Clinical Outcome and Factors with Dietary Behaviors in Pregnant Women with Listeria monocytogenes: A Hospital-Based Case-Control Study in Shanghai.

Listeriosis is a globally rare foodborne disease that causes fetal-placental infection, leading to adverse pregnancy outcome, while limited research among pregnant women is available in China. This study was therefore aimed at analyzing the incidence, clinical manifestations, and clinical outcome of listeriosis among pregnant women and its associated dietary behavior risk factors in prevention. A hospital-based case-control study had been conducted from January 2017 to December 2021. Clinical data, laboratory information, and questionnaires including dietary behaviors and personal hygiene were collected within 2 days after case diagnosis. There were 48 pregnant women, including 12 cases and 36 controls, with an average age of 31.19 ± 3.75 years. The incidence of admission-based listeriosis among pregnant women was 1.6058 per 10,000. The 12 strains were divided into 3 serotypes: 1/2a(83.33%), 1/2b(8.33%), and 4b(8.33%). Among the cases, 5 cases (41.67%) resulted in abortion, 3 cases (25%) induced preterm labor, and 4 cases (33.33%) had full-term deliveries after treatment. There were 7 live births in the case group, among which 6 were admitted to the neonatal intensive care unit (NICU), while 1 case had a healthy fetal outcome. All patients in the control group gave birth to live fetuses. Epidemiological investigation revealed that pregnant women dining at restaurants three or more times per week might increase the risk of having Listeria infection. There were no significant differences in dietary consumed behaviors, hand hygiene, and refrigerator usage behaviors between case and control groups. The study suggested that dining at restaurants might be associated with Listeria infection among pregnant women. Therefore, it is essential to enhance education on listeriosis serious consequences and promote healthy dietary and hygiene habits among pregnant women.

Symmetry constraints on the orientation dependence of high-order elastic constants for the hexagonal boron nitride monolayer.

Group theory is a powerful tool to explore fundamental symmetry constraints for the physical properties of crystal structures, e.g. it is well-known that only a few components of the elastic constants are independent due to the symmetry constraint. This work further applies group theory to derive constraint relationships for high-order elastic constants with respect to the orientation angle, where the constraint relationships are more explicit than the traditional tensor transformation law. These analytic symmetry constraints are adopted to explain the molecular dynamics simulation results, which disclose that the high-order elastic constants are highly anisotropic with an anisotropy percentage of up to 25% for the hexagonal boron nitride monolayer. The elastic constant is a basic quantity in the mechanics field, so its high anisotropy shall cause strong anisotropy for other mechanical properties. Based on the anisotropic high-order elastic constants, we demonstrate that Poisson's ratio is highly anisotropic for the hexagonal boron nitride at large strains. These findings provide fundamental insights into the symmetry dependence of high-order elastic constants and other mechanical properties.

Nonlinearity induced negative Poisson's ratio of two-dimensional nanomaterials.

Materials exhibiting a negative Poisson's ratio have garnered considerable attention due to the improved toughness, shear resistance, and vibration absorption properties commonly found in auxetic materials. In this work, the nonlinear effect on the Poisson's ratio was derived theoretically and verified by first-principle calculations and molecular dynamics simulations of two-dimensional nanomaterials including graphene and hexagonal boron nitride. The analytic formula explicitly shows that the Poisson's ratio depends on the applied strain and can be negative for large applied strains, owing to the nonlinear interaction. Both first-principle calculations and molecular dynamics simulations show that the nonlinear effect is highly anisotropic for graphene, where the nonlinearity-induced negative Poisson's ratio is much stronger for the strain applied along the armchair direction. These findings provide valuable insights into the behavior of materials with negative Poisson's ratios and emphasize the importance of considering nonlinear effects in the study of the Poisson's ratio of two-dimensional materials.

The effect of ambient PM2.5 exposure on survival of lung cancer patients after lobectomy.

Exposure to fine particulate matter (PM2.5) is linked to lung cancer incidence and mortality. However, the impact of PM2.5 exposure on lung cancer patients after lobectomy, which remains the primary treatment for early-stage lung cancer, is unknown. Therefore, we investigated the correlation between PM2.5 exposure and the survival of lung cancer patients after lobectomy. This study included 3,327 patients with lung cancer who underwent lobectomy procedures. We converted residential addresses into coordinates and estimated individual patients' daily PM2.5 and O3 exposure levels. A Cox multivariate regression model was used to analyze the specific monthly association between PM2.5 exposure and lung cancer survival. Every 10 µg/m3 increase in monthly PM2.5 concentration in the first and second months after lobectomy increased the risk of death (hazard ratio [HR]: 1.043, 95% confidence interval [CI]: 1.019-1.067 and HR: 1.036, 95% CI: 1.013-1.060, respectively). Non-smokers, younger patients, and patients with longer hospitalization durations had worse survival rates when exposed to greater concentrations of PM2.5. High postoperative PM2.5 exposure immediately after lobectomy reduced the survival of patients with lung cancer. Patients living in areas with high PM2.5 should be offered the opportunity to transfer to areas with better air quality after undergoing lobectomies, to prolong their survival times.

Effects of maternal pre-pregnancy body mass index and gestational weight gain on antenatal mental disorders in China: a prospective study.

BACKGROUND: Maternal obesity is the most common medical condition among women of reproductive age worldwide. The pre-pregnancy body mass index and gestational weight gain have been suggested to be associated with maternal mental disorders. This study aimed to investigate the effects of the pre-pregnancy body mass index and gestational weight gain on antenatal depression, stress, and anxiety. METHODS: In total, 4,890 pregnant women were enrolled in the present study, which is based on an ongoing prospective cohort study. We used self-reported pre-pregnancy weights and the last weights measured prior to delivery (using professional instruments) to calculate the pre-pregnancy body mass index and gestational weight gain. The questionnaires used included the Center for Epidemiologic Studies Depression Scale (CES-D), Self-Rating Anxiety Scale (SAS), and 10-item version of the Perceived Stress Scale (PSS-10). We used Pearson product-moment correlation and multivariable logistic regression models to examine the impact of the pre-pregnancy body mass index and gestational weight gain on different maternal mental disorders. RESULTS: After adjusting for conception, annual household income, occupation, education, smoking status, and drinking status, excessive gestational weight gain during pregnancy was associated with a greater chance of anxiety symptoms in the entire sample (adjusted model: odds ratio = 1.479, 95% confidence interval = 1.128, 1.938) and especially in women with a normal body mass index (adjusted model: odds ratio = 1.668, 95% confidence interval = 1.209, 2.302). However, the relationship between the maternal pre-pregnancy body mass index and mental health was not significant. CONCLUSION: Pregnant women with a normal pre-pregnancy body mass index had a greater chance of experiencing anxiety symptoms before delivery if gestational weight gain was excessive; however, its effects on depression or stress symptoms were not observed. The maternal pre-pregnancy body mass index may not be independently associated with maternal mental disorders.

Corrigendum: Delayed diagnosis and treatment of cancer patients during the COVID-19 pandemic in Henan, China: An interrupted time series analysis.

[This corrects the article DOI: 10.3389/fpubh.2022.881718.].

Delayed Diagnosis and Treatment of Cancer Patients During the COVID-19 Pandemic in Henan, China: An Interrupted Time Series Analysis.

Objective: To investigate the possible impact of lockdown policies on the diagnosis and treatment of cancer patients in Henan, China. Design Setting and Participants: We collected data from the Henan Cancer Hospital, affiliated with Zhengzhou University. The monthly numbers of inpatient admissions from January 2014 to December 2019 were used to forecast the number of inpatient admissions in 2020, which was then compared to the actual number of patients admitted during the pandemic to evaluate how the actual number diverges from this forecast. We conducted an interrupted time series analysis using the autoregressive integrated moving average (ARIMA) model. Main Outcomes and Measures: For specific diagnoses, treatment modalities, and age groups, we compared the changes in monthly admissions after the pandemic with the forecasted changes from the model. Results: The observed overall monthly number of inpatient admissions decreased by 20.2% [95% confidence interval (CI), 11.7-27.2%], 78.9% (95% CI, 77.3-80.4%), and 40.9% (95% CI, 35.6-45.5%) in January, February, and March 2020, respectively, as compared with those predicted using the ARIMA model. After the lockdown, visits for all treatment modalities decreased sharply. However, apparent compensation and recovery of the backlog appeared in later surgeries. As a result, the number of patients who underwent surgery in 2020 (30,478) was close to the number forecasted by the ARIMA model (30,185). In the same period, patients who received other treatments or underwent examinations were 106,074 and 36,968, respectively; the respective numbers that were forecasted by ARIMA were 127,775 and 60,025, respectively. These findings depict a decrease of 16.9 and 38.4% in patients who received other treatments or underwent examinations only, respectively. Regarding diagnosis, the reported incidence of various cancers decreased dramatically in February, with varying extent and speed of recovery. Conclusion and Relevance: The COVID-19 pandemic has significantly delayed the diagnosis and treatment of cancer in Henan, China. Long-term research should be conducted to assess the future effects of lockdown policies.

Effect of PM2.5 exposure on Vitamin D status among pregnant women: A distributed lag analysis.

BACKGROUND: Serum vitamin D levels are associated with exposure to air pollution, however, the lagged effect of exposure to air pollution remains unknown in pregnant women. METHODS: Pregnant women who delivered at a maternity center in Shanghai, China, from 2015 to 2019 were included in the present study. The concentration of particulate matter 2.5 (PM2.5) before 25-Hydroxyvitamin D [25(OH)D] detection was estimated using the satellite-based grid models. The distributed lag non-linear models were performed to examine the lagged association between weekly-specific PM2.5 exposure and vitamin D deficiency (VDD) or serum 25(OH)D levels. RESULTS: Among the 58,025 pregnant women included in the study (mean age at conception, 30.77 ± 3.75 years; mean prepregnancy BMI, 21.09 ± 2.55 kg/m2), 61.32% were diagnosed with VDD. Weekly-specific PM2.5 exposure at weeks 1-10 before the detection of 25(OH)D was significantly associated with an increased incidence of VDD (p < 0.05). For every 10 µg/m3 increase in PM2.5 exposure, the serum 25(OH)D level decreased by 1.346 nmol/L (95%CI: 1.183-1.508 nmol/L). The association between average PM2.5 exposure and VDD at 1-10 weeks was more significant in weather conditions with low mean sunshine hours (OR: 1.246, 95%CI: 1.221-1.271). CONCLUSION: Our study provided suggestive evidence that PM2.5 exposure at 1-10 weeks before the 25(OH)D detection may decrease the circulating 25(OH)D levels in pregnant women and increase VDD risk in pregnant women. More attention should be paid to the long-term impact of PM2.5, in particular, during weather conditions with a relatively short duration of sunshine.

Associations of PM2.5 exposure with blood glucose impairment in early pregnancy and gestational diabetes mellitus.

Exposure to fine particulate matter (PM2.5) during pregnancy has been linked to the risk of gestational diabetes mellitus (GDM), while conclusions are inconsistent. In this study we aimed to estimate the effects of prenatal PM2.5 exposure with blood glucose in early pregnancy and the GDM risk. Participants were recruited from the SH-IPMCH-BTH cohort (n = 41,929), a study of air pollution and birth outcome. All participants provided serum samples for analyses of fasting blood glucose (FBG) and HbA1c during early pregnancy. GDM was diagnosed using an oral glucose tolerance test (OGTT) with the time interval of 1 h. Prenatal exposure to PM2.5 was estimated using gap-filled satellite exposure assessments in Shanghai, China. Both FBG and HbA1c levels were significantly and positively associated with PM2.5 exposure during early pregnancy. A 10 µg/m3 increase of PM2.5 exposure from early to middle pregnancy was associated with the risk of GDM (first trimester OR=1.09, 95% CI: 1.02, 1.16; second trimester OR=1.09, 95% CI: 1.03, 1.16; first two trimester OR=1.15, 95%CI: 1.04, 1.28). The combined effects were greater among elevated FBG and HbA1c women with higher PM2.5 exposure in middle trimester (P for interaction=0.037 and 0.001, respectively). This study found that exposure to PM2.5 exposure in the 1st and 2nd trimesters was related to GDM. FBG and HbA1c played roles in the relationship between PM2.5 exposure in the 2nd trimester and GDM.

Association of triclosan and triclocarban in urine with obesity risk in Chinese school children.

BACKGROUND: Laboratory studies have suggested that triclosan and triclocarban can influence energy metabolism by multiple mechanisms and are potential obesogens, but the effect on obesity risk has not been well investigated in human. OBJECTIVE: To examine the associations of triclosan and triclocarban in urine with childhood obesity. METHODS: We investigated 458 school children aged 7-11 years who entered a dynamic cohort of children established in Shanghai in 2019 and 2020. Triclosan and triclocarban were determined in first morning urine by liquid chromatography coupled to mass spectrometry. Body mass index (BMI) and waist circumference (WC) were used to identify general overweight/obesity and central obesity, respectively. Logistic regression and linear models of generalized estimating equations (GEE) were used to investigate the association between urinary triclosan and triclocarban with obesity prevalence. RESULTS: After adjusting for potential confounders, children with detectable triclocarban in urine had a higher proportion of general overweight/obesity (odds ratio (OR): 1.84; 95% confidential interval (95% CI): 1.19, 2.85) or central obesity (OR: 1.71; 95% CI: 1.03, 2.84). Compared to the low tertile, children in the median tertile of triclosan showed a higher proportion of central obesity (OR: 1.78; 95 %CI: 0.98, 3.24) and children in the high tertile of triclocarban had a higher proportion of general overweight/obesity (OR: 2.25; 95 %CI: 1.31, 3.88) and central obesity (OR: 2.08; 95 %CI: 1.12, 3.87). When the tertiles of triclocarban in urine were treated as a continuous variable, a positive exposure-response relationship was found with general overweight/obesity (OR: 1.50; 95 %CI: 1.15, 1.96) and central obesity (OR: 1.44; 95 %CI: 1.06, 1.95). Multiple linear regression showed a positive exposure-response relationship between triclocarban and BMI (ß: 0.45; 95 %CI: 0.11, 0.80) values. CONCLUSION: Exposure to triclosan and triclocarban was associated with increased risk of childhood obesity. Given the cross-sectional design, more studies are needed to interrogate these findings.

Influence of ambient temperature and diurnal temperature variation on the premature rupture of membranes in East China: A distributed lag nonlinear time series analysis.

BACKGROUND: Extreme ambient temperature has an adverse effect on pregnancy outcomes, but the conclusions have been inconsistent. The influence of ambient temperature and diurnal temperature variation on the premature rupture of membranes (PROM) needs further study. METHODS AND FINDINGS: The daily data of PROMs, daily meteorological and air pollutant were obtained. After controlling for potential confounding factors, the quasi-Poisson generalized additive model (GAM) combined with the distributed lag nonlinear model (DLNM) was used to analyze the association between temperature or diurnal temperature variation and PROM, including preterm premature rupture of membranes (PPROM) and term premature rupture of membranes (term PROM). Compared with the median temperature(18.7 °C), the mean temperature of 5-7 days lagging beyond 31.5 °C and below -1.5 °C was positively correlated with PROM; the mean temperature had more sensitive effect on the term PROM. Exposure to extremely high temperatures (97.5th percentile, 32 °C) had a 6-day lagging relative risk (RR) (95% CI: 1.005-1.160) of 1.08 for PROM and a 6-day lagging RR of 1.079 (95% CI: 1.005-1.159) for term PROM; Exposure to a high diurnal temperature variation (diurnal temperature variation greater than 16 °C) was positively correlated with the term PROM. Compared with the 2.5th percentile diurnal temperature variation (2 °C), exposure to the 95th percentile diurnal temperature variation (17 °C) significantly increased the risk of term PROM (RR: 1.229, 95% CI: 1.029-1.467). CONCLUSIONS: Exposure to a high-temperature and a high diurnal temperature variation environment will increase the relative risks of PROM. For pregnant women in the 3rd trimester, it is important to reduce exposure to extremely high-temperatures and greater diurnal temperature changes.

Blood Glucose Level, Gestational Diabetes Mellitus and Maternal Birth Season: A Retrospective Cohort Study.

Background: Previous evidence indicates that birth season is associated with type 2 diabetes in adults. However, information on the association of birth with gestational diabetes mellitus (GDM) is lacking. The present study explores the association between birth seasonality and GDM in East China. Methods: This retrospective cohort study was conducted at the International Peace Maternal and child health hospital between 2014 and 2019. A total of 79, 292 pregnant women were included in the study after excluding participants with previous GDM, stillbirth, polycystic ovary syndrome, and lack of GDM laboratory records. The multivariate logistic regression model was employed to estimate the odds ratio and 95% confidence interval. After log transformation of blood glucose level, the percentage change and 95% confidence interval were estimated by a multivariate linear model. Results: The risk of GDM among pregnant women born in spring, autumn, and winter was not significantly different compared to that among participants born in summer. Pregnant women born in autumn had significantly higher 1-hour postprandial blood glucose (PBG-1h) and 2-hour postprandial blood glucose (PBG-2h) levels than pregnant women born in summer. Compared to pregnant women born in August, the PBG-1h level of pregnant women born in October, November, and December increased significantly, whereas the PBG-2h levels of pregnant women born in November and December increased significantly. Conclusion: Pregnant women born in autumn exhibit higher postprandial blood glucose levels during pregnancy than in those born in summer. The findings provide evidence that exposure to seasonal changes in early life may influence blood glucose metabolism during pregnancy.

Predictors, sources, and health risk of exposure to neonicotinoids in Chinese school children: A biomonitoring-based study.

BACKGROUND: Recent studies have suggested an extensive exposure to neonicotinoids in human, but the information on predictors, sources, and health risk remains limited in children. OBJECTIVE: To explore the predictors, sources, and health risk for exposure of Chinese school children to neonicotinoids by biomonitoring method. METHODS: In 2019, 309 school children aged 7-11 years were selected from a dynamic cohort of children established in Shanghai, East China. Eight neonicotinoids and four metabolites were determined in first morning urine. After detailed information on demographic and socioeconomic indices, intake of drinking water, food consumption, and anthropometric measurements was collected, the predictors and sources of exposure to neonicotinoids were explored by binary and ordinal logistic regression models. Health risk was assessed by the hazard quotient (HQ) and hazard index (HI) based on estimated daily exposure dose. RESULTS: Six neonicotinoids (thiamethoxam, clothianidin, imidacloprid, acetamiprid, nitenpyram, and dinotefuran) and three metabolites (N-desmethyl-thiamethoxam, N-desmethyl-clothianidin, and N-desmethyl-acetamiprid) were detected in 81.3% of urine samples. Children in nuclear family or girls had a higher detection frequency of thiamethoxam. N-desmethyl-acetamiprid was more likely to be detected in children who were older, physically active, or obese. Parents' occupation was heterogeneously associated with the detection of thiamethoxam and clothianidin. Thiamethoxam and clothianidin were more likely to be detected in children consuming more fresh vegetables in all or its specific items of cabbage, nori, and kelp. N-desmethyl-acetamiprid was more likely to be detected in children who drank more tap water. The maximum HQ and HI were 0.3522 and 0.5187, respectively, and 2.8% of children had a HI between 0.1 and 1. CONCLUSION: Predictors for the exposure of children to neonicotinoids included demographic and socioeconomic factors, physical exercise, and relative body weight. Tap water and fresh vegetables were potential sources. A low risk was posed on children's health by the neonicotinoids.

Prevalence and associated factors of Treponema pallidum infection in a rural area of southwestern China.

BACKGROUND: Epidemiological data on Treponema pallidum infection are scarce from the southwestern region of China. The purpose of this study was to determine the distribution and determinants of T. pallidum infection in the region. METHODS: A community-based cross-sectional study of 2608 participants aged ≥14 years was conducted in a rural area of southwestern China in 2014-15. A pretested questionnaire was used to collect sociodemographic characteristics and other factors associated with T. pallidum infection. The diagnoses of T. pallidum, human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infections were determined by commercial test kits. Logistic regression analysis was used to determine the correlates for T. pallidum infection, and adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. RESULTS: The prevalence of T. pallidum infection was 1.2% (95% CI 0.8 to 1.7%). Risk factors varied by gender. In the male group, T. pallidum infection was significantly associated with ever injection drug use (aOR = 9.42, 95% CI 2.47 to 35.87) and HCV infection (aOR = 13.28, 95% CI 3.20 to 51.70). In the female group, correlates for T. pallidum infection included spouse having syphilis (aOR = 126.66, 95% CI 7.58 to 2122.94), ever having blood transfusion (aOR = 10.51, 95% CI 1.58 to 41.21) and HBV infection (aOR = 4.19, 95% CI 1.35 to 10.93). CONCLUSIONS: The prevalence of T. pallidum infection was high in the rural area of southwestern China. Correlates for T. pallidum infection varied with sex specific. Intervention should be developed for the prevention and control of T. pallidum infection.

Prevalence of Cryptosporidium Infection in the Global Population: A Systematic Review and Meta-analysis.

BACKGROUND: Cryptosporidium is a protozoan parasite that can infect both humans and animals and cause cryptosporidiosis. We aimed to estimate the global prevalence of Cryptosporidium infection. METHODS: In this study, Web of Science, Medline and PubMed were searched for relative articles, published between January 1, 1960 and January 1, 2018. Included articles were restricted to English language and that sample size of articles was not less than 50. Studies with no information on the study period, location, method of diagnosis, sample size and number of infected people were excluded. Studies about outbreak, laboratory report or immunocompromised population were excluded as well. The quality of the included publications was assessed. The prevalence of cryptosporidiosis was estimated by DerSimonian-Laird random-effects model, after converting by the Freeman-Tukey type double arcsine transformation. FINDINGS: From 13,064 publications selected by literature search, 221 studies were included in the meta-analysis. The global pooled prevalence of Cryptosporidium infection was 7.6 % (95% CI: 6.9-8.5). The highest estimated prevalence of Cryptosporidium infection was in Mexico (69.6%, 95% CI 66.3-72.8), Nigeria (34.0%, 95% CI 12.4-60.0), Bangladesh (42.5%, 95% CI 36.1-49.0) and Republic of Korea (8.3%, 95% CI 4.4-13.2) among general residents, patients, school children and healthy population, respectively. The estimated prevalence was high in people from low-income country, people with gastrointestinal symptoms, people younger than 5 years old and residents not living in urban areas. CONCLUSIONS: These estimates indicate the substantial prevalence of Cryptosporidium infection in the world, which may provide a theoretical basis for the formulation of the prevention strategy about Cryptosporidium.

Factors associated with uptake of Haemophilus influenzae type b vaccination in Shanghai, China.

BACKGROUND: Haemophilus influenzae type b (Hib) vaccine is effective in reducing the burden of Hib related diseases, but little is known about factors influencing the uptake of Hib vaccine. This study aimed to assess the uptake of Hib vaccination and its associated factors in Shanghai City, China. METHODS: We used data from a retrospective cohort of 183,246 children born in 2012-2016 obtained from the Shanghai Immunization Program Information System, which provided information on the uptake of Hib vaccination. We conducted a cross-sectional study of 451 children to collect information on demographic and other factors that might be associated with Hib vaccination. RESULTS: In the retrospective cohort study, the proportions of Hib dose-1 coverage, vaccination completion and timeliness were 67.7, 52.2 and 29.4%, respectively. These measures were better among local children and increased with birth year, while there were regional differences. Hib vaccine uptake was significantly associated with maternal occupation (non-health vs health workers, OR = 2.33, 95% CI: 1.32-4.13, P = 0.004) and caregivers' awareness of Hib (yes vs no, OR = 1.75, 95% CI: 1.12-2.74, P = 0.013). CONCLUSIONS: We found low levels of coverage of dose-1 Hib vaccine, timeliness and completion, suggesting inadequate protection against Hib disease for children in Shanghai. Non-local children and those of health workers should be targeted for interventions. The inclusion of Hib vaccine into the national immunization program could help improve the uptake of Hib vaccines.

Elimination of Schistosoma japonicum Transmission in China: A Case of Schistosomiasis Control in the Severe Epidemic Area of Anhui Province.

Over the several decades, China has been incessantly optimizing control strategies in response to the varying epidemic situations of schistosomiasis. We evaluated continuously the changing prevalence under different control strategies of two villages, Sanlian and Guifan, in China through five phases lasting 37 years. We tested residents, calculated prevalence and discussed change causes. We found the prevalence in Sanlian did not differ significant from that of Guifan (p = 0.18) in 1981, but decreased to 2.66%, much lower than Guifan's 11.25%, in 1984 (p = 0). Besides, prevalence in Guifan increased to 21.25% in 1987, while in Sanlian it rose to 20.78% until 1989. Those data confirmed that praziquantel combined with snail control could better reduce the prevalence. From 1992 to 1994, the prevalence in the two villages displayed downtrends, which showed the World Bank Loan Project worked. From 1995 to 2004, repeated oscillations with no obvious change trend was seen. Since 2005, the prevalence in both villages has shown a significant downtrend (p < 0.05), which suggests the integrated strategy is effective. We considered the control strategies were implemented suitably in the study area under changing social circumstances. Adjusting the strategy in consideration of social transformations is necessary and vital. The experience may be useful for policy making of other epidemic areas with an analogous situation.

Geographical variation in lung cancer risk associated with road traffics in Jiading District, Shanghai.

Few studies have investigated the spatial variation in road traffic indicators associated with lung cancer risk. The purpose of this study was to explore the relationship between road traffic-related indicators and lung cancer risk and to estimate its spatial variability. The population-based case control study was conducted, including all the newly diagnosed lung cancer patients (cases) and colorectal cancer patients (controls) in Jiading District, Shanghai from 2014 to 2016. Traffic intensity variable (traffic intensity in a 500 m buffer), residential distance to major road or highway, and greenness exposure at the residence were estimated for each individual. We conducted unconditional logistic regression with adjustment for age, sex, smoking status and NDVI values and geographically weighted logistic regression (GWLR). The clustering of lung cancer risk was analyzed by Bernoulli model of the SaTScan software. This study included 1461 lung cancer patients and 954 colorectal cancer patients. In multivariate logistic regression, smoking [OR 1.25 95% CI (1.15-1.35)], living <50 m from the major road [OR 1.43 95% CI (1.02-2.03)] were significantly associated with lung cancer risk. Residential Proximity to highway, residential greenness, and traffic intensity were not significantly associated with lung cancer risk. The GWLR model showed that the degree of correlation between residential proximity to major road and lung cancer risk varied geographically. The SaTScan results showed a lung cancer cluster in the southwest of Jiading District, Shanghai. Our study suggested that the distance from residence to the main road was significantly associated with lung cancer risk, which varied geographically. It is helpful to further study the traffic factors' spatial variation related to lung cancer risk and carry out reasonable regional planning.

Prevalence and Risk Factors of Ascaris lumbricoides, Trichuris trichiura and Cryptosporidium Infections in Elementary School Children in Southwestern China: A School-Based Cross-Sectional Study.

Background: Intestinal parasitic infections pose great public health challenges in school children in developing countries. The aim of this study was to assess the prevalence of A. lumbricoides, T. trichiura and Cryptosporidium among elementary school children in rural southwestern China. Methods: A school-based cross-sectional study involving 321 elementary school children was conducted in 2014 in the southwest of China. They were invited to provide a stool sample and interviewed about the sanitary situation and hygiene behavior. Stool specimens were examined for A. lumbricoides and T. trichiura using the Kato-Katz fecal thick-smear technique. The presence of Cryptosporidium was determined using a modified acid-fast staining method. Results: The prevalence of infection was 10.0% (95% CI: 6.9⁻13.8%) for A. lumbricoides, 25.2% (95% CI: 20.6⁻30.4%) for T. trichiura and 2.4% for (95% CI: 1.1⁻4.9%) Cryptosporidium. The prevalence of co-infection was 3.7% (95% CI: 1.9⁻6.4%) for A. lumbricoides/T. trichiura, 0.3% (95% CI: 0⁻1.7%) for A. lumbricoides/Cryptosporidium and 0.9% (95% CI: 0.2⁻2.7%) for T. trichiura/Cryptosporidium. Children from households using well or river water were associated with a greater odds of A. lumbricoides infection (aOR = 2.61, 95% CI: 1.12⁻6.05). Having a household lavatory was associated with a lower odds of T. trichiura infection (aOR = 0.50, 95% CI: 0.30⁻0.84). Children who had three meals at the school canteen on week days were at a lower risk of Cryptosporidium infection. The use of spring water as a water source was associated with lower odds of any intestinal infection (aOR = 0.56, 95% CI: 0.35⁻0.91). Conclusions: Our study calls for an intervention program of school-based deworming combined with health education, hygiene promotion and provision of safe water and improved sanitation.