Impact factors of Blastocystis hominis infection in persons living with human immunodeficiency virus:a large-scale,multi-center observational study from China

Background Blastocystis hominis(Bh)is zoonotic parasitic pathogen with a high prevalent globally,causing opportunistic infections and diarrhea disease.Human immunodeficiency virus(HIV)infection disrupts the immune system by depleting CD4^(+)T lymphocyte(CD4^(+)T)cell counts,thereby increasing Bh infection risk among persons living with HIV(PLWH).However,the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood.Hence,the purpose of the study was to explore the association between Bh infection risk and CD4^(+)T cell counts,HIV viral load(VL),and duration of interruption in antiviral therapy among PLWH.Methods A large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022.The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction,the CD4^(+)T cell counts in venous blood was measured using flowcytometry,and the HIV VL in serum was quantified using fluorescence-based instruments.Restricted cubic spline(RCS)was applied to assess the non-linear association between Bh infection risk and CD4^(+)T cell counts,HIV VL,and duration of interruption in highly active antiretroviral therapy(HARRT).Results A total of 1245 PLWH were enrolled in the study,the average age of PLWH was 43 years[interquartile range(IQR):33,52],with 452(36.3%)being female,50.4%(n=628)had no immunosuppression(CD4^(+)T cell counts>500 cells/μl),and 78.1%(n=972)achieved full virological suppression(HIV VL<50 copies/ml).Approximately 10.5%(n=131)of PLWH had interruption.The prevalence of Bh was found to be 4.9%[95%confidence interval(CI):3.8-6.4%]among PLWH.Significant nonlinear associations were observed between the Bh infection risk and CD4^(+)T cell counts(Pfor nonlinearity<0.001,L-shaped),HIV VL(Pfor nonlinearity<0.001,inverted U-shaped),and duration of interruption in HARRT(Pfor nonlinearity<0.001,inverted U-shaped).Conclusions The study revealed that VL was a better predictor of Bh infection than CD4^(+)T cell counts.It is crucial to consider the simultaneous surveillance of HIV VL and CD4^(+)T cell counts in PLWH in the regions with high level of socioeconomic development.The integrated approach can offer more comprehensive and accurate understanding in the aspects of Bh infection and other opportunistic infections,the efficacy of therapeutic drugs,and the assessment of preventive and control strategies.

Infestation risk of the intermediate snail host of Schistosomajaponicum in the Yangtze River Basin: improved results by spatial reassessment and a random forest approach

Background:Oncomelania hupensis is only intermediate snail host of Schistosomajaponicum,and distribution of 0.hupensis is an important indicator for the surveillance of schistosomiasis.This study explored the feasibility of a random forest algorithm weighted by spatial distance for risk prediction of schistosomiasis distribution in the Yangtze River Basin in China,with the aim to produce an improved precision reference for the national schistosomiasis control programme by reducing the number of snail survey sites without losing predictive accuracy.Methods:The snail presence and absence records were collected from Anhui,Hunan,Hubei,Jiangxi and Jiangsu provinces in 2018.A machine learning of random forest algorithm based on a set of environmental and climatic variables was developed to predict the breeding sites of the 0.hupensis intermediated snail host of S.japonicum.Different spatial sizes of a hexagonal grid system were compared to estimate the need for required snail sampling sites.The predictive accuracy related to geographic distances between snail sampling sites was estimated by calculating Kappa and the area under the curve(AUC).Results:The highest accuracy(AUC=0.889 and Kappa=0.618)was achieved at the 5 km distance weight.The five factors with the strongest correlation to 0.hupensis infestation probability were:(1)distance to lake(48.9%),(2)distance to river(36.6%),(3)isothermality(29.5%),(4)mean daily difference in temperature(28.1%),and(5)altitude(26.0%).The risk map showed that areas characterized by snail infestation were mainly located along the Yangtze River,with the highest probability in the dividing,slow-flowing river arms in the middle and lower reaches of the Yangtze River in Anhui,followed by areas near the shores of China's two main lakes,the Dongting Lake in Hunan and Hubei and the Poyang Lake in Jiangxi.Conelusions:Applying the machine learning of random forest algorithm made it feasible to precisely predict snail infestation probability,an approach that could improve the sensitivity of the Chinese schistosome surveillance.system.Redesign of the snail surveillance system by spatial bias correction of 0.hupensis infestation in the Yangtze River Basin to reduce the number of sites required to investigate from 2369 to 1747.

Efficacy of the combination of modern medicine and traditional Chinese medicine in pulmonary fibrosis arising as a sequelae in convalescent COVID-19 patients: a randomized multicenter trial

Background:The coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)has led to a significant number of mortalities worldwide.COVID-19 poses a serious threat to human life.The clinical manifestations of COVID-19 are diverse and severe and 20%of infected patients are reported to be in a critical condition.A loss in lung function and pulmonary fibrosis are the main manifestations of patients with the severe form of the disease.The lung function is affected,even after recovery,thereby greatly affecting the psychology and well-being of patients,and significantly reducing their quality of life.

Identifying key bird species and geographical hotspots of avian influenza A(H7N9)virus in China

Background:In China since the first human infection of avian influenza A(H7N9)virus was identified in 2013,it has caused serious public health concerns due to its wide spread and high mortality rate.Evidence shows that bird migration plays an essential role in global spread of avian influenza viruses.Accordingly,in this paper,we aim to identify key bird species and geographical hotspots that are relevant to the transmission of avian influenza A(H7N9)virus in China.Methods:We first conducted phylogenetic analysis on 626 viral sequences of avian influenza A(H7N9)virus isolated in chicken,which were collected from the Global Initiative on Sharing All Influenza Data(GISAID),to reveal geographical spread and molecular evolution of the virus in China.Then,we adopted the cross correlation function(CCF)to explore the relationship between the identified influenza A(H7N9)cases and the spatiotemporal distribution of migratory birds.Here,the spatiotemporal distribution of bird species was generated based on bird observation data collected from China Bird Reports,which consists of 157272 observation records about 1145 bird species.Finally,we employed a kernel density estimator to identify geographical hotspots of bird habitat/stopover that are relevant to the influenza A(H7N9)infections.Results:Phylogenetic analysis reveals the evolutionary and geographical patterns of influenza A(H7N9)infections,where cases in the same or nearby municipality/provinces are clustered together with small evolutionary differences.Moreover,three epidemic waves in chicken along the East Asian-Australasian flyway in China are distinguished from the phylogenetic tree.The CCF analysis identifies possible migratory bird species that are relevant to the influenza A(H7N9)infections in Shanghai,Jiangsu,Zhejiang,Fujian,Jiangxi,and Guangdong in China,where the six municipality/provinces account for 91.2%of the total number of isolated H7N9 cases in chicken in GISAID.Based on the spatial distribution of identified bird species,geographical hotspots are further estimated and illustrated within these typical municipality/provinces.Conclusions:In this paper,we have identified key bird species and geographical hotspots that are relevant to the spread of influenza A(H7N9)virus.The results and findings could provide sentinel signal and evidence for active surveillance,as well as strategic control of influenza A(H7N9)transmission in China.

Comprehensive strategies and measures to control COVID-19

Background Infectious diseases pandemic can lead to explosive effect with unpredictability on the world,as exemplified the bubonic–pneumonic plague pandemic in the fourteenth century[1],the 1918 influenza pandemic and the coronavirus disease 2019(COVID-19)pandemic caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).From January 2020 to May 2022,a total of 527.5 million individuals were suffered from an COVID-19,and more than 6.2 million individuals were died[2].The global all-age rate of excess mortality due to the COVID-19 pandemic was 120.3 deaths per 100,000[3].Its threat to human beings,especially those with underlying health issues,no one overlook this outcome.