Comparative effectiveness of noninvasive therapeutic interventions for myofascial pain syndrome: a network meta-analysis of randomized controlled trials.

BACKGROUND: Myofascial pain syndrome (MPS) has an impact on physical health and quality of life for patients, with various noninvasive methods used for relieving myofascial pain. The authors aimed to compare the effectiveness of different noninvasive therapeutic interventions for MPS. MATERIALS AND METHODS: The authors searched PubMed, Embase, CINAHL Complete, Web of Science, Cochrane, and Scopus to identify randomized controlled trials describing the effects of any noninvasive treatments in patients with MPS. The primary outcome was pain intensity, while pressure pain threshold and pain-related disability were secondary outcomes. RESULTS: The analysis included 40 studies. Manual therapy [mean difference (MD) of pain: -1.60, 95% CI: -2.17 to -1.03; MD of pressure pain threshold: 0.52, 95% CI: 0.19 to 0.86; MD of pain-related disability: -5.34, 95% CI: -8.09 to -2.58], laser therapy (MD of pain: -1.15, 95% CI: -1.83 to -0.46; MD of pressure pain threshold: 1.00, 95% CI: 0.46 to 1.54; MD of pain-related disability: -4.58, 95% CI: -7.80 to -1.36), extracorporeal shock wave therapy (MD of pain: -1.61, 95% CI: -2.43 to -0.78; MD of pressure pain threshold: 0.84, 95% CI: 0.33 to 1.35; MD of pain-related disability: -5.78, 95% CI: -9.45 to -2.12), and ultrasound therapy (MD of pain: -1.54, 95% CI: -2.24 to -0.84; MD of pressure pain threshold: 0.77, 95% CI: 0.31 to 1.22) were more effective than no treatment. CONCLUSION: Our findings support that manual therapy, laser therapy, and extracorporeal shock wave therapy could effectively reduce pain intensity, pressure pain threshold, and pain-related disability with statistical significance when compared with placebo. This finding may provide clinicians with appropriate therapeutic modalities for patients with MPS among different scenarios.

SFTSV infection is associated with transient overproliferation of monoclonal lambda-type plasma cells.

The impairment of antibody-mediated immunity is a major factor associated with fatal cases of severe fever with thrombocytopenia syndrome (SFTS). By collating the clinical diagnosis reports of 30 SFTS cases, we discovered the overproliferation of monoclonal plasma cells (MCP cells, CD38+cLambda+cKappa-) in bone marrow, which has only been reported previously in multiple myeloma. The ratio of CD38+cLambda+ versus CD38+cKappa+ in SFTS cases with MCP cells was significantly higher than that in normal cases. MCP cells presented transient expression in the bone marrow, which was distinctly different from multiple myeloma. Moreover, the SFTS patients with MCP cells had higher clinical severity. Further, the overproliferation of MCP cells was also observed in SFTS virus (SFTSV)-infected mice with lethal infectious doses. Together, SFTSV infection induces transient overproliferation of monoclonal lambda-type plasma cells, which have important implications for the study of SFTSV pathogenesis, prognosis, and the rational development of therapeutics.

Association between anxiety and metabolic syndrome: An updated systematic review and meta-analysis.

Objective: Previous studies have demonstrated an association between anxiety and metabolic syndrome (MetS). However, the association is still controversial. This updated meta-analysis aimed to reanalyze the association between anxiety and MetS. Methods: We comprehensively searched PubMed, Embase and Web of Science for all related studies published before January 23, 2023. Observational studies that informed effect size with 95% confidence interval (CI) for the association between anxiety and MetS were included. According to heterogeneity between studies, fixed or random effects models were applied to calculate the pooled effect size. Publication bias was examined by funnel plots. Results: The research included 24 cross-sectional studies: 20 studies used MetS as the dependent variable with a pooled OR of 1.07 (95% CI: 1.01-1.13) and four studies used anxiety as the dependent variable with a pooled OR of 1.14 (95% CI: 1.07-1.23). Three cohort studies were found: two studies detected the association of baseline anxiety with the risk of MetS, one of the studies demonstrated a significant association, but a similar result was not found in another study; one study showed no significant association between baseline MetS and the risk of anxiety. Conclusion: Cross-sectional studies indicated an association between anxiety and MetS. The results from cohort studies are still inconsistent and limited. More large-scale prospective studies are needed to further reveal the causal relationship of anxiety with MetS.

Association between autoimmune diseases of the nervous system and schizophrenia: A systematic review and meta-analysis of cohort studies.

INTRODUCTION: Numerous studies have found an association between autoimmune diseases of the nervous system (ADNS) and schizophrenia (SCZ), but the findings remain controversial. We conducted the first meta-analysis to summarize the current evidence from cohort studies that evaluated the association between ADNS and SCZ. METHODS: PubMed, Web of Science, and Embase were comprehensively searched until May 30, 2022 for articles on the association between ADNS and SCZ. Every included study was reported effect size with 95% CIs for the association between ADNS and SCZ. Meta-regression and subgroup analysis were used to assess the heterogeneity. RESULTS: A total of 8 cohort studies with 12 cohorts were included in the meta-analysis. We observed a significant association between ADNS and SCZ (RR = 1.42; 95%CI, 1.18-1.72). Subgroup analysis showed that the risk of SCZ was significantly increased when ADNS were used as exposure factors (RR = 1.48; 95%CI, 1.15-1.89), whereas with SCZ did not observe an increased risk of subsequent ADNS (RR = 1.33; 95%CI, 0.92-1.92); multiple sclerosis (MS) was positively associated with SCZ (RR = 1.36; 95%CI, 1.12-1.66), but no significant association was found between Guillain-Barre syndrome (GBS) and SCZ (RR = 1.90; 95%CI, 0.87-4.17). Meanwhile, we found location was the source of heterogeneity. LIMITATIONS: High heterogeneity was observed (I2 = 92.0%), and only English literature was included in the meta-analysis. CONCLUSIONS: We found a positive association between ADNS and SCZ, and the association was different across the different types of ADNS. The results of the study are helpful for clinicians to carry out targeted preventive measures for ADNS and SCZ.

Association between cold spells and serum lipid levels among the elders: a distributed-lagged effects analysis.

Little evidence about the effects of cold spells on serum lipid levels is available. The aim of this study was to explore the association between cold spells and serum lipid levels among the elders in Jinan, China. Data of old adults from health check-up program in Shandong Provincial Qianfoshan Hospital was collected for this study. Linear mixed models combined with distributed lag nonlinear models were used to examine the relationship between cold spells and serum lipid levels, considering the confounding effects of age, sex, blood pressure, body mass index, and other meteorological factors. Subgroup analysis by gender and analysis based on different definitions of cold spells were also conducted. Increased TG levels in lag 0-lag 2 days and decreased TG levels in lag 5-lag 8 days after cold spells were observed among the elders. The largest increase was 0.363 mmol/L (95% CI: 0.184 ~ 0.543) in lag 0 day, while the largest decreased TG levels was 0.083 mmol/L (95% CI: 0.147 ~ 0.019) in lag 6 day. Similar results were obtained in the analysis of different sex and based on different definitions of cold spells. However, no significant association was found between cold spells with TC, LDL-C, and HDL-C. This study indicates that cold spells were significantly associated with serum TG levels in the elders. Effective preventive measures should be implemented around the cold spells to reduce the volatility of serum lipid levels and the occurrence of subsequent cardiovascular diseases.

Seroprevalence of influenza viruses in Shandong, Northern China during the COVID-19 pandemic.

Nonpharmaceutical interventions (NPIs) have been commonly deployed to prevent and control the spread of the coronavirus disease 2019 (COVID-19), resulting in a worldwide decline in influenza prevalence. However, the influenza risk in China warrants cautious assessment. We conducted a cross-sectional, seroepidemiological study in Shandong Province, Northern China in mid-2021. Hemagglutination inhibition was performed to test antibodies against four influenza vaccine strains. A combination of descriptive and meta-analyses was adopted to compare the seroprevalence of influenza antibodies before and during the COVID-19 pandemic. The overall seroprevalence values against A/H1N1pdm09, A/H3N2, B/Victoria, and B/Yamagata were 17.8% (95% CI 16.2%-19.5%), 23.5% (95% CI 21.7%-25.4%), 7.6% (95% CI 6.6%-8.7%), and 15.0 (95% CI 13.5%-16.5%), respectively, in the study period. The overall vaccination rate was extremely low (2.6%). Our results revealed that antibody titers in vaccinated participants were significantly higher than those in unvaccinated individuals (P < 0.001). Notably, the meta-analysis showed that antibodies against A/H1N1pdm09 and A/H3N2 were significantly low in adults after the COVID-19 pandemic (P < 0.01). Increasing vaccination rates and maintaining NPIs are recommended to prevent an elevated influenza risk in China.

Hydrogen intake relieves alcohol consumption and hangover symptoms in healthy adults: a randomized and placebo-controlled crossover study.

BACKGROUND: Alcohol-induced hangover represents a significant, yet understudied, global hazard and a large socioeconomic burden. OBJECTIVE: The aim of this study was to investigate the effects of hydrogen on relieving drinking and hangover symptoms in 20 healthy volunteers. METHODS: In this pilot, randomized, double-blinded, placebo-controlled, matched, crossover interventional trial, participants were matched into pairs and randomly assigned. Study group 1 inhaled placebo air for 1 h, followed by drinking 100 mL liquor (40% alcohol) within 10 min, and then pure water. Study group 2 inhaled a mixture of hydrogen and oxygen gas for 1 h, followed by drinking 100 mL liquor within 10 min, and then hydrogen dissolved in water. On a second intervention day (crossover) ≥1 wk later, study-group subjects were switched to the opposite order. Breath alcohol concentration (BrAC), hangover severity, and cognitive scores were measured. RESULTS: The BrACs within the hydrogen group were significantly lower than those within the placebo group after 30 min, 60 min, and 90 min (P< 0.05). The hydrogen group reported having fewer hangover symptoms compared with the placebo group (placebo: 77% of symptoms absent, 19.7% of mild symptoms, 2.7% of moderate symptoms, 0.7% of severe symptoms; hydrogen: 88.6% of symptoms absent, 10% of mild symptoms, 1.3% of moderate symptoms, 0% of severe symptoms; P< 0.001). Hydrogen treatment improved cognitive testing scores (P< 0.05), including attention and executive functions. Furthermore, consumption of hydrogen was negatively (ß = -13.016; 95% CI: -17.726, -8.305; P< 0.001) and female sex was positively (ß = 22.611; 95% CI: 16.226, 28.997; P< 0.001) correlated with increased BrACs. Likewise, the consumption of hydrogen was negatively (OR: 0.035; 95% CI: 0.007, 0.168; P< 0.001) while female sex was positively (OR: 28.838; 95% CI: 5.961, 139.506; P< 0.001) correlated with the severity of hangover symptoms. CONCLUSIONS: Hydrogen decreases BrACs and relieves the symptoms of hangovers. This trial was registered at the China Clinical Trial Registry (http://www.chictr.org.cn/showproj.aspx?proj=58359) as ChiCTR2200059988.

Effectiveness of thalidomide for ankylosing spondylitis: a meta-analysis of randomized controlled trials in China.

Several studies have demonstrated the benefits of thalidomide as a treatment for patients with ankylosing spondylitis (AS); however, published literature reported controversial results. We conducted a meta-analysis to systematically evaluate the efficacy of thalidomide in AS patients. PubMed, Embase, Cochrane Library, Web of Science, Wanfang Data, and China National Knowledge Infrastructure (CNKI) were searched for relevant studies. The Q test and I2 statistic were used to examine between-study heterogeneity. Fixed- or random-effects models were selected based on study heterogeneity. The risk difference (RD), absolute risk reduction (ARR), and weighted mean difference (WMD) with 95% confidence intervals (CI) were pooled for dichotomous or continuous data, as appropriate. Sensitivity analyses, funnel plots, and the Begg's tests were also performed. Overall, 19 trials with 1471 patients were included. The effectiveness of thalidomide alone and combined with other drugs was significantly higher than the control group, and the pooled RDs were 0.15 (95% CI: 0.10-0.20, I2 = 0%) and 0.20 (95% CI: 0.14-0.25, I2 = 13.4%), respectively. Thalidomide treatment yielded significant improvements in secondary outcomes for patients with AS. The adverse reaction rate for thalidomide alone was low than that for the control group (ARR = 0.08, 95% CI: 0.01-0.15, I2 = 0.0%), while there was no significant difference in the safety between the group in which thalidomide was combined with other drugs and the control (ARR = 0.03, 95% CI: - 0.04-0.10, I2 = 41.1%). The findings suggest that thalidomide improves the effectiveness of AS treatment, which should be considered by physicians. However, owing to the inclusion of several low-quality and Chinese studies, additional rigorous randomized controlled trials (RCTs) are needed in the future to confirm the results of this meta­analysis.

Human-to-human transmission of Chlamydia psittaci in China, 2020: an epidemiological and aetiological investigation.

BACKGROUND: Chlamydia psittaci can infect a wide range of avian species, occasionally causing psittacosis (also known as parrot fever) in humans. Most human psittacosis cases are associated with close contact with pet birds or poultry. In December, 2020, an outbreak of severe community-acquired pneumonia of unknown aetiology was reported in a hospital in Shandong province, China, and some of the patients' close contacts had respiratory symptoms. Our aims were to determine the causative agent of this epidemic and whether there had been human-to-human transmission. METHODS: For this epidemiological and aetiological investigation study, we enrolled patients who had community-acquired pneumonia confirmed by chest CT at two local hospitals in Shandong Province in China. We collected sputum, bronchoalveolar lavage fluid, and nasopharyngeal swab samples from participants and detected pathogens by surveying for 22 target respiratory microbes using a commercial assay, followed by metagenomic next-generation sequencing, specific nested PCR, and qPCR tests. We excluded individuals who were C psittaci-negative on both tests. We recruited close contacts of the C psittaci-positive patients, and tested nasopharyngeal swabs from the close contacts and samples from ducks from the processing plant where these patients worked. We then integrated the epidemiological, clinical, and laboratory data to reveal the potential chain of transmission of C psittaci that characterised this outbreak. FINDINGS: Between Dec 4 and 29, 2020, we used metagenomic next-generation sequencing and different PCR-based approaches to test 12 inpatients with community-acquired pneumonia, of whom six (50%) were workers at a duck-meat processing plant and two (17%) were unemployed people, who were positive for C psittaci and enrolled in this study. We contacted 61 close contacts of the six patients who worked at the duck-meat processing plant, of whom 61 (100%) were enrolled and tested, and we determined that the community-acquired pneumonia outbreak was caused by C psittaci. Within the outbreak cluster, 17 (77%) of 22 participants had confirmed C psittaci infections and five (23%) of 22 participants were asymptomatic C psittaci carriers. The outbreak had begun with avian-to-human transmission, and was followed by secondary and tertiary human-to-human transmission, which included transmission by several asymptomatic carriers and by health-care workers. In addition, some of the participants with confirmed C psittaci infection had no identified source of infection, which suggested cryptic bacterial transmission. INTERPRETATION: Our study data might represent the first documented report of human-to-human transmission of C psittaci in China. Therefore, C psittaci has the potential to evolve human-to-human transmission via various routes, should be considered an elevated biosecurity and emergent risk, and be included as part of the routine diagnosis globally, especially for high-risk populations. FUNDING: Academic Promotion Programme of Shandong First Medical University, National Science and Technology Major Project, ARC Australian Laureate Fellowship.

Association Between Immunoglobulin G N-glycosylation and Vascular Cognitive Impairment in a Sample With Atherosclerosis: A Case-Control Study.

BACKGROUND: Atherosclerosis is considered a crucial component in the pathogenesis of decreased cognitive function, as occurs in vascular cognitive impairment (VCI). Inflammation and the immune response play a significant role in the development of many chronic diseases. Immunoglobulin G (IgG) N-glycosylation has been implicated in the development of a variety of diseases by affecting the anti-inflammatory and proinflammatory responses of IgG. This study aimed to investigate the association between IgG N-glycosylation and VCI in a sample of patients with atherosclerosis through a case-control study. METHOD: We recruited a total of 330 patients with atherosclerosis to participate in this case-control study, including 165 VCI patients and 165 sex- and age-matched participants with normal cognitive function. The plasma IgG N-glycans of participants were separated by ultrahigh-performance liquid chromatography. An enzyme-linked immunosorbent assay (ELISA) kit was used to determine the corresponding serum inflammatory factors. Atherosclerosis was diagnosed by carotid ultrasound, and the diagnosis of VCI was based on the "Guidelines for the Diagnosis and Treatment of Vascular Cognitive Impairment in China (2019)". A multivariate logistic regression model was used to explore the association between IgG N-glycans and VCI. We also analyzed the relationship between IgG N-glycans and the inflammatory state of VCI through canonical correlation analysis (CCA). RESULTS: Through the multivariate logistic regression analysis, 8 glycans and 13 derived traits reflecting decreased sialylation and galactosylation and increased bisecting GlcNAc significantly differed between the case and control groups after adjusting for confounding factors (P < 0.05, q < 0.05). Similarly, the differences in TNF-α, IL-6, and IL-10 were statistically significant between the case and control groups after adjusting for the effects of confounding factors (P < 0.05, q < 0.05). The CCA results showed that VCI-related initial N-glycans were significantly correlated with VCI-related inflammatory factors (r = 0.272, P = 0.004). The combined AUC value (AUC combined = 0.885) of 7 initial glycans and inflammatory factors was higher than their respective values (AUC initial glycans = 0.818, AUC inflammatory factors = 0.773). CONCLUSION: The findings indicate that decreased sialylation and galactosylation and increased bisecting GlcNAc reflected by IgG N-glycans might affect the occurrence of VCI in patients with atherosclerosis though promoting the proinflammatory function of IgG. IgG N-glycans may serve as potential biomarkers to distinguish VCI in individuals with atherosclerosis.

Incidence, circulation, and spatiotemporal analysis of seasonal influenza in Shandong, China, 2008-2019: A retrospective study.

BACKGROUND: Understanding the influenza-like illness (ILI) incidence, circulation pattern of virus strains and spatiotemporal pattern of influenza transmission are important for designing control interventions. Based on the 10 years' surveillance data, we aimed to provide a baseline characterization and the epidemiology and dynamics of influenza virus in Shandong. METHODS: We extracted surveillance and laboratory testing data. We estimated the ILI incidence and analyzed the predominant virus. A wavelet power analysis was used to illustrate the periodicity. In addition, we applied a linear regression model to characterize the correlation of influenza seasonality with longitude. RESULTS: The average ILI incidence was estimated to be 3744.79 per 1 million (95% confidence interval [CI]: 2558.09-4931.45) during 2009-2018. Influenza A/H1N1 and A/H3N2 strains predominated in the most influenza seasons in Shandong. The annual amplitude of influenza epidemics decreased with longitude (P < 0.05). In contrast, the epidemic peak of influenza emerged earlier in the western region and increased with longitude in influenza A (P < 0.05). The annual peak of the influenza B epidemic lagged a median of 4.2 weeks compared with that of influenza A. CONCLUSIONS: The development or modification of seasonal influenza vaccination strategies requires the recognition that the incidence is higher in preschool- and school-aged children. Although seasonal influenza circulates annually in Shandong, the predominant virus strain circulation pattern is extremely unpredictable and strengthening surveillance for the predominant virus strain is necessary. Lower longitude inland regions need to take nonpharmaceutical or pharmaceutical interventions in advance during influenza high-occurrence seasons.

Clinical features of 162 fatal cases of COVID-19: a multi-center retrospective study.

Background: The coronavirus disease 2019 (COVID-19) has affected approximately 2 million individuals worldwide; however, data regarding fatal cases have been limited. Objective: To report the clinical features of 162 fatal cases of COVID-19 from 5 hospitals in Wuhan between December 30, 2019 and March 12, 2020. Methods: The demographic data, signs and symptoms, clinical course, comorbidities, laboratory findings, computed tomographic (CT) scans, treatments, and complications of the patients with fatal cases were retrieved from electronic medical records. Results: The median patient age was 69.5 (interquartile range: 63.0-77.25) years, and 80% of the patients were over 61 years. A total of 112 (69.1%) patients were men. Hypertension (45.1%) was the most common comorbidity, while 59 (36.4%) patients had no comorbidity. At admission, 131 (81.9%) patients had severe or critical COVID-19, whereas 39 (18.1%) patients with hypertension or chronic lung disease had moderate COVID-19. In total, 126 (77.8%) patients received antiviral treatment, while 132(81.5%) patients received glucocorticoid treatment. A total of 116 (71.6%) patients were admitted to the intensive care unit (ICU), and 137 (85.1%) patients received mechanical ventilation. Most patients received mechanical ventilation before ICU admission. Approximately 93.2% of the patients developed respiratory failure or acute respiratory distress syndrome. There were no significant differences in the inhospital survival time among the hospitals (P=0.14). Conclusion: Young patients with moderate COVID-19 without comorbidity at admission could also develop fatal outcomes. The in-hospital survival time of the fatal cases was similar among the hospitals of different levels in Wuhan.

Effects of ambient temperature on influenza-like illness: A multicity analysis in Shandong Province, China, 2014-2017.

Background: The associations between ambient temperature and influenza-like illness (ILI) have been investigated in previous studies. However, they have inconsistent results. The purpose of this study was to estimate the effect of ambient temperature on ILI in Shandong Province, China. Methods: Weekly ILI surveillance and meteorological data over 2014-2017 of the Shandong Province were collected from the Shandong Center for Disease Control and Prevention and the China Meteorological Data Service Center, respectively. A distributed lag non-linear model was adopted to estimate the city-specific temperature-ILI relationships, which were used to pool the regional-level and provincial-level estimates through a multivariate meta-analysis. Results: There were 911,743 ILI cases reported in the study area between 2014 and 2017. The risk of ILI increased with decreasing weekly ambient temperature at the provincial level, and the effect was statistically significant when the temperature was <-1.5°C (RR = 1.24, 95% CI: 1.00-1.54). We found that the relationship between temperature and ILI showed an L-shaped curve at the regional level, except for Southern Shandong (S-shaped). The risk of ILI was influenced by cold, with significant lags from 2.5 to 3 weeks, and no significant effect of heat on ILI was found. Conclusion: Our findings confirm that low temperatures significantly increased the risk of ILI in the study area. In addition, the cold effect of ambient temperature may cause more risk of ILI than the hot effect. The findings have significant implications for developing strategies to control ILI and respond to climate change.

Association Between Infections and Risk of Ankylosing Spondylitis: A Systematic Review and Meta-Analysis.

Background: Previous literature on the association between infections and the risk of developing ankylosing spondylitis (AS) presented controversial results. This meta-analysis aimed to quantitatively investigate the effect of infections on the risk of AS. Methods: We searched the PubMed, Embase, and Web of Science databases until March 26, 2021 for analytical epidemiological studies on the association between infections and the risk of AS. Fixed or random effect models were used to calculate total risk estimates based on study heterogeneity. Subgroup analysis, and sensitivity analysis were also performed. Publication bias was estimated using funnel plots and Begg's test. Results: Six case-control articles (n=1,296,239) and seven cohort articles (n=7,618,524) were incorporated into our meta-analysis. The pooled odds ratio (OR) from these case-control studies showed that infections were associated with an increased risk of AS (OR=1.46, 95% confidence interval [CI], 1.23-1.73), and the pooled relative risk (RR) from the cohort studies showed the same findings (RR=1.35, 95% CI, 1.12-1.63). Subgroup analysis showed that infections in participants with unadjusted comorbidities (OR=1.66, 95% CI, 1.35-2.03), other types of infection (OR=1.40, 95% CI, 1.15-1.70), and infection of the immune system (OR=1.46, 95% CI, 1.42-1.49) were associated with the risk of AS in case-control studies. In cohort studies, infections with adjusted comorbidities (RR=1.39, 95% CI, 1.15-1.68), viral infection (RR=1.43, 95% CI, 1.22-1.66), other types of infection (RR=1.44, 95% CI, 1.12-1.86), and other sites of infection (RR=1.36, 95% CI, 1.11-1.67) were associated with an increased risk of AS. Conclusions: The findings of this meta-analysis confirm that infections significantly increase the risks of AS. This is helpful in providing an essential basis for the prevention of AS via the avoidance of infections.

Analysis of spatial-temporal distribution of notifiable respiratory infectious diseases in Shandong Province, China during 2005-2014.

BACKGROUND: Little comprehensive information on overall epidemic trend of notifiable respiratory infectious diseases is available in Shandong Province, China. This study aimed to determine the spatiotemporal distribution and epidemic characteristics of notifiable respiratory infectious diseases. METHODS: Time series was firstly performed to describe the temporal distribution feature of notifiable respiratory infectious diseases during 2005-2014 in Shandong Province. GIS Natural Breaks (Jenks) was applied to divide the average annual incidence of notifiable respiratory infectious diseases into five grades. Spatial empirical Bayesian smoothed risk maps and excess risk maps were further used to investigate spatial patterns of notifiable respiratory infectious diseases. Global and local Moran's I statistics were used to measure the spatial autocorrelation. Spatial-temporal scanning was used to detect spatiotemporal clusters and identify high-risk locations. RESULTS: A total of 537,506 cases of notifiable respiratory infectious diseases were reported in Shandong Province during 2005-2014. The morbidity of notifiable respiratory infectious diseases had obvious seasonality with high morbidity in winter and spring. Local Moran's I analysis showed that there were 5, 23, 24, 4, 20, 8, 14, 10 and 7 high-risk counties determined for influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella, respectively. The spatial-temporal clustering analysis determined that the most likely cluster of influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella included 74, 66, 58, 56, 22, 64, 2, 75 and 56 counties, and the time frame was November 2009, March 2008, January 2007, February 2005, July 2007, December 2011, November 2009, June 2012 and May 2005, respectively. CONCLUSIONS: There were obvious spatiotemporal clusters of notifiable respiratory infectious diseases in Shandong during 2005-2014. More attention should be paid to the epidemiological and spatiotemporal characteristics of notifiable respiratory infectious diseases to establish new strategies for its control.

Arbidol is associated with increased in-hospital mortality among 109 patients with severe COVID-19: A multicenter, retrospective study.

BACKGROUND: The antiviral therapy has been considered as an ordinary intervention for COVID-19 patients. However, the effectiveness of antiviral therapy is uncertain. This study was designed to determine the association between the antiviral therapy and in-hospital mortality among severe COVID-19 patients. METHODS: This study enrolled severe COVID-19 patients admitted to four designated hospitals in Wuhan, China. The use of antiviral treatments, demographics, laboratory variables, co-morbidities, complications, and other treatments were compared between survival and fatal cases. The association between antiviral agents and in-hospital mortality were analyzed. RESULTS: In total, 109 severe COVID-19 patients (mean age 65.43) were enrolled for analysis, among which, 61 (56.0%) patients were discharged alive, and 48 (44.0%) died during hospitalization. We found no association between lopinavir/ritonavir (LPV/r) treatment and the in-hospital mortality (odds ratio (OR) = 0.195, 95% confidence interval (CI) = 0.023-1.679). Besides, ribavirin (OR = 0.738, 95% CI = 0.344-1.582), oseltamivir (OR = 0.765, 95% CI = 0.349-1.636), and interferon-alpha (IFN-α) (OR = 0.371, 95% CI = 0.112-1.236) were not associated with the in-hospital mortality. However, arbidol monotherapy (OR = 5.027, 95% CI = 1.795-14.074) or the combination of arbidol and oseltamivir (OR = 5.900, 95% CI = 1.190-29.247) was associated with an increased in-hospital mortality. In addition, the multiple logistic regression identified a significant association between the use of arbidol and the in-hospital mortality (adjusted OR = 4.195, 95% CI = 1.221-14.408). CONCLUSIONS: Our findings indicated that LPV/r, IFN-α, ribavirin, or oseltamivir have no beneficial effects on the prognosis of severe COVID-19 patients, whereas the use of arbidol is associated with increased in-hospital mortality.

The Burden of Alzheimer's Disease Mortality in the United States, 1999-2018.

BACKGROUND: The increasing prevalence of Alzheimer's disease (AD), along with the associated burden on healthcare systems, presents a substantial public health challenge. OBJECTIVE: This study aimed to investigate trends in AD mortality and the relevant burden across the United States (U.S.) from 1999 to 2018 and to predict mortality trends between 2019 and 2023. METHODS: Data on AD-related deaths between 1999 and 2018 were collected from the WONDER database administered by the U.S. Centers for Disease Control and Prevention (CDC). The Joinpoint Regression Program was used to analyze mortality trends due to AD. Years of life lost (YLL) were calculated to explore the burden of AD deaths. An autoregressive integrated moving average (ARIMA) model was employed to forecast mortality trends from 2019 to 2023. RESULTS: Over a recent 20-year period, the number of AD deaths in the U.S. increased from 44,536 (31,145 females and 13,391 males) to 122,019 (84,062 females and 37,957 males). The overall age-adjusted mortality rate increased from 16.5/100,000 in 1999 to 30.5/100,000 in 2018. AD mortality is projected to reach 42.40/100000 within the year 2023. Overall, AD resulted in 322,773.00 YLL (2.33 per 1000 population) in 1999 and 658,501.87 YLL (3.68 per 1000 population) in 2018. CONCLUSION: Our findings demonstrate an increase in AD mortality in the U.S. from 1999 to 2018 as well as a rapid increase from 2019 to 2023. The high burden of AD deaths emphasizes the need for targeted prevention, early diagnosis, and hierarchical management.

The association between extreme temperature and pulmonary tuberculosis in Shandong Province, China, 2005-2016: a mixed method evaluation.

BACKGROUND: The effects of extreme temperature on infectious diseases are complex and far-reaching. There are few studies to access the relationship of pulmonary tuberculosis (PTB) with extreme temperature. The study aimed to identify whether there was association between extreme temperature and the reported morbidity of PTB in Shandong Province, China, from 2005 to 2016. METHODS: A generalized additive model (GAM) was firstly conducted to evaluate the relationship between daily reported incidence rate of PTB and extreme temperature events in the prefecture-level cities. Then, the effect estimates were pooled using meta-analysis at the provincial level. The fixed-effect model or random-effect model was selected based on the result of heterogeneity test. RESULTS: Among the 446,016 PTB reported cases, the majority of reported cases occurred in spring. The higher reported incidence rate areas were located in Liaocheng, Taian, Linyi and Heze. Extreme low temperature had an impact on the reported incidence of PTB in only one prefecture-level city, i.e., Binzhou (RR = 0.903, 95% CI: 0.817-0.999). While, extreme high temperature was found to have a positive effect on reported morbidity of PTB in Binzhou (RR = 0.924, 95% CI: 0.856-0.997) and Weihai (RR = 0.910, 95% CI: 0.843-0.982). Meta-analysis showed that extreme high temperature was associated with a decreased risk of PTB (RR = 0.982, 95% CI: 0.966-0.998). However, extreme low temperature was no relationship with the reported incidence of PTB. CONCLUSION: Our findings are suggested that extreme high temperature has significantly decreased the risk of PTB at the provincial levels. The findings have implications for developing strategies to response to climate change.

Association Between Gamma-Glutamyl Transferase and Mild Cognitive Impairment in Chinese Women.

Background: Dementia, as a global public health problem, is becoming increasingly serious. As a precursor of dementia, mild cognitive impairment (MCI) plays an important role in the diagnosis and prevention of dementia. Recent studies have found a correlation between gamma-glutamyl transferase (GGT) levels and cognitive function in men. The relationship between GGT levels and cognitive function in women remains unclear because GGT activity and expression differ between the sexes. Method: We recruited a total of 2,943 Chinese women from Jidong and Taian in 2019. We grouped the participants according to GGT levels, diagnosed MCI using the Montreal Cognitive Assessment (MOCA) scale, and modeled the study outcomes using logistic regression to explore the relationship between GGT level and MCI. We also analyzed the interaction of obesity, sleep duration, and hyperuricemia with GGT in the development of MCI. Results: The prevalence of MCI increased with increasing GGT level, from the lowest quartile to the highest quartile of GGT: 8.4% (66/786), 14.2% (119/840), 17.6% (108/613), and 21.4% (151/704), respectively. At the same time, as GGT levels increased, so did the risk of MCI. In the fully adjusted model, compared with those for participants in the lowest GGT quartiles, the odds ratios (ORs), and 95% confidence intervals (CIs) for MCI for participants in the second, third, and fourth GGT quartiles were 1.49 (1.04-2.12), 1.53(1.06-2.21), and 1.88 (1.33-2.65), respectively. The risk of developing MCI was further increased in people with high GGT levels who were obese (OR = 1.96, 95% CI: 1.39-2.76, P < 0.001), slept less (OR = 1.91, 95% CI: 1.35-2.71, P < 0.001), had high levels of uric acid (OR = 1.55, 95% CI: 1.03-2.32, P < 0.001), or after menopause (OR = 2.92, 95% CI: 2.07-4.12, P < 0.001). Conclusion: We found that MCI is more common in women with elevated GGT levels, so GGT could be a potential diagnostic marker for MCI. Meanwhile, our findings indicated that women with high GGT levels had an increased risk of MCI when they were obese, sleep deprived, had high serum uric acid (SUA) levels or underwent menopause.

The association of metabolic syndrome and cognitive impairment in Jidong of China: a cross-sectional study.

BACKGROUND: Metabolic syndrome (Mets) is prevalent in the general population and has been reported to be an independent risk factor for cognitive impairment. This study aimed to investigate the association of Mets with the risk of cognitive impairment. METHODS: We studied 5854 participants from the Jidong community. Cognitive function was assessed by the Mini-Mental State of Examination (MMSE) scale. Mets was diagnosed according to the International Diabetes Federation criteria. We used logistic regression analysis to investigate the association of metabolic syndrome with the risk of cognitive impairment. RESULT: Among the 5854 adults included in the study, the age mean (SD) of age was 44 (13.57) years, and 2916 (50.34%) were male. There was a higher (56.03%) cognitive impairment incidence rate among participants with Mets than among those without Mets. In addition, there was a significant association between Mets and cognitive impairment (OR: 2.39, 95% CI: 2.00-2.86, P < 0.05) after adjusting for potential confounders, including age, gender, education level, marital status, smoking and alcohol consumption status. Regarding the 5 Mets components, abdominal obesity and elevated blood pressure were associated with the risk of Mets (OR: 1.36, 95% CI: 1.09-1.70, P < 0.001; OR: 1.32, 95% CI: 1.07-1.63, P < 0.05). Moreover, the strongest statistical correlation (adjusted OR: 1.86, 95% CI: 1.22-2.83, P < 0.05) was found when the number of Mets components was three. CONCLUSION: Our study suggested that Mets was associated with cognitive impairment and that abdominal obesity and hypertension were associated with an increased risk of cognitive impairment.