Class 1 integron carrying qacEΔ1 gene confers resistance to disinfectant and antibiotics in Salmonella.

Salmonella has presented increasingly alarming rates of antimicrobial resistance believed to be a result of a high prevalence of integrons. It is speculated that disinfectant-resistant isolates are due to the expression of qacEΔ1, an efflux pump located in the 3' conserved sequence (3'CS) of class 1 integrons. With this concern, we tested the antibiotic and disinfectant resistance of 581 Salmonella strains collected from different sources, and characterized their integron structures. Gene expression and induction experiments were also performed. Results showed that Salmonella have high resistance to antimicrobials, especially to sulfonamides (SAs, 78.83 %), tetracyclines (TCs, 75.04 %) and benzalkonium chloride (BC, 87.26 %). The multi-drug resistance (MDR) frequency reached up to 63.17 %, and the prevalence of intI1 was 45.78 %. Molecular characterization of class 1 integrons exhibited nine different gene cassette arrays, of these, dfrA12-orf-aadA2 (n = 75), EstX (n = 25) and aadA2 (n = 14) were the most frequent. Importantly, 74.06 % of intI1-positive isolates were carrying qacEΔ1-sul1 genes in the 3'CS. This study also demonstrated that phenotypic resistance to both antibiotics and disinfectants was significantly correlated with the emergence of intI1 (p < 0.05). 91.37 % of qacEΔ1-sul1 positive Salmonella were found with disinfectant resistance. Additionally, expression of qacEΔ1 gene in Escherichia coli confirmed qacEΔ1 is predominantly involved in conferring disinfectant resistance. Disinfectant induction experiments further implicated qacEΔ1 in disinfectant resistance. RT-qPCR revealed a disinfectant-mediated increase in the relative expression of antibiotic-resistant genes (ARGs), aadA2 and dfrA12 on the integron, and efflux pump genes (mdtH and acrD) indicating that disinfectant could trigger co or cross-resistance. Therefore, our study confirmed that using disinfectant could provide selection pressure for strains with acquired resistance to antibiotics, providing new insights into the public health impact of Salmonella and guide continued efforts in antimicrobial stewardship and prevention of antibiotic resistance.

Association between ageing knowledge and willingness to care for older adults among nursing students in China: the mediating role of attitude towards older adults.

Little is known about the mediating effect of attitude toward older adults on the relationship between aging knowledge and willingness to care for older adults. We applied the theory of planned behavior (TPB) and the knowledge-attitude-behavior (KAB) model as theoretical frameworks to examine the mediation effect of attitude toward older adults. Data from 388 Chinese nursing students were analyzed. The Willingness to Care for Older People (WCOP) scale, Kogan's Attitude toward Older People scale (KAOP) and Facts on Aging Quiz (FAQ) were utilized to assess willingness, attitude and aging knowledge, respectively. Data were analyzed using SPSS 22. 0 with the PROCESS macro. Bootstrap methods were used to obtain the significance of mediating effects. The study showed that aging knowledge was significantly associated with willingness to care for older adults and that attitude toward older adults mediated the association. Bootstrapping method confirmed the significance of the indirect effect of aging knowledge through attitude, accounting for 18.9% of the total willingness variance. Overall, based on the TPB and the KAB theoretical framework, our data support the notion that improving aging knowledge and attitude may contribute to improve the willingness to aged care among nursing students.

Metagenome and analysis of metabolic potential of the microbial community in pit mud used for Chinese strong-flavor liquor production.

Complex microbiomes of pit mud (PM) play significant roles in imbuing flavors and qualities of Chinese strong-flavor liquor (CSFL) during fermentation. However, understanding both of the taxonomic and functional diversity of the whole microorganisms in PM still remain a major challenge. Here, PM microbiomes were investigated based on metagenomic sequencing, assembly and binning. Metagenomic data revealed that Euryarchaeota was the predominant phylum, followed by Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria. For further functional exploration, 703 metagenome-assembled genomes (MAGs), including 304 novel strains, 197 novel species, and 94 novel genera were reconstructed. Three primary groups of Firmicutes (n = 406), Euryarchaeota (n = 130) and Bacteroidetes (n = 74), particularly genus of them Syntrophomonas, Thermacetogenium and Clostridium, methanogens (Methanobacterium, Methanoculleus, and Methanosarcina), Proteiniphilum and Prevotella, contained most of metabolic potential genes. Additionally, Chloroflexi was firstly reported to have potential to be involved in the caproic acid (CA) production. Bacteroidetes could be the key phylum to synthesize terpenes, and Armatimonadetes, Firmicutes, Ignavibacteriae and Verrucomicrobia may possess the same metabolic potential as well. Overall, this study will significantly improve our understanding of the diverse PM microbiome and help guide the future exploration of microbial resources for modifying PM fermentation processes.

Urinary incontinence status and risk factors in women aged 50-70 years: a cross-sectional study in Hunan, China.

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is a common condition that may decrease women's quality of life. Risk factors remain debatable based on previous research. We aimed to determine the prevalence of UI and associated risk factors among women aged 50-70 years in Hunan, China. METHODS: A cross-sectional study was conducted from May to August 2018 using a face-to-face questionnaire. In total, 2790 women aged 50-70 years were recruited using multi-stage stratified random sampling in Hunan. Dependent variable was UI. Independent variables were demographic characteristics, health behaviours, obstetric history and comorbidity. Data were entered into EpiData and analysed using SPSS. Chi-square tests were used to assess associations between categorical variables. Statistically significant variables (p ≤ 0.05) were then analysed by logistic regression. RESULTS: The prevalence of UI was 14.84% (414/2790). Of the women with UI, 61.1% (253/414) had stress urinary incontinence (SUI), 21.5% (89/414) had urgency urinary incontinence (UUI), and 17.1% (72/414) had mixed urinary incontinence (MUI). Risk factors for UI included ageing, living in the countryside, history of gynaecological disease, hypertension and cardiovascular disease. CONCLUSIONS: UI in women aged 50-70 years in Hunan was not as prevalent as reported in previous studies. Some possible reasons are addressed; for example, the primary survey in this study was not a UI-focused survey. Women who were older, lived in the countryside and had histories of gynaecological disease, hypertension or cardiovascular disease were more likely to have UI. Health departments and medical staff should target patients with factors that potential contribute to UI development.

Abortion is associated with knee osteoarthritis among older women in China: A STROBE-compliant article.

The current studies revealed inconsistent relationship between reproductive factors and osteoarthritis. Community-based research has not been conducted in China. The study was to examine the association of reproductive factors with the prevalence of knee osteoarthritis (OA).Through a multistage stratified random sampling method, 10 streets or villages from 5 cities in Hunan province were randomly selected, a total 2746 eligible women aged 50 to 83 were recruited in this cross-sectional study. A structured questionnaire including demographic factors, socio-economic status, reproductive factors, and knee OA was used. According to the criteria of American College of Rheumatology, clinical knee OA was assessed by doctors in community or village health clinics for knee pain, age, morning stiffness, crepitus on active motion or for knee pain, morning stiffness, crepitus on active motion, and tenderness of the bony navigation of the joint. Self-reported age of menarche, parity, abortion history, and menopausal status were collected.The prevalence of knee OA was 13.44%. Abortion is associated with knee OA (odds ratio [OR] = 1.271, 95% confidence interval [CI] = 1.007, 1.606), but age at menarche, parity, and menopausal status were not the factors. Furthermore, age (OR = 1.040, 95% CI = 1.020, 1.060), weight (OR = 1.019, 95% CI = 1.004, 1.035), higher education level (OR = 1.530, 95% CI = 1.121, 2.088), higher monthly household income (OR = .583, 95% CI = 0.441, 0.770 for 3000-4999 ¥ and OR = 0.599, 95% CI = 0.431, 0.833 for 5000 ¥ or more), and chronic gastritis (OR = 3.364, 95% CI = 2.548, 4.442) were associated with knee OA.Abortion may increase the risk of knee OA. Special attention should be paid to women with a history of abortion, and women who are planning to abort should be informed of the risk of knee OA later in life. The relationship between abortion and knee OA should be interpreted with caution and further confirmed.

Reproductive health status and related knowledge among women aged 20-39 years in rural China: a cross-sectional study.

BACKGROUND: Reproductive health is the core science of human life and is critical to the healthy and sustainable development of human society. Since 1980, China has enforced a "one child" policy. With the implementation of the Universal Two-Child Policy in 2016, every couple is allowed to have two children instead of one, which will lead to more pregnancies, births, and advanced maternal age. Thus, women aged 20-39 years, at the peak of sexual activity and fertility, will face more reproductive health problems related to pregnancies and births. This study aimed to investigate the current reproductive health status, knowledge, and factors associated with reproductive health knowledge among women aged 20-39 years in rural China. METHODS: A cross-sectional study was conducted in five villages of five cities in China. The data were collected using pre-tested and structured questionnaires through face-to-face interviews. The data were entered into Epidata version 3.0, and analyzed using SPSS version 18.0. A descriptive summary of the data and logistic regression were used to identify associated factors. RESULTS: One-third of the participants reported that they had suffered from gynecopathy, and 38.89% of participants with gynecopathy-related discomfort did not seek medical treatment. Condoms and intrauterine devices were the main contraceptive measures used, and 28.70% of women had a history of induced abortion. Over half of the respondents (53.00%) were classified as having a low reproductive health knowledge score. Factors associated with lower knowledge levels were lower education, no history of gynecopathy, and lack of acquiring knowledge from medical staff, WeChat/micro-blog, or the internet. CONCLUSION: A poor reproductive health situation and low level of health knowledge were found among women aged 20-39 years in rural China. More specific interventions promoting reproductive health and targeting rural women aged 20-39 years are needed.

College students responding to the Chinese version of Cardiff fertility knowledge scale show deficiencies in their awareness: a cross-sectional survey in Hunan, China.

BACKGROUND: Fertility knowledge is vital to the fertility health of young people and greatly impacts their fertility choices. Delayed childbearing has been increasing in high-income countries, accompanied by the risk of involuntary childlessness or having fewer children than desired. The aim of this study was to investigate knowledge about fertility issues, the related influencing factors, the method of acquiring fertility knowledge, and the relationship between fertility knowledge and fertility intentions among college students. METHODS: An online cross-sectional survey of Chinese college students was conducted in Hunan Province from March to April 2018. A total of 867 college students from three comprehensive universities responded to a poster invitation utilizing the Chinese version of the Cardiff Fertility Knowledge Scale (CFKS-C). Data were explored and analysed by SPSS (version 22.0) software. Descriptive statistics, chi-squared tests, T-tests, and Pearson's correlations were used for the measurements. RESULTS: The average percent-correct score on the CFKS-C was 49.9% (SD = 20.8), with greater knowledge significantly related to living in a city district, being not single status, majoring in medicine, being in year 4 or above of study, and intention to have children (all p<0.05). A total of 81.9% of the participants reported that they would like to have children, the average score of the importance of childbearing was 6.3 (SD = 2.7), and the female score was lower than the male score (p = 0.001). A small positive relationship was observed between the CFKS-C and the importance of childbearing (r = 0.074, p = 0.035). Respondents indicated that they gained most of their knowledge from the media and internet (41.4%) and from schools (38.2%). CONCLUSION: Yong people in college have a modest level of fertility knowledge, a relatively low intention to have a child, and deficiencies in fertility health education. There is a need to improve the accessibility of fertility health services by developing a scientific and reliable fertility health promotion strategy.

Acceptability of vaccination against human papillomavirus among women aged 20 to 45 in rural Hunan Province, China: A cross-sectional study.

OBJECTIVE: This study aimed to examine the intentions of and barriers to vaccination against human papillomavirus (HPV) among women aged 20 to 45 in rural areas, and to determine the popular sources to getting information about HPV vaccine and vaccination. METHODS: This cross-sectional study was conducted in 2018 with a sample of women aged 20 to 45 from rural areas of Hunan Province in China. Anonymous self-administered questionnaires were used to collect sociodemographic information and characteristics related to reproductive health of participants, and intentions of and barriers to HPV vaccination. All statistical analysis methods were performed with SPSS 18.0. RESULTS: A total of 2101 women participated in the study, with 58.55% intended to vaccinate against HPV. Increased intention of HPV vaccination was associated with higher age (adjusted odds ratio [AOR] = 1.35 and 1.50, respectively) and education level (AOR = 1.13 and 1.47, respectively). Women who have heard of HPV vaccine (AOR = 2.67, 95% confidence interval [CI]: 1.20-5.98) and have been aware of that cervical cancer could be prevented (AOR = 2.01, 95%CI: 1.44-2.82) were more willing to vaccinate. Having never heard of HPV vaccine and worry about efficacy and safety of vaccines were the most commonly cited reasons to refuse vaccination. The preferred source to get the knowledge was medical personnel (58.45%), followed by WeChat or Microblog, TV programs, and Internet. CONCLUSION: We found the intention of HPV vaccination among women aged 20 to 45 in rural China is low. Findings highlighted the importance of knowledge and trust in HPV vaccine, and suggested strengthening educational interventions on HPV vaccine and vaccination through multiple sources, including HPV vaccine coverage in health insurance to increase access.

Level of depression, anxiety and stress in patients with intrauterine adhesions in Hunan Province, China: A cross-sectional study.

BACKGROUND: The incidence of intrauterine adhesions has been increasing in recent years, seriously affecting women's health. This study aimed to investigate the psychological status and identify risk factors associated with high psychological distress in patients with intrauterine adhesions. METHODS: A cross-sectional study was conducted in Hunan Province, China. A total of 258 patients who presented with intrauterine adhesions between February and May 2018 were included. Data were collected by a questionnaire packet that included the Depression Anxiety Stress Scale, the Medical Coping Mode Questionnaire, and demographic and clinical information. Descriptive statistics, t-tests, one-way ANOVA, Pearson's correlations and multiple linear stepwise regression were employed in this study. RESULTS: Among 258 participants, the detection rates of mild depression and moderate to extremely severe depression were 10.1% and 10.5%, respectively; the detection rates of mild anxiety and moderate to extremely severe anxiety were 11.2% and 20.2%, respectively; the detection rates of mild stress and moderate to extremely severe stress were 9.3% and 10.2%, respectively. Avoidance and resignation coping were positively correlated with the overall scores of general distress which represents the total scores of the Depression Anxiety Stress Scale (r = 0.171, 0.475, P < 0.01). Multiple linear stepwise regression results showed that husband-wife relationships and avoidance and resignation coping strategies were the main factors predicting general distress levels. CONCLUSIONS: Patients with intrauterine adhesions have psychological distress in a certain extent. Target interventions should be taken to improve the mental health level of patients.

Preparation and characterization of magnetic molecular imprinted polymers with ionic liquid for the extraction of carbaryl in food.

Magnetic molecular imprinted polymers with ionic liquid used as an auxiliary solvent (IL@MMIPs) for the recognition of the methyl carbamate pesticide carbaryl (CBR) in foodstuff have been synthesized. The properties and application of IL@MMIPs were determined. The kinetic and isotherm adsorption processes were found to follow the pseudo-second-order and the Scatchard models, respectively. The selective experiment showed that the IL@MMIPs exhibited good selectivity to CBR compared to magnetic nonimprinted polymers with IL (IL@MNIPs). By using the IL@MMIPs as an adsorbent for the enrichment of CBR in food samples, the limit of detection (LOD, S/N = 3) and the limit of quantitation (LOQ, S/N = 10) of this method were 3 µg kg-1 and 10 µg kg-1, respectively. Compared with the traditional method, the IL@MMIP method has better recoveries (83.23-99.83%), precision (1.12-2.09%), and stabilization (intraday, 1.08-2.81%; interday, 2.26-3.30%). IL@MMIPs are an ideal adsorbent that could be applied to conveniently detect CBR in complex food, and the proposed method can be considered as a selective and sensitive alternative to traditional methods with affordable cost, avoiding the complex pretreatment procedure. Graphical abstract .

Access to reproductive health services among the female floating population of childbearing age: a cross-sectional study in Changsha, China.

BACKGROUND: The floating population serves an important role in economic and social development. However, little is known about the floating population's reproductive health (RH) services, especially in low- and middle-income countries. This study aimed to assess the use of reproductive health services in the female floating population in China, which is a country with the largest floating population in the world. METHODS: A cross-sectional survey was conducted for more than 3 months. Six hundred twenty females of childbearing age in a floating population were recruited into the study by using random sampling, with these individuals being recruited from six community centres in Changsha, China. The use of reproductive health services was assessed by utilizing a self-designed questionnaire. RESULTS: A total of 555 participants returned the completed questionnaires (effective response rate of 89.5%), including 405 married women and 150 unmarried women. The utilization of RH services was poor in individuals who could access RH policies (39.3%), RH education (36.4%), RH counselling (27.4%), gratis contraceptives (36.0%), and free RH examinations (38.9%), and married women utilized these services at higher rates than unmarried women (P < 0.01), although 63.3% of the unmarried women had sexual lifestyles. The marital status was significantly associated with receiving RH education, RH counselling, gratis contraceptives, and free RH examinations. Age was significantly associated with the use of RH education and free RH examinations. The average personal monthly income had a significantly beneficial effect on the use of free RH examinations. Obstetrics and gynaecological disease prevention (67.2%) were the greatest needs of the RH services, and the use of the Internet was the best way to obtain these services. Most of the individuals (77.3%) hoped to receive gynaecological health screenings that were provided by obstetrics and gynaecology hospitals. CONCLUSIONS: The female floating population exhibited poor awareness of RH and rarely used RH services, especially in unmarried women. The results suggest that educational interventions for the female floating population, as well as policy and resource developments should meet the demands for RH services, which are urgently needed in China.

Preparation and application of magnetic molecular imprinted polymers for extraction of cephalexin from pork and milk samples.

A highly selective and effective method was successfully developed using magnetic molecular imprinted polymers (MMIPs) as solid-phase extraction (SPE) coupled with high performance liquid chromatography-ultraviolet detector (HPLC-UV) to rapidly determine cephalexin (CFX) in complex animal-derived food. MMIPs were creatively synthesized via suspension polymerization using Fe3O4 magnetic nanoparticles as supporter, CFX as template, acrylamide (AM) as functional monomer, and ethylene glycol dimethacrylate (EGDMA) as cross-linker. The MMIPs were characterized using X-ray diffraction (XRD), Fourier transform infrared spectrometry (FT-IR), scanning electron microscopy (SEM), and vibrating sample magnetometry (VSM). The binding process fitted well with pseudo-second-order model with good selectivity. Scatchard plot analysis suggested that MMIPs have two types of binding sites with the Qmax of 24.18 mg g-1 and 40.25 mg g-1, respectively. And Langmuir model proved that the recognition sites were uniformly distributed in a monolayer on the surface of MMIPs. The methodological assessment showed good applicability of MMIPs with excellent recovery (85.5%-94.0%), precision (1.2%-2.4%), and stability (intra-day 1.3%-3.6%; inter-day 2.6%-4.3%) in determining CFX content. In addition, the linearity of the calibration curve was good in the range of 0.02-5.00 mg L-1, with a sensitive detection limit of 5.00 µg kg-1. The results above suggest that the obtained MMIPs exert good performance for separation of CFX in animal-derived food, and the proposed method is suitable for the reliable determination of CFX in complex samples.