Pythium insidiosum keratitis reported in China, raising the alertness to this fungus-like infection: a case series

Background The objective of this study is to report typical clinical and laboratory characteristics of three cases of keratitis caused by Pythium insidiosum in China. Case presentation Three Chinese patients of Han nationality diagnosed with Pythium keratitis from 2017 to 2019 were included. One 45-year-old female and one 55-year-old male were exposed to river water, and one 51-year-old female was burned by ash in the eyes. All of them are of Han ethnicity. Upon slit-lamp examination, subepithelial and superficial stromal opacities were observed in a reticular pattern. After conventional treatment with antifungal agents, the clinical status worsened and therapeutic penetrating keratoplasty was performed. Unfortunately, enucleation was performed to remove all infected tissue and relieve pain. Pythium insidiosum was identified in culture and confirmed by internal transcribed spacer ribosomal RNA gene sequencing analysis. Following the systemic and local antibiotic regimens, the patients were cured ultimately and no regression of infection was observed. Conclusions It is significant for ophthalmologists and microbiologist to be alert to this eye-threatening infection, especially in patients who are resistant to antifungal treatments and with water-related exposure.

Sociodemographic Correlates of Organized Sports Participation in a Sample of Middle School Students in China

Background: Organized sport participation (OSP) is considered as one method with the potential to increase overall physical activity (PA) levels in young people. It is essential to understand the correlates of OSP to inform future PA interventions.Purpose: This study aimed to explore the sociodemographic correlates of OSP among middle school students from the Nanjing City of China.Methods: A total of 7,097 adolescents (50.1% girls) aged 12–15 years from Nanjing, China, were recruited in this survey. Self-reported data on sex, grade, race, residence areas, proficient sport skills, and parental highest education were obtained. OSP was assessed by the question asked in the questionnaire on whether participants were involved in any “sports club or team” with the binary answer options of “yes” and “no,” for statistical analysis purposes. Generalized linear models were used to determine the correlates of OSP.Results: Only 16.6% reported participating in any organized sport over the past whole year, while boys (OR = 1.34, 95% CI: 1.18–1.53) and 7th graders (OR = 1.40, 95% CI: 1.18–1.65) were more likely to participate in organized sport. Adolescents being Han ethnicity were less likely to either participate in organized sport (OR = 0.60, 95% CI: 0.40–0.92), or masterless (one or two) proficient sport skills [OR (one) = 0.27, 95%CI: 0.20–0.37; OR (two) = 0.43, 95% CI: 0.36–0.50]. Besides, both residence area and parental highest education were not significantly associated with OSP among the participating adolescents.Conclusion: The current study confirmed that only one-sixth of adolescents participate in the organized sport over the past year. At-risk population subgroups include girls, older adolescents, being Han ethnicity, and those proficient in fewer sport skills. Sex, grades, race, and proficient sport skills were significant correlates of OSP. School, community, and families need to provide more resources and support for disadvantaged populations in OSP.

Risk factors for physical disability in patients with leprosy disease in Yunnan, China: Evidence from a retrospective observational study

Background Leprosy is potentially debilitating. The risk factors related to physical disabilities associated with leprosy disease in Yunnan, China was not clear. Methodology/Principal findings We studied 10644 newly detected leprosy patients from Yunnan, China, from 1990 to 2019. Factors associated with Grade 1 (G1D) and Grade 2 (G2D) physical disabilities or overall physical disabilities (combined G1D and G2D) associated with leprosy were analyzed using multinomial and ordinal logistic regression analyses. The following factors were associated with the development of physical disability in these patients with leprosy: delayed diagnosis [odds ratio (OR): 5.652, 4.399, and 2.275; 95% confidence intervals (CIs): 4.516–7.073, 3.714–5.212, and 2.063–2.509; for ≥ 10, 5–10 y, and 2–5 years, respectively], nerve damage (OR: 3.474 and 2.428; 95% CI: 2.843–4.244, and 1.959–3.008; for 2 and 1 damaged nerves, respectively), WHO classification of PB (OR: 1.759; 95% CI: 1.341–2.307), Ridley-Jopling classification (OR: 1.479, 1.438, 1.522 and 1.239; 95% CI: 1.052–2.079, 1.075–1.923, 1.261–1.838, and 1.072–1.431; for TT, BT, BB, and BL when compared with LL, respectively), advanced age (OR: 1.472 and 2.053; 95% CI: 1.106–1.960 and 1.498–2.814; for 15–59 and over 60 years old, respectively), zero skin lesions (OR: 1.916; 95% CI: 1.522–2.413), leprosy reaction (OR: 1.528; 95% CI: 1.195–1.952), rural occupation (OR: 1.364; 95% CI: 1.128–1.650), Han ethnicity (OR: 1.268; 95% CI: 1.159–1.386), and male sex (OR: 1.128; 95% CI: 1.024–1.243). Conclusions Delayed diagnosis, nerve damage, no skin lesions, WHO and Ridley-Jopling classifications, leprosy reactions, advanced age, rural occupation, Han ethnicity, and male sex were associated with disability in leprosy patients. Identifying risk factors could help to prevent physical disability.

Job burnout and its impact on work ability in biosafety laboratory staff during the COVID-19 epidemic in Xinjiang

Background The coronavirus disease 2019 (COVID-19) has increased the physical and psychological stress of medical workers. This study was designed to investigate the prevalence and risk factors of job burnout and its impact on work ability among Biosafety Laboratory (BSL) staffs during the COVID-19 epidemic in Xinjiang. Methods A total of 7911 qualified BSL staffs in Xinjiang were investigated by electronic questionnaires. The Maslach Burnout Inventory-General Survey (MBI-GS) was used for job burnout survey. Work Ability Index (WAI) was used for work ability survey. The prevalence and risk factors of job burnout in BSL staffs were analyzed through chi square test, t-test and one-way ANOVA. And then, the influence of demographic and job-related variables, i.e., confounding factors, were eliminated to the greatest extent by the propensity score analysis (PSA) method, to investigate the impact of job burnout on work ability in BSL staffs. Results A total of 67.6% BSL staffs experienced job burnout. There were significant differences in the detection rate of job burnout among demographic and job-related variables, including gender, age, ethnicity, education, working years, professional title, marital status, number of night shift per month and overall sleep condition (all P < 0.05). The detection rate of job burnout in female was higher than that in male. The detection rates of job burnout in 45–50 years old, Han ethnicity, education of postgraduate or above, 11–20 years of working, intermediate professional title, married, staff with many night shifts per month and poor overall sleep condition were higher than that of other groups. The average burnout scores of the Emotional Exhaustion (EE), Cynicism (CY), Reduced Personal Accomplishment (PA) scale were 10.00 ± 5.99, 4.64 ± 4.59 and 15.25 ± 8.16, respectively. Multiple logistic regression analysis showed that the three dimensions of job burnout, i.e., EE, CY, PE, were negatively correlated with work ability and significantly affected the work ability of BSL staffs (all P < 0.001). Conclusions Our results suggest that the prevalence of job burnout is extremely common among BSL staffs. In addition, the work ability decreases with the increase of job burnout and the improvement of job burnout can enhance work ability among BSL staffs.

Postpartum depression and postpartum post-traumatic stress disorder: prevalence and associated factors

Background Despite the increased global interest from researchers in postpartum depression (PPD) and postpartum post-traumatic stress disorder (PP-PTSD), studies of PPD in China have shown a wide range of variability. Indeed, the prevalence and risk factors for PP-PTSD have received little attention in China. Aim To determine the prevalence of PPD and PP-PTSD in China, and to examine the relationships between a range of sociodemographic, pregnancy-related, and newborn-related variables, and PPD and PP-PTSD. Methods A cross-sectional study involving 1136 women who returned to the obstetrics clinic for routine postpartum examination were enrolled. The sociodemographic, pregnancy-related, and newborn-related characteristics were collected. Social support, and PPD and PP-PTSD symptoms were measured by the Perceived Social Support Scale (PSSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Post-traumatic Stress Questionnaire (PPQ). Results The prevalence rates of PPD and PP-PTSD symptoms were 23.5 and 6.1%, respectively. A multivariate model showed that the presence of PP-PTSD was the strongest risk factor for PPD symptoms and vice versa. Other risk factors for PPD included low sleep quality, low social support and newborn’s incubator admission. In terms of PP-PTSD symptoms, risk factors included the presence of PPD symptoms, non-Han ethnicity, and low social support, while having one child was a protective factor. Conclusions This study addressed some gaps in the literature and provided a better understanding of PPD and PP-PTSD in China, which may contribute to early detection and intervention. Attention should be paid to women who are most susceptible to PPD and/or PP-PTSD, including those with low social support, low sleep quality, newborn’s incubator admission, non-Han ethnicity, and women with siblings.

Genome-Wide DNA Methylation Profile in Whole Blood of Patients With Chronic Spontaneous Urticaria

BackgroundChronic spontaneous urticaria (CSU) is a common autoimmune skin disease. Little is known about the role of epigenetics in the pathogenesis of CSU. This study aimed to investigate genome-wide DNA methylation profile in whole blood of patients with CSU.Patients and MethodsGenome-wide DNA methylation levels in whole blood samples of 95 Chinese Han ethnicity adult CSU patients and 95 ethnicity-, age- and sex-matched healthy controls were analyzed using Illumina 850K methylation chip. The differentially methylated genes (DMGs) were screened out and then functionally annotated by the gene ontology and the Kyoto encyclopedia of genes and genomes databases.ResultsA total of 439 differentially methylated positions (DMPs) (p &lt; 0.01 and |Δβ| ≥ 0.06) were identified with 380 hypomethylated and 59 hypermethylated. The average global DNA methylation levels of the 439 DMPs in the CSU patients were significantly lower than those in the healthy controls (p &lt; 0.001). The distribution of the 439 DMPs was wide on chromosome 1 to 22 and chromosome X. Chromosome 6 embodied the largest number of DMPs (n = 51) and their annotated genes were predominantly related to autoimmunity. The 304 annotated DMGs were mainly enriched in autoimmune disease- and immune-related pathways. A total of 41 DMPs annotated to 28 DMGs were identified when p &lt; 0.01 and |Δβ| ≥ 0.1. Of the 28 DMGs, HLA-DPB2, HLA-DRB1, PPP2R5C, and LTF were associated with autoimmunity. CSU cases with elevated total IgE, positive anti-thyroid peroxidase IgG autoantibodies, positive anti-thyroglobulin IgG autoantibodies, angioedema, UASday &gt; 4, or recurrent CSU showed phenotype-specific DMPs as compared with cases with normal total IgE, negative anti-thyroid peroxidase IgG autoantibodies, negative anti-thyroglobulin IgG autoantibodies, no angioedema, UASday ≤ 4, or non-recurrent CSU respectively.ConclusionThis study shows a distinct genome-wide DNA methylation profile in Chinese Han ethnicity adult CSU patients and indicates a role of epigenetics in the pathogenesis of CSU. The predominant enrichment of the CSU-associated DMGs in immunological pathways provides supportive evidence for the immunopathogenesis of CSU. Future research on the CSU-associated DMPs and DMGs will help discover potential therapeutic targets for CSU.

The prevalence and correlates of vision impairment and glasses ownership among ethnic minority and Han schoolchildren in rural China

Purpose To determine the prevalence of visual impairment and glasses ownership among Han Chinese and Hui minority junior high school children in Ningxia Hui Autonomous Region, China. Design Population-based cross-sectional study. Methods Vision screening was conducted on 20,376 children (age 12–15 years) in all 124 rural junior high schools in Ningxia. Personal and family characteristics, glasses ownership, and academic performance were assessed through a survey questionnaire and standardized mathematics test, respectively. Results The prevalence of visual acuity (VA) ≤6/12 in either eye was significantly higher among Han (54.5%) than Hui (45.2%) children (P<0.001), and was significantly positively associated with age, female sex, Han ethnicity, parental outmigration for work, shorter time spent outside during recess, shorter time spent watching television and higher time spent studying. Among children with VA≤6/12 in both eyes, only 56.8% of Han and 41.5% of Hui children had glasses (P<0.001). Glasses ownership was significantly associated with worse vision, greater family wealth, female sex, higher test scores, age, parental outmigration for work, understanding of myopia and glasses, higher time spent studying and Han ethnicity. Conclusion One of the first of its kind, this report on Han and Hui ethnic schoolchildren confirms a high prevalence of visual impairment among both populations, but slightly higher among the Han. Both groups, especially the Hui, have low rates of glasses ownership. Future interventions and policies designed to improve glasses usage should focus on populations with lower incomes and seek to correct erroneous beliefs about the safety of glasses and efficacy of traditional eye exercises.

Investigation and Analysis of Sanitation-Related Knowledge and Hygiene Routines Among China’s WASH Plus Program Students

Objective: This study was performed to determine the knowledge level of students in China’s WASH Plus Program about sanitation and hygiene practices to provide a scientific basis for well-targeted health education.Methods: The researchers randomly selected one fourth-grade class from each of the 12 schools in each of the five WASH Plus Program provinces (municipalities or autonomous regions). The students in the selected fourth-grade classes were then asked to complete a self-designed questionnaire. Chi-square testing and Bonferroni correction were used for paired and multiple comparisons of the enumeration data, respectively. Results: The 2330 respondents (mean age, 9.9 ± 0.3 years) included 1151 male students (49.40%), 1489 students of minority (non-Han) ethnicity (63.91%), and 433 boarding students (18.58%). Overall, 81.09% of the students were found to have gained sanitation-related knowledge, and 79.64% had formed hygiene routines. Specifically, only 41.76% of students knew that “diarrhea can be transmitted through contaminated water,” and 68.88% of students were aware that “diarrhea can be prevented by not drinking untreated water.” In addition, only 67.94%, 62.83%, and 62.62% of students “wash hands with running water and soap/hand sanitizer at school,” “never drink untreated water at school,” and “never drink untreated water at home,” respectively. Regionally, 88.54%, 87.13%, 79.13%, 77.23%, and 72.81% of students in Chongqing, Yunnan, Guangxi, Guizhou, and Xinjiang, respectively, had strong knowledge of sanitation, and 92.11%, 80.70%, 74.04%, 79.43%, and 69.86% of them practiced hygiene. In terms of gender, 80.53% of male students and 81.64% of female students had acquired sanitation-related knowledge, whereas 77.45% of male students and of 81.78% female students had adopted hygiene practices. The total awareness rates of sanitation-related knowledge for Han students and minority students were 83.10% and 79.96%, respectively. Approximately 85.53% of Han students and 76.32% of minority students had formed good hygiene routines. Some 81.32% of boarding students and 81.04% of non-boarding students had strong knowledge of sanitation, and 78.65% and 79.87%, respectively, had formed good hygiene habits. Conclusions: Some of the students surveyed had insufficient hygiene knowledge, and a small number had poor hygiene habits. To provide students with well-targeted health education, improve their hygiene awareness, and change their bad habits, full consideration should be given to factors such as region, gender, ethnicity, boarding status, and the influence of the process via which students acquire hygiene knowledge and form effective hygiene routines.

Association of HLA-DQA2 and HLA-B With Moyamoya Disease in the Chinese Han Population

ObjectiveAn HLA imputation was conducted to explore the relationship between HLA and patients with moyamoya disease (MMD) in the Chinese Han population.MethodsIn this study, we performed an association analysis of the major histocompatibility complex region in 2,786 individuals of Chinese Han ancestry (2,031 controls and 755 patients with MMD), through a widely used HLA imputation method.ResultsWe identified that the variant rs3129731 (odds ratio [OR] = 1.79, p = 3.69 × 10−16) located between the MTCO3P1 and HLA-DQA2 is a major genetic risk factor for MMD. In addition to this variant, found in the conditional association analysis, we also detected another independent signal, rs1071817 (OR = 0.62, p = 1.20 × 10−11), in HLA-B.ConclusionsOur research suggests that the genetic polymorphism of HLA-DQA2 and HLA-B could be a genetic predisposing factor for MMD in Chinese Han. This may provide some evidence for further HLA-related studies of patients with MMD of Chinese Han ethnicity and indicates that MMD is an immune-related disease.