Quantifying Disparities in COVID-19 Vaccination Rates by Rural and Urban Areas: Cross-Sectional Observational Study.

BACKGROUND: Vaccination plays an important role in preventing COVID-19 infection and reducing the severity of the disease. There are usually differences in vaccination rates between urban and rural areas. Measuring these differences can aid in developing more coordinated and sustainable solutions. This information also serves as a reference for the prevention and control of emerging infectious diseases in the future. OBJECTIVE: This study aims to assess the current coverage rate and influencing factors of COVID-19 (second booster) vaccination among Chinese residents, as well as the disparities between urban and rural areas in China. METHODS: This cross-sectional study used a stratified random sampling approach to select representative samples from 11 communities and 10 villages in eastern (Changzhou), central (Zhengzhou), western (Xining), and northeast (Mudanjiang) Mainland China from February 1 to February 18, 2023. The questionnaires were developed by experienced epidemiologists and contained the following: sociodemographic information, health conditions, vaccine-related information, information related to the Protective Motivation Theory (PMT), and the level of trust in the health care system. Vaccination rates among the participants were evaluated based on self-reported information provided. Binary logistic regression models were performed to explore influencing factors of vaccination among urban and rural participants. Urban-rural disparities in the vaccination rate were assessed using propensity score matching (PSM). RESULTS: A total of 5780 participants were included, with 53.04% (3066/5780) being female. The vaccination rate was 12.18% (704/5780; 95% CI 11.34-13.02) in the total sample, 13.76% (341/2478; 95% CI 12.40-15.12) among the rural participants, and 10.99% (363/3302; 95% CI 9.93-12.06) among the urban participants. For rural participants, self-reported health condition, self-efficacy, educational level, vaccine knowledge, susceptibility, benefits, and trust in the health care system were independent factors associated with vaccination (all P＜.05). For urban participants, chronic conditions, COVID-19 infection, subjective community level, vaccine knowledge, self-efficacy, and trust in the health care system were independent factors associated with vaccination (all P＜.05). PSM analysis uncovered a 3.42% difference in vaccination rates between urban and rural participants. CONCLUSIONS: The fourth COVID-19 vaccination coverage rate (second booster) among the Chinese population was extremely low, significantly lower than the previous vaccine coverage rate. Given that COVID-19 infection is still prevalent at low levels, efforts should focus on enhancing self-efficacy to expand the vaccine coverage rate among the Chinese population. For rural residents, building awareness of the vaccine's benefits and improving their overall health status should be prioritized. In urban areas, a larger proportion of people with COVID-19 and patients with chronic illness should be vaccinated.

Comprehensive effects of lifestyle reform, adherence, and related factors on hypertension control: A review.

Despite the effectiveness of currently available antihypertensive medications, there is still a need for new treatment strategies that are more effective in certain groups of hypertensive and for additional resources to combat hypertension. However, medication non-adherence was previously recognized as a major problem in the treatment of hypertension. The mechanisms behind the positive impacts of lifestyle changes might occur in different ways. In comparison with other studies, the efficacy and effectiveness of lifestyle modifications and antihypertensive pharmaceutical treatment for the prevention and control of hypertension and concomitant cardiovascular disease have been demonstrated in randomized controlled trials. However, in this review, the attitudinal lifestyle modifications and barriers to blood pressure control were elaborated on. An effective method for reducing blood pressure (BP) and preventing cardiovascular events with antihypertensive medications has been outlined. Maintaining healthy lifestyle factors (body mass index, diet, smoking, alcohol consumption, sodium excretion, and sedentary behavior) could lower systolic blood pressure BP by 3.5 mm Hg and reduce the risk of cardiovascular disease (CVD) by about 30%, regardless of genetic susceptibility to hypertension. Conducting a lifestyle intervention using health education could improve lifestyle factors, such as reducing salt, sodium, and fat intake, changing eating habits to include more fruits and vegetables, not smoking, consuming less alcohol, exercising regularly, maintaining healthy body weight, and minimizing stressful conditions. Each behavior could affect BP by modulating visceral fat accumulation, insulin resistance, the renin-angiotensin-aldosterone system, vascular endothelial function, oxidative stress, inflammation, and autonomic function. Evidence of the joint effect of antihypertensive medications and lifestyle reforms suggests a pathway to reduce hypertension.

How urban versus rural residency relates to COVID-19 vaccine hesitancy: A large-scale national Chinese study.

RATIONALE: Although urban-rural residency has been shown to influence individual COVID-19 vaccine hesitancy, the differences between urban and rural China have yet to be uncovered. OBJECTIVE: This study aims to assess the current prevalence and factors associated with COVID-19 vaccine hesitancy in urban and rural areas and explore whether the rural versus urban residency is associated with COVID-19 vaccine hesitancy. METHODS: A national, cross-sectional, online survey among Chinese urban and rural adults (≥18 years old) was conducted from 6th to August 9, 2021. A questionnaire was used to collect data on sociodemographic factors, perceptions of the COVID-19 pandemic and vaccination status. A multivariable logistic regression model was used to identify the factors that influence COVID-19 vaccine hesitancy. Propensity score matching (PSM) analysis was performed to explore the association between urban versus rural residency and COVID-19 vaccine hesitancy. RESULTS: In total, 29,925 participants (80.56% urban participants) were recruited. Urban participants had a higher COVID-19 vaccine hesitancy than their rural counterparts (9.39% vs. 4.26%). After adjusting for potential confounders, we found that COVID-19 vaccine hesitancy among females was lower than that in males in both urban (aOR = 0.78, 95% CI [0.69-0.88]) and rural areas (aOR = 0.54, 95% CI [0.39-0.75]). The lack of trust towards vaccine producers was found to be associated with vaccine hesitancy among the urban participants (aOR = 2.76, 95% CI [2.22-3.43]). The rural floating population had a lower COVID-19 vaccine hesitancy than the rural permanent residents (aOR = 0.58, 95% CI [0.42-0.80]). PSM analysis revealed a 2.38% difference in COVID-19 vaccine hesitancy between urban and rural participants. CONCLUSIONS: Urban participants were more hesitant to receive the COVID-19 vaccine than rural participants. Priority should be placed on boosting confidence in the healthcare system to reduce COVID-19 vaccine hesitancy among urban residents. Furthermore, we advocate for extra incentives and vaccination education for rural permanent residents.

Effects of iron-catalyzed oxidation and methemoglobin oxidation systems on endogenous enzyme activity and myofibrillar protein degradation in yak meat.

In this study, the effects of different oxidation intensities on the degradation of myofibrillar protein by endogenous enzymes in iron-catalyzed oxidizing (IOS) and metmyoglobin oxidizing system (MOS) were compared. The results showed that carbonyl content and endogenous enzyme activities (caspase-3, caspase-6 and calpain-1) increased significantly and the total sulfhydryl content decreased significantly with H2O2 concentration in both oxidation systems. Meanwhile, the rate of carbonyl formation and the inhibition of endogenous enzymes activities of IOS were significantly lower than MOS for the same oxidation intensity. In addition, IOS and MOS mainly produced myosin light chains degradation products of 20-25 kDa and 20-17 kDa. At the same oxidation intensity, MOS of myofibrillar protein significantly enhanced the degradation of troponin-T and desmin by caspase-3/-6 compared with IOS, while inhibiting the degradation of troponin-T by calpain-1. In conclusion, MOS inhibited endogenous enzyme degradation in vitro more than IOS during post-slaughter maturation of yak meat.

Storage and Packaging Effects on the Protein Oxidative Stability, Functional and Digestion Characteristics of Yak Rumen Smooth Muscle.

The objective of this study was to investigate the effects on protein oxidative stability, functional and digestion characteristics of yak rumen smooth muscle with overwrap packaging using oxygen-permeable film (OWP) and vacuum packaging bag (VP) during storage (0, 7, 14, 28, 42, 56, 84, 168 and 364 days) at -18 °C. The results show that yak rumen smooth muscle was oxidized with frozen storage through the formation of protein carbonyls and disulfide bonds, the loss of total sulfhydryl. The emulsifying activity of yak rumen smooth muscle protein (SMP) under VP began to perform a higher level than that under OWP after 14 days, and the foaming capacity under VP showed the highest level on the 28th day of 111.23%. The turbidity under VP reached the minimum 0.356 on the 28th day as well, followed by significantly increasing on the 56th day compared with OWP. The digestibility of yak rumen SMP under both OWP and VP reached the maximum on the 28th day of frozen storage. Moreover, yak rumen under VP at 28-56 days of frozen storage had good functional properties and high digestibility of SMP, which showed better edible value.

Effect of Salt (Sodium Chloride) Replacement With Potassium Chloride, High Pressure Processing, and Cold Storage at 4°C on Beef Sausage Volatile Compounds.

This study aimed to investigate the partial substitution of 0, 25 and 50% sodium chloride (NaCl) by potassium chloride (KCl) coupled with high-pressure processing (HPP) effects on volatile compounds and lipid oxidation of beef sausage at five (0, 3, 7, 14, and 21) different cold storage days (4°C). The odor activity values (OAV) of the various compounds were visualized by heat map analysis. Thiobarbituric acid reactive substances (TBARS) of the samples treated with 100% NaCl and HPP increased by an average of 0.52 ± 0.01 mg MDA/kg compared with the control (100% NaCl-no HPP) across the 21 storage days. In addition, 50% NaCl substitution with KCl in combinations with HPP treatments increased TBARS across the 21 storage days by an average of 0.40 ± 0.02 mg MDA/kg compared with no HPP treatment. However, on day 3, there was a sharp decrease in TBARS by an average of 0.10 ± 0.01 mg MDA/kg compared with days 0, 7, 14, and 21 in all treatments. At the end of 21 days of storage, a total of 227 volatile compounds were identified and quantified in the beef sausage, including 43 aldehydes, 46 phenols, 8 ketones, 30 alcohols, 14 acids, 12 esters, 27 terpenes, and 47 alkanes. However, no ketone compounds were detected on days 7, 14 and 21; esters on day 14 and acids on days 14 and 21 in the samples treated with or without HPP across the salts levels. However, high OAVs (OAV > 1) were obtained after partial substitution of NaCl with KCl at 25 and 50% with HPP treatment compared to the samples not treated with HPP. The aroma perceived in the beef sausage was due to compounds with the highest OAVs such as; pentadecanal, benzyl carbazate, anethole, myristicin, o-cresol, phenylacetaldehyde and (E)-methyl isoeugenol, pentadecanal, hexanoic acid, octanoic acid, eugenol, trans-2-nonenal, trans-2-octenal, trans-2-decenal, 2-butyl-1-octanol, 2,3-butanedione, ethyl hexanoate, ethyl octanoate, (-)-4-terpineol which had an OAV > 1 as compared to the other compounds with an OAV < 1. In conclusion, 25 and 50% NaCl partial replacement with KCl coupled with HPP technique can be considered in producing low-NaCl beef sausage in order to improve the flavor and decrease lipid oxidation during cold storage.