scholarly journals Burden and etiology of moderate and severe diarrhea in children less than 5 years of age living in north and south of China: Prospective, population-based surveillance

Gut Pathogens ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Hong-Lu Zhou ◽  
Theresa Bessey ◽  
Song-Mei Wang ◽  
Zhao-Jun Mo ◽  
Leslie Barclay ◽  
...  
Keyword(s):  
Southern China ◽  
Northern China ◽  
Population Based ◽  
Prevention Measures ◽  
Conventional Pcr ◽  
Effective Prevention ◽  
E Coli ◽  
Severe Diarrhea ◽  
Health Significance ◽  
Taqman Array

Abstract Background Diarrhea remains the leading cause of childhood illness in China. Better understanding of burden and etiology of diarrheal diseases is important for development of effective prevention measures. Methods Population-based diarrhea surveillance was conducted in Sanjiang (southern China) year-round and Zhengding (northern China) in autumn/winter. Stool specimens were collected from children < 5 years of age experiencing diarrhea. The TaqMan Array Card (TAC), based on multiplex real-time PCR, was applied to detect multiple enteric microbial agents simultaneously. Results using these methods were compared to those derived from conventional PCR assays. Results During the study period, 6,380 children in Zhengding and 3,581 children in Sanjiang < 5 years of age participated. Three hundred and forty (31.2%) and 279 (22.9%) diarrhea episodes were identified as moderate-to-severe in the two counties, with incidence of 60.4 and 88.3 cases per 1,000 child-years in Zhengding and Sanjiang, respectively. The five most frequently detected bacterial and viral agents in Sanjiang were adenovirus, enterovirus, enteroaggregative Escherichia coli (EAEC), rotavirus, and sapovirus all the year round, while the most common viral agents in Zhengding were rotavirus, followed by astrovirus and adenovirus during the cool season. Compared to conventional PCR assay, the average incremental detection via the TAC method was twofold. Conclusion Our study demonstrated high diversity and prevalence of multiple major bacterial and viral agents, including rotavirus and calicivirus, among children in China. Further studies are needed to define the public health significance of neglected but frequently detected pathogens such as EAEC, enterotoxigenic E. coli, Campylobacter, adenovirus, and enterovirus.

scholarly journals Burden and Etiology of Moderate and Severe Diarrhea in Chinese Children Less than 5 years of Age: Prospective, Population-based Surveillance

2020 ◽  
Author(s):  
Hong-Lu Zhou ◽  
Theresa Bessey ◽  
Song-Mei Wang ◽  
Zhao-Jun Mo ◽  
Leslie Barclay ◽  
...  
Keyword(s):  
Southern China ◽  
Northern China ◽  
Population Based ◽  
Prevention Measures ◽  
Conventional Pcr ◽  
Effective Prevention ◽  
E Coli ◽  
Severe Diarrhea ◽  
Health Significance ◽  
Taqman Array

Abstract Background. Diarrhea remains the leading cause of childhood illness in China. Better understanding of burden and etiology of diarrheal diseases is important for development of effective prevention measures.Methods. Population-based diarrhea surveillance was conducted in Sanjiang (southern China) year-round and Zhengding (northern China) in autumn/winter. Stool specimens were collected from children <5 years of age experiencing diarrhea. The TaqMan Array Card (TAC), based on multiplex real-time PCR, was applied to detect multiple enteric microbial agents simultaneously. Results using these methods were compared to those derived from conventional PCR assays.Results. During the study period, 6,380 children in Zhengding and 3,581 children in Sanjiang <5 years of age participated. Three hundred and forty (31.2%) and 279 (22.9%) diarrhea episodes were identified as moderate-to-severe in the two counties, with incidence of 60.4 and 88.3 cases per 1,000 child-years in Zhengding and Sanjiang, respectively. The five most frequently detected bacterial and viral agents in Sanjiang were adenovirus, enterovirus, enteroaggregative Escherichia coli (EAEC), rotavirus, and sapovirus all the year round, while the most common viral agents in Zhengding were rotavirus, followed by astrovirus and adenovirus during the cool season. Compared to conventional PCR assay, the average incremental detection via the TAC method was 2-fold.Conclusion. Our study demonstrated high diversity and prevalence of multiple major bacterial and viral agents, including rotavirus and calicivirus, among children in China. Further studies are needed to define the public health significance of neglected but frequently detected pathogens such as EAEC, enterotoxigenic E. coli, Campylobacter, adenovirus, and enterovirus.

scholarly journals Folic acid supplementation and risk for congenital limb reduction defects in China

2019 ◽  
Vol 48 (6) ◽  
pp. 2010-2017 ◽  
Author(s):  
Jufen Liu ◽  
Zhiwen Li ◽  
Rongwei Ye ◽  
Aiguo Ren ◽  
Jianmeng Liu
Keyword(s):  
Folic Acid ◽  
Southern China ◽  
Large Population ◽  
Northern China ◽  
Population Based ◽  
Folic Acid Supplementation ◽  
Live Births ◽  
Limb Reduction ◽  
Congenital Limb ◽  
Gestational Week

Abstract Background Folic acid (FA) supplementation prevents neural tube defects, but there are mixed results for its ability to prevent limb reduction defects. We examined whether a preventive effect of FA supplementation exists for congenital limb reduction defects in a large population in China. Methods Data from a large population-based cohort study in China were used to evaluate the effects of FA supplementation on birth defects. All births at 20 complete gestational weeks, including live births, stillbirths and pregnancy terminations, and all structural congenital anomalies, regardless of gestational week, were recorded. A total of 247 831 singleton live births delivered at gestational ages of 20–42 weeks to women from northern and southern China with full information on FA intake were included. Limb reduction defects were classified by subtype and maternal FA supplementation. Results The prevalence of limb reduction defects was 2.7 per 10 000 births among women who took FA compared with 9.7 per 10 000 births among those who did not take FA in northern China; the prevalence was 4.5 and 3.8 per 10 000 births, respectively, in southern China. In both unadjusted and adjusted analyses, the estimated relative risk for upper limb reduction defects [odds ratio (OR) = 0.17, 95% confidence interval (CI): 0.04, 0.63] and total limb reduction defects (OR = 0.24, 95% CI: 0.08, 0.70) in northern China, but not for lower limb reduction defects ,was significantly decreased in association with FA supplementation in northern China. There was no association between FA supplementation and either an increased or decreased risk for limb reduction defects in southern China. Conclusions FA supplementation successfully reduces the prevalence of limb reduction defects in northern China, whose population has low folate concentrations.

scholarly journals Trends of injury mortality during the COVID-19 period in Guangdong, China: a population-based retrospective analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045317
Author(s):  
Xue-Yan Zheng ◽  
Si-Li Tang ◽  
Shu-Li Ma ◽  
Wei-Jie Guan ◽  
Xiaojun Xu ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Interpersonal Violence ◽  
Negative Binomial ◽  
Southern China ◽  
Control Period ◽  
Guangdong Province ◽  
Population Based ◽  
Prevention Measures ◽  
Injury Mortality ◽  
Self Harm

ObjectiveWe aimed to ascertain the trends of injury mortality during the COVID-19 period in southern China.MethodsWe conducted a population-based retrospective analysis to compare the mortality changes of all-cause injury and transport injuries, poisoning, falls, fire/heat/hot substances, drowning, self-harm and interpersonal violence, which were further stratified by sex and age. Comparisons were made between the COVID-19 period (between January 2020 and June 2020) and control period (between January 2019 and June 2019) in Guangdong province. We used the negative binomial models to explore the associations of deaths during the COVID-19 period, according to the different sex and age strata.ResultsThe all-cause injury mortality in Guangdong province decreased significantly from 28.65 per 100 000 population during the control period to 23.24 per 100 000 population during COVID-19 pandemic period. Similar results were found in specific injury categories. Mortality of self-harm increased by 139.26% in the 10–14 year group during the COVID-19 period as compared with the control period. Although mortality changes in some groups were not statistically significant, some increases were noteworthy during the COVID-19 period (ie, self-harm, transport injury and falls) in the 70–79 year group. The corresponding increase in mortality rate was 16.83%, 3.32% and 4.92%, respectively.ConclusionThe mortality of all-cause injury, transport injury and drowning during the COVID-19 pandemic was consistently decreased. However, the increase in mortality associated with falls, fire/heat/hot substance injury and self-harm in specific age populations warrant the targeted control and prevention measures for the population at risk.

Folic acid supplementation and risk for foetal abdominal wall defects in China: Results from a large population-based intervention cohort study

2021 ◽  
pp. 1-20
Author(s):  
Jufen Liu ◽  
Zhiwen Li ◽  
Rongwei Ye ◽  
Aiguo Ren ◽  
Jianmeng Liu
Keyword(s):  
Cohort Study ◽  
Folic Acid ◽  
Abdominal Wall ◽  
Birth Defects ◽  
Southern China ◽  
Large Population ◽  
Northern China ◽  
Population Based ◽  
Abdominal Wall Defects ◽  
Birth Prevalence

Abstract Folic acid (FA) can reduce the risk for selected birth defects other than neural tube defects (NTDs). We examined whether FA has preventive effects against foetal abdominal wall defects (AWDs) in a unique intervention cohort in China. Birth outcomes of 247 831 singleton births from a population-based cohort study with detailed preconceptional FA intake information were collected in China in 1993-1996. Information on births at 20 complete gestational weeks, including live births, stillbirths, and pregnancy terminations, and all structural birth defects regardless of gestational week was recorded. The birth prevalence of omphalocele, gastroschisis, and total foetal AWDs was classified by maternal FA supplementation. The prevalence of total AWDs was 4.30 per 10 000 births among women who took FA compared to 13.46 per 10 000 births among those who did not take FA in northern China and 6.28 and 5.18 per 10 000 births, respectively, in southern China. The prevalence of omphalocele was 0.54 per 10 000 births among women who took FA compared to 3.74 per 10 000 births among those who did not take FA in northern China and 1.79 and 1.44 per 10 000 births, respectively, in southern China. FA supplementation significantly prevented total AWDs in multivariate analysis (relative risk=0.26, 95% confidence interval: 0.11-0.61) in northern China, although no preventive effect of FA on AWDs was observed in southern Chin. FA supplementation successfully reduced the prevalence of AWDs in northern China.

Family-, Media-, and School-Related Risk Factors of Video Game Addiction

2013 ◽  
Vol 25 (3) ◽  
pp. 118-128 ◽  
Author(s):  
Florian Rehbein ◽  
Dirk Baier
Keyword(s):  
Risk Factors ◽  
Video Game ◽  
Age Groups ◽  
Well Being ◽  
Epidemiological Studies ◽  
Prevention Measures ◽  
School Life ◽  
Video Game Addiction ◽  
Effective Prevention ◽  
Game Addiction

In recent years, a variety of epidemiological studies have provided empirical data on the prevalence of video game addiction (GA) in different age groups. However, few studies investigated the causes of GA and could explain why video game playing as a widespread phenomenon leads to a comparatively small percentage of addicted players. Additionally, the existing longitudinal studies mainly consider psychological trait variables and neglect the possible explanatory value of predictors in socialization regarding media availability, media use, and family and everyday school life. In this paper, the results of a two-wave longitudinal study comprising a sample of students from Grades 4 to 9 (N = 406) are presented. The data show that 15-year-old video game addicts had already exhibited a number of specific risk factors at the age of 10. Students from single-parent families seem to be particularly at risk, as are students with low experienced school well-being and with a weaker social integration in class. The data also indicate that problematic use of video games in childhood increases the risk of GA in adolescence. Male students are especially vulnerable for developing GA. The results of this study are an important contribution to understanding risk factors for GA in adolescents, thereby laying the groundwork for effective prevention measures.

scholarly journals Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mortality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Day Case ◽  
Fatality Risk ◽  
E Coli ◽  
Factors Associated ◽  
Case Fatality Risk ◽  
Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

scholarly journals Temporal Trend of ST131 Clone among Urinary Escherichia coli Isolates in the Community: A Taiwan National Surveillance from 2002 to 2016

2021 ◽  
Vol 9 (5) ◽  
pp. 963
Author(s):  
Jiun-Ling Wang ◽  
Wen-Chien Ko ◽  
Chih-Hsin Hung ◽  
Ming-Fang Cheng ◽  
Hui-Ying Wang ◽  
...  
Keyword(s):  
Temporal Trend ◽  
Multidrug Resistant ◽  
Population Based ◽  
Pulsed Field Gel Electrophoresis ◽  
Sequence Type ◽  
E Coli ◽  
Factors Associated ◽  
Resistant Group ◽  
Ciprofloxacin Resistance ◽  
Susceptible Group

Sequence type (ST) 131 is a multidrug-resistant pandemic lineage of E. coli responsible for extraintestinal infections. Few surveillance data of ST131 included all antimicrobial-susceptible and -resistant isolates or focused on community-acquired urinary tract infection (UTI). From a population-based surveillance pool of 2997 outpatient urine E. coli isolates, 542 were selected for detection of ST131 based on ciprofloxacin and/or cefotaxime resistance. Pulsed-field gel electrophoresis (PFGE) was performed on all ST131 isolates to further determine their relatedness. The estimated overall ST131 prevalence in this community UTI cohort increased from 11.2% (in 2002–2004), 12.2% (in 2006–2008), 13.6% (in 2010–2012), to 17.4% in 2014–2016 (p < 0.01). In the ciprofloxacin-resistant/cefotaxime-resistant group, ST131 increased from 33.3% in 2002–2004 to 72.1% in 2014–2016 (p < 0.01). In the ciprofloxacin-resistant/cefotaxime-susceptible group, ST131 was found in 24.3% overall without significant increase in its prevalence over time. PFGE showed emergence of a cluster of ciprofloxacin-resistant/cefotaxime-resistant ST131 carrying Gr. 1 CTX-M ESBL in 2014–2016, especially 2016. Multivariate analysis revealed that age (≥65 y.o) and ciprofloxacin resistance were independent factors associated with ST131. This longitudinal surveillance showed that ciprofloxacin-resistant/cefotaxime-susceptible ST131 has been circulating in the community since 2002 but ciprofloxacin-resistant/cefotaxime-resistant ST131 increased rapidly in the later years.

Spatial variation of East Asian winter monsoon evolution between northern and southern China since the last glacial maximum

2021 ◽  
pp. 1-14
Author(s):  
Qin Li ◽  
Haibin Wu ◽  
Jun Cheng ◽  
Shuya Zhu ◽  
Chunxia Zhang ◽  
...  
Keyword(s):  
East Asian Winter Monsoon ◽  
Southern China ◽  
Ice Sheets ◽  
Northern China ◽  
Winter Monsoon ◽  
Asian Winter Monsoon ◽  
Spatial Differences ◽  
The Last Glacial Maximum ◽  
The Last Glacial

Abstract The East Asian winter monsoon (EAWM) is one of the most dynamic components of the global climate system. Although poorly understood, knowledge of long-term spatial differences in EAWM variability during the glacial–interglacial cycles is important for understanding the dynamic processes of the EAWM. We reconstructed the spatiotemporal characteristics of the EAWM since the last glacial maximum (LGM) using a comparison of proxy records and long-term transient simulations. A loess grain-size record from northern China (a sensitive EAWM proxy) and the sea surface temperature gradient of an EAWM index in sediments of the southern South China Sea were compared. The data–model comparison indicates pronounced spatial differences in EAWM evolution, with a weakened EAWM since the LGM in northern China but a strengthened EAWM from the LGM to the early Holocene, followed by a weakening trend, in southern China. The model results suggest that variations in the EAWM in northern China were driven mainly by changes in atmospheric carbon dioxide (CO2) concentration and Northern Hemisphere ice sheets, whereas orbital insolation and ice sheets were important drivers in southern China. We propose that the relative importance of insolation, ice sheets, and atmospheric CO2 for EAWM evolution varied spatially within East Asia.

scholarly journals Entropy-driven binding of gut bacterial β-glucuronidase inhibitors ameliorates irinotecan-induced toxicity

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hsien-Ya Lin ◽  
Chia-Yu Chen ◽  
Ting-Chien Lin ◽  
Lun-Fu Yeh ◽  
Wei-Che Hsieh ◽  
...  
Keyword(s):  
Cancer Metabolism ◽  
Glucuronic Acid ◽  
Intestinal Epithelial Cells ◽  
Primary Treatment ◽  
Water Molecules ◽  
Intestinal Epithelial ◽  
E Coli ◽  
Severe Diarrhea ◽  
Coordinated Water ◽  
Consequent Increase

AbstractIrinotecan inhibits cell proliferation and thus is used for the primary treatment of colorectal cancer. Metabolism of irinotecan involves incorporation of β-glucuronic acid to facilitate excretion. During transit of the glucuronidated product through the gastrointestinal tract, an induced upregulation of gut microbial β-glucuronidase (GUS) activity may cause severe diarrhea and thus force many patients to stop treatment. We herein report the development of uronic isofagomine (UIFG) derivatives that act as general, potent inhibitors of bacterial GUSs, especially those of Escherichia coli and Clostridium perfringens. The best inhibitor, C6-nonyl UIFG, is 23,300-fold more selective for E. coli GUS than for human GUS (Ki = 0.0045 and 105 μM, respectively). Structural evidence indicated that the loss of coordinated water molecules, with the consequent increase in entropy, contributes to the high affinity and selectivity for bacterial GUSs. The inhibitors also effectively reduced irinotecan-induced diarrhea in mice without damaging intestinal epithelial cells.

scholarly journals Development of revised diagnostic criteria for Fuchs’ uveitis syndrome in a Chinese population

2021 ◽  
pp. bjophthalmol-2021-319343
Author(s):  
Peizeng Yang ◽  
Wanyun Zhang ◽  
Zhijun Chen ◽  
Han Zhang ◽  
Guannan Su ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Symptoms ◽  
Southern China ◽  
High Sensitivity ◽  
Northern China ◽  
Chinese Patients ◽  
Tertiary Referral Centre ◽  
Tree Algorithms ◽  
Vitreous Opacities ◽  
Fuchs Uveitis Syndrome

Background/aimsFuchs’ uveitis syndrome (FUS) is one of the frequently misdiagnosed uveitis entities, which is partly due to the absence of internationally recognised diagnostic criteria. This study was performed to develop and evaluate a set of revised diagnostic criteria for FUS.MethodsThe clinical data of Chinese patients with FUS and patients with non-FUS were collected and analysed from a tertiary referral centre between April 2008 and December 2020. A total of 593 patients with FUS and 625 patients with non-FUS from northern China were enrolled for the development of diagnostic criteria for FUS. Three hundred and seventy-seven patients with FUS and 503 patients with non-FUS from southern China were used to validate the criteria. Clinical symptoms and ocular signs were collected from all patients with FUS and patients with non-FUS. Multivariate two-step cluster analysis, logistic regression and decision tree algorithms in combination with the clinical judgement of uveitis experts were used to revise diagnostic criteria for FUS.ResultsThree essential findings including diffuse iris depigmentation, absence of posterior synechiae, mild inflammation in the anterior chamber at presentation and five associated findings including mostly unilateral involvement, cataract, vitreous opacities, absence of acute symptoms and characteristic iris nodules were used in the development of FUS diagnostic criteria. All essential findings were required for the diagnosis of FUS, and the diagnosis was further strengthened by the presence of associated findings.ConclusionRevised diagnostic criteria for FUS were developed and validated by analysing data from Chinese patients and showed a high sensitivity (96.55%) and specificity (97.42%).

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