[Genetic characterization of influenza A virus and assessment of vaccine efficacy in Yantai from 2014 to 2017].

In this study, the swabs were collected among patients with an influenza-like illness (ILI) admitted to 2 sentinel surveillance hospitals of Yantai from April 2014 to August 2017. All specimen were cultured and identified by hemagglutination inhibition assay. Complete sequences of Hemagglutinin (HA) of influenza A were amplified, sequenced and analyzed using molecular and phylogenetic methods. The potential vaccine efficacy were calculated using Pepitope model. The results showed that the antigenicity of A (H3N2) had changed greatly. 8 strains of influenza A (H1N1) pdm09 belonged to subclade 6B.1 and 14 strains clustered in 6B.2. 12 strains of influenza A (H3N2) fell into subgroup 3C.3a and 33 strains clustered in 3C.2a. Several residues at antigen sites and potential glycosylation sites had changed in influenza A strains. Vaccine efficacy of influenza A (H1N1) pdm09 in 2015/2016 and 2016/2017 seasons were 77.29% and 79.11% of that of a perfect match with vaccine strain, meanwhile vaccine efficacy of influenza A (H3N2) in 2014/2015, 2015/2016 and 2016/2017 were-5.18%, 16.97% and 42.05% separately. In conclusion, the influenza A virus circulated in Yantai from 2014 to 2017 presented continual genetic variation. The recommended vaccine strains still afforded protection against influenza A (H1N1) pdm09 strains and provided suboptimal protection against influenza A (H3N2) strains.

A PCR-based intergenic spacer region-capillary gel electrophoresis typing method for identification and subtyping of Nocardia species.

While 16S rRNA sequence-based identification of Nocardia species has become the gold standard, it is not without its limitations. We evaluated a novel approach encompassing the amplification of the Nocardia 16S-23S rRNA intergenic spacer (IGS) region followed by fragment analysis by capillary gel electrophoresis (CGE) of the amplified product for species identification of Nocardia. One hundred forty-five Nocardia isolates (19 species) and four non-Nocardia aerobic actinomycetes were studied. Reproducibility testing was performed in a subset (21%) of isolates. Ninety-five different electropherograms were identified, with heterogeneity within species being a general observation. Among common Nocardia species (e.g., Nocardia cyriacigeorgica, N. nova, N. farcinica), 2 or 3 dominant electropherogram subgroups were typical. While only a minority (8/19; 42%) of the different Nocardia species contained isolates displaying unique fragment sizes that were predictive of a particular species, virtually all isolates (142/145; 98%) could be assigned to the correct species using IGS-CGE typing based on the number and size of amplified fragments. The median number of fragments for each isolate was 2 (range, 1 to 5) with only a minority (17%) having a single fragment detected. The majority (93%) of amplified fragments were between 408 and 461 bp. The technique was also non-operator dependent, highly reproducible, and quicker and less expensive than 16S sequencing. In summary, PCR-based IGS-CGE typing is relatively simple, accurate, reproducible, and cost-effective and offers a potential alternative to 16S rRNA sequencing for identifying and subtyping Nocardia isolates.

Promoting positive health behaviours--'tooth worm' phenomenon and its implications.

UNLABELLED: 'Tooth worm' is a traditional belief about the pathogen of dental caries (tooth decay). Nevertheless, in our previous study, parental 'tooth worm' belief was linked to a reduced caries risk of their children. OBJECTIVES: This study aimed to further characterize the impact of parental 'tooth worm' belief on their children's caries experience and its psychobehavioural mechanisms. BASIC RESEARCH DESIGN: analytic observational study. SETTING: Thirteen randomly selected kindergartens in Singapore. PARTICIPANTS: 1,782 preschoolers aged 3-6 years. METHODS: Each child received an oral examination and microbiological tests. Parents completed a self-administered questionnaire on their socio-demographic background, oral health knowledge/attitude and child's oral health habits. RESULTS: Multivariate analysis confirmed a reduced chance of 'high caries rate' (number of affected teeth > 2) among children whose parents held the 'tooth worm' belief (Odds Ratio = 0.41; 95% Confidence Interval = 0.19-0.89). With such perception among parents, children brushed their teeth more frequently (p = 0.042). Since no difference in oral hygiene was observed, the health benefit of the "tooth worm" perception may be acquired through the delivery of fluoride (an agent with proven anti-caries effect) during frequent toothbrushing episodes. CONCLUSIONS: This study revealed a 'tooth worm' phenomenon, indicating that parental 'tooth worm' belief is associated with early establishment of regular toothbrushing habit and reduction of dental caries in children. This phenomenon and its psychobehavioural mechanisms, enriching our understanding of oral health behaviours, have implications for effective health education.

Behavioral pathways explaining oral health disparity in children.

Policymakers' understanding of and ability to reduce health disparities are pivotal for health promotion worldwide. This study aimed to verify the behavioral pathways leading to oral health disparities. Oral examinations were conducted for 1782 randomly selected preschoolers (3-6 yrs), and 1576 (88.4%) participants were followed up after 12 months. Parents were surveyed on their knowledge (K), attitude (A), and practices (P) regarding their children's oral health homecare (infant feeding, diet, and oral hygiene) and dental attendance. Structural equation modeling substantiated the links between specific KAs and corresponding practices, while generic KA did not affect practices. KAP pathways partly explained the ethnic and socio-economic disparities in oral health. Deprivation had a direct effect (not mediated by KA) on dental attendance, but not on oral health homecare. Ethnicity directly influenced oral health homecare practices, but not dental attendance. These behavioral pathways, furthering our understanding of health disparity, may have practical implications for health promotion and policy-making.

The clinical assessment of Glidescope in orotracheal intubation under general anesthesia.

AIM: The aims of this study were to further evaluate the efficacy and safety of the GlideScope as a device to aid orotracheal intubation, and to further determine whether the GlideScope can provide a better laryngeal view in patients predicted to have a difficult laryngoscopy compared to the Macintosh laryngoscope. METHODS: Ninety-one adult patients, ASA physical status I-II, scheduled for elective plastic and intraoral surgery under general anesthesia requiring orotracheal intubation were included in this study. The laryngeal view was estimated by the classification of Cormack-Lehane and the orotracheal intubation was then performed using a GlideScope. The times required for full visualization of the glottis and for the successful tracheal intubation were recorded, respectively. Noninvasive blood pressure and heart rate were also recorded before (baseline values) and immediately after induction (postinduction values), at intubation and every minute for 5 min after intubation. In patients preoperatively predicted to have a difficult laryngoscopy, the laryngeal views obtained by a GlideScope and a Macintosh laryngoscope were also compared. RESULTS: All patients were successfully intubated using a GlideScope, of which 97% (88/91) required only one attempt. In the patients with successful intubation at one attempt, the times required for full visualization of the glottis and for successful tracheal intubation were 21+/-9 s and 38+/-11 s, respectively. The orotracheal intubation caused significant increases in blood pressure and heart rate compared to the postinduction values, and the maximal values of blood pressure and heart rate during the observation were significantly higher than the baseline values. In 27 patients preoperatively predicted to have a difficult laryngoscopy, the laryngeal views in using the GlideScope were significantly better than those in using the Macintosh laryngoscope. The incidence of minor upper airway trauma was 3.4% in all patients. CONCLUSION: The orotracheal intubation using a GlideScope had advantages of easy and simple operation, excellent laryngeal view, and the ability to provide an improved laryngeal view in the patients with a difficult laryngoscopy. The general anesthesia of clinical standard depth was able to suppress the pressor response, but not temporary tachycardiac response to the orotracheal intubation using a GlideScope.