de Chapecó, Santa Catarina, Brasil: estudio ecológico, 1996-2018 / Spatial patterns and epidemiological characterization of suicides in the Chapecó micro-region, Santa Catarina, Brazil: an ecological study, 1996-2018

Objective: to identify spatial clusters of suicide and its epidemiological characteristics in the Chapecó (SC) micro-region from 1996 to 2018. Methods: this was an exploratory ecological study, using data from the Mortality Information System; specific suicide rates and relative risks (RR) were calculated with a 95% confidence interval (95%CI); the scan statistic was used for spatial analysis. Results: there were 1,034 suicides (13.7/100,000 inhabitants), with a male/female ratio of 3.79; the ≥ 60 age group was at higher risk for both sexes; a high risk cluster was found in the southwest region (RR = 1.57) and a low risk cluster in the southeast region, including Chapecó itself (RR = 0.68); risk of suicide among widowed (RR = 3.05; 95%CI 1.99;4.67), separated (RR = 2.48; 95%CI 1.44;4.27), and married (RR = 1.97; 95%CI 1.54;2.51) people was higher than among single people. The main methods were hanging (81.2%) and firearms (9.7%). Conclusion: there was a higher risk of suicide in the elderly, male and widowed people. Hanging was the most frequent method and risk clustering was found in the southwest.

Objetivo: identificar agregados espaciales de suicidio y el perfil epidemiológico en la microrregión de Chapecó (SC), 1996-2018. Métodos: estudio ecológico exploratorio, con datos del Sistema de Información de Mortalidad. Fueron calculadas tasas específicas de suicidio y riesgos relativos (RR) con intervalo de confianza 95% (IC95%). Para el análisis espacial se utilizó la estadística scan. Resultados: hubo 1.034 suicidios (13,7/100.000 habitantes), razón sexo masculino/femenino de 3,79. El grupo de ≥ 60 años presentó mayor riesgo para ambos sexos. Se observó un agregado de alto riesgo en la región suroeste (RR = 1,57) y un agregado de menor riesgo en el sureste (RR = 0,68). El riesgo de suicidio entre viudos (RR = 3.05; IC95% 1,99;4,67), separados (RR = 2.48; IC95% 1,44;4,27) y casados (RR = 1.97; IC95% 1,54;2,51) fueron mayores que entre solteros. El principal medio fue el ahorcamiento (81,2%), seguido de las armas de fuego (9,7%). Conclusión: hubo mayor riesgo de suicidio en ancianos, sexo masculino y viudos. Ahorcamiento fue el método más frecuente y se observó agrupación de riesgos hacia el Suroeste.

Objetivo: identificar conglomerados espaciais do suicídio e características epidemiológicas na microrregião de Chapecó, SC, Brasil, 1996-2018. Métodos: estudo ecológico exploratório, com dados do Sistema de Informações sobre Mortalidade; foram calculadas taxas específicas de suicídio, e riscos relativos (RR) com intervalo de confiança de 95% (IC95%); na análise espacial, utilizou-se estatística scan. Resultados: 1.034 suicídios (13,7/100 mil habitantes), a razão sexo masculino/feminino de 3,79; a idade ≥ 60 anos apresentou maior risco para ambos os sexos; observou-se um conglomerado de alto risco na região sudoeste (RR = 1,57) e um de menor risco a sudeste, incluindo Chapecó (RR = 0,68); risco de suicídio entre viúvos (RR = 3,05; IC95% 1,99;4,67), separados (RR = 2,48; IC95% 1,44;4,27) e casados (RR = 1,97; IC95% 1,54;2,51) maior que entre solteiros; principal método, enforcamento (81,2%), seguido por uso de arma de fogo (9,7%). Conclusão: maior risco de suicídio para idosos, sexo masculino e viúvos; enforcamento foi mais frequente; conglomerado de risco a sudoeste.

Age, skin color, self-rated health, and depression associated with co-occurrence of obesogenic behaviors in university students: a cross-sectional study

ABSTRACT BACKGROUND: The university context plays an important role in the health-disease process since students are potentially vulnerable to obesogenic behaviors that can influence long-term health. OBJECTIVE: To estimate the prevalence of and factors associated with the co-occurrence of obesogenic behaviors among university students. DESIGN AND SETTING This was a cross-sectional study at a Brazilian public university. METHODS: This study was conducted with all university students in the first and second semesters of 2019 at Universidade Federal de Ouro Preto, Minas Gerais, Brazil. Data were collected between April and September 2019, using a self-administered questionnaire. The outcome was the co-occurrence of obesogenic behaviors, measured as the sum of three risk behaviors: inadequate eating practices, leisure-time physical inactivity, and sedentary behavior. A Venn diagram was used to evaluate the simultaneous occurrence of risk behaviors. Pearson's chi-square test and multivariate logistic regression were used for statistical analyses. RESULTS: A total of 351 students participated in the study. Inadequate eating practices constituted the most prevalent isolated risk behavior (80.6%), which was also the most prevalent when combined with sedentary behavior (23.6%). University students aged 20 years or younger, with non-white skin color, poor self-rated health, and symptoms of depression had increased chances of simultaneous occurrence of obesogenic behaviors. CONCLUSION: These findings highlight the importance of developing and implementing actions to reduce combined obesogenic behaviors in the university environment. Institutions should focus on creating an environment that promotes health-protective behaviors such as physical activity and healthy eating.

Mental Health Profiles of University Students and Associated Life Habits / Perfis de Saúde Mental de Estudantes Universitários e Hábitos de Vida Associados

Abstract We sought to investigate the mental health profile of university students and possible individual aspects, life habits and associated academic experiences. 844 students were included, predominantly female with a mean age of 22.57 years, who answered a socioeconomic and life habits questionnaire and the Depression, Anxiety and Stress Scale. Cluster and multinomial logistic regression analyses were performed. Three profiles were identified: students with good, moderate and poor mental health. Married or single students, from exact sciences, who studied in a public university and did not work, with low alcohol consumption were more likely to have a good mental health. Understanding the association of life habits and academic experiences with different profiles is relevant to develop interventional strategies with this public.

Resumo Buscou-se investigar os perfis de saúde mental de universitários e possíveis aspectos individuais, hábitos de vida e vivências acadêmicas associados. Participaram 844 estudantes, com predominância feminina e idade média de 22,57 anos, que responderam a Depression, Anxiety and Stress Scale e questionário socioeconômico e de hábitos de vida. Foram feitas análises de cluster e de regressão logística multinomial. Foram identificados 3 perfis: universitários com saúde mental prejudicada, mediana e boa. Estudantes solteiros ou casados, que não trabalhavam e cursavam universidade pública, curso de exatas e bebiam menos tiveram maiores chances de integrar o perfil com boa saúde mental. Compreender os hábitos de vida e vivências acadêmicas associados aos diferentes perfis é relevante para desenvolver estratégias interventivas com este público.

Simulation calculation of relative biological effectiveness based on DNA double strand break clusters / 中华放射医学与防护杂志

Objective:To obtain the relative biological effectiveness (RBE) of DNA double strand breaks (DSB) clusters by tracing the mechanism of radiated DNA damage, and explore the relationship among the biological effectiveness of DNA damage, chromosomal aberrations and germ cell death.Methods:Taking low-energy electrons, protons, and α particles as the research objects, this study simulated the process that cell nuclei were exposed to particle radiation using a radiation-related physicochemical model. On the ground of the DSB density-based spatial clustering of applications with noise (DBSCAN) algorithm, the DSB cluster classification method was improved to weaken the connection between the DSBs and the random distribution assumptions of energy depositions during the simulation. In this manner, the DSB clusters can be much closer to a non-random distribution. Furthermore, this study obtained the yields of DSB clusters and proposed a method to calculate the RBE values of DSB clusters.Results:The calculated RBE value (12.29) of DSB clusters of 2 MeV α particles was similar to the experimental RBE values of chromosomal fragments (15.3±5.9) and cell survival (14.7±5.1).Conclusions:After high-LET ionizing radiation, unlike the single DSB, the RBE of DSB clusters was similar to that of chromosomal aberration and cell survival.

Prevalence and spatio-temporal clustering of visceral leishmaniasis in Gansu Province from 2015 to 2021 / 中华地方病学杂志

Objective:To analyze the epidemic status and spatial and temporal cluster distribution of visceral leishmaniasis (VL) in Gansu Province, and to provide evidence for making precise prevention and control measures and epidemic surveillance.Methods:The data of VL cases in Gansu Province reported in the China Disease Prevention and Control Information System Infectious Disease Reporting Information Management System from 2015 to 2021 were collected, descriptive epidemiology analysis was performed (three distribution of the disease). SaTScan v9.6 and ArcMap 10.7 were used for spatio-temporal cluster analysis.Results:A total of 368 VL cases were reported from 2015 to 2021, 89.13% (328/368) were concentrated in Longnan City and Gannan Tibetan Autonomous Prefecture. The number of VL cases increased year by year from 2015 to 2017, reaching a peak in 2017 (79 cases, accounting for 21.47%), and had decreased year by year since 2018. There were cases every month throughout the year, and the peak was in April in spring (38 cases). The ratio of male to female patients was 1.3 ∶ 1.0 (208/160). Scattered children aged less than 5 years old were more common (41.30%, 152/368). The spatio-temporal cluster analysis showed that both the spatial and temporal aggregation zones of VL in Tanchang County and Chengxian County were of statistical significance ( P < 0.05). Conclusion:The incidence of VL in Gansu Province is showing a low epidemic trend, having spatio-temporal aggregation, and precise monitoring and prevention and control should be strengthened in epidemic areas with different prevalence levels.

Drug resistance characteristics and spatial clustering of Mycobacterium tuberculosis in Qinghai Province from 2016 to 2019 / 中国热带医学

@#Abstract: Objective To analyze the resistance and spatial distribution of Mycobacterium tuberculosis (MTB) to six commonly used anti-tuberculosis drugs in Qinghai Province from 2016 to 2019, so as to provide a reference for tuberculosis treatment and drug-resistant tuberculosis control. Methods A total of 1 182 identified strains of Mycobacterium tuberculosis in Qinghai Province from 2016 to 2019 were collected, and 6 anti-tuberculosis drugs were subjected to drug susceptibility tests and strain confirmed by the proportional method. By means of ArcMap10.7 and SaTScan10.1 software, map visualization, spatial autocorrelation analysis and spatial scanning of MTB drug resistance were performed to identify MTB drug resistance clusters in Qinghai Province. Results From 2016 to 2019, the total drug resistance (TDR) rate of 1 182 Mycobacterium tuberculosis strains in Qinghai Province was 23.77% (281/1 182), with a mono-resistance (MR) rate of 11.08% (131/1 182), a poly-resistance (PDR) rate of 3.89% (46/1 182), a multi-drug resistance (MDR) rate of 8.80% (104/1 182), and an extensive drug resistance (XDR) rate of 0.85% (10/1 182). The rates of MDR, XDR and TDR all showed a decreasing trend year by year (P<0.01). The drug resistance spectrum displayed 21 combinations. The TDR rate and MDR rate in the retreatment patients were higher than those of the initial treated patients, and the difference was statistically significant (χ2 TDR=22.784, χ2MDR=45.082, P<0.01). In terms of demographic characteristics, the TDR rate in males was higher than that in females, and the middle-aged group was higher than other age groups, and the differences were statistically significant (χ2=7.541, 10.825, P<0.05). The results of global spatial autocorrelation analysis showed that there was no statistical significance in the autocorrelation and obvious spatial clustering of MTB drug resistance in Qinghai Province from 2016 to 2019 (P>0.05), which indicated a random distribution. The results of spatiotemporal scanning showed that there was a kind of clustering area, but the clustering effect was not significant (P>0.05), indicating a random distribution. Conclusions The TDR of MTB in Qinghai Province from 2016 to 2019 showed a downward trend year by year. In comparison with the national average, the rate of multi-drug resistance and extensive drug resistance was still high, and most of the multi-drug resistance resulted from rifampicin and isoniazid. The drugresistant population mainly consisted of retreatment, males, and young and middle-aged pop

Spatial temporal feature of tuberculosis among high school students in Gansu Province from 2018 to 2022 / 中国学校卫生

Objective@#To analyze the spatial temporal distribution characteristics of tuberculosis among high school students at county levels in Gansu Province from 2018 to 2022,so as to provide a scientific basis for tuberculosis prevention and control in schools.@*Methods@#Tuberculosis data from high school students in counties (districts) reported in Gansu Province from 2018 to 2022 was collected from the Tuberculosis Information Management System and Infectious Disease Information Reporting System of the Chinese Disease Prevention and Control Information Management System. Demographic data of high school students in counties (districts) came from the General Management System of the Chinese Disease Prevention and Control Information Management System, and the spatial clustering of the reported incidence rate of pulmonary tuberculosis among high school students in Gansu Province in the past five years was analyzed using the methods of global spatial autocorrelation (Moran s I) and local indicators of spatial audocorrelation(LISA).@*Results@#A total of 41 885 pulmonary tuberculosis cases were reported in various counties of Gansu Province From 2018 to 2022, with an average reported incidence rate of 32.81/100 000. During the same period, 1 170 high school students cases were reported, with an average reported incidence rate of 13.72/100 000. With the exception of 2020, the reported incidence rate of pulmonary tuberculosis among high school students was non random distribution in other 4 years, showed a moderate intensity of spatial clustering. From 2018 to 2022, most counties in Gansu Province reported that the incidence rate of pulmonary tuberculosis among high school students was 10.00/100 000 or below, the counties with reported incidence rate >40.00/100 000 were mainly distributed in Luqu County, Maqu County, Diebu County, Hezuo City, Xiahe County of Gannan Prefecture, Gangu County and Wushan County of Tianshui Prefecture, Wenxian County and Kangxian County of Longnan Prefecture, Huachi County of Pingliang Prefecture, Huanxian County of Qingyang Prefecture. The number of counties where the reported incidence rate of tuberculosis among high school students more than 30.00/100 000 gradually decreased from 2018 to 2022. In the past five years, the reported incidence rate of tuberculosis among high school students in all counties of Gannan Prefecture remained above 40.00/ 100 000 . The LISA analysis results showed that the high incidence areas were mainly concentrated in Gannan Prefecture.@*Conclusions@#The epidemic situation of pulmonary tuberculosis among high school students in Gansu province from 2018 to 2022 is still a serious condition, showing the characteristics of unbalanced regional distribution. The reported incidence rate shows a strong spatial clustering, and the hot spots are concentrated in the counties (districts) of Gannan prefecture in Gansu Province.

Distribution characteristics of newly reported occupational welder′s pneumoconiosis in Guangdong Province, 2013-2022 / 中国职业医学

Objective To analyze the distribution features of newly reported cases of occupational welder′s pneumoconiosis (OWP) in Guangdong Province from 2013 to 2022. Methods Data of newly reported cases of OWP from National Occupational Disease Network Direct Reporting System of Guangdong Province from 2013 to 2022 was analyzed using conventional data analyzing Methods. Results A total of 294 cases of OWP were reported in Guangdong Province from 2013 to 2022 with an overall downward trend. The average age at diagnosis for new OWP cases was 44±6 years old, and the median of dust exposure duration was 11 years. Males accounted for 99.3% of the cases, and 94.2% of the cases were phase Ⅰ OWP. Guangzhou City had the highest regional distribution with 74.8% of the cases. The industry distribution was mainly manufacturing, accounting for 86.7% of the cases. The scale of enterprises was most common in small enterprises, followed by large and medium-sized enterprises, accounting for 38.4%, 30.6% and 24.5% of the cases respectively. The economic types of enterprises were mostly private enterprises, followed by state-owned enterprises, accounting for 54.1% and 32.0% of the cases respectively. Conclusion In Guangdong Province, the newly reported OWP cases were clustered in terms of disease stage, regional distribution, industry, enterprise scale and enterprise economic type. There was a tendency of younger age at diagnosis and shorter dust exposure duration.

Identification and cluster analysis of Streptococcus suis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry / 公共卫生与预防医学

Objective To evaluate the feasibility of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) for identification and cluster analysis of Streptococcus suis. Methods Eighteen clinical isolates biochemically identified as Streptococcus suis were pre-treated by smearing formic acid method and formic acid-acetonitrile extraction method. The identification results and protein profiles of MALDI-TOF-MS method were analyzed and compared. A self-constructed database of profiling with better pretreatment method was established, and cluster analysis was performed on the 18 strains of Streptococcus suis. At the same time, PFGE homology analysis was performed to compare the results of the two genotyping. Results Both pretreatment methods could accurately identify Streptococcus suis with scores above 2.1. The protein fingerprint of formic acid and acetonitrile extraction method had a smoother baseline, fewer miscellaneous peaks and more identifiable ion peaks. Comparison of the results of homology typing showed that the homology results of MALDI-TOF-MS were significantly different from those of PFGE. Conclusion MALDI-TOF-MS can accurately identify Streptococcus suis for the strains pre-treated with formic acid method or formic acid-acetonitrile extraction method, and the formic acid-acetonitrile extraction method can obtain a better protein mapping. MALDI-TOF-MS can play a certain role in typing, but it still has some limitations and cannot completely replace the PFGE.

Research on multi-Atlas segmentation based on feature clustering / 中华放射肿瘤学杂志

Objective:To study the improvement of normal tissue region of interest (ROI) segmentation based on clustering-based multi-Atlas segmentation method, thereby achieving better delineation of organs at risk.Methods:CT images of 100 patients with cervical cancer who had completed treatment in Zhejiang Cancer Hospital during 2019-2020 were selected as the Atlas database. According to the volume characteristic parameters of the organs at risk (bladder, rectum and outer contour), the Atlas database was divided into several subsets by k-means clustering algorithm. The image to be segmented was matched to the corresponding Atlas library for multi-Atlas segmentation. The dice similarity coefficient (DSC) was used to evaluate the segmentation results.Results:Using 30 patients as the test set, the sub-Atlas generated by different clustering methods were compared for the improvement of image segmentation results. Compared with general multi-Atlas segmentation methods, clustering-based multi-Atlas segmentation method significantly improve the segmentation accuracy for the bladder (DSC=0.83±0.09 vs. 0.69±0.15, P<0.001) and the rectum (0.7±0.07 vs. 0.56±0.16, P<0.001), but no statistical significance was observed for left and right femoral head (0.92±0.04, 0.91±0.02) and bone marrow (0.91±0.06). The average segmentation time of clustering-based multi-Atlas segmentation method was shorter than that of the general multi-Atlas segmentation method (2.7 min vs. 6.3 min). Conclusion:The clustering-based multi-Atlas segmentation method can not only reduce the number of Atlas images registered with the image to be segmented, but also can be expected to improve the segmentation effect and obtain higher accuracy.

Spatial distribution and prediction analysis of the national AIDS epidemic in 2009 - 2020 / 公共卫生与预防医学

Objective Tto analyze the spatial distribution and characteristics of the national AIDS/HIV epidemics from 2009 to 2020 to discover its distribution, aggregation, and hot spots, and provide corresponding suggestions for AIDS prevention and control. Methods Spatial autocorrelation analysis, hot spot analysis, and Kriging interpolation prediction were used to describe, analyze, and predicting the spatial distribution of AIDS epidemics across the country. Results The national AIDS incidence and mortality rate increased yearly, but the growth rate shows a downward tendency with uneven spatial distribution,focusing on the southwest and northwest regions; the average annual incidence rate of AIDS ( Moran's I> 0, P 0, P “high-high” clusters of AIDS incidence; Sichuan, Yunnan, Guangxi,Hunan,Xinjiang and Guizhou were the areas with “high-high” clusters of average annual mortality. The “hot spot” areas were mainly concentrated in the southwestern part of China, and the “cold spot” areas were mainly concentrated in the eastern coastal and northern parts of China; Kriging interpolation predicted that Xinjiang would be the new hot spot area for future epidemics. Conclusion The spatial distribution of AIDS in China is uneven, showing spatial aggregation, hot spots and cold spots coexist, and the high-risk areas will continue to expand in the future.So the prevention and control work should be carried out in a targeted and localized manner.

Relationship between reduction of urban PM2.5 and mental health of middle-aged and elderly people after China's Air Pollution Prevention and Control Action Plan / 环境与职业医学

Background Epidemiological evidence indicates an association of particulate matter with depression and cognitive performance. From 2013 to 2017, China implemented the Air Pollution Prevention and Control Action Plan to reduce particulate matter concentration. There are few studies on the relationship between the decrease of particulate matter concentration and the improvement of mental health in middle-aged and elderly people. Objective To analyze the relationship between the decrease of city-level particulate matter concentration and the improvement of depression and cognitive function in the middle-aged and elderly population after the implementation of the Air Pollution Prevention and Control Action Plan. Methods Using the China Health and Retirement Longitudinal Study (CHARLS) data in 2011 and 2018, this study applied longitudinal data clustering technology to group cities based on the actual response of each city to the policy (the dynamic change trajectory of PM2.5 in each city during the study period); the higher the degree of response, the greater the reduction of PM2.5 concentration in the city. We assigned participants to three groups with different degrees of response to the policy, including low-response group A as the control group, medium-response intervention group B, and high-response intervention group C. A difference-in-differences (DID) model was used to estimate the influence of PM2.5 decline on the depression and cognitive function among middle-aged and elderly people in China by considering potential individual and city-level time-varying confounders. Depression was measured using the 10-item Center for the Epidemiological Studies of Depression Scale (CES-D10) (10 questions, total score range 0-30) with higher score representing higher severity of depression. Cognitive function was evaluated with reference to the international cognitive function test questionnaire for the middle-aged and the elderly which was further categorized into two dimensions of memory and cognitive status and included 31 questions with a score range of 0-31; the higher the score, the better the cognitive function. Samples with relatively complete outcomes were selected for analysis, including 10729 people in depression analysis and 4510 people in cognitive analysis. Results The longitudinal clustering results indicated that the urban groups with the highest decline of PM2.5 concentrations (high-response group C) had the highest baseline PM2.5 concentrations, mainly in Beijing-Tianjin-Hebei region, Chengdu-Chongqing metropolitan area, and Wuhan metropolitan area. In 2011, no significant differences were observed in depression and cognitive function among the three groups of middle-aged and elderly populations (Kruskal Wallis test: Pdepression=0.864, Pcognition=0.239). Significant differences were found in depression and cognitive function in both low-response group A and medium-response group B in 2018 compared to 2011 (paired Wilcox test, all P<0.001). However, in the high-response group C, there was no significant difference in depression in 2018 compared to 2011 (P=0.195), while a significant difference was detected in cognitive function (P=0.006). As PM2.5 concentrations decreased, the DID model showed that the depression of the middle-aged and elderly people in the high-response group C decreased by 7.55% (95%CI: 2.83%-12.03%), and the cognitive function improved by 2.70% (95%CI: 0.25%-5.22%) compared with the low-response group A. However, no intervention effect was observed in group B with moderate response level compared with group A with low response level. Conclusion After the implementation of the Air Pollution Prevention and Control Action Plan policy, the decrease of PM2.5 concentration has an ameliorative effect on the depression and cognitive function of middle-aged and elderly people in China. Given the aging population and the increasing burden of mental-related diseases in China, the promotion of environmental air pollution control has important public health implications.

Epidemiological investigation of a pulmonary tuberculosis outbreak involving six high schools / 预防医学

@#In September 2020, three pulmonary tuberculosis cases were identified during school physical examinations at a senior high school in a district (School B) of Hangzhou City. Immediate epidemiological surveys were performed by local district and Hangzhou Center for Disease Control and Prevention, and a pulmonary tuberculosis outbreak involving 9 cases in 6 schools were identified. All cases were once Grade 9 students in Class of 2019 at a junior high school (School A), and the source of infection might be a laboratory-confirmed cases (index case) in this class reported in April, 2019. Following exposure to index case, other cases developed disease onset or were screened after entering senior high schools. In November, 2020, tuberculin skin test and chest X-ray scan were performed to screen pulmonary tuberculosis among 43 students and teachers in a class of Grade 9 in Class of 2019 at School A, and 17 students strongly positive for tuberculin skin test were given prophylactic therapy. No pulmonary tuberculosis case were identified until June 2021. It is suggested that early epidemiological surveys facilitates the identification of the epidemiological correlation between cases. Active search for individuals with common exposure history and prophylactic therapy are required if a possible outbreak is found, which is helpful to avoid the spread of the outbreak.

Clustering of health-risk behaviors among children and adolescents in Yancheng City / 预防医学

Objective@#To investigate the clustering of health-risk behaviors and its influencing factors among children and adolescents in Yancheng City, Jiangsu Province, so as to provide insights into the prevention and control of health-risk behaviors among children and adolescents. @*Methods@#Students were randomly sampled from 4 primary schools, 4 junior high schools and 4 senior high schools in Yancheng City using a multi-stage stratified cluster random sampling method from September to December 2021. Students' demographics and 12 health-risk factors including unhealthy diet, insufficient physical activity and attempted smoking were collected using the Student's Health Status and Influencing Factors Questionnaire by Jiangsu Provincial Center for Disease Control and Prevention, and factors affecting the clustering of health-risk behaviors were identified using a multivariable linear regression model.@*Results@#A total of 2 925 valid questionnaires were recovered, and the respondents included 1 611 boys (55.08%) and 1 314 girls (44.92%). A total of 2 896 respondents were detected with health-risk behaviors, with a detection rate of 99.09%, and 2 772 respondents were detected with clustering of health-risk behaviors (93.06%). Insufficient sleep, insufficient physical activity and insufficient duration of outdoor activity were predominant patterns of clustering. The median number of health-risk behaviors was 4.00 (interquartile range, 2.00) per capita. Multivariable linear regression analysis showed that boys (β=0.232), grade (junior high school, β=0.519; senior high school, β=0.427), urban area (β=0.241), living at school (β=0.395), family structure (single parental family, β=0.188; other families, β=0.344) and father's education level of primary school and below (β=0.369) were factors affecting clustering of health-risk behavior among primary and high school students. @*Conclusions@#The detection of health-risk behaviors is high among children and adolescents in Yancheng City, and insufficient sleep, insufficient physical activity and insufficient duration of outdoor activity are predominant health-risk behaviors. Boys, junior high school and above, urban areas, living at schools, single parents, and fathers with a low educational level lead to a high degree of clustering of health-risk behaviors.

Epidemiological investigation of a cluster of COVID-19 in badminton venues / 预防医学

Objective@#To perform an epidemiological survey of the first case with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Pinghu City of Jiaxing City, Zhejiang Province on March 13, 2022, so as to provide insights into the management of coronavirus disease (COVID-19) epidemics. @*Methods@#According to the requirements of the Protocol on Prevention and Control of COVID-19 (8th Edition), epidemiological investigations were performed among 39 cases with SARS-CoV-2 infections in Pinghu City from March 13 to 20, 2022. Cases' demographics, clinical symptoms, history of immunization and exposure were collected, and close contacts were identified. Pharyngeal swabs were sampled from infected cases for detection of SARS-CoV-2 nucleic acid and whole-genome sequencing, and the source of infection and transmission route were investigated. @*Results@#The index case for this COVID-19 epidemic was an imported case from Shanghai Municipality, who infected 6 persons via aerosol transmission when playing in the badminton venue of Pinghu National Fitness Center on March 9; subsequently, one of these infected cases infected another 18 persons when playing in the badminton venue of Jiadian Village Resident's Fitness Center in Zhapu Township on March 12. Sixteen confirmed cases were reported, and all cases were mild; another 23 asymptomatic cases were diagnosed, with no death reported. This epidemic occurred from March 11 to 20, with 3 generations of spread and a median incubation period of 3 days. The SARS-CoV-2 infected cases had a median age of 33.5 (interquartile range, 12.0) years and included 36 cases with a history of COVID-19 vaccination. There were 16 cases with fever, cough, runny nose and sore throat, and 13 cases with imaging features of pneumonia. The effective reproductive number (Rt) of the COVID-19 epidemic was 7.73 at early stage, and was less than 1 since March 21. Whole-genome sequencing identified Omicron BA.2 variant among 33 cases, which had high homology with the index cases. @*Conclusion@#This epidemic was a cluster of COVID-19 caused by imported Omicron BA.2 variant infection from Shanghai Municipality, and the COVID-19 transmission was mainly caused by indoor aerosols.