Occurrence, transmission and risks assessment of pathogens in aquatic environments accessible to humans.

Pathogens are ubiquitously detected in various natural and engineered water systems, posing potential threats to public health. However, it remains unclear which human-accessible waters are hotspots for pathogens, how pathogens transmit to these waters, and what level of health risk associated with pathogens in these environments. This review collaboratively focuses and summarizes the contamination levels of pathogens on the 5 water systems accessible to humans (natural water, drinking water, recreational water, wastewater, and reclaimed water). Then, we showcase the pathways, influencing factors and simulation models of pathogens transmission and survival. Further, we compare the health risk levels of various pathogens through Quantitative Microbial Risk Assessment (QMRA), and assess the limitations of water-associated QMRA application. Pathogen levels in wastewater are consistently higher than in other water systems, with no significant variation for Cryptosporidium spp. among five water systems. Hydraulic conditions primarily govern the transmission of pathogens into human-accessible waters, while environmental factors such as temperature impact pathogens survival. The median and mean values of computed public health risk levels posed by pathogens consistently surpass safety thresholds, particularly in the context of recreational waters. Despite the highest pathogens levels found in wastewater, the calculated health risk is significantly lower than in other water systems. Except pathogens concentration, variables like the exposure mode, extent, and frequency are also crucial factors influencing the public health risk in water systems. This review shares valuable insights to the more accurate assessment and comprehensive management of public health risk in human-accessible water environments.

Socioeconomic factors, perceived stress, and social support effect on neonatal nurse burnout in China: a cross-sectional study.

BACKGROUND: Neonatal nurses' working environments are highly stressful, and burnout is common. This study examines the effect of socioeconomic factors, perceived stress, and social support on neonatal nurse burnout. METHODS: A total of 311 neonatal nurses participated in this study. They were administered a validated Maslach Burnout Inventory. The study employed a 14-item perceived stress scale (PSS-14) and a social support rate scale (SSRS) to examine stress, socioeconomic factors, and lifestyles. RESULTS: Of the neonatal nurses, 40.19% had burnout, 89.60% had mild burnout, and 10.40% had moderate burnout; no neonatal nurse experienced severe burnout. Young nurses and those with low technical skills, poor interpersonal relationships, irregular diet, and insufficient rest were exposed to burnout (all p < 0.05).Most burnout nurses experienced moderate-severe perceived stress, and their PSS-14 scores were higher (all p < 0.05).The scores for objective social support, subjective social support, utilization of social support, total SSRS scores, and the level of social support were all lower in burnout nurses (all p < 0.05). Perceived stress was correlated positively and significantly with emotional exhaustion and personal accomplishment (all p < 0.05). Social support correlated significantly with and reduced personal accomplishments (p < 0.05). Age, poor interpersonal relationships, perceived stress, and social support were all independent factors associated with neonatal nurse burnout (all p < 0.05). CONCLUSION: The prevalence of burnout in neonatal nurses was higher than average. Socioeconomic factors, higher perceived stress, and lower social support contribute to neonatal nurse burnout. Nursing managers should pay attention to socioeconomic factors, perceived stress, and social support among neonatal nurses and employ strategies to reduce neonatal nurse burnout.

Lifestyle and Social Factors Exacerbated on the Prevalence of Mood Disorders and Functional Dyspepsia Among Neonatal Nurses in China.

Background: Nursing is a high-stress occupation that can have an impact on mental health, particularly for neonatal nurses. Job-related stress factors and work-related behaviors have played a critical role in nurses' mental health. This study aimed to explore the prevalence of mood disorders and the impact of social factors, lifestyle on mood disorders among neonatal nurses. Methods: A total of 260 participants comprising neonatal nurses and nurses who work in neonatal intensive care units (NICU) were recruited. Data were collected using a validated generalized anxiety disorder questionnaire, patient health questionnaire-9, Pittsburgh sleep quality index, and social factors and lifestyle assessments. Results: In total, 49.23% of neonatal nurses exhibited mood disorders, particularly a combination of depression and anxiety. Female, poor interpersonal relationships and unhappy marital status, preference for smoking, alcohol, irregular diet, and poor sleep were common in neonatology nurses who exhibited mood disorders; preference for coffee and tea were lower in neonatology nurses without mood disorders (all P < 0.05). Interpersonal relationships, marital status, irregular diet, and poor sleep were independent factors associated with mood disorders among neonatal nurses (all P < 0.05). Mood disorders presented as functional dyspepsia (FD) among 50.78% of the participants (P < 0.05). Poor sleep and preference for smoking were common among neonatal nurses who had FD with mood disorders (all P < 0.05). Furthermore, the preference for sugary beverages was lower in participants with FD and mood disorders (P < 0.05). Poor sleep was independently associated with FD with mood disorders in neonatology nurses (P < 0.05). Conclusion: Prevalence of anxiety and depression was higher among neonatal nurses. Furthermore, most cases of mood disorders presented as FD. Thus, social factors and lifestyle have an impact on mood disorders which can manifest through somatic symptoms.

Medical care needs for patients receiving home healthcare in Taiwan: Do gender and income matter?

Studies about medical care needs for home healthcare (HHC) previously focused on disease patterns but not gender and income differences. We used the Taiwan National Health Research Insurance Database from 1997 to 2013 to examine trends in medical care needs for patients who received HHC, and the gender and income gaps in medical care needs, which were represented by resource utilization groups (RUG). We aimed to clarify three questions: 1. Are women at a higher level of medical care needs for HHC than men, 2. Does income relate to medical care needs? 3. Is the interaction term (gender and income) related to the likelihood of medical care needs? Results showed that the highest level of medical care need in HHC was reducing whereas the basic levels of medical care need for HHC are climbing over time in Taiwan during 1998 and 2013. The percentages of women with income-dependent status in RUG1 to RUG4 are 26.43%, 26.24%, 30.68%, and 32.07%, respectively. Women were more likely to have higher medical care needs than men (RUG 3: odds ratio, OR = 1.17, 95% confidence interval, CI = 1.10-1.25; RUG4: OR = 1.13, 95% CI = 1.06-1.22) in multivariates regression test. Compared to the patients with the high-income status, patients with the income-dependent status were more likely to receive RUG3 (OR = 2.34, 95% CI = 1.77-3.09) and RUG4 (OR = 1.98, 95% CI = 1.44-2.71). The results are consistent with the perspectives of fundamental causes of disease and feminization of poverty theory, implying gender and income inequalities in medical care needs. Policymakers should increase public spending for delivering home-based integrated care resources, especially for women with lower income, to reduce the double burden of female poverty at the higher levels of medical care needs for HHC.

Differences in absorption of cadmium and lead among fourteen sweet potato cultivars and health risk assessment.

Planting sweet potato (Ipomoea batatas (L.) Lam.) instead of rice in the area contaminated with heavy metals is one of the measures to ensure people's health and agricultural economy. Therefore, it is important to screen the low accumulation cultivars of sweet potato and to find out the concentration rule of cadmium (Cd) and lead (Pb) in edible parts along with the associated health risks to humans. A field experiment was performed with fourteen of three main types (starch, purple, and edible-type) of sweet potato cultivars grown on farmland polluted with Cd and Pb in eastern Hunan Province, China. The Cd and Pb concentrations in the sweet potato tissues as well as the yield were measured. The yield of the shoot and tuberous root of the fourteen sweet potato cultivars ranged from 14.59 to 68.57 and 26.35-50.76 t ha-1 with mean values of 33.09 and 33.46 t ha-1, respectively. Compared with purple and edible-type cultivars, the starch-type cultivar had lower Cd and Pb concentrations in the flesh, but higher in the shoot. The Cd and Pb concentrations in the flesh of cultivars Shangshu 19, Sushu 24, Yushu 98, and Xiangshu 98 were lower than MCL provided in Chinese National Food Safety Standards GB2762-2017. Based on the hazard index (HI), the consumption of sweet potato flesh is lower health risk, while shoots pose a greater health risk to local people and Cd is the main cause of the risk. As a result, sweet potato cultivars Shangshu 19, Sushu 24, Yushu 98 and Xiangshu 98 can be plant in serve Cd and Pb contaminated soils with the advantages of easy cultivation, high yield and economic benefits without stopping agricultural production.

Intergenerational differences in the intention to use psychological cybercounseling: A Chinese case study.

OBJECTIVE: This study applied an extended theory of planned behavior (E-TPB) model to investigate factors that contribute to the intention to use psychological cybercounseling in a Chinese sample. The moderating effects of intergenerational differences on relationships of E-TPB variables were also tested. METHODS: A total of 1494 Chinese participants Mage = 18.95 years, SD = 10.19; 49.9 % male) completed a self-report questionnaire measuring seven constructs: intention (INT), attitude (ATT), subjective norms (SN), perceived behavioral control (PBC), attitude toward the Internet (ATI), social stigma of seeking psychological help (SSSPH), and computer self-efficacy (CSE). RESULTS: Structural equation modeling showed that the E-TPB model accounted for 32.5 % of variance in INT. SN was the strongest determinant of INT, followed by PBC and ATT. Multi-group analysis revealed that intergenerational differences significantly moderated three paths: CSE → PBC, ATT → INT, and SN → INT. CONCLUSION: The results demonstrated the efficacy of E-TPB in explaining the intention to use psychological cybercounseling in a Chinese sample. Several factors related to the intention to use psychological cybercounseling were identified in this sample. PRACTICE IMPLICATIONS: The results can help promote psychological cybercounseling use in this population.

Glycosaminoglycan / gold nanocluster hybrid nanoparticles as a new sensing platform: Metastatic potential assessment of cancer cells.

A novel fluorescent heparanase assay based on hybrid nano-assembly of gold nanocluster and glycosaminoglycan is developed. The nanoparticle probes are fabricated through the co-assembly of positively charged gold nanoclusters with negatively charged heparin molecules, which is accompanied by a dramatic size change and a 2.5-fold fluorescence enhancement. It is demonstrated that the fluorescence enhancement is due to denser aggregation of Au-thiolate complexes in the hybrid nanoparticle and the fluctuation of the fluorescence intensity is an indicator of the variation in assembly efficiency. Experiments in solution and in cell lysis media showed that the heparanase could turn-off the fluorescence with a high selectivity, which could be utilized for the assessment of heparanase activity and the metastatic potentials of different tumour cells. This assay technique is low cost, easy to prepare, and showing good performance. The co-assembly strategy has potential to be transferable to construct other functional nanomaterial.

A low-cost microwell device for high-resolution imaging of neurite outgrowth in 3D.

OBJECTIVE: Current neuronal cell culture is mostly performed on two-dimensional (2D) surfaces, which lack many of the important features of the native environment of neurons, including topographical cues, deformable extracellular matrix, and spatial isotropy or anisotropy in three dimensions. Although three-dimensional (3D) cell culture systems provide a more physiologically relevant environment than 2D systems, their popularity is greatly hampered by the lack of easy-to-make-and-use devices. We aim to develop a widely applicable 3D culture procedure to facilitate the transition of neuronal cultures from 2D to 3D. APPROACH: We made a simple microwell device for 3D neuronal cell culture that is inexpensive, easy to assemble, and fully compatible with commonly used imaging techniques, including super-resolution microscopy. MAIN RESULTS: We developed a novel gel mixture to support 3D neurite regeneration of Aplysia bag cell neurons, a system that has been extensively used for quantitative analysis of growth cone dynamics in 2D. We found that the morphology and growth pattern of bag cell growth cones in 3D culture closely resemble the ones of growth cones observed in vivo. We demonstrated the capability of our device for high-resolution imaging of cytoskeletal and signaling proteins as well as organelles. SIGNIFICANCE: Neuronal cell culture has been a valuable tool for neuroscientists to study the behavior of neurons in a controlled environment. Compared to 2D, neurons cultured in 3D retain the majority of their native characteristics, while offering higher accessibility, control, and repeatability. We expect that our microwell device will facilitate a wider adoption of 3D neuronal cultures to study the mechanisms of neurite regeneration.

A simple LC-MS/MS method for the simultaneous quantification of resveratrol and its major phase II metabolites: Assessment of their urinary and biliary excretions in rats.

Trans-resveratrol (Res) is rapidly metabolized, extensively distributed into various tissues and mainly excreted by urine. The present study aimed to establish a simple LC-MS/MS method to simultaneously quantify Res and its major phase II metabolites (Res-3-O-ß-d-glucuronide, R3G; Res-4'-O-ß-d-glucuronide, R4'G; Res-resveratrol 3-sulfate, R3S; and Res-4'-sulfate, R4'S), and apply this method to assess their urinary and biliary excretions in rats. A simplified salting-out assisted liquid-liquid extraction (SALLE) strategy was developed to prepare samples with acetonitrile-methanol mixture (8:2, v/v) as extractant and ammonium acetate solution (10M) as salting-out reagent. The method validation demonstrated an acceptable recovery (>80%), good accuracy (85-115%), low deviation of detection (<15%) and no obvious matrix effect (<20%). Then the validated method was successfully applied to analyze the excretion of Res and its metabolites after intragastric administration of Res at 50mg/kg in rats. Only a minor proportion of Res (0.51nmol) and its metabolites (R3S, 35.8nmol; R4S, 0.25nmol; R3G, 142.3nmol; R4'G, 0.19nmol) were eliminated via bile, while the majority of Res (1670.2nmol), R3G (14,089.0nmol) and R3S (2975.6nmol) were excreted through urine. The major forms found in feces were Res and R3S, which were accumulated up to 241.8 and 250.8nmol, respectively. In summary, the SALLE technique simplified the samples preparation and could be well popularized, especially for those highly polar compounds in biosamples like urine, bile and feces, where various endogenous substances could significantly affect the extraction recovery and detection response.

Antimicrobial prescribing patterns in a large tertiary hospital in Shanghai, China.

Whilst the 'Principles of clinical use of antibiotics' was released by the Ministry of Health of the People's Republic of China in 2004, limited research has been conducted to evaluate the quality of antibiotic use in real-world practice. In this study, we sought to examine antimicrobial prescribing patterns in a large tertiary hospital in Shanghai, China. De-identified outpatient and emergency department pharmacy records containing antimicrobials were extracted from the hospital electronic health records system. Antimicrobial prescribing patterns and out-of-pocket medical costs for antimicrobials were evaluated by patient demographics and the primary diagnosis. Antimicrobial prescriptions stratified by patient age group (<5, 5-17, 18-49, 50-64 and ≥65 years) were also examined. A total of 363 642 antimicrobial prescriptions in 2014 were obtained, corresponding to 197 781 unique patients. Approximately 18% of antimicrobial-containing prescriptions were for acute upper respiratory infection and bronchitis, 15% for fever or cough, 5% for gastritis and duodenitis and non-infective gastroenteritis and colitis, and 7% for other diagnoses without clear indications of bacterial infection. Cephalosporins were the most frequently prescribed antibiotic class (55%). Age-specific antimicrobial prescriptions showed different patterns between children and adults. A total of US$4.6 million were spent as out-of-pocket costs on antimicrobials in 2014, and the median antimicrobial cost per prescription was $9. Unnecessary antibiotic use is still common in real-world clinical practice and remains a public health challenge. Antibiotic-related medical expenditure also presents an important economic burden.

Gender Disparity in the Safety and Efficacy of Radial and Femoral Access for Coronary Intervention: A Systematic Review and Meta-Analysis.

Our aim was to investigate the gender disparity in the safety and efficacy of transradial percutaneous coronary intervention (PCI; TRI) and transfemoral PCI (TFI) by a meta-analysis. MEDLINE, Embase, and CENTRAL were searched to identify studies on vascular access with sex-specific events available or studies on sex difference with the events reported by vascular access. Fifteen studies involving 3 921 848 participants were included. Transradial PCI significantly reduced the risk of bleeding complications in both sexes (TRI-versus-TFI odds ratio [OR]: 0.37 in females vs 0.47 in males) and major adverse cardiac events (MACE) in females (OR: 0.70, P < .001) but not in males (OR: 0.83, P = .15) compared to TFI. Transradial PCI diminished the sex difference in the incidence of bleeding complications (female-versus-male OR: 1.82 with TRI vs 2.39 with TFI; interaction P = .01) and MACE (female-versus-male OR: 1.21 with TRI vs 1.41 with TFI; interaction P = .003) compared to TFI. Females were associated with higher crossover rate in the TRI subgroup but not in the TFI subgroup (interaction P = .05). In conclusion, TRI may improve the safety and efficacy of outcomes in both sexes and be an effective means to cut down the gender difference in prognosis.

[Study on Speciation Analysis and Ecological Risk Assessment of Heavy Metals in Surface Sediments in Gansu, Ningxia and Inner Mongolia Sections of the Yellow River in Wet Season with HR-ICP-MS].

In order to continuously study the contents, pollution condition and potential ecological risk of heavy metals in surface sediments in Gansu, Ningxia and Inner Mongolia sections of the Yellow River in wet seasons in different years, the speciation analysis of 9 kinds of heavy metals including Cd, Pb, Cr, Ni, Cu, V, Co, Zn and Mn, pollution condition and potential ecological risk of heavy metals in surface sediments from 10 sampling sites like Baotoufuqiao (S2), Shizuishantaolezhen (S6) and Wujinxia (S9) in Gansu, Ningxia and Inner Mongolia sections of the Yellow River in 2012 wet season were studied with BCR sequential extraction and high resolution inductively coupled plasma-mass spectrometry (HR-ICP-MS) based on our previous works. The results implied that the order of heavy metals average contents in the 10 sediment samples were the same: Mn>V> Zn>Cr>Cu>Ni>Pb>Co>Cd. In the sediments, heavy metals mainly existed in the form of residual fraction, which indicated that the bioavailability or environmental impact was low. Results of geo-accumulation indices (Igeo) showed that Igeo(CD), was the largest among the heavy metals with the strongest pollution, while IGEO(Mn)was the smallest. Enrichment factor (EF) indicated that only Cd and Cu were enriched at some sampling sites. In S5, because EFcd reached 4. 69, Cd was affected by human activities obviously and the result was consistent with I. Potential ecological risk index (RI) implied that the RI values in S1, S2 and S5 were between 150 and 300, which belonged to moderate polluting degree, while others were less than 150, belonging to light pollution degree. The results of this paper could not only provide reliable experimental data and theoretical basis for the relevant departments, but also supply the technical support for constructing mathematics model of sediments-pollutants transport, systematically researching the migration and transformation rule of persistent toxic substances and environmental assessment in these reaches.

Correlation among lens opacities classification system III grading, visual function index-14, pentacam nucleus staging, and objective scatter index for cataract assessment.

PURPOSE: To investigate the relationship among Lens Opacities Classification System III (LOCS III) grading score, Visual Function Index-14 (VF-14) score, average lens density by the Pentacam Nucleus Staging system, and the objective scatter index measured by the Optical Quality Analysis System in age-related cataract patients. DESIGN: Prospective, single-center, cross-sectional study. METHODS: Thirty-six subjects (60 eyes) with age-related cataract were recruited. Subjects with any corneal anomaly potentially affecting intraocular scatter were excluded. The best-corrected visual acuity (BCVA), LOCS III nuclear opalescence score and cortical cataract score, VF-14 score, average lens density, and objective scatter index were obtained. Correlations among these parameters were analyzed. RESULTS: The LOCS III nuclear opalescence score was correlated with the BCVA (r = 0.438; P = .001), objective scatter index (r = 0.543; P < .001), and average lens density (r = 0.621; P < .001). The objective scatter index was also correlated with the BCVA (r = 0.779; P < .001) and the average lens density (r = 0.320; P = .013). The VF-14 score had the strongest correlation with the objective scatter index (r = -0.712; P < .001). The difference between groups with objective scatter index<3.0 and ≥3.0 was significant with regard to BCVA, average lens density, LOCS III nuclear opalescence score, and VF-14 score. CONCLUSIONS: LOCS III grading remains an economical and effective method to assess lens opacities, especially in the formation of early cortex cataracts. The objective scatter index can be a useful parameter to objectively analyze the correlation between ocular examination findings and patient concerns. Furthermore, the objective scatter index scores ≥3.0 can be a possible objective cut-off for preoperative decision making.

[Analysis report of the national technique competition for diagnosis of parasitic diseases in 2012: I. Capability analysis of Plasmodium detection].

OBJECTIVE: To analyze the result of the national technique competition for diagnosis of parasitic diseases in 2012, so as to understand the capability of detection on Plasmodium parasites among professionals from institutes for disease control and prevention at different levels. METHODS: Four professionals from institution were selected as contestants (age < or = 45 and at least two contestants from county-level institution). The content of the competition included making thick and thin blood slides of Plasmodium (3 slides in 30 min, 10 scores as full marks and 6 as passing score) and identification of species and number with microscopy (5 slides, 8 min per slide, 30 scores as full marks and 18 as passing score). All contestants were grouped by gender, age, professional title, level of institution, classification according to malaria endemicity, geographical location and economic development of the province. Their scores were statistically analyzed by SPSS 16.0 software. RESULTS: The average score of blood smear making test in 120 contestants from 30 provinces was 8.7, the highest was 10 and the lowest was 5.8, 118 (98.3%) contestants passed the test. The average score of blood smear reading was 16.0, the highest was 29 and the lowest was 0, 52 (43.3%) contestants passed the test. There were no significant differences for the scores among genders, ages (< or = 30, 31-40, > 40), professional titles (junior, intermediate and senior), institution levels (provincial, municipal or county level) (P > 0.05). However, there was a significant difference among provinces with different malaria endemicity, geographical location and development status (P < 0.05). For the blood slide-making and film-reading, scores of contestants from malaria endemic provinces including Class I (9.29 +/- 0.41, 18.17 +/- 6.42), Class II (8.92 +/- 0.79, 18.31 +/- 6.94) and Class III (8.61 +/- 0.89, 15.63 +/- 7.52) were higher than those from non-endemic provinces (7.95 +/- 1.00, 10.19 +/- 7.01) (P < 0.01). Scores of contestants from southern provinces (9.16 +/- 0.61, 18.82 +/- 6.78) were significantly higher than that from northern ones (8.30 +/- 0.99, 13.23 +/- 7.45) (P < 0.01). The film-reading scores were significantly higher in those from eastern provinces (18.20 +/- 6.88) than those from western (13.39 +/- 7.60) (P < 0.05), while no significant difference was found in blood slide-making (P > 0.05). CONCLUSION: The capability of malaria parasite detection is imbalanced.

[Assessment of the quality of randomized controlled trials in treating coronary heart disease by Chinese patent medicine].

OBJECTIVE: To assess the quality of randomized controlled trials (RCTs) on Compound Danshen Dripping Pill, Compound Danshen Tablet, Suxiao Jiuxin Pill, Tongxinluo Capsule, and isosorbide dinitrate (ISDN) in treating coronary heart disease angina. METHODS: RCT reports were retrieved from CNKI, Wanfang Data, PubMed, China Master Theses Full-text Database, Chinese Electronic Periodical Services, Social Sciences Citation Index, Science Direct, Cambridge Journals Online, and EBM Reviews. Qualities of RCTs were assessed according to Jadad scale, M scale, CONSORT 2010, and CONSORT for herbal medicine. Kendall correlations between basic study characteristics and qualities of included RCTs were analyzed using R statistical software. RESULTS: Eighty-eight RCTs were included. The medians (means, 95% CIs) were 2.00 (2.09, [1.81,2.37]) for the Jadad scale, 4.00 (3.52,[2.95, 4.09]) for the M scale, 15.00 (15.39, [13.87, 16.91]) for the CONSORT 2010, and 19.00 (19.06,[17.16, 20.96]) for the CONSORT for herbal medicine. Only 9.09% (8/88) of RCTs were of high quality (Jadad score >2). These RCT quality measures were not correlated with individual items of reporting, such as sample sizes and follow-up periods. CONCLUSIONS: The quality of RCTs on Chinese patent medicine compared with ISDN was not improved from 1997 to 2009. It is urgent to improve the design of RCTs and the report quality.

Meteorological factors-based spatio-temporal mapping and predicting malaria in central China.

Despite significant reductions in the overall burden of malaria in the 20th century, this disease still represents a significant public health problem in China, especially in central areas. Understanding the spatio-temporal distribution of malaria is essential in the planning and implementing of effective control measures. In this study, normalized meteorological factors were incorporated in spatio-temporal models. Seven models were established in WinBUGS software by using Bayesian hierarchical models and Markov Chain Monte Carlo methods. M1, M2, and M3 modeled separate meteorological factors, and M3, which modeled rainfall performed better than M1 and M2, which modeled average temperature and relative humidity, respectively. M7 was the best fitting models on the basis of based on deviance information criterion and predicting errors. The results showed that the way rainfall influencing malaria incidence was different from other factors, which could be interpreted as rainfall having a greater influence than other factors.