Assessment of medical information on irritable bowel syndrome information in Wikipedia and Baidu Encyclopedia: comparative study.

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder (FGID) with heterogeneous clinical presentations. There are no clear testing parameters for its diagnosis, and the complex pathophysiology of IBS and the limited time that doctors have to spend with patients makes it difficult to adequately educate patients in the outpatient setting. An increased awareness of IBS means that patients are more likely to self-diagnose and self-manage IBS based on their own symptoms. These factors may make patients more likely to turn to Internet resources. Wikipedia is the most popular online encyclopedia among English-speaking users, with numerous validations. However, in Mandarin-speaking regions, the Baidu Encyclopedia is most commonly used. There have been no studies on the reliability, readability, and objectivity of IBS information on the two sites. This is an urgent issue as these platforms are accessed by approximately 1.45 billion people. Objective: We compared the IBS content on Wikipedia (in English) and Baidu Baike (in Chinese), two online encyclopedias, in terms of reliability, readability, and objectivity. Methods: The Baidu Encyclopedia (in Chinese) and Wikipedia (in English) were evaluated based on the Rome IV IBS definitions and diagnoses. All possible synonyms and derivatives for IBS and IBS-related FGIDs were screened and identified. Two gastroenterology experts evaluated the scores of articles for both sites using the DISCERN instrument, the Journal of the American Medical Association scoring system (JAMA), and the Global Quality Score (GQS). Results: Wikipedia scored higher overall with DISCERN (p < .0001), JAMA (p < .0001) and GQS (p < .05) than the Baidu Encyclopedia. Specifically, Wikipedia scored higher in DISCERN Section 1 (p < .0001), DISCERN Section 2 (p < .01), DISCERN Section 3 (p < .001), and the General DISCERN score (p < .0001) than the Baidu Encyclopedia. Both sites had low DISCERN Section 2 scores (p = .18). Wikipedia also had a larger percentage of high quality scores in total DISCERN, DISCERN Section 1, and DISCERN Section 3 (p < .0001, P < .0001, P < .0004, respectively, based on the above 3 (60%) rule). Conclusions: Wikipedia provides more reliable, higher quality, and more objective IBS-related health information than the Baidu Encyclopedia. However, there should be improvements in the information quality for both sites. Medical professionals and institutions should collaborate with these online platforms to offer better health information for IBS.

Spatiotemporal heterogeneity and long-term impact of meteorological, environmental, and socio-economic factors on scrub typhus in China from 2006 to 2018.

BACKGROUND: Large-scale outbreaks of scrub typhus combined with its emergence in new areas as a vector-borne rickettsiosis highlight the ongoing neglect of this disease. This study aims to explore the long-term changes and regional leading factors of scrub typhus in China, with the goal of providing valuable insights for disease prevention and control. METHODS: This study utilized a Bayesian space-time hierarchical model (BSTHM) to examine the spatiotemporal heterogeneity of scrub typhus and analyze the relationship between environmental factors and scrub typhus in southern and northern China from 2006 to 2018. Additionally, a GeoDetector model was employed to assess the predominant influences of geographical and socioeconomic factors in both regions. RESULTS: Scrub typhus exhibits a seasonal pattern, typically occurring during the summer and autumn months (June to November), with a peak in October. Geographically, the high-risk regions, or hot spots, are concentrated in the south, while the low-risk regions, or cold spots, are located in the north. Moreover, the distribution of scrub typhus is influenced by environment and socio-economic factors. In the north and south, the dominant factors are the monthly normalized vegetation index (NDVI) and temperature. An increase in NDVI per interquartile range (IQR) leads to a 7.580% decrease in scrub typhus risk in northern China, and a 19.180% increase in the southern. Similarly, of 1 IQR increase in temperature reduces the risk of scrub typhus by 10.720% in the north but increases it by 15.800% in the south. In terms of geographical and socio-economic factors, illiteracy rate and altitude are the key determinants in the respective areas, with q-values of 0.844 and 0.882. CONCLUSIONS: These results indicated that appropriate climate, environment, and social conditions would increase the risk of scrub typhus. This study provided helpful suggestions and a basis for reasonably allocating resources and controlling the occurrence of scrub typhus.

The application value of high-frequency ultrasound in the feasibility assessment of endoscopic retrograde appendicitis therapy in children with appendicitis.

Acute appendicitis is one of the common acute abdominal diseases in pediatrics. However, the implementation of radiological examination guided endoscopic retrograde appendicitis therapy (ERAT) in adults is limited in children. Our previous research explored the non-invasive guidance of high-frequency ultrasound (HFUS) for ERAT and achieved good therapeutic effects. This study mainly focuses on exploring the application value of HFUS in the feasibility assessment of ERAT in children with appendicitis. 163 children with appendicitis received ERAT guided by HFUS were analyzed retrospectively. According to the parameters evaluated by HFUS before and during ERAT, the results indicated that the distance between the appendix orifice and the ileocecal valve significantly affected the time required for the guidewire to enter the appendix cavity (P < 0.05). The diameter and the texture of the fecalith, the thickness of the intestinal wall of the appendiceal orifice all had significant effects on the successful removal of the fecalith (P < 0.05). The success rate, treatment time and final flushing effect of the guidewire to reach the blind end of the appendix were significantly affected by the tortuosity of the appendix and whether there was adhesion with surrounding tissues (P < 0.05). HFUS can accurately assess the feasibility of ERAT in children with appendicitis.

Urban heat vulnerability: A dynamic assessment using multi-source data in coastal metropolis of Southeast China.

Extreme heat caused by global climate change has become a serious threat to the sustainable development of urban areas. Scientific assessment of the impacts of extreme heat on urban areas and in-depth knowledge of the cross-scale mechanisms of heat vulnerability forming in urban systems are expected to support policymakers and stakeholders in developing effective policies to mitigate the economic, social, and health risks. Based on the perspective of the human-environment system, this study constructed a conceptual framework and index system of "exposure-susceptibility-adaptive capacity" for urban heat vulnerability (UHV) and proposed its assessment methods. Taking Xiamen City, a coastal metropolis, as an example, spatial analysis and Geodetector were used to explore the spatial and temporal changes, spatial characteristics, and patterns of UHV under multiple external disturbances from natural to anthropological factors, and to reveal the main factors influencing UHV forming and spatial differentiation. Results showed that the exposure, susceptibility, adaptive capacity, and UHV in Xiamen City had a spatial structure of "coastal-offshore-inland". On the hot day, both the exposure and UHV showed a temporal pattern of "rising and then falling, peaking at 14:00" and a spatial pattern of "monsoonal-like" movement between coast and inland. Coastal zoning with favorable socioeconomic conditions had less magnitude of changes in UHV, where the stability of the urban system was more likely to be maintained. During the hot months, the high UHV areas were mainly distributed in the inland, while coastal areas showed low UHV levels. Further, coastal UHV was mainly dominated by "heat exposure", offshore by "comprehensive factors", and inland in the northern mountainous areas by "lack of adaptive capacity". Multi-scale urban adaptive capacity was confirmed to alter spatial distribution of exposure and reshape the spatial pattern of UHV. This study promotes the application of multi-scale vulnerability framework to disaster impact assessment, enriches the scientific knowledge of the urban system vulnerability, and provides scientific references for local targeted cooling policy development and extreme heat resilience building programs.

Wearable Sensors for Remote Health Monitoring: Potential Applications for Early Diagnosis of Covid-19.

Wearable sensors are emerging as a new technology to detect physiological and biochemical markers for remote health monitoring. By measuring vital signs such as respiratory rate, body temperature, and blood oxygen level, wearable sensors offer tremendous potential for the noninvasive and early diagnosis of numerous diseases such as Covid-19. Over the past decade, significant progress has been made to develop wearable sensors with high sensitivity, accuracy, flexibility, and stretchability, bringing to reality a new paradigm of remote health monitoring. In this review paper, the latest advances in wearable sensor systems that can measure vital signs at an accuracy level matching those of point-of-care tests are presented. In particular, the focus of this review is placed on wearable sensors for measuring respiratory behavior, body temperature, and blood oxygen level, which are identified as the critical signals for diagnosing and monitoring Covid-19. Various designs based on different materials and working mechanisms are summarized. This review is concluded by identifying the remaining challenges and future opportunities for this emerging field.

Cost-Effectiveness of Short-Course Radiation Plus Temozolomide for the Treatment of Newly Diagnosed Glioblastoma Among Elderly Patients in China and the United States.

Background: Glioblastoma multiforme (GBM) is a fatal type of brain tumor with a high incidence among elderly people. Temozolomide (TMZ) has proven to be an effective chemotherapeutic agent with significant survival benefits. This study aimed to evaluate the economic outcomes of radiotherapy (RT) and TMZ for the treatment of newly diagnosed GBM in elderly people in the United States (US) and China. Methods: A partitioned survival model was constructed for RT plus TMZ and RT alone among patients with methylated and unmethylated tumor status. Base case calculations and one-way and probabilistic sensitivity analyses were performed. Life-years, quality-adjusted life-years (QALYs), costs (in 2021 US dollars [$] and Chinese Yuan Renminbi [¥]), and incremental cost-effectiveness ratios (ICERs) were calculated. Results: RT plus TMZ was found to be associated with significantly higher costs and QALYs in all groups. Only US patients with methylated status receiving RT plus TMZ had an ICER ($89358.51) less than the willingness-to-pay (WTP) threshold of $100000 per QALY gained when compared with receiving RT alone. When the WTP threshold ranged from $100000 to $150000 from the US perspective, the probability of RT plus TMZ being cost-effective increased from 80.5 to 99.8%. The cost of TMZ must be lower than ¥120 per 20 mg for RT plus TMZ to be cost-effective among patients with methylated tumor status in China. Conclusion: RT plus TMZ was not cost-effective in China, and a reduction in the TMZ price was justified. However, it is highly likely to be cost-effective for patients with methylated tumor status in the US.

Socioeconomic Relation with Plastic Consumption on 61 Countries Classified by Continent, Income Status and Coastal Regions.

In this study, World Bank socioeconomic data of 61 countries during 2009-2015 combine with a semi-systematic literature review was applied to analyze the relationship between plastic consumptions and socioeconomic levels statistically. Based on a total data volume of 5551, we found that all countries can be divided into different groups like the continent, income status, and coastal countries. It is showed that most plastics were consumed by North America, Europe, high-income countries, and coastal countries in the Pacific and the Atlantic Ocean. A potential relation occurred in plastic consumptions with different socioeconomic parameters like Gross National Income (GNI) per capita, Gross Domestic Product (GDP) per capita, life expectancy, agriculture land use, etc. The results indicated the need should continue to support initiatives to cover identified gaps, either geographic or thematic, to address plastic consumptions.

Determination of influencing factors on historical concentration variations of PAHs in West Taihu Lake, China.

The adsorption of polycyclic aromatic hydrocarbons (PAHs) by components such as elemental carbon (EC), total organic carbon (TOC), and particles is different, and EC and PAHs are good materials for reconstructing historical human activity patterns and pollution conditions. In this study, the effects of EC (soot and char), TOC and particles of different grain size on PAHs in surface sediments were quantitatively analysed, and their historical concentrations in a sediment core from western Taihu Lake were reconstructed. The contents of soot, TOC, clay, EC and char explained 57.2%, 27.6%, 26.0%, 24.0% and 16.4%, respectively, of the PAH concentrations in surface sediments. The correlation between the soot and PAH levels was significantly higher than that between the char, TOC, and clay contents and PAH levels, and PAHs were mainly affected by the local economic development and human activity, as indicated by metrics of population, highway mileage, coal burning, and industrial output. With the development of the economy of the Taihu Lake Basin, the composition of PAHs in the sediments has changed: the proportion of low-molecular-weight PAHs decreased from 42.4% to 17.5%, and that of high-molecular-weight PAHs increased from 58.7% to 82.5%. The concentration of PAHs in pore water from Taihu Lake over the past 100 years was reconstructed and ranged from 43.1 to 961.2 µg L-1, with an average of 180.7 µg L-1. After China's reform and opening up, the concentrations of various PAHs in Taihu Lake changed from safe to chronic pollution levels. The ratios of lead (Pb) isotopes and the diagnostic ratios of PAHs showed that the main sources of PAHs in western Taihu Lake sediments were human activities such as coal and petroleum combustion.

Heavy metals in food crops, soil, and water in the Lihe River Watershed of the Taihu Region and their potential health risks when ingested.

Environmental pollution by heavy metals resulting from rapid economic development is a major concern. Soil, water, wheat, and rice samples were collected from the Lihe River Watershed in the Taihu Region (east China). In this study area, many types of industrial plants, including ceramics factories, plants working with refractory materials, and chemical plants are densely distributed and cause serious heavy metal pollution. In addition, well-developed transportation and agricultural activities are also important sources of heavy metals. Thus, the concentrations of selected heavy metals including cadmium (Cd), chromium (Cr), copper (Cu), nickel (Ni), lead (Pb), and zinc (Zn) in the samples were analyzed to evaluate their potential integral risk (IR) to the health of the local population. Accordingly, the spatial distribution pattern of the IR values was determined in the study. The soil in the study area showed heavy Cd pollution, whereas the pollution by other elements was relatively slight. When the proportions of grain samples in which the concentrations exceeded the tolerance limits were examined, the grains were primarily contaminated with Pb, Ni, Cd, and Zn; and less contaminated with Cu and Cr. The drinking water of the local inhabitants was safe. The average IR value was 3.53 for adults and 3.91 for children, indicating that both adults and children may experience adverse health effects. The spatial distribution pattern of the IR values among the exposed populations in the study area showed high values in the eastern and middle parts, with maximum values >5, and low values in the western part, with minimum values <2. This is consistent with the distributions of the industries and the population. The study may provide a basis for comparison to other regions both in China and worldwide.

Efficacy of human papillomavirus-based screen-and-treat for cervical cancer prevention among HIV-infected women.

BACKGROUND: Cervical cancer prevention should be provided as part of primary healthcare services for HIV-infected women but conventional screening programs are difficult to implement in low-resource settings. Here, we evaluate the efficacy among HIV-infected women of a simpler, screen-and-treat strategy in which all women with a positive screening test are treated with cryotherapy. METHODS: We conducted a randomized clinical trial of two screen-and-treat strategies among 6555 women in Cape Town, South Africa, among whom 956 were HIV-positive. Women were randomized to screen-and-treat utilizing either human papillomavirus DNA testing or visual inspection with acetic acid as the screening method or to a control group. Women were followed for up to 36 months after randomization with colposcopy and biopsy to determine the study endpoint of cervical intraepithelial neoplasia grade 2 or higher. RESULTS: In the control group, HIV-positive women had higher rates of cervical intraepithelial neoplasia grade 2 or higher detected by 36 months (14.9%) than HIV-negative women (4.6%) (P = 0.0006). Screen-and-treat utilizing human papillomavirus DNA testing significantly reduced cervical intraepithelial neoplasia grade 2 or higher through 36 months in both HIV-positive (relative risk = 0.20, 95% confidence interval 0.06-0.69) and HIV-negative women (relative risk = 0.31, 95% confidence interval 0.20-0.50). Reductions in the visual inspection with acetic acid-and-treat group were less marked. Complications of cryotherapy were mostly minor and did not differ in frequency between HIV-positive and HIV-negative women. CONCLUSION: Screen-and-treat using human papillomavirus testing is a simple and effective method to reduce high-grade cervical cancer precursors in HIV-infected women.