Job burnout among primary healthcare workers during COVID-19 pandemic: cross-sectional study in China.

Objective: This study evaluated job burnout among primary healthcare workers (PHCWs) in China during the COVID-19 pandemic, explored its influencing factors, and examined PHCWs' preferences for reducing job burnout. Method: We conducted a multicenter cross-sectional study in Heilongjiang, Sichuan, Anhui, Gansu, and Shandong Provinces. An electronic questionnaire survey was conducted through convenience sampling in communities from May to July 2022. We collected sociodemographic characteristics, job burnout level, job satisfaction, and preferred ways to reduce job burnout among PHCWs. Results: The job burnout rate among PHCWs in China was 59.87% (937/1565). Scores for each dimension of job burnout were lower among PHCWs who had a better work environment (emotional exhaustion OR: 0.60; depersonalization OR: 0.73; personal accomplishment OR: 0.76) and higher professional pride (emotional exhaustion OR: 0.63; depersonalization OR: 0.70; personal accomplishment OR: 0.44). PHCWs with higher work intensity (emotional exhaustion OR: 2.37; depersonalization OR: 1.34; personal accomplishment OR: 1.19) had higher scores in all job burnout dimensions. Improving work environments and raising salaries were the preferred ways for PHCWs to reduce job burnout. Conclusion: Strategies should be developed to improve job satisfaction among PHCWs, enhance their professional identity, and alleviate burnout to ensure the effective operation of the healthcare system, especially during periods of overwork.

A Case-Control Study on Factors of HPV Vaccination for Mother and Daughter in China.

(1) Background: To explore the influencing factors of human papillomavirus (HPV) vaccination among mothers and daughters so as to provide evidence and strategies for improving the HPV vaccination rate of 9-18-years-old girls. (2) A questionnaire survey was conducted among the mothers of 9-18-year-old girls from June to August 2022. The participants were divided into the mother and daughter vaccinated group (M1D1), the mother-only vaccinated group (M1D0), and the unvaccinated group (M0D0). Univariate tests, the logistic regression model, and the Health Belief Model (HBM) were employed to explore the influencing factors. (3) Results: A total of 3004 valid questionnaires were collected. According to the regions, Totally 102, 204, and 408 mothers and daughters were selected from the M1D1, M1D0, and M0D0 groups, respectively. The mother having given her daughter sex education (OR = 3.64; 95%CI 1.70, 7.80), the mother's high perception of disease severity (OR = 1.79; 95%CI 1.02, 3.17), and the mother's high level of trust in formal information (OR = 2.18; 95%CI 1.26, 3.78) were all protective factors for both the mother and her daughter's vaccination. The mother's rural residence (OR = 0.51; 95%CI 0.28, 0.92) was a risk factor for vaccination of both mother and daughter. The mother's education of high school or above (OR = 2.12; 95%CI 1.06, 4.22), the mother's high level of HPV and HPV vaccine knowledge (OR = 1.72; 95%CI 1.14, 2.58), and the mother's high level of trust in formal information (OR = 1.72; 95%CI 1.15, 2.57) were protective factors of mother-only vaccination. The older the mother (OR = 0.95; 95%CI 0.91, 0.99) was classed as a risk factor for mother-only vaccination. "Waiting until the daughters are older to receive the 9-valent vaccine" is the main reason why the daughters of M1D0 and M0D0 are not vaccinated". (4) Chinese mothers had a high willingness to vaccinate their daughters with the HPV vaccine. The higher education level of the mother, giving sex education to the daughter, the older ages of mothers and daughters, the mother's high level of HPV and HPV vaccine knowledge, a high level of perception of the disease severity, and a high level of trust in formal information were promoting factors of HPV vaccination for mother and daughter, and rural residence was a risk factor to vaccination. To promote HPV vaccination in girls from 9-18 years old, communities could provide health education to rural mothers with low education levels; the government could advocate for HPV vaccination through issuing policy documents; and doctors and the CDC could popularize the optimal age for HPV vaccination to encourage mothers to vaccinate their daughters at the age of 9-14 years old.

Epidemiology of human papillomavirus on condyloma acuminatum in Shandong Province，China.

Condyloma acuminatum (CA) is a sexually transmitted disease (STD) caused by human papillomavirus (HPV) infection. It is important to study the prevalence and distribution of HPV genotypes before implementing the HPV vaccination program. Therefore, the aim of this study was to evaluate the epidemiological characteristics of CA cases and the distribution of HPV genotypes in Shandong Province, China. One-to-one questionnaire surveys were conducted on all patients diagnosed with CA in sentinel hospitals from Shandong Province, China. HPV genotypes were determined using the polymerase chain reaction (PCR)-reverse dot blot hybridization method. The study enrolled 1185 patients (870 males and 315 females) and found that CA patients are mainly males and sexually active people between the ages of 20 and 40. Recurrence occurred in 34.7% patients. Among the 880 CA patients who underwent HPV typing, the HPV test positivity rate was 91.4%. In these cases, low-risk (LR) HPV infection was predominant, with an infection rate of 91.3%, while high-risk (HR) HPV genotypes were found in 53.5% patients. The most frequent HPV genotypes encountered were HPV6 (57.8%), HPV11 (37.2%), HPV16 (13.7%), and HPV42 (10.3%). HPV6 and/or HPV11 are the main infections in all patients, and more than half of the patients are coinfected with HR-HPV. However, unlike other regions, HPV42 has a higher prevalence rate among CA patients in Shandong Province and is a nonvaccine HPV genotype. Therefore, regular HPV typing helps to understand the characteristics of specific genotypes and the choice of the best type for vaccine coverage.

Can the implementation of family doctor contracted service enable the elderly to utilize primary health care services more equally? empirical evidence from Shandong, China.

BACKGROUND: While the elderly are facing greater health risks, they also face more serious inequalities in utilization of medical services. The family doctor contracted service is the core policy of the Chinese government to cope with aging and to achieve the outcome that everyone has the right to primary health care. However, previous research has neither revealed the degree of inequality in the use of contracted services among the elderly in China, nor has it revealed what factors are related to the inequality in the use of services. OBJECTIVE: Assess and decompose the inequality in the use of family doctors contracted services in the elderly population in China. METHODS: A cross-sectional study of 1037 elderly people was conducted in Shandong Province, China. According to the first consultation rate of family doctors, the physical examination rate, the healthy lifestyle guidance rate and the chronic disease management rate, the situation of elderly people's utilization of family doctor contracted service was investigated. The concentration index is used to measure the degree of inequality in the use of family doctors contracted services by the elderly. In order to test the contribution of different factors to the inequality of utilization of family doctors contracted services, the concentration index was also decomposed. RESULTS: The first consultation rate of family doctors for the elderly in Shandong Province was 24.6%, the physical examination rate was 65.8%, the healthy lifestyle guidance rate was 13.7%, and the chronic disease management rate was 52.2%. The horizontal inequality index of the healthy lifestyle guidance rate and the chronic disease management rate were 0.451 and 0.573, respectively, indicating that there is an inequality of pro-wealth. The concentration index of physical examination rate and chronic disease management rate is negative (- 0.260, - 0.518), which means inequality to the poor. Education level is the most important factor affecting the unequal utilization of health services for the elderly, followed by income. CONCLUSION: The family doctor contracted service has had a positive impact on alleviating the health inequality in the utilization of basic medical and health services for the elderly. Although there is still inequality in terms of pro-wealth for the elderly, the utilization of family doctor contracted service has weakened the inequality of service utilization brought about by income. Enhancing the health literacy of the elderly, narrowing the gap between the rich and the poor, bridging the gap between urban and rural areas, and building a harmonious family relationship can promote the realization of basic medical and health care services for every elderly.

Identification and analysis of miRNAs in the normal and fatty liver from the Holstein dairy cow.

MicroRNAs (miRNAs) are a class of non-coding short RNAs with ∼22 nts in length, which play important roles in the regulation of numerous biological processes in animals. In this study, two small RNA libraries from fatty (S01) and normal livers (S02) from Holstein Dairy Cow (HDC) were sequenced through deep sequencing. A total of 12,964,411 and 15,426,289 clean reads were obtained, representing 370 known and 182 novel miRNAs, respectively. The characterization, expression pattern, potential functions and target genes of these miRNAs were investigated. Analysis identified 66 upregulated and seven downregulated differentially expressed miRNAs (DIE-miRNAs). To verify the sequencing results, 10 DIE-miRNAs were selected for qRT-PCR, and the results were confirmed to be consistent with the miRNA sequencing. In addition, a total of 5,578 targets of the 73 DIE-miRNAs were predicted. GO analysis revealed that DIE-miRNAs targets are associated with cellular process, cell part and molecular transducer activity. KEGG pathway analysis showed that Arrhythmogenic right ventricular cardiomyopathy, Axon guidance, Ether lipid metabolism and Cocaine addiction were closely associated with liver metabolism. These findings will provide valuable information for further functional verification of miRNAs between normal and fatty liver, as might exploit new attractive miRNAs biomarkers for diseases detection in HDC.

Evaluating active versus passive sources of human brucellosis in Jining City, China.

Human brucellosis (HB) remains a serious public health concern owing to its resurgence across the globe and specifically in China. The timely detection of this disease is the key to its prevention and control. We sought to describe the differences in the demographics of high-risk populations with detected cases of HB contracted from active versus passive sources. We collected data from a large sample population from January to December 2018, in Jining City, China. We recruited patients that were at high-risk for brucellosis from three hospitals and Centers of Disease Control and Prevention (CDCs). These patients were classified into two groups: the active detection group was composed of individuals receiving brucellosis counseling at the CDCs; the passive detection group came from hospitals and high-risk HB groups. We tested a total of 2,247 subjects and 13.3% (299) presented as positive for HB. The positive rates for active and passive detection groups were 20.5% (256/1,249) and 4.3% (43/998), respectively (p < 0.001). The detection rate of confirmed HB cases varied among all groups but was higher in the active detection group than in the passive detection group when controlled for age, sex, ethnicity, education, career, and contact history with sheep or cattle (p < 0.05). Males, farmers, those with four types of contact history with sheep or cattle, and those presenting fever, hyperhidrosis and muscle pain were independent factors associated with confirmed HB cases in multivariate analysis of the active detection group. Active detection is the most common method used to detect brucellosis cases and should be applied to detect HB cases early and avoid misdiagnosis. We need to improve our understanding of brucellosis for high-risk populations. Passive HB detection can be supplemented with active detection when the cognitive changes resulting from brucellosis are low. It is important that healthcare providers understand and emphasis the timely diagnosis of HB.

Identification of differentially expressed miRNAs on normal cell, fatty liver cell and processed cell by monoammonium glycyrrhizinate from cattle (Bos indicus) by deep sequencing approach.

Cattle fatty liver has caused mass damage in milk production during the past few years. In our study, to identify different miRNAs involved in cell physiological regulation in fatty liver, we performed miRNA deep sequencing on a normal liver cell (S01), fatty liver cell (S02) and processed cell by monoammonium glycyrrhizinate (S03). As a result, a total of 15,277,462, 14,190,360 and 13,771,060 raw reads representing 13,904,074, 12,784,128 and 11,017,604 clean reads per library were obtained separately. Through bioinformatics analysis, a total of 511 known miRNAs were identified when they were aligned with the known animal miRNAs, and 197 novel miRNAs were predicted using mirDeep2 software. A total of 511 miRNAs including 101 known and 51 novel miRNAs were expressed significantly different. Additionally, expression levels of eight randomly selected miRNAs were confirmed using the stem-loop qPCR, and their expression profiles were consistent with the deep sequencing results. For better understanding the functions of miRNAs, a total of 14,231 targets were predicted. These predicted target genes were further analyzed by function annotation and enrichment pathways, the results showed that these targets of the identified miRNAs are involved in a broad range of physiological functions.

Biological functions of circRNAs and their progress in livestock and poultry.

CircRNAs are a new member of endogenous RNAs, which characterized by a closed-loop structure without terminated 5' caps and 3' tails via covalent bonding, which are evolutionarily conserved among different species and often exhibit tissue or developmental stage-specific expression. So far, thousands of circRNAs have been discovered in eukaryotic cells. CircRNAs are more stable due to its resistance to exonuclease implying important biological functions in all kingdoms of life. They could function as miRNA sponges, interfere with splicing and bind to protein to regulate the expression of host genes and so on. In addition, emerging evidence suggests that circRNAs are closely related to a series of physiological processes in livestock and poultry. In this review, we summarized the biogenesis mechanism, major biological function and detection methods and focused on research advance of circRNAs in livestock and poultry, aiming at providing certain reference value and novel techniques for the development of new molecular genetic markers and breeding of livestock and poultry. Meanwhile, we hope this review could show significant prospect for other researches.

Identification and expression analysis of miRNA in hybrid snakehead by deep sequencing approach and their targets prediction.

MicroRNAs (miRNAs) play important regulatory roles in numerous biological processes, but there is no report on miRNAs of hybrid snakehead. In this study, four independent small RNA libraries were constructed from the spleen, liver kidney and muscle of hybrid snakehead. These libraries were sequenced using deep sequencing technology, as result, a total of 1,067,172, 1,152,002, 1,653,941 and 970,866 clean reads from these four libraries were obtained. 252 known miRNAs and 63 putative novel miRNAs in these small RNA dataset were identified. The stem-loop RT-qPCR analysis indicated that eight known miRNAs and two novel miRNAs show different expression in eight different kinds of tissues. For better understanding the functions of miRNAs, 95,947 predicated target genes were analyzed by GO and their pathways, the results indicated that these targets of the identified miRNAs are involved in a broad range of physiological functions.

Consumption of antibiotics in Chinese public general tertiary hospitals (2011-2014): Trends, pattern changes and regional differences.

BACKGROUND: China has a high rate of antibiotic use. The Chinese Ministry of Health (MOH) established the Center for Antibacterial Surveillance (CAS) to monitor the use of antibacterial agents in hospitals in 2005. The purpose of this study was to identify trends, pattern changes and regional differences in antibiotic consumption in 151 public general tertiary hospitals across China from 2011-2014. MATERIALS AND METHODS: Valid data for antibiotic use were collected quarterly, and the antibiotic consumption data were expressed as the defined daily dose (DDD) per 100 inpatient days (ID). We compared the patterns of antibiotic use in different classes and geographical clusters. RESULTS: Total antibiotic use significantly decreased (P = 0.018) from 75.86 DDD/100 ID in 2011 to 47.03 DDD/100 ID in 2014. The total consumption of flomoxef sodium and cefminox increased from 1.31 DDD/100 BD in 2011 to 8.6 DDD/100 BD in 2014. Cephalosporins were the most frequently used antibiotics in all regions. Third-generation cephalosporins accounted for more than 45% of the cephalosporins used. Carbapenem use substantially increased (P = 0.043). Penicillin combinations with inhibitors accounted for 50% of the penicillin used, and prescribed meropenem accounted for most of the carbapenems used in all regions in 2014. The subclasses in each antibiotic group were used differently between the seven regions, and the total hospital antibiotic use in 2014 differed significantly by region (P = 0.014). CONCLUSION: Although the volume and intensity of total antibiotic use decreased, the antibiotic use patterns were not optimal, and broad-spectrum antibiotics were still the main classes. The aggregate data obtained during the study period reveal similar antibiotic consumption patterns in different regions. These findings provide useful information for improving the rational use of antibiotics. More detailed data on antibiotics linked to inpatient diseases need to be collected in future studies.

Identification of the conserved and novel microRNAs by deep sequencing and prediction of their targets in Topmouth culter.

MicroRNAs (miRNAs) are endogenous non-coding small RNAs that play important roles in regulation of almost all biological processes in organisms. Topmouth culter is an economically important fish species in the Chinese freshwater polyculture system for its delicacy and high economic value. However, to date, no miRNAs have been reported in Topmouth culter species. In this study, the liver, muscle, spleen and kidney of Topmouth culter are sampled and used for construction of a small RNA library for deep sequencing. A total of 273 conserved miRNAs/miRNAs-star and 8 novel miRNAs/miRNAs-star were discovered, these miRNAs belong to 86 different miRNA families. There is a strong base bias on miRNA nucleotide compositions at certain positions. U is the dominant nucleotide, particularly at the beginning, middle, and end of conserved miRNAs. The expression of all 8 novel identified miRNAs in Topmouth culter was validated by using stem-loop qRT-PCR. Furthermore, the potential targets were predicted for these miRNAs, which were found to be involved in diverse biological processes. Our study is the first significantly enriches the Topmouth culter miRNA repertoire and provides a reference for further elucidation of complex miRNA-mediated regulatory networks for gene expression in the growth and developmental progression of Topmouth culter.

Genome-wide identification and characterization of conserved and novel microRNAs in grass carp (Ctenopharyngodon idella) by deep sequencing.

MicroRNAs (miRNAs) are post-transcriptional regulators which bind to target to regulate protein expression by repressing translation or promoting degradation of the target mRNA. Studies have shown that deep sequencing is a powerful tool for the identification of miRNAs, and it is believed that may more miRNAs remain to be discovered in grass carp. In the present study, a pool of equal amounts of RNA obtained from 8 different adult grass carp tissues (spleen, liver, muscle, kidney, skin, testis, gut and heart) was sequenced using deep sequencing technology. A total of 16.579.334 raw reads were yielded from the pooled small RNA library. Using bioinformatics analysis, we identified 160 conserved miRNAs and 18 novel miRNAs in grass carp. Randomly selected 6 conserved and 2 novel miRNAs were confirmed their expression by stem-loop qRT-PCR assay. Furthermore, the 1212 potential targets of these miRNAs were predicted using miRNA target prediction tool. GO and KEGG pathway enrichment analyses indicated relevant biological processes. Our study provides the first genome-wide investigation of miRNAs from 8 mixed tissues of grass carp, and the data obtained expand the known grass carp miRNA inventory and provide a basis for further understanding functions of grass carp miRNAs.

Nausea and vomiting in early pregnancy and the risk of neural tube defects: a case-control study.

There has been considerable professional debate on the association between nausea and vomiting in early pregnancy (NVP) and neural tube defects (NTDs) risk. This study explored the association between NVP and NTDs risk, and the effect of folic acid supplements on the association. A 1:1 matched case-control study was conducted and conditional logistic regression model was used to analyze the associations. The result showed the odds ratio (OR) of severe NVP for NTDs was 2.403 (95%CI 1.437,4.017; P<0.001) and that of moderate NVP was 1.469 (95%CI 1.063,2.031; P = 0.020) compared with light NVP when adjusted by the potential confounders. Stratified by intake of folic acid supplements, the ORs for severe and moderate NVP turned to 2.147 (95%CI 1.140, 4.043; P = 0.018) and 2.055 (95%CI 1.320, 3.199; P = 0.001) in the stratum of non-intake of folic acid supplements while ORs reduced to 1.851 (95%CI 0.729, 4.699; P = 0.195) and 1.003 (95%CI 0.594, 1.694; P = 0.992) in the stratum of intake of folic acid supplements, respectively. We conclude that severe/moderate NVP has an association with the risk of NTDs, which was not found in the group with intake of folic acid supplements. Folic acid supplements should be recommended to use for the prevention of NTDs.

Maternal body mass index and the association between folic acid supplements and neural tube defects.

AIM: To study the influence of maternal body mass index (BMI) on the association between folic acid supplementation and neural tube defects (NTDs) risk in offspring. METHODS: A hospital-based, case-control study was conducted between 2006 and 2008 on 459 mothers with NTDs-affected births and 459 mothers without NTDs-affected births. Logistic regression models examined the associations between folic acid supplementation and the NTDs risk in offspring for all mothers, underweight/normal weight mothers (BMI<24.0) and overweight/obese mothers (BMI ≥24.0). The effects were evaluated by adjusted odds ratio (AOR) and 95% confidence intervals (CIs) with SAS 9.1.3 software. RESULTS: The overall AOR for periconceptional folic acid supplementation was 0.315 (95% CI = 0.172-0.577) when compared with no supplements. Stratified by maternal BMI, the AOR for periconceptional folic acid supplementation in overweight/obese mothers was greater than in underweight/normal weight mothers (0.646 vs. 0.208). The AOR for folic acid supplementation within 3 months before conception was 0.711 (95% CI = 0.323-1.563) in all mothers. Stratified by maternal BMI, the AOR for folic acid supplementation within 3 months before conception in overweight/obese mothers was greater than in underweight/normal weight mothers (0.658 vs. 0.527). CONCLUSION: The association between folic acid supplementation and the reduced NTDs risk was weaker in overweight/obese mothers (BMI ≥24.0) than in underweight/normal weight mothers (BMI <24.0).

Maternal overweight and obesity and the risk of neural tube defects: a case-control study in China.

BACKGROUND: Studies have suggested that being obese before pregnancy is a risk factor for neural tube defects (NTDs), while results of many studies are controversial. This study aims to explore the association between maternal overweight and obesity before pregnancy and risk of NTDs. METHODS: A 1:1 matched case-control study was conducted. Cases were 459 women who delivered infants or conceived fetuses with NTDs in two provinces of China and controls were 459 women with live-born infants, without an apparent congenital malformation, matched with cases by region, delivery hospital, and year of childbirth. RESULTS: Compared with normal body weight, maternal obesity (body mass index, BMI ≥ 28 kg/m(2)) before pregnancy had a significant increased risk for NTDs as a group after adjusting for age, occupation, educational level, family income, parity, and use of folic acid (odds ratio, OR = 2.45; p < 0.05). No significant increase in NTD risk was found for maternal underweight (BMI < 18.5 kg/m(2)) and overweight (BMI from 24 to 28 kg/m(2)). For three subtypes of NTDs, anencephaly, spina bifida, and encephalocele, no significant increase in risk was found with maternal underweight, overweight, or obesity (all, p > 0.05). CONCLUSION: Maternal obesity before pregnancy is associated with risk of NTDs and should be considered in maternal reproductive health care.

Previous abortion and the risk of neural tube defects: a case-control study.

OBJECTIVE: To further explore the association between abortion history and neural tube defect (NTD) risk and the association of different interpregnancy intervals from prior abortion to current conception on NTD risk. STUDY DESIGN: A matched case-control study was conducted. Cases were 459 women who delivered and gestated babies/fetuses with NTDs in two provinces of China and 459 women with live-born infants, without an apparent congenital malformation, matched with cases by the same region, the same hospital, and childbirth in the same year as controls. All of the subjects were investigated by trained interviewers with the same criteria. Conditional logistic regression models were used to calculate odds ratios (ORs) and their 95% CI of abortion history and interpregnancy intervals on NTD risk. RESULTS: Women with abortion history did not have an increased risk for spina bifida and encephalocele. The interpregnancy interval of < 6 months from prior abortion to current conception was significantly associated with anencephaly risk. CONCLUSION: Abortion with an interpregnancy interval of < 6 months from prior abortion to current conception may have an increased risk for anencephaly and should be considered in maternal reproductive health care.

A case-control study of the effects of pregnancy planning on neural tube defects and its primary preventive measures.

BACKGROUND: Measures for prevention of neural tube defects (NTDs) have been recommended for many years in China, but the compliance with these measures is unsatisfactory. This study aims to compare the effect differences between planned pregnancy and unplanned pregnancy in the compliance with these measures and analyze the interactions between pregnancy planning and these measures for NTD prevention. METHODS: A 1:1 matched case-control study was conducted. We randomly selected 349 women who delivered or gestated babies/fetuses with NTDs in the last two years in two provinces and matched them with 349 women who delivered babies without obvious birth defects as controls. RESULTS: In the case group, 99 women reported that they had planned their pregnancies, accounting for 28.4%, and the proportion who received preconception examinations and took folic acid prior to conception was 13.8 and 8.6%, respectively. According to the multivariate analysis, health education (odds ratio [OR], 0.350), preconception examinations (OR, 0.497) and folic acid consumption prior to conception (OR, 0.257) all had preventative effects on NTDs (for all, p < 0.05). In both groups, the proportions of women who received preconception examinations and reported folic acid intake were much higher for those who reported planning their pregnancies compared to women with an unplanned pregnancy (for all, p < 0.01); and for NTD prevention, synergistic interactions existed between pregnancy planning and the other preventive measures. CONCLUSION: Folic acid consumption prior to conception, preconception examinations, and health education have preventive effects on NTDs. Pregnancy planning can significantly promote compliance with these preventive behaviors. In addition, there are synergistic interactions between pregnancy planning and these measures.