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1.
Jpn J Clin Oncol ; 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38711392

RESUMEN

BACKGROUND: The incidence and risk factors of peripherally inserted central catheter-related thrombosis in patients with breast cancer have not been fully elucidated. METHOD: Meta-analysis was performed by searching all studies on the incidence of peripherally inserted central catheter-associated thrombosis and risk factors for its formation in breast cancer patients from the establishment of the database to May 2023, including PubMed, Embase, Web of Science, China Knowledge Network, China Biomedical Literature Service System (SinoMed) and Wanfang databases. Then the incidence of peripherally inserted central catheter-related thrombosis and risk factors for its formation were analyzed in breast cancer patients. RESULTS: A total of 15 articles were included, involving 8635 patients. The total incidence of peripherally inserted central catheter-related thrombosis in breast cancer patients was 7.0% (95% confidence interval: 4.0-13.0%) and 12.9% (95% confidence interval: 7.0-22.5%) after correction. Thirty-two risk factors were included, and eight risk factors could be combined. Among these risk factors, there were statistically significant differences (P < 0.05) in body mass index ≥ 25 (odds ratio = 6.319, 95% confidence interval: 2.733-14.613; P < 0.001), D-dimer >500 ng/ml (odds ratio = 1.436, 95% confidence interval: 1.113-1.854; P = 0.005), increased fibrinogen (odds ratio = 4.733, 95% confidence interval: 1.562-14.346; P = 0.006), elevated platelet count (odds ratio = 4.134, 95% confidence interval: 2.694-6.346; P < 0.001) and catheter malposition (odds ratio = 8.475, 95% confidence interval: 2.761-26.011; P < 0.001). CONCLUSION: The incidence rate of peripherally inserted central catheter-related thrombosis in breast cancer patients was 7.0% (95% confidence interval: 4.0-13.0%). Body mass index ≥ 25, D-dimer >500 ng/ml, elevated fibrinogen, elevated platelet count and catheter malposition were risk factors for peripherally inserted central catheter-related thrombosis in breast cancer patients.

2.
BMC Infect Dis ; 24(1): 24, 2024 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-38166829

RESUMEN

BACKGROUND: The first local outbreak of Delta Variant B.1.617.2 COVID-19 of China occurred in Guangzhou city, south China, in May 2021. This study analyzed the transmission chains and local cluster characteristics of this outbreak, intended to provide information support for the development and adjustment of local prevention and control strategies. METHODS: The transmission chains and local cluster characteristics of 161 local cases in the outbreak were described and analyzed. Incubation period, serial interval and generation time were calculated using the exact time of exposure and symptom onset date of the cases. The daily number of reported cases and the estimated generation time were used to estimate the effective reproduction number (Rt). RESULTS: We identified 7 superspreading events who had more than 5 next generation cases and their infected cases infected 70.81%(114/161) of all the cases transmission. Dining and family exposure were the main transmission routes in the outbreak, with 29.19% exposed through dining and 32.30% exposed through family places. Through further analysis of the outbreak, the estimated mean incubation period was 4.22 (95%CI: 3.66-4.94) days, the estimated mean generation time was 2.60 (95%CI: 1.96-3.11) days, and the estimated Rt was 3.29 (95%CI: 2.25-5.07). CONCLUSIONS: Classification and dynamically adjusted prevention and control measures had been carried out according to analysis of transmission chains and epidemical risk levels, including promoting nucleic acid screening at different regions and different risk levels, dividing closed-off area, controlled area according to the risk of infection, raising the requirements of leaving Guangzhou. By the above control measures, Guangzhou effectively control the outbreak within 28 days without implementing a large-scale lockdown policy.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , SARS-CoV-2/genética , Control de Enfermedades Transmisibles , Brotes de Enfermedades , China/epidemiología
3.
Patient Prefer Adherence ; 18: 53-67, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38223440

RESUMEN

Purpose: The purpose of this study was to examine how fatalism acts as a mediator in the correlation between family resilience and self-management among patients with chronic wounds in China. Participants and Methods: This study used a cross-sectional research design. A total of 269 adult patients (18-94 years old) with chronic wounds residing in Wuxi, China participated in this study. Participants completed the Chinese version of the Walsh Family Resilience Questionnaire, 16-item Chinese version of the Fatalism Scale, and Self-Management Scale of Chronic Wound Patients. We conducted correlation and mediation analyses using SPSS 27.0 and PROCESS 4.0. Results: The results indicated family resilience was a significant positive predictor of self-management (ß = 0.7101, p < 0.0001), and the pathway between family resilience and self-management was partially mediated by fatalism (Effect = 0.1432, 95% confidence interval [0.0625, 0.2341]). Conclusion: The results indicated that incorporating spiritual interventions into future person-centered self-management programs could align with the motivation of patients with chronic wounds and their families, and reduce the negative impact of fatalism on health outcomes.

5.
Environ Health Perspect ; 131(8): 87010, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37585351

RESUMEN

BACKGROUND: Greenness, referring to a measurement of the density of vegetated land (e.g., gardens, parks, grasslands), has been linked with many human health outcomes. However, the evidence on greenness exposure and human microbiota remains limited, inconclusive, drawn from specific regions, and based on only modest sample size. OBJECTIVES: We aimed to study the association between greenness exposure and human microbial diversity and composition in a large sample across 34 countries and regions. METHODS: We explored associations between residential greenness and human microbial alpha-diversity, composition, and genus abundance using data from 34 countries. Greenness exposure was assessed using the normalized difference vegetation index and the enhanced vegetation index mean values in the month before sampling. We used linear regression models to estimate the association between greenness and microbial alpha-diversity and tested the effect modification of age, sex, climate zone, and pet ownership of participants. Differences in microbial composition were tested by permutational multivariate analysis of variance based on Bray-Curtis distance and differential taxa were detected using the DESeq2 R package between two greenness exposure groups split by median values of greenness. RESULTS: We found that higher greenness was significantly associated with greater richness levels in the palm and gut microbiota but decreased evenness in the gut microbiota. Pet ownership and climate zone modified some associations between greenness and alpha-diversity. Palm and gut microbial composition at the genus level also varied by greenness. Higher abundances of the genera Lactobacillus and Bifidobacterium, and lower abundances of the genera Anaerotruncus and Streptococcus, were observed in people with higher greenness levels. DISCUSSION: These findings suggest that residential greenness was associated with microbial richness and composition in the human skin and gut samples, collected across different geographic contexts. Future studies may validate the observed associations and determine whether they correspond to improvements in human health. https://doi.org/10.1289/EHP12186.


Asunto(s)
Microbioma Gastrointestinal , Humanos , Clima , Características de la Residencia , China
7.
Innovation (Camb) ; 4(4): 100450, 2023 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-37485083

RESUMEN

Hyperglycemia is a key risk factor for death and disability worldwide. To better inform prevention strategies, we aimed to delineate and predict the temporal, spatial, and demographic patterns in mean fasting plasma glucose (FPG) levels and their related disease burden globally. Based on the Global Burden of Disease Study 2019, we estimated the distributions of mean FPG levels and high FPG-related disease burden by age, sex, year, socioeconomic status (SES), and geographical region from 1990 to 2050. We also investigated the possible associations of demographic, behavioral, dietary, metabolic, and environmental factors with FPG levels and high FPG-related disease burden. In 2019, the global mean FPG level was 5.40 mmol/L (95% uncertainty interval [UI]: 4.86-6.00), and high FPG contributed to 83.0 deaths (95% UI, 64.5-107.1) and 2,104.3 DALYs (95% UI: 1,740.7-2,520.7) per 100,000 people. For both historical (1990-2019) and future (2020-2050) periods, the mean FPG levels and the high FPG-related disease burden increased globally, with greater increases among the middle-aged and elderly, and people in low-to-middle SES countries, relative to their counterparts. Aging, unhealthy lifestyles, elevated body mass index, and lower air temperatures were potential risk factors for high FPG levels and the high FPG-related disease burden. This study demonstrates that high FPG continues to contribute to the global disease burden and is expected to do so for at least the next 30 years. Older people and those living in low-to-middle SES countries should receive more attention in glycemic management health interventions. In addition, effective interventions that target identified risk factors should be adopted to handle the increasingly large disease burden of high FPG.

8.
Sci Total Environ ; 887: 164023, 2023 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-37172852

RESUMEN

BACKGROUND: Effects of green space on human health have been well-documented in western, high-income countries. Evidence for similar effects in China is limited. Moreover, the underlying mechanisms linking green space and mortality are yet to be established. We therefore conducted a nation-wide study to assess the association between green space and mortality in China using a difference-in-difference approach, which applied a causal framework and well controlled unmeasured confounding. In addition, we explored whether air pollution and air temperature could mediate the association. METHODS: In this analysis, we collected data on all-cause mortality and sociodemographic characteristics for each county in China from the 2000 and 2010 censuses and the 2020 Statistical Yearbook. Green space exposure was assessed using county-level normalized difference vegetation index (NDVI) and the percentage of green space (forest, grasslands, shrub land and wetland). We applied a difference-in-differences approach to evaluate the association between green space and mortality. We also performed mediation analysis (by air pollution and air temperature). RESULTS: Our sample consisted of 2726 counties in 2000 and 2010 as well as 1432 counties in 2019. In the 2000 versus 2019 comparison, a 0.1 unit increase in NDVI was associated with a 2.4 % reduction in mortality [95 % confidence interval (CI) 0.4-4.3 %], and a 10 % increase in percentage of green space was associated with a 4.7 % reduction (95 % CI 0-9.2 %) in mortality. PM2.5 and air temperature mediated 0.3 % to 12.3 % of the associations. CONCLUSIONS: Living in greener counties may be associated with lower risk of mortality in China. These findings could indicate the potential of a population-level intervention to reduce mortality in China, which has important public health implications at the county level.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Humanos , Parques Recreativos , Contaminación del Aire/análisis , China , Renta , Bosques , Material Particulado/análisis , Exposición a Riesgos Ambientales/análisis , Contaminantes Atmosféricos/análisis
9.
Sci Total Environ ; 871: 161975, 2023 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-36740066

RESUMEN

BACKGROUND: Maternal exposure to fine particular matter (PM2.5) during pregnancy, including ambient and household PM2.5, has been linked with increased risk of preterm birth (PTB). However, the global spatio-temporal distribution of PTB-related deaths and disability-adjusted life years (DALYs) attributable to PM2.5 is not well documented. We estimated the global, regional, and national patterns and trends of PTB burden attributable to both ambient and household PM2.5 from 1990 to 2019. METHODS: Based on the Global Burden of Disease Study (GBD) 2019 database, we obtained the numbers of deaths and DALYs as well as age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of PTB attributable to total, ambient, and household PM2.5 by socio-demographic index (SDI) and sex during 1990-2019. The average annual percentage changes (AAPCs) were calculated to assess the temporal trends of attributable burdens. RESULTS: In 2019, 126,752 deaths and 11.3 million DALYs related to PTB worldwide (two-thirds in Western Sub-Saharan Africa and South Asia) could be caused by excess PM2.5 above the theoretical minimum-risk exposure level (TMREL), of which 39 % and 61 % were attributable to ambient PM2.5 and household PM2.5, respectively. From 1990 to 2019, the global ASMR due to ambient PM2.5 increased slightly by 7.08 % whereas that due to household PM2.5 decreased substantially by 58.81 %, although the latter still dominated the attributable PTB burden, especially in low and low-middle SDI regions. Similar results were also observed for ASDRs. In addition, PTB burden due to PM2.5 was higher in male infants and in lower SDI regions. CONCLUSIONS: Globally in 2019, PM2.5 remains a great concern on the PTB burden, especially in Western Sub-Saharan Africa and South Asia. Between 1990 and 2019, age-standardized burden of PTB due to ambient PM2.5 increased globally, while that due to household PM2.5 decreased markedly but still dominated in low and low-middle SDI regions.


Asunto(s)
Nacimiento Prematuro , Lactante , Femenino , Humanos , Masculino , Recién Nacido , Años de Vida Ajustados por Calidad de Vida , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/inducido químicamente , Carga Global de Enfermedades , Material Particulado/toxicidad , Sur de Asia
10.
J Hum Hypertens ; 37(1): 74-79, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35046496

RESUMEN

Suboptimal medication adherence is a major barrier to hypertension control in Kenya, especially among informal urban settlement areas (sometimes referred to as "slums"). The few studies that have specifically explored medication adherence among this population have received discordant results, implying that additional factors which influence medication adherence merit further investigation. This study explores the relationship between family support and medication adherence among people with hypertension in informal settlements in Nairobi, Kenya. We conducted a quantitative survey followed up by semi-structured qualitative interviews. The sampling frame comprised two health facilities in informal settlement areas of the Korogocho neighborhood and participants were recruited via convenience sampling. We performed multiple logistic regressions for quantitative data and thematic analysis for qualitative data. A total of 93 people participated in the survey (mean age: 57 ± 14.7, 66% female). Most participants reported high family support (82%, n = 76) and suboptimal medication adherence (43% by the Morisky Scale; 76% by the Hill-Bone Scale), with no significant associations between family support and medication adherence. During interviews, many participants reported they lacked health knowledge and education. We suggest that the lack of health knowledge among this population may have contributed to a failure for family support to meaningfully translate into improvements in medication adherence. Our results underscore the need for further research to improve hypertension control among this uniquely disadvantaged population, especially with respect to the possible mediating influence of health education on family support and medication adherence.


Asunto(s)
Apoyo Familiar , Hipertensión , Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Masculino , Kenia/epidemiología , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Áreas de Pobreza , Cumplimiento de la Medicación
11.
Environ Pollut ; 317: 120746, 2023 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-36457224

RESUMEN

Little evidence exists concerning the associations of greenspace with childhood lipid profiles and dyslipidemias, especially in developing countries and regions. We aimed to investigate the associations of greenspace surrounding schools with lipid levels and dyslipidemia prevalence among Chinese children and teenagers. We obtained baseline information and health data of 10,408 children and teenagers (aged 6-18 years) who studied from 94 schools in China. We measured levels of four blood lipids: triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Dyslipidemias were defined using standard recommendations. Greenness surrounding schools were assessed using two satellite-based greenness indices, Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI) at 300-, 500-, and 1000-m circular buffers based on each school's latitude and longitude. We used random forest model combined with meteorological and remote sensing data to estimate air pollution levels surrounding each school. We used generalized linear mixed models to estimate the associations of greenness with lipid levels and dyslipidemias prevalence. We also performed sub-group and mediation analyses. An interquartile range (IQR) increase in NDVI500m was significantly associated with a 0.064 mmol/L (95% confidence interval [CI]: 0.083, -0.045) and 0.049 mmol/L (95% CI: 0.065, -0.033) decreased TC and LDL-C levels, respectively, as well as a 0.13-fold (95% CI: 0.01, 0.23) and 0.17-fold (95% CI: 0.01, 0.30) decreased odds of hypercholesterolemia and hyperbetalipoproteinemia, respectively. Associations were stronger in students aged ≤12 years and born to parents having lower education levels compared to their counterparts. Particle with aerodynamic diameter ≤2.5 µm (PM2.5) mediated 61.5% and 16.7% of the association of greenness with TG and LDL-C levels, respectively. In summary, higher school-based greenness exposure was beneficially associated with lipid levels among Chinese children and adolescents, and part of the association can be explained by lowed PM2.5 levels.


Asunto(s)
Contaminación del Aire , Dislipidemias , Humanos , Niño , Adolescente , Parques Recreativos , LDL-Colesterol , Pueblos del Este de Asia , Material Particulado/análisis , Contaminación del Aire/análisis , Lípidos , Triglicéridos , Dislipidemias/epidemiología , China/epidemiología
12.
Sci Total Environ ; 862: 160617, 2023 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-36462653

RESUMEN

BACKGROUND: Evidence concerning associations of per- and polyfluoroalkyl substances (PFASs) exposure with bone mineral density (BMD) and osteoporosis is scarce. Additionally, no study has examined the effects of PFAS isomers and alternatives on bone health. OBJECTIVES: To evaluate the associations of PFASs and PFAS alternatives with BMD levels and osteoporosis prevalence. METHODS: A total of 1260 healthy adults from southern China were enrolled. Serum concentrations of 32 legacy PFASs, PFAS isomers, and alternatives were measured using modified liquid chromatography-tandem mass spectrometry. Logistic and linear regression models were applied to evaluate the associations of PFASs with osteoporosis prevalence and BMD levels, respectively, adjusting for confounding factors. We performed stratified analyses to assess potential effect modifications of age and sex. We further used sensitivity analyses to testify the robustness of the main findings. RESULTS: There were 204 (16.2 %) participants diagnosed with osteoporosis. Eleven of the studied PFASs (i.e., PFHpA, PFOA, PFBS, PFHpS, total-PFHxS, n-PFHxS, br-PFHxS, br-PFOS, 1m-PFOS, Σ3 + 4 + 5m-PFOS, and 6:2 Cl-PFESA) showed significant and inverse associations with BMD levels (mean differences ranged from -6.47 to -26.07 per one ln-unit increase in the PFASs). Additionally, we observed that each one ln-unit increase in PFHpA was significantly associated a 23 % (OR = 1.23, 95 % CI = 1.04, 1.45) greater odds of osteoporosis. The above associations were consistent in several sensitivity analyses we performed. Stratified analyses showed stronger associations among women and younger compared to their counterparts. CONCLUSIONS: Our findings suggested that greater PFAS exposure is associated with poorer bone health, especially in women and younger people.


Asunto(s)
Ácidos Alcanesulfónicos , Contaminantes Ambientales , Fluorocarburos , Osteoporosis , Adulto , Humanos , Femenino , Densidad Ósea , Osteoporosis/epidemiología , China/epidemiología
13.
Wounds ; 35(12): E439-E447, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-38277633

RESUMEN

BACKGROUND: Small-area burn is a common but specific type of injury that can still lead to serious complications if not managed properly. Researchers have introduced a number of interventions. OBJECTIVE: The objective of this study was to compare the effects of eCASH concept-based care (ie, eBCare) with those of standard treatment on wound healing in patients with small-area burns. METHODS: In this prospective randomized controlled trial, patients with small-area burns received either eBCare (n = 35) or standard burn treatment (n = 35) for 2 weeks. Pain, anxiety, heart rate, exudate, and wound area were measured during and after dressing changes. Scar color and thickness were assessed 4 years or longer after discharge. RESULTS: The eBCare group had a lower median pain score, anxiety score, and heart rate compared with the control group (P < .001). The eBCare group also had a higher median wound healing rate on day 14 than the control group (P < .05). At follow-up 4 years or more after discharge, the eBCare group had better scar color and thickness than the control group (P < .05). CONCLUSION: The use of eBCare reduced pain and anxiety, accelerated wound healing, and improved scar outcomes in patients with small-area burns, which suggests that eBCare may be a feasible option for this population.


Asunto(s)
Quemaduras , Cicatriz , Humanos , Cicatriz/terapia , Cicatriz/patología , Estudios Prospectivos , Proyectos Piloto , Resultado del Tratamiento , Dolor/complicaciones , Quemaduras/terapia , Quemaduras/complicaciones
14.
Glob Health Res Policy ; 7(1): 48, 2022 12 06.
Artículo en Inglés | MEDLINE | ID: mdl-36474302

RESUMEN

BACKGROUND: Identifying factors associated with cardiovascular disease (CVD) is critical for its prevention, but this topic is scarcely investigated in Kashgar prefecture, Xinjiang, northwestern China. We thus explored the CVD epidemiology and identified prominent factors associated with CVD in this region. METHODS: A total of 1,887,710 adults at baseline (in 2017) of the Kashgar Prospective Cohort Study were included in the analysis. Sixteen candidate factors, including seven demographic factors, 4 lifestyle factors, and 5 clinical factors, were collected from a questionnaire and health examination records. CVD was defined according to International Clinical Diagnosis (ICD-10) codes. We first used logistic regression models to investigate the association between each of the candidate factors and CVD. Then, we employed 3 machine learning methods-Random Forest, Random Ferns, and Extreme Gradient Boosting-to rank and identify prominent factors associated with CVD. Stratification analyses by sex, ethnicity, education level, economic status, and residential setting were also performed to test the consistency of the ranking. RESULTS: The prevalence of CVD in Kashgar prefecture was 8.1%. All the 16 candidate factors were confirmed to be significantly associated with CVD (odds ratios ranged from 1.03 to 2.99, all p values < 0.05) in logistic regression models. Further machine learning-based analysis suggested that age, occupation, hypertension, exercise frequency, and dietary pattern were the five most prominent factors associated with CVD. The ranking of relative importance for prominent factors in stratification analyses showed that the factor importance generally followed the same pattern as that in the overall sample. CONCLUSIONS: CVD is a major public health concern in Kashgar prefecture. Age, occupation, hypertension, exercise frequency, and dietary pattern might be the prominent factors associated with CVD in this region.In the future, these factors should be given priority in preventing CVD in future.


Asunto(s)
Enfermedades Cardiovasculares , Hipertensión , Humanos , Enfermedades Cardiovasculares/epidemiología , Estudios Prospectivos , Factores Socioeconómicos , Aprendizaje Automático
15.
Mol Ther Nucleic Acids ; 30: 353, 2022 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-36381580

RESUMEN

[This retracts the article DOI: 10.1016/j.omtn.2017.12.022.].

16.
Hum Vaccin Immunother ; 18(6): 2045854, 2022 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-36399713

RESUMEN

BACKGROUND: As measles vaccination coverage has increased, measles infection has shifted to the population of infants. We conducted a follow-up seroepidemiological study among mothers and their infants to evaluate measles seroprevalence and the persistence of maternal measles antibody in Shufu, Kashgar from 2018 to 2020. METHODS: Maternal venous blood and cord blood was obtained among mothers and their infants at 0, 3, 5, 8, 9, and 12 months of age. An enzyme-linked immunosorbent assay was used for quantitative measurement of measles antibodies. We analyzed the correlation between maternal and neonatal measles antibodies, and antibodies persistence after infants were born. RESULTS: The overall neonatal maternal ratio was 2.38 (95%CI: 2.05-2.71). The measles antibodies for mothers and newborns were 438.93 IU/mL (95%CI: 409.47-470.51 IU/mL) and 440.10 IU/mL (95%CI: 410.82-471.48 IU/mL), respectively. Neonatal measles antibodies were dropping after birth and then beginning to increase starting at 8 months of age. CONCLUSIONS: Infant measles antibody levels progressively declined after birth regardless of maternal measles antibody levels. Efforts should be carried out to eliminate measles.


Asunto(s)
Virus del Sarampión , Sarampión , Lactante , Femenino , Recién Nacido , Humanos , Estudios Seroepidemiológicos , Sarampión/epidemiología , Sarampión/prevención & control , Anticuerpos Antivirales , Ensayo de Inmunoadsorción Enzimática , Vacuna Antisarampión , Inmunidad Materno-Adquirida
18.
Natl Sci Rev ; 9(4): nwac004, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35497644

RESUMEN

The SARS-CoV-2 B.1.617.2 (Delta) variant flared up in late May in Guangzhou, China. Transmission characteristics of Delta variant were analysed for 153 confirmed cases and two complete transmission chains with seven generations were fully presented. A rapid transmission occurred in five generations within 10 days. The basic reproduction number (R0) was 3.60 (95% confidence interval: 2.50-5.30). After redefining the concept of close contact, the proportion of confirmed cases discovered from close contacts increased from 43% to 100%. With the usage of a yellow health code, the potential exposed individuals were self-motivated to take a nucleic acid test and regained public access with a negative testing result. Facing the massive requirement of screening, novel facilities like makeshift inflatable laboratories were promptly set up as a vital supplement and 17 cases were found, with 1 pre-symptomatic. The dynamic adjustment of these three interventions resulted in the decline of Rt from 5.00 to 1.00 within 9 days. By breaking the transmission chain and eliminating the transmission source through extending the scope of the close-contact tracing, health-code usage and mass testing, the Guangzhou Delta epidemic was effectively contained.

19.
PLoS Negl Trop Dis ; 16(1): e0010048, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34986169

RESUMEN

BACKGROUND: The first community transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC) in Guangzhou, China occurred between May and June 2021. Herein, we describe the epidemiological characteristics of this outbreak and evaluate the implemented containment measures against this outbreak. METHODOLOGY/PRINCIPAL FINDINGS: Guangzhou Center for Disease Control and Prevention provided the data on SARS-CoV-2 infections reported between 21 May and 24 June 2021. We estimated the incubation period distribution by fitting a gamma distribution to the data, while the serial interval distribution was estimated by fitting a normal distribution. The instantaneous effective reproductive number (Rt) was estimated to reflect the transmissibility of SARS-CoV-2. Clinical severity was compared for cases with different vaccination statuses using an ordinal regression model after controlling for age. Of the reported local cases, 7/153 (4.6%) were asymptomatic. The median incubation period was 6.02 (95% confidence interval [CI]: 5.42-6.71) days and the means of serial intervals decreased from 5.19 (95% CI: 4.29-6.11) to 3.78 (95% CI: 2.74-4.81) days. The incubation period increased with age (P<0.001). A hierarchical prevention and control strategy against COVID-19 was implemented in Guangzhou, with Rt decreasing from 6.83 (95% credible interval [CrI]: 3.98-10.44) for the 7-day time window ending on 27 May 2021 to below 1 for the time window ending on 8 June and thereafter. Individuals with partial or full vaccination schedules with BBIBP-CorV or CoronaVac accounted for 15.3% of the COVID-19 cases. Clinical symptoms were milder in partially or fully vaccinated cases than in unvaccinated cases (odds ratio [OR] = 0.26 [95% CI: 0.07-0.94]). CONCLUSIONS/SIGNIFICANCE: The hierarchical prevention and control strategy against COVID-19 in Guangzhou was timely and effective. Authorised inactivated vaccines are likely to contribute to reducing the probability of developing severe disease. Our findings have important implications for the containment of COVID-19.


Asunto(s)
Vacunas contra la COVID-19/uso terapéutico , COVID-19/epidemiología , COVID-19/prevención & control , Control de Enfermedades Transmisibles/métodos , SARS-CoV-2/aislamiento & purificación , Adulto , Anciano , Número Básico de Reproducción , COVID-19/transmisión , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevención Primaria/métodos , Índice de Severidad de la Enfermedad , Vacunación/estadística & datos numéricos , Adulto Joven
20.
Environ Res ; 204(Pt D): 112358, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34774507

RESUMEN

BACKGROUND: Living in greener areas may reduce adiposity, but epidemiological evidence on this topic is still inconsistence and limited, especially in rural areas. METHODS: We performed a cross-sectional study among 4651 Uyghur adults in rural areas in Xinjiang province, northwestern China, from May to September 2016. We measured residential greenness levels using satellite-derived Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI) in 100 m, 300 m, 500 m, and 1000 m buffers around each home address. Body height, weight, and waist circumference were assessed according to recommended guidelines. Data on baseline characteristics and confounders were collected using a questionnaire. We used generalized linear mixed models to estimate the associations of residential greenness with overweight/obesity prevalence and obesity-related anthropometric indices. RESULTS: Higher residential greenness levels were associated with lower waist circumference and body mass index levels, as well as with a lower odds ratio of peripheral overweight/obesity prevalence. No significant association was found for greenness and central obesity prevalence. The associations persisted in magnitude and direction across several sensitivity analyses we performed. Stratified analysis suggested that the associations were generally stronger in older adults than those in younger adults. Additionally, neither air pollutants nor physical activity significantly mediated the associations between greenness and obesity. CONCLUSIONS: Our results suggest that higher residential greenness were associated with lower odds of overweight/obesity and lower obesity-related anthropometric indices among rural Uyghur adults in China, especially for older adults.


Asunto(s)
Obesidad , Sobrepeso , Parques Recreativos , Características de la Residencia , Adiposidad , Adulto , China/epidemiología , Estudios Transversales , Humanos , Obesidad/epidemiología , Sobrepeso/epidemiología , Población Rural
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