The Environmental and Socioeconomic Effects and Prediction of Patients With Tuberculosis in Different Age Groups in Southwest China: A Population-Based Study.

BACKGROUND: While the End Tuberculosis (TB) Strategy has been implemented worldwide, the cause of the TB epidemic is multifactorial and not fully understood. OBJECTIVE: This study aims to investigate the risk factors of TB and incorporate these factors to forecast the incidence of TB infection across different age groups in Sichuan, China. METHODS: Correlation and linear regression analyses were conducted to assess the relationships between TB cases and ecological factors, including environmental, economic, and social factors, in Sichuan Province from 2006 to 2017. The transfer function-noise model was used to forecast trends, considering both time and multifactor effects. RESULTS: From 2006 to 2017, Sichuan Province had a reported cumulative incidence rate of 1321.08 cases per 100,000 individuals in male patients and 583.04 cases per 100,000 individuals in female patients. There were significant sex differences in the distribution of cases among age groups (trend χ225=12,544.4; P<.001). Ganzi Tibetan Autonomous Prefecture had the highest incidence rates of TB in both male and female patients in Sichuan. Correlation and regression analyses showed that the total illiteracy rate and average pressure at each measuring station (for individuals aged 15-24 years) were risk factors for TB. The protective factors were as follows: the number of families with the minimum living standard guarantee in urban areas, the average wind speed, the number of discharged patients with invasive TB, the number of people with the minimum living standard guarantee in rural areas, the total health expenditure as a percentage of regional gross domestic product, and being a single male individual (for those aged 0-14 years); the number of hospitals and number of health workers in infectious disease hospitals (for individuals aged 25-64 years); and the amount of daily morning and evening exercise, the number of people with the urban minimum living standard guarantee, and being married (for female individuals aged ≥65 years). The transfer function-noise model indicated that the incidence of TB in male patients aged 0-14 and 15-24 years will continue to increase, and the incidence of TB in female patients aged 0-14 and ≥65 years will continue to increase rapidly in Sichuan by 2035. CONCLUSIONS: The End TB Strategy in Sichuan should consider environmental, educational, medical, social, personal, and other conditions, and further substantial efforts are needed especially for male patients aged 0-24 years, female patients aged 0-14 years, and female patients older than 64 years.

Epidemiological characteristics and quarantine assessment of imported international COVID-19 cases, March to December 2020, Chengdu, China.

International flights have accelerated the global spread of Coronavirus Disease 2019 (COVID-19). Determination of the optimal quarantine period for international travelers is crucial to prevent the local spread caused by imported COVID-19 cases. We performed a retrospective epidemiological study using 491 imported COVID-19 cases in Chengdu, China, to describe the characteristic of the cases and estimate the time from arrival to confirmation for international travelers using nonparametric survival methods. Among the 491 imported COVID-19 cases, 194 (39.5%) were asymptomatic infections. The mean age was 35.6 years (SD = 12.1 years) and 83.3% were men. The majority (74.1%) were screened positive for SARS-CoV-2, conducted by Chengdu Customs District, the People's Republic of China. Asymptomatic cases were younger than presymptomatic or symptomatic cases (P < 0.01). The daily number of imported COVID-19 cases displayed jagged changes. 95% of COVID-19 cases were confirmed by PT-PCR within 14 days (95% CI 13-15) after arriving in Chengdu. A 14-day quarantine measure can ensure non-infection among international travelers with a 95% probability. Policymakers may consider an extension of the quarantine period to minimize the negative consequences of the COVID-19 confinement and prevent the international spread of COVID-19. Nevertheless, the government should consider the balance between COVID-19 and socioeconomic development, which may cause more serious social and health crises.

Vaccination coverage and immunization safety among children with special health status in Chongqing, China.

Vaccination of children with special health status has become one of the most urgent issues in China. We aim to evaluate vaccination coverage and safety as well as its associated factors among children with special health status in China during 2016‒2020. We conducted a retrospective cohort review of all children with special health status recorded in the Electronic Immunization Registries System in Chongqing, China, between 2016 and 2020. Univariate and multivariate logistic regression analyses were used to analyze the influence factors. Among the 2,175 children with special health status enrolled in the study, the overall vaccination coverage rate was lower than that among the general population, and the incidence of adverse event in them following immunization was very rare. Children with congenital heart disease were better vaccinated (aOR = 1.508-6.331), while most of the jaundice children had missed vaccination (aOR = 0.441‒0.556). The purchase of vaccine compensation insurance was associated with higher completion rate of basic immunization for Bacillus Calmette-G vaccine (aOR = 1.706, 95% CI: 1.249‒2.329) and rotavirus vaccine (aOR = 1.346, 95% CI: 1.061‒1.708). Children with special health status can be safely vaccinated. However, the vaccination coverage in these huge and vulnerable group is too low to protect them from vaccine-preventable diseases through immunization. More researches and interventions should be conducted to ensure a higher vaccination rate among the children with special health status.

Estimating the impact of non-pharmaceutical interventions against COVID-19 on mumps incidence in Sichuan, China.

BACKGROUND: A series of social and public health measures have been implemented to contain coronavirus disease 2019 (COVID-19) in China. We examined the impact of non-pharmaceutical interventions against COVID-19 on mumps incidence as an agent to determine the potential reduction in other respiratory virus incidence. METHODS: We modelled mumps incidence per month in Sichuan using a seasonal autoregressive integrated moving average (ARIMA) model, based on the reported number of mumps cases per month from 2017 to 2020. RESULTS: The epidemic peak of mumps in 2020 is lower than in the preceding years. Whenever compared with the projected cases or the average from corresponding periods in the preceding years (2017-2019), the reported cases in 2020 markedly declined (P < 0.001). From January to December, the number of mumps cases was estimated to decrease by 36.3% (33.9-38.8%), 34.3% (31.1-37.8%), 68.9% (66.1-71.6%), 76.0% (73.9-77.9%), 67.0% (65.0-69.0%), 59.6% (57.6-61.6%), 61.1% (58.8-63.3%), 49.2% (46.4-52.1%), 24.4% (22.1-26.8%), 30.0% (27.5-32.6%), 42.1% (39.6-44.7%), 63.5% (61.2-65.8%), respectively. The total number of mumps cases in 2020 was estimated to decrease by 53.6% (52.9-54.3%). CONCLUSION: Our study shows that non-pharmaceutical interventions against COVID-19 have had an effective impact on mumps incidence in Sichuan, China.

Associations of Caregiving Knowledge and Skills With Caregiver Burden, Psychological Well-Being, and Coping Styles Among Primary Family Caregivers of People Living With Schizophrenia in China.

Background: There is a lack of clarity regarding the correlation of caregiving knowledge and skills with caregiving experiences of people living with schizophrenia (PLSs). To address this gap, this comprehensive study examines the relationships of caregiving knowledge and skills to the primary family caregiver's experiences of burden, psychological well-being (stress, anxiety, depression, caregiving rewarding feelings), and coping styles in China. Methods: A total of 395 primary family caregivers of PLSs were enrolled in a cross-sectional study between May 2019 and September 2019. Each family caregiver was independently assessed on caregiving knowledge and skills, caregiver burden, and psychological well-being, as well as coping styles. Results: A higher level of caregiving knowledge and skills was positively correlated with less stress (b = -0.48, P < 0.001), anxiety (b = -0.23, P = 0.029), depression (b = -0.29, P = 0.013), and more caregiving rewarding feelings (b = 0.54, P < 0.001). Also, caregivers with more knowledge and skills were more inclined to adopt positive coping strategies (b = 0.44, P < 0.001). Despite these differences, caregivers with different levels of caregiving knowledge and skills reported comparable caregiver burden (b = 0.11, P = 0.705) and the use of a passive coping style (b = 0.10, P = 0.169). Conclusion: Caregiving knowledge and skills are a reliable predictor of psychological well-being and active coping among the primary family caregivers of PLSs. These findings inform the development of psychoeducational interventions to support family caregivers of PLSs.

Independent and joint associations of body mass index, waist circumference, waist-height ratio and their changes with risks of hyperuricemia in middle-aged and older Chinese individuals: a population-based nationwide cohort study.

BACKGROUND: Previous reports regarding the predictive power of adiposity indices remain inconsistent, and longitudinal studies on this top are limited. The associations of hyperuricemia risk with changes in obesity status, as well as the joint effects of baseline adiposity indices and body adiposity change on hyperuricemia risk are not fully elucidated. This study aimed to explore the independent and joint associations of baseline adiposity indicators and body adiposity change with hyperuricemia risk among middle-aged and older population in China. METHODS: A total of 2895 participants aged ≥ 45 years from the baseline survey of the China Health and Retirement Longitudinal Study were followed up for 4 years. Anthropometric parameters (weight, height, and waist circumference) and serum uric acid were obtained using standard devices. Adjusted odds ratio and 95% confidential interval were calculated to estimate the associations between predictor variables and hyperuricemia risk using multivariate logistic regression. RESULTS: Of the 2895 participants, 293 (10.12%) cases of hyperuricemia were identified. Increased baseline body mass index (BMI), waist circumference, and waist-height ratio (WHtR) were significantly associated with higher risks of hyperuricemia. A slightly greater but non-significant area under the curve value was observed for waist circumference (0.622) than for BMI (0.611) and WHtR (0.614) (P = 0.447). Compared to subjects with stable adiposity status, participants with weight loss of ≥ 4 kg or waist circumference loss of ≥ 6 cm had a 56% or 55% lower risk of hyperuricemia, and those with weight gain of > 4 kg had a 1.62-fold higher risk of hyperuricemia. Compared to those without obesity, participants with incident or persistent obesity were more likely to develop hyperuricemia. Additionally, regardless of stable or increased weight/waist circumference during follow-up, individuals with obesity at baseline had a higher risk of incident hyperuricemia. CONCLUSION: This study demonstrates that BMI, waist circumference, and WHtR equally predict the development of hyperuricemia, and weight loss and waist circumference reduction are favorable in preventing hyperuricemia.

Long-term neurodevelopment outcomes of hand, foot and mouth disease inpatients infected with EV-A71 or CV-A16, a retrospective cohort study.

Hand, foot and mouth disease (HFMD) is a common infectious disease in western Asia area and the full range of the long-term sequelae of HFMD remains poorly described. We conducted a retrospective hospital-based cohort study of HFMD patients with central nervous system (CNS) complications caused by EV-A71 or CV-A16 between 2010 and 2016. Patients were classified into three groups, including CNS only, autonomic nervous system (ANS) dysregulation, and cardiorespiratory failure. Neurologic examination, neurodevelopmental assessments, Magnetic Resonance Imaging (MRI) and lung function, were performed at follow up. Of the 176 patients followed up, 24 suffered CNS only, 133 ANS dysregulation, and 19 cardiorespiratory failure. Median follow-up period was 4.3 years (range [1.4-8.3]). The rate of neurological abnormalities was 25% (43 of 171) at discharge and 10% (17 of 171) at follow-up. The rates of poor outcome were significantly different between the three groups of complications in motor (28%, 38%, 71%) domain (p=0.020), but not for cognitive (20%, 24%, 35%), language (25%, 36%, 41%) and adaptive (24%, 16%, 26%) domains (p = 0.537, p = 0.551, p = 0.403). For children with ventilated during hospitalization, 41% patients (14 of 34) had an obstructive ventilatory defect, and one patient with scoliosis had mixed ventilatory dysfunction. Persistent abnormalities on brain MRI were 0% (0 of 7), 9% (2 of 23) and 57% (4 of 7) in CNS, ANS and cardiorespiratory failure group separately. Patients with HFMD may have abnormalities in neurological, motor, language, cognition, adaptive behaviour and respiratory function. Long-term follow-up programmes for children's neurodevelopmental and respiratory function may be warranted.

Epidemiological and spatiotemporal analyses of HIV/AIDS prevalence among older adults in Sichuan, China between 2008 and 2019: A population-based study.

OBJECTIVES: To describe epidemiological trends and spatial distributions of HIV/AIDS among older adults (aged ≥50) in Sichuan Province, China during 2008-19, and provide scientific reference for HIV/AIDS prevention, intervention and treatment. METHODS: Data on HIV/AIDS cases reported in 2008-19 was extracted from the Case Report System. The Cochran-Armitage trend test was used to determine epidemic trends. Spatial autocorrelation and space-time analysis were conducted with ArcGIS10.6 and ArcGIS Pro2.4, respectively. RESULTS: A total of 77854 HIV/AIDS cases among older adults were included in the study. Newly reported cases increased from 320 in 2008 to 22189 in 2019, and the reported incidence rate (number of new reported cases/older adult population) rose from 0.001% to 0.077%. Infections through heterosexual transmission increased from 65.3% to 98.2% of total cases in older adults in this period. Spatial analysis at the county-level showed significant clustering throughout Sichuan, with the main hot spots concentrated in the southeast. Spatiotemporal analysis indicated that most of the southeastern counties/districts were Consecutive Hot Spots. CONCLUSIONS: Older adults have become a key population in the HIV/AIDS epidemic in Sichuan; comprehensive prevention and intervention measures targeted to older adults are urgently needed to control the spread of HIV/AIDS.

Effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life for patients with Parkinson's disease: A systematic review and meta-analysis.

OBJECTIVE: To conduct a systematic review evaluating the effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life among individuals with Parkinson's disease. DATA SOURCES: A systematic search of PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, and Physiotherapy Evidence Database was carried out to identify eligible papers published up to December 10, 2020. REVIEW METHODS: Literature selection, data extraction, and methodological quality assessment were independently performed by two investigators. Publication bias was determined by funnel plot and Egger's regression test. "Trim and fill" analysis was performed to adjust any potential publication bias. RESULTS: Seventeen studies involving 598 participants were included in this meta-analysis. Music-based movement therapy significantly improved motor function (Unified Parkinson's Disease Rating Scale motor subscale, MD = -5.44, P = 0.002; Timed Up and Go Test, MD = -1.02, P = 0.001), balance (Berg Balance Scale, MD = 2.02, P < 0.001; Mini-Balance Evaluation Systems Test, MD = 2.95, P = 0.001), freezing of gait (MD = -2.35, P = 0.039), walking velocity (MD = 0.18, P < 0.001), and mental health (SMD = -0.38, P = 0.003). However, no significant effects were observed on gait cadence, stride length, and quality of life. CONCLUSION: The findings of this study show that music-based movement therapy is an effective treatment approach for improving motor function, balance, freezing of gait, walking velocity, and mental health for patients with Parkinson's disease.

Associations between sleep duration, midday napping, depression, and falls among postmenopausal women in China: a population-based nationwide study.

OBJECTIVE: To explore the independent and joint associations of sleep duration, midday napping, and depression with fall accidents in Chinese postmenopausal women. METHODS: A total of 2,378 postmenopausal women aged ≥ 45 years from the baseline survey of the China Health and Retirement Longitudinal Study were enrolled in the study. Each participant provided data on falls, sleep duration, midday napping by a self-reporting approach. We employed the Chinese version of the Center for Epidemiologic Studies Depression Scale to assess depression. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated to estimate the associations of predictor variables with falls using multivariate logistic regression. RESULTS: Of the 2,378 postmenopausal women, 478 (20.10%) reported falls in the preceding 2 years. Compared with sleep duration of 7 to 8 h/night, sleep duration of 5 to 6 h/night (OR, 1.49; 95% CI, 1.03-2.15) and of ≤ 5 h/night (OR, 1.63; 95% CI, 1.18-2.25) were associated with a higher fall prevalence. However, no significant correlation was found between sleep duration of > 8 h/night and falls. Furthermore, participants with depression were more likely to report falls (OR, 1.78; 95% CI, 1.41-2.25) than their depression-free counterparts. The duration of midday napping was not independently associated with falls, but significant joint associations of sleeping ≤ 6 h/night and no napping (OR, 1.72; 95% CI, 1.07-2.76) or napping > 60 minutes (OR, 2.14; 95% CI, 1.18-3.89) with more falls were found. Similarly, a combined status of sleeping ≤ 6 h/night and depression was related to more falls (OR, 2.97; 95% CI, 1.86-4.74). CONCLUSION: The present study demonstrates that short sleep duration and depression are independently associated with more falls among postmenopausal women in China. Moreover, short sleep duration combined with no or long napping, short sleep duration combined with depression are jointly correlated with more falls. Future longitudinal studies are warranted to confirm these findings.

The prevalence of smoking in male medical students from 16 Chinese medical colleges and the associated factors.

BACKGROUND: The prevalence of smoking among Chinese medical students in medical colleges is a matter of significant concern. This study aimed to explore the prevalence of smoking and the associated factors among these students. METHODS: A total of 7,728 students from 16 colleges in 12 provinces were surveyed to measure their smoking behaviors, attitudes toward tobacco control, and knowledge about smoking risk. An evaluation of campus environment and policy was conducted at the same time. Frequencies were calculated using weighted estimators for complex sampling. A two-level logistic regression model was used to assess factors associated with current smoking. RESULTS: The prevalence of smoking among male medical students in the 16 medical colleges was 12.8%. Students' participation in smoking, smoking initiation after school enrollment, and intention-to-quit-smoking rates may be influenced by their anti-tobacco attitude, the belief that smoking can help to relieve stress, their parents' smoking behaviors, their best friend's attitude towards smoking and second-hand smoke exposure (SHSE), and their awareness of tobacco hazards. CONCLUSIONS: This study provides sufficient evidence to support the implementation of systematic intervention strategies to decrease the smoking rate among male medical students. These strategies may include tobacco control education, smoking cessation technologies, communication, and the enforcement of smoke-free policies to create a tobacco-controlled campus environment.

Viral shedding in patients with hand, foot and mouth disease induced by EV71, CA16, or CA6: A protocol for systematic review and meta analysis.

INTRODUCTION: Hand, foot, and mouth disease (HFMD) has been an important public health concern worldwide, especially in the Asia-Pacific region. Unfortunately, the effect of current measures on preventing and controlling HFMD may be limited. Isolation of infectious sources is reported as an important way to prevent and control this disease. The isolation period is determined on the basis of duration of viral shedding in patients with HFMD. However, the results of previous researches on duration of viral shedding remain controversial. Here, we present a protocol of a systematic review and single-arm meta-analysis for assessing the duration of viral shedding in patients with HFMD induced by Enterovirus 71 (EV71), Coxsackievirus A16 (CA16), or Coxsackievirus A6 (CA6). METHODS AND ANALYSIS: A comprehensive literature search will be performed in PubMed, EMBASE, the Cochrane library, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), and Wanfang Database, covering the period from inception to May 1, 2019. Point estimate of positive rate with corresponding 95% confidence intervals (CIs) of EV71, CA16, or CA6 in HFMD patients' fecal or throat samples will be carried out using STATA 14.0. Subgroup analyses will be performed for mild cases, severe cases, and close contacts. Sensitive analysis will also be performed to evaluate the influences of individual studies on the final effect by exclusion of a few articles of poor quality. We will assess the risk of bias for the final studies included in our meta-analysis using previously available tools and the modified risk of bias tool. RESULTS: The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. CONCLUSION: To the best of our knowledge, this paper will be the first systematic review and meta-analysis for assessing the duration of viral shedding in patients with HFMD induced by EV71, CA16, or CA6. The conclusions drawn from this review will provide the scientific basis to formulate the isolation period of HFMD. ETHICS AND DISSEMINATION: Ethical review is not required as this article is for a systematic review since there is no direct involvement of patients in the whole process. We will publish the results of this systematic review and meta-analysis of single-arm studies in a peer-reviewed journal. REGISTRATION NUMBER: Prospero CRD42020139999.

Epidemiology of Hand, Foot, and Mouth Disease Before and After the Introduction of Enterovirus 71 Vaccines in Chengdu, China, 2009-2018.

BACKGROUND: Hand, foot, and mouth disease (HFMD) has posed a serious threat to children's health. Three inactivated monovalent enterovirus 71 (EV71) vaccines are proved to be highly efficacious in phase III clinical trials and are now available in China. METHODS: We analyzed the citywide surveillance data on HFMD cases in Chengdu during 2009-2018, and estimated cumulative first-dose EV71 vaccination coverage among children eligible to EV71 vaccination after August 2016 in Chengdu. Time series susceptible-infected-recovered model was developed to analyze basic reproduction number and herd immunity threshold of HFMD. Overall and serotype-specific HFMD incidences and severity risks were compared before and after the EV71 vaccination. RESULTS: Among 3 laboratory-identified serotype categories, i.e. EV71, coxsackievirus A16 (CV-A16), and other enteroviruses, the major serotype attributed to HFMD has been changing across years. The cumulative first-dose EV71 vaccination coverage rate was estimated as 60.8% during the study period in Chengdu. By contrast, herd immunity threshold for EV71-related HFMD was 94.0%. After introduction of EV71 vaccines, the overall incidence of HFMD increased 60.8%, mainly driven by 173.7% and 11.8% increased in HFMD caused by other enteroviruses and CV-A16, respectively, which offset a significant reduction in the incidence of HFMD caused by EV71. The overall case-severity risk decreased from 1.4% to 0.3%, with significantly declined presented in all serotype categories. CONCLUSIONS: The incidence and severity of EV71-related HFMD decreased following implementation of EV71 vaccination. Developing multivalent vaccines and strengthening laboratory-based surveillance could further decline burden of HFMD.

[Prevalence and associated factors of underweight among the elderly in Qionglai City].

OBJECTIVE: To examine the prevalence and associated factors of underweight among the elderly in Qionglai City. METHODS: A total of 14 929 residents aged ≥60 years recruited through multistage stratified cluster random sampling in 24 towns or streets of Qionglai City were surveyed from August to October 2018, including 7581 males and 7348 females; 8121 aged 60-69, 5176 aged 70-79, and 1632 aged ≥ 80. Questionnaires and physical examinations were conducted to collect the characteristics, behaviors, healthy history of the subjects, height, and weight, etc. The judgment of underweight was based on the criteria of weight for adults(WS/T 428-2013). The prevalence of underweight was calculated and its determinants were analyzed with a non-conditional logistic regression model. RESULTS: The prevalence of underweight among the elderly was 5. 7%(851/14929), 5. 4% for male(413/7581) and 6. 0% for female(438/7348). The result of logistic regression analysis revealed that female(OR=1. 365, 95%CI 1. 147-1. 624), aged elderly ≥ 70 years(70-79 years: OR=1. 652, 95%CI 1. 402-1. 948; ≥80 years: OR=2. 557, 95%CI 2. 079-3. 145), no spouse(OR=1. 196, 95%CI 1. 008-1. 420), former and current smokers(current smokers: OR=1. 247, 95%CI 1. 018-1. 528; former smokers: OR=1. 536, 95%CI 1. 036-2. 276), daily physical activities less than 6000 steps(OR=1. 259, 95%CI 1. 083-1. 462), those who didn't receive medical diagnosis of hypertension(OR=1. 591, 95%CI 1. 321-1. 915) presented a high prevalence of being underweight. CONCLUSION: The prevalence of underweight is at a low level among the elderly in Qionglai City. Gender, age, marital status, smoking, daily physical activities, hypertension were associated with being underweight.

[Epidemiology, Treatment, and Epidemic Prevention and Control of the Coronavirus Disease 2019: a Review].

This review summarizes the ongoing researches regarding etiology, epidemiology, transmission dynamics, treatment, and prevention and control strategies of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with comparison to severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and pandemic H1N1 virus. SARS-CoV-2 may be originated from bats, and the patients and asymptomatic carriers are the source of epidemic infection. The virus can be transmitted human-to-human through droplets and close contact, and people at all ages are susceptible to this virus. The main clinical symptoms of the patients are fever and cough, accompanied with leukocytopenia and lymphocytopenia. Effective drugs have been not yet available thus far. In terms of the prevention and control strategies, vaccine development as the primary prevention should be accelerated. Regarding the secondary prevention, ongoing efforts of the infected patients and close contacts quarantine, mask wearing promotion, regular disinfection in public places should be continued. Meanwhile, rapid detection kit for serological monitoring of the virus in general population is expected so as to achieve early detection, early diagnosis, early isolation and early treatment. In addition, public health education on this disease and prevention should be enhanced so as to mitigate panic and mobilize the public to jointly combat the epidemic.

Early-life exposure to the Chinese famine of 1959-61 and risk of Hyperuricemia: results from the China health and retirement longitudinal study.

BACKGROUND: Short-term starvation has been related to hyperuricemia. However, little is known about the long-term effect of early-life exposure to famine on hyperuricemia risk in adulthood. METHODS: The analysis included 2383 participants from the China Health and Retirement Longitudinal Study in 2015. Hyperuricemia was diagnosed as serum uric acid ≥7 mg/dL in men and serum uric acid ≥6 mg/dL in women. Famine exposure subgroups were defined as unexposed (born between October 1, 1962, and September 30, 1964), fetal-exposed (born between October 1, 1959, and September 30, 1961), and early-childhood exposed (born between October 1, 1956, and September 1, 1958). The association between early-life famine exposure and hyperuricemia risk was assessed using multivariate logistic regression. RESULTS: The prevalence of hyperuricemia in the unexposed, fetal-exposed, and early-childhood exposed participants was 10.7, 14.1, 11.1%, respectively. Compared with unexposed and early-childhood exposed participants combined as an age-balanced control, fetal-exposed participants showed an increased risk of hyperuricemia in adulthood (OR = 1.41; 95% CI: 1.06-1.88), after adjusting for gender, marital status, famine severity, residence, smoking, drinking, BMI, hypertension, and diabetes. The famine effect on hyperuricemia was accentuated by overweight or obesity (P for interaction = 0.042). Compared with unexposed and BMI < 24 kg/m2 participants, the OR (95%CI) of hyperuricemia was 3.66 (2.13-6.30) for fetal-exposed and overweight/obesity participants. However, combined unexposed and early-childhood exposed participants as an age-balanced control, the interaction of famine exposure and BMI was not statistically significant (P for interaction = 0.054). CONCLUSION: Famine exposure in the fetal stage was associated with an increased risk of hyperuricemia in adulthood.

Analysis of the burden and trend of injury in Sichuan, China, from 2006 to 2015: results from the national injury surveillance system.

OBJECTIVE: This study investigates the distribution, burden and trends of injuries in Sichuan, China. DESIGN: A surveillance study using injury data collected by the National Injury Surveillance System. SETTING AND PARTICIPANTS: 312 511 injury cases reported in the National Injury Surveillance System in Sichuan, China, from 2006 to 2015. PRIMARY OUTCOME MEASURES: Years of potential life lost (YPLL) were calculated to determine the disease burden from injuries. Trend analysis was performed to assess the trends in specific injuries over time. RESULTS: A total of 312 511 injury cases were reported in the last 10 years in Sichuan with 192 904 (men: 58.58%) and 119 607 (men: 67.11%) cases from the urban and rural surveillance hospitals, respectively. The annual number of injury cases increased from 21 257 in 2006 to 44 112 in 2015 with an average annual increase of 8.45%. The top three common causes of injury were fall (29.3%), animal-related injury (19.1%) and road-related injury (14.6%) in the urban area and fall (38.4%), road-related injury (17.2%) and blunt injuries (16.0%) in the rural area. YPLLs from injuries accounted for 13% of the total YPLLs in the urban area. CONCLUSIONS: The number of injury cases varied according to rural/urban areas and gender and increased sharply in Sichuan over the last decade. It is necessary to develop targeted prevention and control measures to reduce the disease burden of injuries.

[Currency Survey and Influencing Factors Analysis on the Knowledge and Behavior Related to Brucellosis among Occupational Workers in Jianyang City].

OBJECTIVE: To investigate the status and influencing factors of the knowledge and behavior related to brucellosis among occupational workers in Jianyang city, and to provide basic information for developing regional specific strategies for brucellosis prevention and control. METHODS: With multistage cluster random sampling, occupational workers aged ≥18 yr. who had been in contact with sheep and their products were interviewed through a questionnaire about demographic characteristic, knowledge, and behavior related to brucellosis. The knowledge and practice scores were described as frequency and percentage, and the awareness rate of knowledge about brucellosis was calculated. Unconditional logistic regression model was used to analyze the influencing factors of knowledge and behavior related to brucellosis. RESULTS: In total, 378 workers were recruited. The minority (25.1%) of the workers had heard of brucellosis, and the awareness rate of brucellosis was 22.0%. Occupational protective behaviors were poor, and the scoring rates of wearing protective clothes, mask and gloves were 58.7%, 76.5%, 71.7% respectively. The results of multivariate logistic regression analysis revealed that the awareness rate of knowledge about brucellosis decreased with age, while the low educational level was found to be associated with low awareness of knowledge about brucellosis, and occupation type had association with the awareness rate of knowledge. Besides, the awareness of knowledge about brucellosis was a protective factor and occupation type were associated with the behavior related to brucellosis. CONCLUSIONS: The knowledge and behavior related to brucellosis are poor among occupational workers in Jianyang. It is necessary to continuously implement targeted health education and health promotion programs in this region, and the people with low education level and livestock farmers should be paid special attention to.

Effects of tai chi on physiology, balance and quality of life in patients with type 2 diabetes: A systematic review and meta-analysis.

OBJECTIVE: To systematically synthesize and critically evaluate evidence on the effects of tai chi for patients with type 2 diabetes mellitus. DATA SOURCES: Seven electronic databases (Wan Fang, SinoMed, China National Knowledge Infrastructure, VIP, PubMed, Embase, and Cochrane Library) were systematically searched from their inception to March 2018. STUDY SELECTION: Randomized controlled trials investigating the effects of tai chi on individuals with type 2 diabetes mellitus were eligible. DATA EXTRACTION: Biomedical outcomes (fasting plasma glucose, glycosylated haemoglobin (HbA1c), fasting insulin, insulin resistance, body mass index, total cholesterol, blood pressure) as well as balance and quality of life-related outcomes were extracted independently by 2 reviewers. Stata 12.0 software was used to synthesize data if there was no or moderate heterogeneity across studies. Otherwise, narrative summaries were performed. DATA SYNTHESIS: A total of 23 studies (25 articles) involving 1,235 patients were included in this meta-analysis. Significant changes in tai chi-related effects were observed in lowering fasting plasma glucose (standardized mean difference; SMD -0.67; 95% confidence interval (95% CI) -0.87 to -0.47; p <0.001), HbA1c (mean difference; MD-0.88%; 95% CI -1.45% to -0.31%; p =0.002) and insulin resistance (MD -0.41; 95% CI -0.78 to -0.04; p = 0.029). Beneficial effects of tai chi were also found in decreasing body mass index (MD -0.82 kg/m2; 95% CI -1.28 to -0.37 kg/m2; p < 0.001) and total cholesterol (SMD -0.59; 95% CI -0.90 to -0.27; p < 0.001). In addition, tai chi reduced blood pressure (systolic blood pressure (MD -10.03 mmHg; 95% CI -15.78 to -4.29 mmHg; p = 0.001), diastolic blood pressure (MD -4.85 mmHg; 95% CI -8.23 to -1.47 mmHg; p = 0.005)) and improved quality of life-related outcomes (physical function (MD 7.07; 95% CI 0.79-13.35; p = 0.027), bodily pain (MD 4.30; 95% CI 0.83-7.77; p = 0.015) and social function (MD 13.84; 95% CI 6.22-21.47; p < 0.001)). However, no impact was exerted on fasting insulin (SMD -0.32; 95% CI -0.71 to 0.07; p = 0.110) or balance (MD 2.71 s; 95% CI -3.29 to 8.71 s; p = 0.376). CONCLUSION: Tai chi is effective in controlling biomedical outcomes and improving quality of life-related outcomes in individuals with type 2 diabetes mellitus, although no effects were observed on balance and fasting insulin. Further high-quality research is needed to elucidate the effects of different types of tai chi, the long-term effects of tai chi, the impact on respiratory function, and the association between tai chi and the risk of developing type 2 diabetes mellitus in healthy individuals.

The Association between Toxoplasma gondii Infection and Risk of Parkinson's Disease: A Systematic Review and Meta-Analysis.

BACKGROUND: Several studies have investigated the association between Toxoplasma gondii (T. gondii) infection and risk of Parkinson's disease (PD) with inconsistent results. Clarifying this relation might be useful for better understanding of the risk factors and the relevant mechanisms of PD, thus a meta-analysis was conducted to explore whether exposure to T. gondii is associated with an increased risk of PD. METHODS: We conducted this meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A rigorous literature selection was performed by using the databases of PubMed, Embase, Web of Science, Cochrane Library, and ScienceDirect. Odds ratio (OR) and corresponding 95% confidential interval (CI) were pooled by using fixed-effects models. Sensitivity analysis, publication bias test, and methodological quality assessment of studies were also performed. RESULTS: Seven studies involving 1086 subjects were included in this meta-analysis. Pooled data by using fixed-effects models suggested both latent infection (OR, 1.17; 95% CI, 0.86 to 1.58; P=0.314) and acute infection (OR, 1.13; 95% CI, 0.30 to 4.35; P=0.855) were not associated with PD risk. Stable and robust estimates were confirmed by sensitivity analysis. No publication bias was found by visual inspection of the funnel plot, Begg's, and Egger's test. CONCLUSIONS: This meta-analysis does not support any possible association between T. gondii infection and risk of PD. Researches are still warranted to further explore the underlying mechanisms of T. gondii in the pathogenesis of PD and their causal relationship.