Metagenomic characterization of indoor dust fungal associated with allergy and lung inflammation among school children.

The exposure of school children to indoor air pollutants has increased allergy and respiratory diseases. The objective of this study were to determine the toxicodynamic interaction of indoor pollutants exposure, biological and chemical with expression of adhesion molecules on eosinophil and neutrophil. A self-administered questionnaire, allergy skin test, and fractional exhaled nitric oxide (FeNO) analyser were used to collect information on health status, sensitization to allergens and respiratory inflammation, respectively among school children at age of 14 years. The sputum induced were analysed to determine the expression of CD11b, CD35, CD63 and CD66b on eosinophil and neutrophil by using flow cytometry technique. The particulate matter (PM2.5 and PM10), NO2, CO2, and formaldehyde, temperature, and relative humidity were measured inside the classrooms. The fungal DNA were extracted from settled dust collected from classrooms and evaluated using metagenomic techniques. We applied chemometric and regression in statistical analysis. A total of 1869 unique of operational taxonomic units (OTUs) of fungi were identified with dominated at genus level by Aspergillus (15.8%), Verrucoconiothyrium (5.5%), and Ganoderma (4.6%). Chemometric and regression results revealed that relative abundance of T. asahii were associated with down regulation of CD66b expressed on eosinophil, and elevation of FeNO levels in predicting asthmatic children with model accuracy of 63.6%. Meanwhile, upregulation of CD11b expressed on eosinophil were associated with relative abundance of A. clavatus and regulated by PM2.5. There were significant association of P. bandonii with upregulation of CD63 expressed on neutrophil and exposure to NO2. Our findings indicate that exposure to PM2.5, NO2, T. asahii, P.bandonii and A.clavatus are likely interrelated with upregulation of activation and degranulation markers on both eosinophil and neutrophil.

Patients' satisfaction on primary healthcare services in China and its associated factors during COVID-19 pandemic: A cross-sectional study.

Introduction: The provision of a satisfactory service by community healthcare centres in China plays an important role in the prevention and control of communicable diseases, especially during the COVID-19 pandemic. However, there is a lack of study in this field. This study aimed to determine the level of patient satisfaction with primary healthcare services in China and its associated factors during the COVID-19 pandemic. Method: This cross-sectional study was conducted at 10 primary healthcare clinics in Xi'an, China. The 18-Item Patient Satisfaction Questionnaire was used for data evaluation and SPSS version 23.0 for data analysis. Results: A total of 315 patients were recruited. The overall patient satisfaction score was 26.1±3.1. In the multiple linear regression analysis, the highly educated patients had a higher patient satisfaction score than the low-educated patients (ß=1.138, 95% confidence interval=0.135-2.141, P=0.026). Conclusion: The overall patient satisfaction level of the patients who attended community healthcare centres in Xi'an was high. The patients with a higher educational level showed a higher patient satisfaction level than did those with a lower educational level.

Determinants and predictors of mental health during and after COVID-19 lockdown among university students in Malaysia.

BACKGROUND: Young adults, particularly university students might be at greater risk of developing psychological distress, and exhibiting symptoms of anxiety and depression during the COVID-19 pandemic. The primary objective of this study was to explore and compare the determinants and predictors of mental health (anxiety and depression) during and after the COVID-19 lockdown among university students. METHODS: This was an observational, cross-sectional study with a sample size of 417 students. An online survey utilizing International Physical Activity Questionnaire-Short Form (IPAQ-SF), General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) was distributed to Universiti Tunku Abdul Rahman students via Google forms. RESULTS: During lockdown, family income [χ2 (1, n = 124) = 5.155, p = 0.023], and physical activity (PA) [χ2 (1, n = 134) = 6.366, p = 0.012] were associated with anxiety, while depression was associated with gender [χ2 (1, n = 75) = 4.655, p = 0.031]. After lockdown, family income was associated with both anxiety [χ2 (1, n = 111) = 8.089, p = 0.004], and depression [χ2 (1, n = 115) = 9.305, p = 0.002]. During lockdown, family income (OR = 1.60, p = 0.018), and PA (OR = 0.59, p = 0.011) were predictors for anxiety, while gender (OR = 0.65, p = 0.046) was a predictor for depression. After lockdown, family income was a predictor for both anxiety (OR = 1.67, p = 0.011), and depression (OR = 1.70, p = 0.009). CONCLUSION: Significant negative effects attributed to the COVID-19 lockdown, and certain factors predisposed to the worsening of mental health status in university students. Low family income, PA, and female gender were the major determinants and predictors linked to anxiety and depression.

Routine blood parameters of dengue infected children and adults. A meta-analysis.

The World Health Organization (WHO) has revised dengue case classification in 2009 to better reflect the severity of the disease. However, there was no comprehensive meta-analysis of pooled routine blood parameters according to the age or the categories of the 2009 WHO classification. This study aimed to meta-analyze the routine blood parameters of dengue infected children and adults. Electronic search was performed with eligible articles included for review. Meta-analysis was conducted for six blood parameters stratified into children, adults and all ages, which were further grouped into the three 2009 WHO case classifications (dengue without warning signs, DwoWS; dengue with warning signs, DwWS; severe dengue, SD), non-severe dengue (non-SD) and 'All' cases. A total of 55 articles were included in the meta-analysis. Fifteen studies were conducted in the children's age category, 31 studies in the adult category and nine studies in all ages. The four selected pooled blood parameters for children were white blood cell (WBC) (×103/L) with 5.11 (SD), 5.64 (DwWS), 5.52 (DwoWS) and 4.68 (Non-SD) hematocrit (HCT) (%) with 36.78 (SD), 40.70 (DwWS), 35.00 (DwoWS) and 29.78 (Non-SD) platelet (PLT) (×103/µL) with 78.66 (SD), 108.01 (DwWS), 153.47 (DwoWS) and 108.29 (non-SD); and aspartate aminotransferase (AST) (/µL) with 248.88 (SD), 170.83 (DwWS), 83.24 (DwoWS) and 102.99 (non-SD). For adult, WBC were 4.96 (SD), 6.44 (DwWS), 7.74 (DwoWS) and 3.61 (non-SD); HCT were 39.50 (SD), 39.00 (DwWS), 37.45 (DwoWS) and 41.68 (non-SD); PLT were 49.62 (SD), 96.60 (DwWS), 114.37 (DwoWS) and 71.13 (non-SD); and AST were 399.50 (SD), 141.01 (DwWS), 96.19 (DwoWS) and 118.13 (non-SD). These blood parameters could not differentiate between each dengue severity according to the WHO 2009 classification, SD, DwoWS, DwWS and non-SD, because the timing of blood drawing was not known and there was an overlapping confidence interval among the clinical classification. Hence, these pooled blood parameter values could not be used to guide clinicians in management and did not correlate with severity as in previous scientific literatures and guidelines.