Dynamics and Efficacy: A Comprehensive Evaluation of the Advanced Dengue Fever Surveillance and Early Warning System in Ningbo City, 2023.

Objective: To conduct a comprehensive evaluation of the Dengue Fever Surveillance and Early Warning System deployed in Ningbo City during 2023, focusing on its capacity for timely identification and reporting of dengue fever cases, particularly imported cases from endemic regions. Methods: A detailed data of patient clinical features and blood profile trends was collected from clinical records and surveillance reports, focusing on the rapid diagnostic processes and surveillance rigor. This study assessed the effectiveness of the system in identifying and reporting dengue cases and identified the limitations of the existing framework through a basic statistical approach. Results: The system demonstrated timely identification and reporting of dengue fever cases, with a particular emphasis on imported cases. However, several limitations were identified, including the need for more precise monitoring criteria and improved coordination with medical entities. Conclusion: The study underscores the critical role of public health bodies in managing disease outbreaks and advocates for enhanced methodologies to refine epidemic control efforts. The findings contribute to the advancement of early warning mechanisms and the improvement of proactive infectious disease monitoring in metropolitan environments, providing valuable insights for fortifying the Dengue Fever Surveillance and Early Warning System in Ningbo City.

Transmissibility of the variant of concern for SARS-CoV-2 in six regions.

Introduction: Differences in transmissibility of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) in different districts are hard to assess. To address this, our study focused on calculating the Real-time reproduction number (R t ) for these variants in different regions. Methods: According to the criteria defined by the World Health Organization (WHO), the global landscape was categorized into six distinct regions. In each region, the predominant SARS-CoV-2 variant was first identified based on the proportion of variant sequencing analysis results. Then, using serial interval (SI) parameters, we calculated R t for the relevant Variant of Concern (VOC) in each region. This approach enabled us to compare the R t values of the same variant across different regions and analyze the transmissibility of each region's variant in relation to the overall situation in that region. Results: The progression of VOC for SARS-CoV-2 shows regional variations. However, a common sequence of evolution is observed: Wild-type → Alpha → Beta → Delta → Omicron. Moreover, an increasing trend is discerned within diverse regions where the shift in R t of distinct VOC corresponds with the overarching R t route of SARS-CoV-2 in specific regions. Conclusion: As the COVID-19 pandemic advances, regional epidemiological trends are aligning, likely due to similar virus mutations and shared public health strategies, suggesting opportunities for standardized global responses.

Relationship of various COVID-19 antibody titer with individual characteristics and prediction of future epidemic trend in Xiamen City, China.

Background: Reinfection of coronavirus disease 2019 (COVID-19) has raised concerns about how reliable immunity from infection and vaccination is. With mass testing for the virus halted, understanding the current prevalence of COVID-19 is crucial. This study investigated 1,191 public health workers at the Xiamen Center for Disease Control, focusing on changes in antibody titers and their relationship with individual characteristics. Methods: The study began by describing the epidemiological characteristics of the study participants. Multilinear regression (MLR) models were employed to explore the associations between individual attributes and antibody titers. Additionally, group-based trajectory models (GBTMs) were utilized to identify trajectories in antibody titer changes. To predict and simulate future epidemic trends and examine the correlation of antibody decay with epidemics, a high-dimensional transmission dynamics model was constructed. Results: Analysis of epidemiological characteristics revealed significant differences in vaccination status between infected and non-infected groups (χ2=376.706, P<0.05). However, the distribution of antibody titers among the infected and vaccinated populations was not significantly different. The MLR model identified age as a common factor affecting titers of immunoglobulin G (IgG), immunoglobulin M (IgM), and neutralizing antibody (NAb), while other factors showed varying impacts. History of pulmonary disease and hospitalization influenced IgG titer, and factors such as gender, smoking, family history of pulmonary diseases, and hospitalization impacted NAb titers. Age was the sole determinant of IgM titers in this study. GBTM analysis indicated a "gradual decline type" trajectory for IgG (95.65%), while IgM and NAb titers remained stable over the study period. The high-dimensional transmission dynamics model predicted and simulated peak epidemic periods in Xiamen City, which correlated with IgG decay. Age-group-specific simulations revealed a higher incidence and infection rate among individuals aged 30-39 years during both the second and third peaks, followed by those aged 40-49, 50-59, 18-29, and 70-79 years. Conclusions: Our study shows that antibody titer could be influenced by age, previous pulmonary diseases as well as smoking. Furthermore, the decline in IgG titers is consistent with epidemic trends. These findings emphasize the need for further exploration of these factors and the development of optimized self-protection countermeasures against reinfection.

A Mendelian randomization study to examine the causal associations of circulating micronutrient levels with frailty risk.

Background: Observational studies have shown that micronutrients can affect the occurrence of frailty. However, it is not clear whether there is a causal relationship between the two. This study aimed to explore the causal relationship between circulating micronutrient levels and frailty risk using a two-sample Mendelian randomization (TSMR) approach. Methods: We gathered and screened instrumental variables (IVs) for six circulating micronutrients, including vitamin B12, vitamin B6, folate, vitamin C, vitamin D, and vitamin E, from published genome-wide association studies (GWAS) and the IEU OpenGWAS open database. Summary statistics for frailty were obtained from a GWAS meta-analysis, including the UK Biobank and TwinGene (N = 175,226). We performed two independent TSMR analyses and a meta-analysis based on the two independent MR estimates to assess the causal relationship between circulating micronutrientn and frailty. Results: Our study found, no causal relationship between genetically predicted vitamin D (ß = -0.059, p = 0.35), vitamin B6 (ß = 0.006, p = 0.80), vitamin E (ß = -0.011, p = 0.79), vitamin C (ß = -0.044, p = 0.06), vitamin B12 (ß = -0.027, p = 0.37), and folate (ß = 0.029, p = 0.17), with frailty. Conclusion: This study showed that these six micronutrients did not reduce the risk of developing frailty. However, we think it is necessary further to investigate the relationship and mechanisms between micronutrients and frailty using methods such as randomized controlled trials.

Temporal shifts in 24 notifiable infectious diseases in China before and during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic, along with the implementation of public health and social measures (PHSMs), have markedly reshaped infectious disease transmission dynamics. We analysed the impact of PHSMs on 24 notifiable infectious diseases (NIDs) in the Chinese mainland, using time series models to forecast transmission trends without PHSMs or pandemic. Our findings revealed distinct seasonal patterns in NID incidence, with respiratory diseases showing the greatest response to PHSMs, while bloodborne and sexually transmitted diseases responded more moderately. 8 NIDs were identified as susceptible to PHSMs, including hand, foot, and mouth disease, dengue fever, rubella, scarlet fever, pertussis, mumps, malaria, and Japanese encephalitis. The termination of PHSMs did not cause NIDs resurgence immediately, except for pertussis, which experienced its highest peak in December 2023 since January 2008. Our findings highlight the varied impact of PHSMs on different NIDs and the importance of sustainable, long-term strategies, like vaccine development.

MODELS: a six-step framework for developing an infectious disease model.

Since the COVID-19 pandemic began, a plethora of modeling studies related to COVID-19 have been released. While some models stand out due to their innovative approaches, others are flawed in their methodology. To assist novices, frontline healthcare workers, and public health policymakers in navigating the complex landscape of these models, we introduced a structured framework named MODELS. This framework is designed to detail the essential steps and considerations for creating a dependable epidemic model, offering direction to researchers engaged in epidemic modeling endeavors.

The role of microRNAs in axon regeneration after peripheral nerve injury: a bibliometric analysis.

Objective: This study analyzed the current research hotspots and future development trends of the therapeutic effects of microRNA on PNI axonal regeneration through bibliometric methods. Moreover, the current advantages and disadvantages of this field as well as future development prospects are discussed in depth. Methods: CiteSpace V and VOSviewer were used as bibliometric tools to complete the analysis of the research focus and direction of the published articles. To supplement, sort out, and summarize, we analyzed the research status of the study on the application of microRNAs for axonal regeneration after peripheral nerve injury from 2013 to 2023. Results: A total of 207 publications were retrieved from the Web of Science database. After exclusion and screening, a final selection of 174 articles that met the research criteria. These 174 articles were authored by a total of 846 individuals, representing 24 countries and 199 institutions. Additionally, this study presents information on the annual publication output, country distribution, top 5 contributing authors, top 5 most cited articles, and top 10 contributing institutions. Conclusion: As one of the hottest topics today, microRNAs have become the current research hotspot in neural inflammation, neural cell repair and regeneration, neural protection, and functional recovery. With more investment in research in this field, more high-quality articles will be published in both domestic and international outstanding journals, which will bring a new era for the treatment of peripheral nerve injury.

Metabolome-Wide Mendelian Randomization Assessing the Causal Relationship Between Blood Metabolites and Sarcopenia-Related Traits.

Sarcopenia is among the most common musculoskeletal illnesses, yet its underlying biochemical mechanisms remain incompletely understood. In this study, we used Mendelian randomization (MR) to investigate the causal relationship between the genetically determined blood metabolites and sarcopenia, with the overall objective of identifying likely molecular pathways for sarcopenia. We used 2-sample MR to investigate the effects of blood metabolites on sarcopenia-related traits. 452 metabolites were exposure, and 3 sarcopenia-related traits as the outcomes: handgrip strength, appendicular lean mass, and walking pace. The inverse-variance weighted (IVW) causal estimates were determined. For sensitivity analysis, methods such as MR-Egger regression, the weighted median, the weighted mode, and the heterogeneity test were used. Additionally, for complementation, we performed replication, meta-analysis, and metabolic pathway analyses. Candidate biomarkers were defined by meeting one of the following criteria: (1) significant metabolites are defined as pIVW < pBonferroni [1.11 × 10-4 (.05/452)]; (2) strong metabolites are defined as 4 MR methods p < .05; and (3) suggestive metabolites are defined as passing sensitivity analysis. Three metabolites (creatine, 1-arachidonoylglycerophosphocholine, and pentadecanoate [15:0]) with significant causality, 3 metabolites (glycine, 1-arachidonoylglycerophosphocholine, and epiandrosterone sulfate) with strong causality, and 25 metabolites (including leucylleucin, pyruvic acid, etc.) with suggestive causality were associated with sarcopenia-related traits. After further replication analyses and meta-analysis, these metabolites maintained substantial effects on sarcopenia-related traits. We additionally identified 14 important sarcopenia-related trait metabolic pathways. By combining metabolomics with genomics, these candidate metabolites and metabolic pathways identified in our study may provide new clues regarding the mechanisms underlying sarcopenia.

Effect of Infliximab on Radiation-Induced Submandibular Gland Dysfunction in Rats.

Inflammatory response is one of the essential parts of various pathogenic mechanisms of radiation-induced salivary dysfunction. The effect of decreasing the levels of inflammatory cytokines on alleviating submandibular gland injuries after irradiation is unclear. This study aimed to explore the effect of the antibody against tumor necrosis factor-alpha, infliximab, on radiation-induced submandibular gland dysfunction in rats. Male Wistar rats received a single 20 Gy dose to the right submandibular gland region or sham irradiated. Meanwhile, the irradiated group was divided into infliximab treatment groups or untreated groups. Animals were euthanized at 1, 6, and 12 weeks postirradiation, and the irradiated submandibular gland was dissected for subsequent detection. Submandibular gland exposure caused obvious pathological changes. The increased levels of inflammatory cytokines, including tumor necrosis factor-alpha, interleukin-1ß, and interleukin-6, represent an aggravated inflammatory response. The results of the western blot, reverse transcription-quantitative polymerase chain reaction, and immunofluorescence staining showed upregulated levels of claudin-1, claudin-3, and aquaporin 5 and downregulated levels of claudin-4. Moreover, nuclear factor kappa-B phosphorylation levels were also up-regulated. In subsequent experiments, we found that infliximab alleviated inflammatory response, up-regulated tumor necrosis factor-alpha, interleukin-1ß, and interleukin-6 levels, and improved claudin-1, claudin-3, claudin-4, and aquaporin 5 expression. Our results indicate that infliximab might improve the para-cellular pathway and trans-cellular pathway destruction by reducing the inflammatory.

Association between skeletal muscle mass and metabolic syndrome in middle-aged and elderly community residents / 上海预防医学

ObjectiveTo explore the correlation between skeletal muscle mass and metabolic syndrome （MS） disease risk among middle-aged and elderly community residents in Urumqi， and to provide a theoretical basis for understanding the relationship between skeletal muscle mass and MS among middle-aged and elderly community residents in China. MethodsA total of 1 438 community residents ≥ 50 years old were selected as the research subjects from July 2018 to January 2019 in Urumqi. They were selected from a multi-ethnic natural population cohort in Xinjiang. Data were collected through questionnaires， physical examination， bioelectrical impedance analysis （BIA）， laboratory tests， etc. Skeletal muscle mass was evaluated using the limb skeletal muscle mass index （SMI） corrected for body weight； MS was defined as it at least includes three of the following： abdominal obesity， hypertension， hyperglycemia， high triglycerides and low high-density lipoprotein cholesterol. SMI was divided into four quantile arrays of Q1‒Q4. Trend χ2 test was applied to explore whether there was a correlation between SMI changes and MS. A multivariate logistic regression model was used to analyze whether there is a difference in the risk of MS between the higher SMI group （Q2， Q3， Q4） and the reference group Q1. ResultA total of 560 MS patients were detected in this study， with a prevalence rate of 38.94%. Among them， the prevalence rate of MS was 39.16% in males and 38.80% in females. The increase in male SMI grading level is not correlated with the prevalence of MS （trend P>0.05）； After adjusting for confounding factors （model 4）， the increase in SMI was still not related to the prevalence of MS （Ptrend=0.995）. There was no statistical difference in the risk of MS between the lowest quartile group Q1 and the highest quartile group Q4 （OR=1.01， 95%CI： 0.69‒1.78）. The prevalence of MS in women gradually decreased with the increase of SMI grading level （Ptrend<0.001）； After adjusting for confounding factors （model 4）， there was still a correlation between the increase of SMI and the prevalence of MS （Ptrend=0.005）. With the lowest quartile of SMI Q1 as the reference group， the risk of MS in Q2 （OR=0.63， 95%CI： 0.40‒1.00）， Q3 （OR=0.56， 95%CI： 0.34‒0.94）， Q4 （OR=0.42， 95%CI： 0.23‒0.76） decreased. ConclusionAn increase in skeletal muscle mass may be beneficial for preventing MS， especially among middle-aged and elderly female residents. Considering the intensification of aging in China and the close relationship between MS and related comorbidities， managing skeletal muscle mass may contribute to potential MS prevention.

Assessment of transmissibility and measures effectiveness of SARS in 8 regions, China, 2002-2003.

Background: Severe acute respiratory syndrome (SARS) is a form of atypical pneumonia which took hundreds of lives when it swept the world two decades ago. The pathogen of SARS was identified as SARS-coronavirus (SARS-CoV) and it was mainly transmitted in China during the SARS epidemic in 2002-2003. SARS-CoV and SARS-CoV-2 have emerged from the SARS metapopulation of viruses. However, they gave rise to two different disease dynamics, a limited epidemic, and an uncontrolled pandemic, respectively. The characteristics of its spread in China are particularly noteworthy. In this paper, the unique characteristics of time, space, population distribution and transmissibility of SARS for the epidemic were discussed in detail. Methods: We adopted sliding average method to process the number of reported cases per day. An SEIAR transmission dynamics model, which was the first to take asymptomatic group into consideration and applied indicators of R 0, Reff, Rt to evaluate the transmissibility of SARS, and further illustrated the control effectiveness of interventions for SARS in 8 Chinese cities. Results: The R 0 for SARS in descending order was: Tianjin city (R 0 = 8.249), Inner Mongolia Autonomous Region, Shanxi Province, Hebei Province, Beijing City, Guangdong Province, Taiwan Province, and Hong Kong. R 0 of the SARS epidemic was generally higher in Mainland China than in Hong Kong and Taiwan Province (Mainland China: R 0 = 6.058 ± 1.703, Hong Kong: R 0 = 2.159, Taiwan: R 0 = 3.223). All cities included in this study controlled the epidemic successfully (Reff<1) with differences in duration. Rt in all regions showed a downward trend, but there were significant fluctuations in Guangdong Province, Hong Kong and Taiwan Province compared to other areas. Conclusion: The SARS epidemic in China showed a trend of spreading from south to north, i.e., Guangdong Province and Beijing City being the central regions, respectively, and from there to the surrounding areas. In contrast, the SARS epidemic in the central region did not stir a large-scale transmission. There were also significant differences in transmissibility among eight regions, with R0 significantly higher in the northern region than that in the southern region. Different regions were able to control the outbreak successfully in differences time.

Evaluation of the transmissibility of norovirus and the effectiveness of prevention and control measures for schools in Jiangsu Province.

OBJECTIVE: This study aims to estimate the transmissibility of norovirus outbreaks in schools by different transmission routes, and to evaluate the effects of isolation, school-closure and disinfection measures under different intervention intensities, finally, scientific prevention and control suggestions are proposed. METHOD: 23 outbreaks of norovirus infectious diarrhea occurring in Jiangsu Province's school from 2012-2018 were selected and fitted to the model. The data includes various types of school places and pathogen genotype. A 'SEIAQRW' model with two transmission routes was established. The transmissibility of each outbreak was assessed using effective reproduction number, the efficacy of different intervention measures and intensities were evaluated by calculating the total attack rate and peak incidence. RESULTS: The mean effective reproduction number of noroviruses was estimated to be 8.92 for the human-to-human route of transmission and 2.19 for the water or food-to-human route of transmission. When all symptomatic cases were isolated, the median peak incidence for both transmission routes both being less than 1.8%. There was a smaller reduction in total attack rate compared to peak incidence, the median total attack rate for the two transmission routes decreased by 17.59% and 42.09%, respectively. When the effect of school-closure or disinfection is more than 90%, the total attack rate and peak incidence in the human-to-human route are reduced by more than 90% compared to no intervention, and the peak incidence in the water or food-to-human routes can be reduced to less than 1.4%, but the reduction in the total attack rate is only 50% or so. CONCLUSION: Norovirus outbreaks have a high rate of transmission in schools. In the case of norovirus outbreaks, isolation should be complemented by other interventions, and the implementation of high-intensity school closures or disinfection of the external environment can be effective in reducing the spread of the virus.

Analysis of the effect of PCR testing and antigen testing on controlling the transmission for Omicron based on different scenarios.

After the policy adjustment, China no longer carries out COVID-19 PCR testing for all people, and antigen testing has become the main way to detect and manage infectious sources. We developed a dynamic model to evaluate and compare the effects between PCR and antigen testing for controlling the pandemic. Due to the increase of contact degree, the peak reduction effect of PCR testing in population is lower than that of antigen testing. Even if it was only 20% of people isolated at home after antigen testing, the peak of the epidemic could be reduced by 9.46%. If the proportion of antigen testing is further increased to 80%, the peak of the pandemic can be reduced by 31.41%. Antigen testing performed better effects in school (reduction proportion 29.27%) and community (29.34%) than in workplace (27.75%). Therefore, we recommend that antigen testing in the population should be encouraged during the pandemic, and home isolation of infected persons should be advocated, especially in crowded places. To improve the availability of antigen, the testing proportion should be further enhanced.

Trends in disease burden of hepatitis B infection in Jiangsu Province, China, 1990-2021.

Background: The incidence of hepatitis B virus (HBV) has decreased year by year in China after the expansion of vaccination, but there is still a high disease burden in Jiangsu Province of China. Methods: The year-by-year incidence data of HBV in Jiangsu Province from 1990 to 2021 were collected. The incidence rates of males and females age groups were clustered by systematic clustering, and the incidence rates of each age group were analyzed and studied by using Joinpoint regression model and age-period-cohort effect model (APC). Results: Joinpoint regression model and APC model showed a general decrease in HBV prevalence in both males and females. In addition, the results of the APC model showed that the age, period, and cohort effects of patients all affected the incidence of HBV, and the incidence was higher in males than in females. The incidence is highest in the population between the ages of 15 and 30 years (mean: 21.76/100,000), especially in males (mean: 31.53/100,000) than in females (mean:11.67/100,000). Another high-risk group is those over 60 years of age (mean: 21.40/100,000), especially males (mean: 31.17/100,000) than females (mean: 11.63/100,000). The period effect of the APC model suggests that HBV vaccination is effective in reducing the incidence of HBV in the population. Conclusions: The incidence of HBV in Jiangsu Province showed a gradual downward trend, but the disease burden in males was higher than that in females. The incidence is higher and increasing rapidly in the population between the ages of 15 and 30 years and people over 60 years of age. More targeted prevention and control measures should be implemented for males and the elderly.

Epidemiological characteristics and transmissibility of HPV infection: A long-term retrospective study in Hokkien Golden Triangle, China, 2013-2021.

OBJECTIVE: Multiple human papillomavirus (HPV)-associated diseases have put a significant disease burden on the world. Therefore, we conducted a study to explore the epidemiological characteristics of HPV and the transmissibility of its genotypes. METHODS: HPV testing data was collected from Hospital. A transmission dynamics model of HPV was constructed to simulate and compare the transmissibility of different HPV genotypes, which was quantitatively described by the basic reproduction number (R0). RESULTS: The collected HPV subjects were mainly from Xiamen City, Zhangzhou City and Quanzhou City, together, they are known as the Hokkien golden triangle. There were variations in the distribution of HPV infections by age groups. Among all HPV genotypes, 13 of them had R0 > 1, with 10 of them being high-risk types. The top five were HPV56, 18, 58, 52 and 53, among which, HPV56, 18, 58 and 42 were of high risk, whereas HPV53 was not, and the R0 values for the five were 3.35 (CI: 0.00-9.99), 3.20 (CI: 0.00-6.46), 3.19 (CI: 1.27-6.94), 3.19 (CI: 1.01-8.42) and 2.99 (CI: 0.00-9.39), respectively. In addition, HPV52 had R0 > 1 for about 51 months, which had the longest duration. CONCLUSION: Most high-risk HPV types in the Hokkien golden triangle could transmit among the population. Therefore, there is a need of further optimization for developing HPV vaccines and better detection methods in the region.

Model-based risk assessment of dengue fever transmission in Xiamen City, China.

Background: Quantitative assessment of the risk of local transmission from imported dengue cases makes a great challenge to the development of public health in China. The purpose of this study is to observe the risk of mosquito-borne transmission in Xiamen City through ecological and insecticide resistance monitoring. Quantitative evaluation of mosquito insecticide resistance, community population and the number of imported cases affecting the transmission of dengue fever (DF) in Xiamen was carried out based on transmission dynamics model, so as to reveal the correlation between key risk factors and DF transmission. Methods: Based on the dynamics model and combined with the epidemiological characteristics of DF in Xiamen City, a transmission dynamics model was built to simulate the secondary cases caused by imported cases to evaluate the transmission risk of DF, and to explore the influence of mosquito insecticide resistance, community population and imported cases on the epidemic situation of DF in Xiamen City. Results: For the transmission model of DF, when the community population is between 10,000 and 25,000, changing the number of imported DF cases and the mortality rate of mosquitoes will have an impact on the spread of indigenous DF cases, however, changing the birth rate of mosquitoes did not gain more effect on the spread of local DF transmission. Conclusions: Through the quantitative evaluation of the model, this study determined that the mosquito resistance index has an important influence on the local transmission of dengue fever caused by imported cases in Xiamen, and the Brayton index can also affect the local transmission of the disease.

Computed Tomography-Based Prediction of Lumbar Pedicle Screw Loosening.

Objective: Pedicle screw loosening is one of the main complications after pedicle screw fixation. However, there are few reliable measures for prediction of screw loosening. The current study was carried out to find an effective method to use preoperative CT scanning as a predictor of screw loosening in the elderly patients and provide guidance for preoperative surgical planning. Methods: Patients who were treated with lumbar pedicle screw fixation procedure in our department for degenerative lumbar disorders between January 2015 and January 2021 were retrospectively included in the current study. CT scan attenuation of each vertebra was measured with Hounsfield units (HU). Screw loosening was determined in postoperatively X-ray tests. One-way analysis of variance (ANOVA) and receiver operating characteristic (ROC) curve analysis were carried out with IBMSPSS 24.00 software. Results: Screw loosening was observed in 44 of 215 patients (124 male, 91 female, average age 58.4 ± 7.6 years) during a mean follow-up time of 19.0 ± 11.2 months (range 12-32 months). No significant differences were found among the patients concerning patient gender, BMI, habit of smoking, and whether or not the patient had diabetes or suffered from spondylolisthesis (P > 0.05). The average HU value of lumbar vertebra was 122.4 ± 32.8 HU in the screw loosening group and 142.4 ± 38.2 HU in the control group, and the difference was significant (P < 0.01). ROC curve analysis revealed that the average HU value of L1-L5 has a relatively larger area under the curve (AUC) of 0.689 (95% CI: 0.605-0.773). With the sensitivity of 68% and specificity of 57%, a HU cut-off value of ≤124 HU is a plausible cut-off point to predict screw loosening. Conclusions: A prospective CT scan HU value-based prediction can be used to decide whether or not to use screw augmentation methods. A cut-off L1-L5 average HU value of 124 HU can be used as an independent risk factor for screw loosening in instrumented lumbar vertebra. More predictive indexes should be involved to achieve higher sensitivity and specificity in future clinical practice.

Possibility of mpox viral transmission and control from high-risk to the general population: a modeling study.

BACKGROUND: Mpox is an emerging infectious disease that is now a global hazard. The strategies for preventing and controlling mpox should be further investigated in terms of transmission characteristics, infection risk among different populations, and ideal therapeutic approaches. METHODS: A multi-group dynamic model was used to quantify the transmissibility of mpox. We further analyzed the transmission risk from men who have sex with men (MSM) to non-MSM and evaluated the effects of three intervention measures, including community-based prevention, early detection, and vaccination. RESULTS: The median value of effective reproduction number (Reff) and probability of contact via a single contact (q) among MSM worldwide is 3.11 (interquartile range [IQR]: 2.82-5.57) and 2.15% (IQR: 1.95-3.84%). We found that the cumulative incidence rate of non-MSM is much lower than that of MSM (< 1/2048) when the possibility of infection (including the percentage of high-risk behaviors of contact degree [C] and q) was lowered to less than 1 in 100,000. When comparing the three intervention measures, if we want to control the cumulative incidence rate to 5.96 × 10-8 we need to increase the vaccine coverage to 81% or reduce the transmission rate factor (Cq) to 70% or shorten the transmission period to 74%. CONCLUSIONS: Mpox has high transmissibility in MSM, which required minimize the risk of infection and exposure to high-risk populations. Community prevention and control is the top priority of interventions to contain the spread of mpox.