COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China: An online cross-sectional study

Objective:To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang,China.Methods:An online cross-sectional study was conducted among parents of teenagers in Zhejiang,China from May 1 to 31,2022.Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences(SPSS)program.Results:A total of 11115(96.11%)participants and 11449(99.00%)of their children in Zhejiang,China had been vaccinated against COVID-19.Children whose parents did not receive COVID-19 vaccination were 19 times(aOR 18.96,95%CI 12.36-29.08)more likely to be unvaccinated than their counterparts.In addition,children with no previous influenza vaccination,those whose parents doubted the COVID-19 vaccine’s safety or effectiveness,were 6.11 times(aOR 6.11,95%CI 2.80-13.34),8.27 times(aOR 8.27,95%CI 5.33-12.83),and 2.69 times(aOR 2.69,95%CI 1.11-6.50)more likely to be unvaccinated than their counterparts,respectively.COVID-19 vaccine uptake varied between different sociodemographic groups.However,the odds of receiving the COVID-19 vaccine decreased as age and education level increased.The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination(53.78%),followed by safety concerns about the vaccine(13.56%),not knowing where to get vaccinated(6.44%),and concerns about fertility issues(5.56%).Conclusions:Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang,China,the elderly and highly educated people had lower COVID-19 vaccine uptake.It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups.Furthermore,with vaccination rates at such a high level,the pandemic is still ongoing,and public confidence in vaccines may decline.Thus,sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public.

Severe liver injury and clinical characteristics of occupational exposure to 2-amino-5-chloro-N,3-dimethylbenzamide: A case series

Background:The 2-amino-5-chloro-N,3-dimethylbenzamide is a key intermediate in the synthesis of pesticides and pharmaceuticals.However,no literature currently exists on 2-amino-5-chloro-N,3-dimethylbenzamide poisoning in humans.This study aimed to reveal the health hazard of this chemical for humans and summarize the clinical characteristics of patients with occupational 2-amino-5-chloro-N,3-dimethylbenzamide poisoning.Methods:This observational study included four patients with 2-amino-5-chloro-N,3-dimethylbenzamide poisoning from June 2022 to July 2022.The entire course of the incidents was described in detail.Blood 2-amino-5-chloro-N,3-dimethylbenzamide concentrations were detected by a mass spectrometer.Hema-toxylin and eosin staining was performed to assess liver injury,and immunofluorescence was used to evaluate hepatic mitophagy.Results:The 2-amino-5-chloro-N,3-dimethylbenzamide powder(99%purity)entered the human body mainly via the skin and respiratory tract due to poor personal protective measures.The typical course of 2-amino-5-chloro-N,3-dimethylbenzamide poisoning was divided into latency,rash,fever,organic dam-age,and recovery phases in accordance with the clinical evolution.Rash and fever may be the important premonitory symptoms for further organ injuries.The chemical was detected in the blood of all patients and caused multiple organ injuries,predominantly liver injury,including kidney,myocardium,and micro-circulation.Three patients recovered smoothly after comprehensive treatments,including artificial liver therapy,continuous renal replacement therapy,glucocorticoids,and other symptomatic and supportive treatments.One patient survived by liver transplantation.The postoperative pathological findings of the removed liver showed acute liver failure,and immunofluorescence staining confirmed the abundance of mitophagy in residual hepatocytes.Conclusions:This study is the first to elaborate the clinical characteristics of patients with 2-amino-5-chloro-N,3-dimethylbenzamide poisoning.The chemical enters the body through the respiratory tract and skin during industrial production.The 2-amino-5-chloro-N,3-dimethylbenzamide poisoning causes multiple-organ dysfunction with a predominance of liver injury.Liver transplantation may be an effective option for patients with severe liver failure.The mechanisms of liver injury induced by 2-amino-5-chloro-N,3-dimethylbenzamide might involve abnormal mitochondrial function and mitophagy.

A Review of the Latest Control Strategies for Mosquito-Borne Diseases

Mosquito-borne diseases are persistent and potentially severe posing a threat to global pandemic preparedness.The risk of mosquito-borne virus transmission is rapidly increasing due to the unprecedented spread of viruses such as dengue and chikungunya,the disruption of global mosquito-borne disease control efforts following the emergence of coronavirus diseases 2019(COVID-19)in 2019,global warming,and human activities.To address this global challenge,various innovative mosquito control technologies are being developed worldwide.This paper summarizes the latest advances in mosquito vector control,focusing on China’s latest mosquito control strategies,to provide insights into implementing novel mosquito-borne disease control measures.

Diabetes and cancer: Associations, mechanisms, and implications for medical practice

Both diabetes mellitus and cancer are prevalent diseases worldwide. It is evident that there is a substantial increase in cancer incidence in diabetic patients. Epidemiologic studies have indicated that diabetic patients are at significantly higher risk of common cancers including pancreatic, liver, breast, colorectal, urinary tract, gastric and female reproductive cancers. Mortality due to cancer is moderately increased among patients with diabetes compared with those without. There is increasing evidence that some cancers are associated with diabetes, but the underlying mechanisms of this potential association have not been fully elucidated. Insulin is a potent growth factor that promotes cell proliferation and carcinogenesis directly and/or through insulin-like growth factor 1(IGF-1). Hyperinsulinemia leads to an increase in the bioactivity of IGF-1 by inhibiting IGF binding protein-1. Hyperglycemia serves as a subordinate plausible explanation of carcinogenesis. High glucose may exert direct and indirect effects upon cancer cells to promote proliferation. Also chronic inflammation is considered as a hallmark of carcinogenesis. The multiple drugs involved in the treatment of diabetes seem to modify the risk of cancer. Screening to detect cancer at an early stage and appropriate treatment of diabetic patients with cancer are important to improve their prognosis. This paper summarizes the associations between diabetes and common cancers, interprets possible mechanisms involved, and addresses implications for medical practice.

Association between Low-density Lipoprotein Receptor-related Protein 5 Polymorphisms and Type 2 Diabetes Mellitus in Han Chinese:a Case-control Study

Objective To investigate the association between low-density lipoprotein receptor-related protein 5 （LRPS） variants （rs12363572 and rs4930588） and type 2 diabetes mellitus （T2DM） in Han Chinese. Methods A total of 1842 T2DM cases （507 newly diagnosed cases and 1335 previously diagnosed cases） and 7777 controls were included in this case-control study. PCR-RFLP was conducted to detect the genotype of the two single nucleotide polymorphisms （SNPs）. Odds ratios （ORs） and 95% confidence intervals （95% CIs） were calculated to describe the strength of the association by logistic regression. Results In the study subjects, neither rs12363572 nor rs4930588 was significantly associated with T2DM, even after adjusting for relevant covariates. When stratified by body mass index （BMI）, the two SNPs were also not associated with T2DM. Among the 3 common haplotypes, only haplotype ~ was associated with reduced risk of T2DM （OR 0.820, 95% CI 0.732-0.919）. In addition, rs12363572 was associated with BMI （P〈0.001） and rs4930588 was associated with triglyceride levels （P=0.043） in 507 newly diagnosed T2DM cases but not in healthy controls. Conclusion No LRP5 variant was found to be associated with T2DM in Han Chinese, but haplotype TT was found to be associated with T2DM.

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population:Findings from the China Cardiometabolic Disease and Cancer Cohort(4C)Study

Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.

The impact of EV71 vaccination program on hand,foot and mouth disease in Zhejiang Province,China:A negative control study

Objective:To estimate the potential causal impact of Enterovirus A71(EV71)vaccination program on the reduction of EV71-infected hand,foot,and mouth disease(HFMD)in Zhejiang Province.Methods:We utilized the longitudinal surveillance dataset of HFMD and EV71 vaccination in Zhejiang Province during 2010-2019.We estimated vaccine efficacy using a Bayesian structured time series(BSTS)model,and employed a negative control outcome(NCO)model to detect unmeasured confounding and reveal potential causal association.Results:We estimated that 20,132 EV71 cases(95%CI:16,733,23,532)were prevented by vaccination program during 2017-2019,corresponding to a reduction of 29%(95%CI:24%,34%).The effectiveness of vaccination increased annually,with reductions of 11%(95%CI:6%,16%)in 2017 and 66%(95%CI:61%,71%)in 2019.Children under 5 years old obtained greater benefits compared to those over 5 years.Cities with higher vaccination coverage experienced a sharper EV71 reduction compared to those with lower coverage.The NCO model detected no confounding factors in the association between vaccination and EV71 cases reduction.

Decontamination Efficacy of Disinfection and Doffing of Medical Protective Clothing:A Combined Mannequin and Personnel Study

Personal protective equipment(PPE)plays a key role in protecting healthcare workers(HCWs)from highly infectious diseases.Appropriate use of PPE based on the level of exposure can prevent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection of otolaryngologists[1].

Exploration for the Priority of HIV Intervention:Modelling Health Impact and Cost-Effectiveness—Six Cities,Eastern China,2019-2028

Introduction:In order to enhance the effectiveness of resource allocation,regions must tailor their responses to their specific epidemiological and economic situations.Methods:Utilizing Spectrum software,we projected the cost-effectiveness of 10 chosen HIV interventions in six cities in eastern China from 2019 to 2028.We assessed three scenarios—Base,Achievable,and Idealized—for each city.The analysis included the projected number of HIV infections and deaths averted,as well as the incremental costeffectiveness ratios for each intervention in the six cities.Results:In Shijiazhuang,Wuxi,Yantai,and Zhenjiang,cities with initially low antiretroviral therapy(ART)coverage,ART showed significant effectiveness,especially for males.Conversely,in Foshan and Ningbo,where ART coverage was notably high,oral pre-exposure prophylaxis(PrEP)for men who have sex with men(MSM)proved effective in the Idealized scenario.MSM outreach,ART for males,and ART for females demonstrated cost-effectiveness across all six cities in both Achievable and Idealized scenarios at the predefined thresholds for each city.Discussion:Maintaining an appropriate coverage rate for outreach to MSM can lead to costeffectiveness.In cities with low ART coverage,scaling up ART remains a crucial intervention.In regions with high ART coverage,consideration may be given to the utilization of oral PrEP for MSM individuals,requiring budget allocation.

Correlations of PCBs, DIOXIN, and PBDE with TSH in Children's Blood in Areas of Computer E-waste Recycling

Objective To study correlations of polychlorinated biphenyls （PCBs）, DIOXIN, and polybrominated diphenyl ethers （PBDE） with thyroid stimulating hormone（TSH） in children, and assess the impact on children＇s health. Methods Three hundred and sixty nine children aged from 6 to 8, including 195 from Luqiao, the computer E‐waste recycling area, and 174 from Longyou, the control area, were selected for this investigation to elucidate the correlation of PCBs, DIOXIN, and PBDE with TSH in children’s blood samples. The children had a physical examination and their blood levels of PCBs, DIOXIN, PBDE, and TSH were detected after sample collection. Results In the E‐waste recycling area, the contents of PCBs, PBDE, DIOXIN, and TSH in the blood samples of children were 484.00±84.86 ng·g ‐1 lipid weight, 664.28±262.38 ng·g ‐1 lipid weight, 26.00±19.58 ng·g ‐1 lipid weight and 1.88±0.42 μIU/mL （serum） respectively, while in the control area, the PCBs, PBDE, DIOXIN, and TSH contents were 255.38±95 ng·g ‐1 lipid weight, 375.81±262.43 ng·g ‐1 lipid weight, 39.64±31.86 ng·g ‐1 lipid weight, and 3.31±1.04 μIU/mL respectively. Conclusion The health status of children in the control area are better than that in the contaminated area. Among children who are exposed to persistent organic pollutants, the pollutant content increases significantly in their serum, and the distribution of TSH levels in their bodies are also affected.

Seroprevalence of Bartonella henselae and Identification of Risk Factors in China

Serum samples were tested for Bartonella henselae Ig G antibodies using indirect immunofluorescence assays.We then analyzed associated risk factors.Serum samples were considered positive when reactive at a dilution of more than 1:320.

NRN1 and CAT Gene Polymorphisms, Complex Noise, and Lifestyles interactively Affect the Risk of Noise-induced Hearing Loss

Objective The effects of interactions between genetic and environmental factors on the noise-induced hearing loss(NIHL)are still unclear.This study aimed to assess interactions among gene polymorphisms,noise metrics,and lifestyles on the risk of NIHL.Methods A case-control study was conducted using 307 patients with NIHL and 307 matched healthy individuals from five manufacturing industries.General demographic data,lifestyle details,and noise exposure levels were recorded.The Kompetitive allele-specific polymerase chain reaction(KASP)was used to analyze the genotypes of 18 SNPs.Results GMDR model demonstrated a relevant interaction between NRN1 rs3805789 and CAT rs7943316(P=0.0107).Subjects with T allele of rs3805789 or T allele of rs7943316 had higher risks of NIHL than those with the SNP pair of rs3805789-CC and rs7943316-AA(P<0.05).There was an interaction among rs3805789,rs7943316,and kurtosis(P=0.0010).Subjects exposed to complex noise and carrying both rs3805789-CT and rs7943316-TT or rs3805789-CT/TT and rs7943316-AA had higher risks of NIHL than those exposed to steady noise and carrying both rs3805789-CC and rs7943316-AA(P<0.05).The best six-locus model involving NRN1 rs3805789,CAT rs7943316,smoking,video volume,physical exercise,and working pressure for the risk of NIHL was found to be the interaction(P=0.0010).An interaction was also found among smoking,video volume,physical exercise,working pressure,and kurtosis(P=0.0107).Conclusion Concurrence of NRN1 and CAT constitutes a genetic risk factor for NIHL.Complex noise exposure significantly increases the risk of NIHL in subjects with a high genetic risk score.Interactions between genes and lifestyles as well as noise metrics and lifestyles affect the risk of NIHL.

The Role of Nutrition Education in the Promotion of Iron-Fortified Soy Sauce in China

Iron deficiency anemia （IDA） is one of the most important nutrition issues in China. Data from the 2002 National Nutrition and Health Survey showed that the average anemia prevalence in China was 20.1% and the prevalence in women of child-bearing age and of children in some poor regions reached more than 50%; it has been estimated that more than 200 million Chinese people are suffering from anemia. Anemia significantly affects physical and mental development in children, decreases productivity in adults, and reduces immune function among the population at large, which leads to a lower health status and limits social development.

Development of Quantitative Real-time Polymerase Chain Reaction for the Detection of Vibrio vulnificus Based on Hemolysin (vvhA) Coding System

Objective To establish a TaqMan real-time fluorescent quantitative PCR to detect Vibrio vulnificus based on the hemolysin gene （vvhA） coding cytolysin. Methods Primers and probes in the conserved region of the vvhA gene sequence were designed for the TaqMan real-time PCR to detect 100 bp amplicon from V. vulnificus DNA. Recombinant plasmid pMD19-vvhA100 was constructed and used as a positive control during the detection. Minimal amplification cycles （Ct value） and fluorescence intensity enhancement （ARn value） were used as observing indexes to optimize the reaction conditions of TaqMan real-time PCR. The TaqMan assay for the detection of Vbirio vulnificus was evaluated in pure culture, mice tissue which artificially contaminated Vibrio vulnificus and clinical samples. Results The established TaqMan real-time PCR showed positive results only for Vibrio vulnificus DNA and pMD19-vvhA100. The standard curve was plotted and the minimum level of the vvhA target from the recombinant plasmid DNA was 103 copies with a Ct value of 37.94±0.19, as the equivalent of 0.01 ng purified genomic DNA of Vibrio vulnificus. The results detected by TaqMan PCR were positive for the 16 clinical samples and all the specimens of peripheral blood and subcutaneous tissue of mice which were infected with Vibrio vulnificus. Conclusion TaqMan real-time PCR is a rapid, effective, and quantitative tool to detect Vibro vulnificus, and can be used in clinical laboratory diagnosis of septicemia and wound infection caused by Vibrio vulnificus.

Identification of Variable-Number Tandem-Repeat(VNTR)Sequences in Acinetobacter pittii and Development of an Optimized Multiple-Locus VNTR Analysis Typing Scheme

Objective To develop a multiple-locus variable-number tandem-repeat(VNTR)analysis(MLVA)assay for Acinetobacter pittii typing.Methods Polymorphic VNTRs were searched by Tandem Repeats Finder.The distribution and polymorphism of each VNTR locus were analyzed in all the A.pittii genomes deposited in the NCBI genome database by BLAST and were evaluated with a collection of 20 well-characterized clinical A.pittii strains and one reference strain.The MLVA assay was compared with pulsed-field gel electrophoresis(PFGE)for discriminating A.pittii isolates.Results Ten VNTR loci were identified upon bioinformatic screening of A.pittii genomes,but only five of them showed full amplifiability and good polymorphism.Therefore,an MLVA assay composed of five VNTR loci was developed.The typeability,reproducibility,stability,discriminatory power,and epidemiological concordance were excellent.Compared with PFGE,the new optimized MLVA typing scheme provided the same and even greater discrimination.Conclusion Compared with PFGE,MLVA typing is a faster and more standardized alternative for studying the genetic relatedness of A.pittii isolates in disease surveillance and outbreak investigation.

Associations of Occupational Stress and Coping Styles with Well-Being Among Couriers-Three Cities,Zhejiang Province,China,2021

Summary What is already known about this topic?Prior research has primarily concentrated on occupational health concerns,including injuries and heatstroke,among couriers.Nevertheless,there has been a scarcity of emphasis on mental health aspects,with existing studies predominantly addressing the risk factors associated with occupational stress.What is added by this report?The present study demonstrated a significant association between occupational stress and well-being among couriers,with positive coping strategies acting as a mediating factor.Furthermore,the results indicate that implementing a positive coping style may mitigate the impact of occupational stress on well-being.What are the implications for public health practice?Future public policy initiatives should focus on promoting the well-being of couriers by fostering improvements in the workplace environment,reevaluating the organization of work,and delivering support to couriers in managing occupational stress.

Potential effects of aerosol generation and transmission during bedside endoscope cleaning

Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East respiratory syndrome(MERS)in 2012,and coronavirus disease 2019(COVID-19),with the latter being on the rampage since the end of 2019 and bringing the effect of aerosols on health back to the fore(Gralton et al.,2011;Wang et al.,2021).An increasing number of studies have shown that certain highly transmissible pathogens can maintain long-term stability and efficiently spread through aerosols(Leung,2021;Lv et al.,2021).As reported previously,influenza viruses that can spread efficiently through aerosols remain stable for a longer period compared to those that cannot.The World Health Organization(WHO)has stated that aerosol-generating procedures(AGPs)play an important role in aerosol transmission in hospitals(Calderwood et al.,2021).AGPs,referring to medical procedures that produce aerosols,including dental procedures,endotracheal intubation,sputum aspiration,and laparoscopic surgeries,have been reported to be significantly associated with an increased risk of nosocomial infection among medical personnel(Hamilton,2021).

Resurgence of pertussis:reasons and coping strategies

Pertussis(whooping cough)is an acute and contagious respiratory disease caused by the pathogen Bordetella pertussis(B.pertussis).B.pertussis can infect individuals of all ages.Children with pertussis may experience severe and persistent coughing and paroxysms;for newborns and infants,pertussis may be life-threatening.The development and widespread administration of the pertussis vaccine had once successfully brought pertussis under control,maintaining it at a low level for many years.However,resurgence of pertussis has been reported in many countries even with high vaccination coverage recently.The resurgence of pertussis was first reported in the United States(USA)in 1993[1].During 2000–2016,the baseline incidence increased and the age distribution of pertussis changed in the USA[2].Other countries including Canada[3],Australia[4],European Union countries,and South Korea have also reported a rise in pertussis outbreaks[2,5].

Coinfection of SARS-CoV-2 Omicron variant and other respiratory pathogens in children

Since the outbreak of coronavirus disease 2019(COVID-19),the entire world has been affected by the epidemic[1,2].On November 9,2021,a variant of the novel coronavirus B.1.1.529 was detected for the first time from case samples in South Africa.The Omicron strain spread and mutated significantly fast.This variant has the characteristics of escape immunity,which can induce relatively extreme disease and reduce the neutralization of antibodies in vaccinators,and is more likely to be reinfected[3,4].The clinical presentation of severe acute respiratory syndrome coronavirus 2(SARSCoV-2)in children has mild symptoms and a lower risk of hospitalization and death.

A Case of an 86-Year-Old Male Survivor with Human Respiratory Syncytial Virus and SARS-CoV-2 Virus Coinfection

As coronavirus disease 2019(COVID-19)public health restrictions are relaxed,the circulation of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)alongside other respiratory viruses may lead to an increased likelihood of coinfection(1).Older patients face a higher risk of severe outcomes,when infected with multiple respiratory viruses(2).This study highlights the successful recovery of the oldest older adult(≥80 years)from pneumonia caused by the dual infection of human respiratory syncytial virus(HRSV)and SARS-CoV-2.