Prevalence and genotype distribution of human papillomavirus infection among 66000 women from 2014 to 2023 in the plateau region of Southwest China.

BACKGROUND: Persistent infection with high-risk human papillomavirus (HR-HPV) plays a key role in the onset of cervical cancer. This study was designed to examine the epidemiological trends and genotype distribution of HPV from 2014 to 2023 in the plateau region of Southwest China. METHODS: The findings could offer valuable insights for clinical screening of cervical cancer and the formulation of HPV vaccination policies. This retrospective study analyzed 66,000 women who received HPV-DNA testing at the First People's Hospital of Qujing, Yunnan, China, between 2014 and 2023. The cohort consisted of 33,512 outpatients, 3,816 inpatients, and 28,672 individuals undergoing health examinations. Cervical cells were collected for DNA extraction, and PCR amplification along with Luminex xMAP technology were used to detect 27 HPV genotypes. The data analysis was conducted using GraphPad Prism and IBM SPSS Statistics 27 software. RESULTS: The overall HPV infection rate at the First People's Hospital of Qujing declined from 24.92% in 2014 to 16.29% in 2023, averaging 16.02%. Specific infection rates were 18.50% among outpatients, 12.97% among inpatients, and 13.53% for health examination attendees. The predominant high-risk HPV genotypes identified were HPV52 (2.61%), HPV16 (2.06%), HPV58 (1.81%), HPV53 (1.55%), and HPV39 (1.09%). Meanwhile, the most frequent low-risk HPV genotypes were HPV6 (1.30%), HPV61 (1.21%), and HPV11 (0.85%). In HPV-positive cases, the distribution of single, double, triple, and quadruple or more infections were 79.90%, 15.17%, 3.59%, and 1.33%, respectively. The proportions of pure LR-HPV, pure HR-HPV, and mixed infections were 22.16%, 67.82%, and 10.02%, respectively. Age-specific analysis revealed a bimodal distribution of HPV infection, with the infection rate rapidly decreasing from 44.02% in the ≤ 19 age group to 19.55% in the 20-29 age group and 13.84% in the 30-39 age group, followed by a gradual increase to 14.64% in the 40-49 age group, 16.65% in the 50-59 age group, and 22.98% in the ≥ 60 age group. The coverage rates of the three available vaccines are all below 50%. The results of this study indicated a declining trend in HPV prevalence in the plateau region of Southwest China over the period from 2014 to 2023, especially in the reduction of genotypes targeted by vaccines. CONCLUSION: There were significant variations in the genotypes prevalent among different age groups, years, and patient sources within the same region. The underwhelming vaccination rates emphasize the critical need for developing either a multivalent vaccine or a personalized vaccine that targets the HPV genotypes common in the Chinese population. Furthermore, vaccinating adolescents to curb HPV infection and ensuring regular cervical cancer screenings for postmenopausal women are crucial steps.

Isolation and genetic characteristics of Novel H4N1 Avian Influenza viruses in ChongQing, China.

BACKGROUND: Avian influenza viruses (AIVs) constitute significant zoonotic pathogens encompassing a broad spectrum of subtypes. Notably, the H4 subtype of AIVs has a pronounced ability to shift hosts. The escalating prevalence of the H4 subtype heightens the concern for its zoonotic potential, signaling an urgent need for vigilance. METHODS: During the period from December 2021 to November 2023, we collected AIV-related environmental samples and assessed them using a comprehensive protocol that included nucleic acid testing, gene sequencing, isolation culture, and resequencing. RESULTS: In this study, a total of 934 environmental samples were assessed, revealing a remarkably high detection rate (43.66%, 289/662) of AIV in the live poultry market. Notably, the H4N1 subtype AIV (cs2301) was isolated from the live poultry market and its complete genome sequence was successfully determined. Subsequent analysis revealed that cs2301, resulting from a reassortment event between wild and domesticated waterfowl, exhibits multiple mutations and demonstrates potential for host transfer. CONCLUSIONS: Our research once again demonstrates the significant role of wild and domesticated waterfowl in the reassortment process of avian influenza virus, enriching the research on the H4 subtype of AIV, and emphasizing the importance of proactive monitoring the environment related to avian influenza virus.

A meta-analysis reveals increases in soil organic carbon following the restoration and recovery of croplands in Southwest China.

In China, the Grain for Green Program (GGP) is an ambitious project to convert croplands into natural vegetation, but exactly how changes in vegetation translate into changes in soil organic carbon remains less clear. Here we conducted a meta-analysis using 734 observations to explore the effects of land recovery on soil organic carbon and nutrients in four provinces in Southwest China. Following GGP, the soil organic carbon content (SOCc) and soil organic carbon stock (SOCs) increased by 33.73% and 22.39%, respectively, compared with the surrounding croplands. Similarly, soil nitrogen increased, while phosphorus decreased. Outcomes were heterogeneous, but depended on variations in soil and environmental characteristics. Both the regional land use and cover change indicated by the landscape type transfer matrix and net primary production from 2000 to 2020 further confirmed that the GGP promoted the forest area and regional mean net primary production. Our findings suggest that the GGP could enhance soil and vegetation carbon sequestration in Southwest China and help to develop a carbon-neutral strategy.

Detection and complete genome sequence analysis of human adenovirus in children with acute diarrhea in Yunnan, China, 2015-2021.

The aims of this study were to determine the distribution and prevalence of gastroenteritis caused by human adenovirus (HAdV) in children in Yunnan province, China, in 2015-2021 and to identify preventive measures that can be taken to reduce morbidity and mortality in children.HAdV is a significant agent of diarrhea in children, but limited data are available regarding the epidemiology and genetic diversity of HAdV in children with diarrhea in Yunnan province, China. A total of 1754 fecal samples were subjected to real-time RT-PCR to detect and quantify HAdV. Positive samples were further analyzed using next-generation sequencing (NGS), and epidemiological data were analyzed as well.1754 patients with diarrhea were enrolled, of which 1041 were male and 713 were female (M:F ratio: 1.46). Seventy-two stool samples out of 1754 (4.10%) were positive for HAdV. The detection rates of all age groups varied from 2.50-4.78%. The highest incidence of HAdV was observed in children under 2 years of age, especially in children 12-24 months-old. From 2015-2021, the annual detection rate ranged from 1.62-12.26%. HAdV was detected throughout the year, but with marked seasonality. Children were most likely to be positive for HAdV in June and November. We detected HAdV in 15.53% (16/103) of samples collected in June and in 8.19% (14/171) of those collected in November. The entire viral genome was successfully sequenced for 13 of the 72 HAdV-positive samples, and 76.92% (10/13) of these were classified as genotype F41 and 23.08% (3/13) were classified as genotype C2.ConclusionsIn Yunnan province, children of all ages are susceptible to HAdV infection, but there has been marked variation in the yearly prevalence. The highest rate of HAdV detection was in June, followed by November. Priority should be given to disease prevention over the development of targeted antiviral therapies, and effective vaccines for preventing HAdV diarrhea are needed. It is also important to establish a surveillance system to collect relevant clinical and epidemiological data quickly in order to assess the potential risk of HAdV infection in children and to identify epidemic strains for the development of effective vaccines.

Establishing a protected area network in Xinlong with other effective area-based conservation measures.

Protected areas (PAs) are pivotal to biodiversity conservation, yet their efficacy is compromised by insufficient funding and management. So-called other effective area-based conservation measures (OECMs) present a paradigm shift and address PA limitations. Such measures can expand conservation areas, enhance connectivity, and improve the existing system. To assess the conservation status of biodiversity in Tibetan cultural areas in China, we investigated the spatial distribution of wildlife vulnerable to human disturbance (large- and medium-sized mammals and terrestrial birds) in Xinlong, a traditional Tibetan cultural area. In particular, we compared a PA (Xionglongxi Nature Reserve) and OECMs targeting species conservation. We also investigated the relationship of wildlife with human temporal and spatial activities. The OECMs complemented areas not covered by PA, especially in rich understory biodiversity regions. More species in OECMs tolerated human presence than species in the PA. Existing biodiversity reserves failed to cover areas of high conservation value in Tibet and offered limited protection capacity. Expanding PAs and identifying OECMs improved Xinlong's system by covering most biodiversity hotspots. Building on the tradition of wildlife conservation in Tibet, harnessing OECMs may be an effective means of augmenting biodiversity conservation capacity. We recommend further evaluation of OECMs effectiveness and coverage in Tibetan area as a way to enhance the current PA system.

自然保护地(protected areas, PAs)被认为是生物多样性保护的最重要且最有效的措施之一。然而, 由于资金不足和管理缺失等因素, 自然保护地体系的有效性被大幅度削弱。"其他有效的基于区域的保护措施(other effective area­based conservation measures, OECMs)"引起了基于区域的保护范式转变, 能够有效弥补PAs的不足。OECMs能够有效实现保护面积的扩大, 加强保护地之间的连通性, 完善现有保护地体系。基于此, 为进一步了解中国藏文化地区生物多样性的保护情况, 评估PAs和OECMs在物种保护上的差异。我们以中国新龙县为例, 调查了当地大中型哺乳动物和地栖鸟类这类容易受人为干扰的野生动物的空间分布和与人类互作的时空活动关系。结果表明, 在保护区无法覆盖的区域, OECMs能够提供有效的补充, 如林下区域的生物多样性保护。在OECMs范围内, 更多的物种能够在时空活动上容忍人类的存在, 尤其是猎物物种。在当前生物多样性优先保护区无法涵盖藏区高保护价值区域以及现有保护区保护能力有限的情况下, 藏区野生动物的保护需要采取更多针对性的措施。通过扩大保护区和确定OECMs区域, 能够覆盖新龙绝大部分生物多样性热点地区。鉴于藏区的野生动物保护传统, 借助OECMs的力量是完善和提高藏区生物多样性保护保护能力的有效手段。我们建议未来进一步评估藏区的OECMs的有效性及覆盖情况, 完善自然保护地体系。 基于其他有效的区域保护措施的中国新龙县保护地体系构建.

Relationship between socioeconomic status and hypertension incidence among adults in southwest China: a population-based cohort study.

PURPOSE: To investigate the correlation between socioeconomic status (SES) and the incidence of hypertension among adults aged 18 or above in southwest China. METHODS: A multistage proportional stratified cluster sampling method was employed to recruited 9280 adult residents from 12 counties in southwest China, with all participants in the cohort tracked from 2016 to 2020. The questionnaire survey gathered information on demographics, lifestyle habits, and household income. The physical exam recorded height, weight, and blood pressure. Biochemical tests measured cholesterol levels. The chi-square test was employed to assess the statistical differences among categorical variables, while the Cox proportional hazards regression model was applied to evaluate the association between socioeconomic status (SES) and the incidence of hypertension. RESULTS: The finally effective sample size for the cohort study was 3546 participants, after excluding 5734 people who met the exclusion criteria. Adults in the highest household income group had a significantly lower risk of hypertension compared to those in the lowest income group (HR = 0.636, 95% CI: 0.478-0.845). Besides, when compared to individuals in the illiterate population, the risk of hypertension among adults with elementary school, junior high school, senior high school and associate degree educational level decreased respectively by 34.4% (HR = 0.656, 95%CI: 0.533-0.807), 44.9% (HR = 0.551, 95%CI: 0.436-0.697), 44.9% (HR = 0.551, 95%CI: 0.405-0.750), 46.1% (HR = 0.539, 95%CI: 0. 340-0.854). After conducting a thorough analysis of socioeconomic status, compared with individuals with a score of 6 or less, the risk of hypertension in participants with scores of 8, 10, 11, 12, and greater than 12 decreased respectively by 23.9% (HR = 0.761, 95%CI: 0.598-0.969), 29.7% (HR = 0.703, 95%CI: 0.538-0.919), 34.0% (HR = 0.660, 95%CI: 0.492-0.885), 34.3% (HR = 0.657, 95%CI: 0.447-0.967), 43.9% (HR = 0.561, 95%CI: 0.409-0.769). CONCLUSION: The findings indicate a negative correlation between socioeconomic status and hypertension incidence among adults in southwest China, suggesting that individuals with higher socioeconomic status are less likely to develop hypertension.

Survey on health literacy and related factors among firefighters of emergency management departments in Southwest China.

OBJECTIVE: Although health literacy (HL) has emerged as a critical public health concern, research on HL in emergency management departments is limited. This study aimed to investigate the awareness of HL and associated factors among firefighters of emergency management departments in southwest China to provide a basis for carrying out targeted health education. METHODS: A cross-sectional convenience sample of 1,742 firefighters from an emergency management department in southwestern China was surveyed from February to April 2023 using the Chinese Citizen's Health Literacy Questionnaire (2019 version). The chi-square test, linear trend chi-square test, Fisher's test, rank sum test, and multifactorial logistic regression model were used to identify influential factors associated with HL. RESULTS: The HL level of the 1742 respondents was 34.3%. Age, ethnicity, education level, length of service, type of job, smoking status, types of parental jobs, annual household income, time of daily internet use, etc. (P < 0.05). The results of multivariate logistic regression analysis indicate that type of job (OR = 0.648, 95%CI:0.426-0.985), length of service (OR = 0.496, 95%CI:0.251-0.981), household income (OR = 1.900, 95%CI:1.443-2.502), daily internet usage time (OR = 0.726, 95%Cl:0.588-0.896), health status (OR = 0.750, 95%Cl:0.585-0.962) and frequency of organizing HL sessions (OR = 1.603, 95%Cl:1.101-2.330) were influencing factors affecting the HL of the officers and soldiers. CONCLUSION: The health literacy level of firefighters in the Emergency Management Department in Southwest China was 34.3%. Lower levels were found in the health-related skills dimension (HRS, 30.1%) and in infectious disease control (ID, 30.7%). Health information literacy (HI, 34.3%) was lower than the national level. The type of urban and rural areas, literacy level, and household income level may be the factors affecting the level of health literacy among the respondents. Therefore, health education and promotion interventions should target high priority dimensions (HRS, HI, and ID) and should focus on strengthening health literacy levels of firefighters with rural types, low education levels, and low household income to improve their health.

Food safety-related practices among residents aged 18-75 years during the COVID-19 pandemic: a cross-sectional study in Southwest China.

BACKGROUND: Good food safety practices are essential to minimizing foodborne diseases. The present study explored the food safety-related practices of residents during the COVID-19 pandemic in Southwest China and identified the impacting factors. METHODS: Residents aged 18-75 years from Guizhou, Yunnan, Sichuan, and Chongqing, China, were included in our study. The convenience sampling method was used to select participants, and face-to-face surveys were conducted in households and communities to collect data. Descriptive statistics including sociodemographic characteristics of respondents and weighted percentages were obtained and the log-binomial regression was used to evaluate the influencing factors associated with food safety-related practices. RESULTS: Overall, 7,848 respondents were involved, with 97.5% efficacy. Disparities in food safety-related practices were observed between males and females, with the former performing poorer practices than the latter (70.5% vs. 68.0%, respectively). Notably, paying attention to nutrition labels when shopping for prepackaged foods was the worst practice. Age, ethnicity, region, occupation, education level, and income were identified as significant determinants of food safety-related practices. Moreover, in comparison to males, females were more likely to acquire pertinent knowledge from diverse sources, including social media, family members/ friends, books/ newspapers/ magazines, experts, and food sales staff (p < 0.05). CONCLUSIONS: Males performed inferior food safety-related practices than females during the COVID-19 pandemic in Southwest China. It is suggested that future food safety education programs should incorporate diverse targeted approaches, with emphasis on males. The role of mainstream media in promoting food safety practices should be expanded and prioritized in the forthcoming initiatives.

First report of the maize cyst nematode Heterodera zeae in Sichuan Province of Southwest China.

Maize is the largest crop planted in China. Nine species of cyst nematodes have been reported to affect maize production. Heterodera zeae, H. avenae and Punctodera chalcoensis can cause significant maize yield losses annually (Luc et al. 2005). In 1971, the maize cyst nematode H. zeae was first detected in Rajasthan, India (Koshy et al. 1971). Subsequently, it has been reported in many other countries such as the United States, Greece, Pakistan, and Egypt. In China, H. zeae was first identified in the maize fields of Laibin City, Guangxi Zhuang Autonomous Region (Wu et al., 2017). Cui et al. (2020) identified H. zeae in a maize field of Yuzhou City, Henan Province of Central China in 2018. From 2018 to 2022, a survey of cyst-forming nematodes was conducted in Southwest China. Fifteen soil samples of about 500 g each were collected from Luding County, Ganzi Prefecture of Sichuan Province. No major aboveground symptoms were shown on maize, but a few females were observed on the roots of maize in one field. The cysts and second-stage juveniles (J2s) were collected from each soil sample using Cobb's screening gravity method. A total of 8.50±2.0 cysts per 100 ml of soil on the average were observed in the field. A thin subcrystalline layer was discernible only in young cysts. Morphological and molecular studies of cysts and J2s indicated that the nematodes were identified to be H. zeae in a maize-field. Morphologically, the cysts were in a lemon shape, light brown or pearly white in color. The vulval cone was prominent. Fenestra ambifenestrate, and semifenestra were separated by a fairly wide vulval bridge, fenestral length and width were variable, and the cyst wall was shown in a zigzag pattern. The J2s' body was in a vermiform, tapering at both ends, with a hyaline tail. Stylet was strongly developed with round or slightly anteriorly directed knobs. Morphological measurements of the cysts (n = 9) determined that the mean body length was 417.2 µm (403.6 to 439.4 µm), body width was 429.7 µm (397.6 to 456.9µm); length-width ratio was 1.4 (0.75 to 3); fenestra length was 525.3 µm (498.5 to 570.7 µm); and the mean semifenestra width was 458.6 µm (403.6 to 546.3 µm). Morphometric measurements of second-stage juveniles (n = 20) showed a body length of 419.7µm (355.8 to 492.5 µm); a stylet length of 20.8 µm (19.51 to 23.3µm); a tail length of 41.5 µm (20 to 49.4 µm); and a hyaline tail length of 20.7 µm (16.6 to 24 µm). The main morphological characteristics and measured values were basically consistent with those described by Cui et al. (2022), and all of which were similar to those of H. zeae. Amplification of DNA from random single cysts (n = 5) was conducted using the protocol described by Cui et al. (2022). The rDNA-internal transcribed spacer (ITS) was amplified and sequenced using a pair of universal primers TW81 (5'-GTTTCCGTAGGTGAA CCTGC-3') and AB28 (5'-ATATGCTTAAGTTCAGCGGGT-3'). The ITS sequences were deposited at GenBank with the accession number OR811029.1. Alignments of sequences showed an identity of 98% with H. zeae sequences from China (OP692769.2, MW785772.1) and the USA (GU145616.1), which were confirmed using a pair of species-specific primers HzF1 (5'-GGGGAGGTGAATGTGGG-3') and HzR1 (5'-CCTTTGGCAATCGGTGA-3') of H. zeae with a targeted PCR fragment of 393 bp (Cui et al. 2022). Pathogenicity was conducted and confirmed by infection and reproduction on maize. Seeds (cv. Zhengda 619) were sown in three pots that contained 150 ml of a sterile soil mixture (loamy soil: sand=1:1), and 5 cysts (103 eggs/cyst on the average) were inoculated in each pot at 25/30°C, under a 12-h dark/12-h light condition (Cui et al. 2023). Fifteen days after sowing, third- and fourth-stage juveniles were observed in the rootstained with acid fuchsin, and a total of 32 cysts per maize plant on the average were collected at 40 days after sowing. The new cysts' morphological and molecular characteristics were identical to the cysts from the original soil samples. To the best of our knowledge, this is the first report of H. zeae as a pathogen on maize in Sichuan Province, Southwest China. Our findings will be useful for management and further research of maize cyst nematodes.

Influences of climatic variation and human activities on vegetation photosynthesis dynamics in Southwest China.

Photosynthesis is a direct route for carbon sequestration in vegetation, and is influenced by climatic variation (CV) and human activities (HA). Therefore, a quantitative assessment of their influence on vegetation photosynthesis dynamics is pivotal for formulating effective carbon neutrality strategies. Herein, based on the solar-induced chlorophyll fluorescence index (SIF), which reflects the vegetation photosynthesis intensity, and TerraClimate meteorological data, we refined the residual trend approach by incorporating more climatic variables and their time effects on vegetation to assess the influences of CV and HA on SIF dynamics in Southwest China. Our results revealed that an increasing rate of vegetation SIF across Southwest China of 0.0312 Wm-2µm-1sr-1/10a (p < 0.001) from 2000 to 2019, and over 90% of the region exhibited an increase in SIF. The influence of CV on SIF dynamics had time effects, including time-cumulative and time-lag effects. Nevertheless, these effects varied by climatic variables and vegetation types. The variable importance in projection demonstrated that temperature was the primary factor influencing SIF dynamics, followed by precipitation, potential evapotranspiration, downward surface solar radiation, vapor pressure deficit, and wind speed. Furthermore, both CV and HA collectively enhanced the vegetation photosynthesis intensity in the region, HA was the main driver of the SIF increase, contributing 0.0239 Wm-2µm-1sr-1/10a, while CV accounted for 0.0073 Wm-2µm-1sr-1/10a. Overall, we refined the previous residual trend approach and provided a new way for quantitatively assessing the influences of CV and HA on vegetation photosynthetic intensity.

Assessing and decoupling ecosystem services evolution in karst areas: A multi-model approach to support land management decision-making.

Incorporating Ecosystem Service Value (ESV) into land use planning provides a fresh perspective for informed land management decisions. ESV, influenced by socio-economic and natural factors, has complex driving mechanisms, particularly in China's southwestern karst regions. Studying mediating variables helps elucidate these mechanisms. Further research into ecosystem services interactions and effective land use policies in karst areas is needed. This study evaluates the ESV of Guizhou Province, located in southern China's karst region, using the benefit transfer approach. Combining the Guizhou Provincial Land Use Planning Outline (2006-2020) with the multi-objective programming (MOP) model optimized by genetic algorithm and the patch-generating land use simulation (PLUS) model, four future development scenarios were designed. The response of ESV to land use and land cover (LULC) changes at the county scale under four different development scenarios from 2000 to 2020 and in the future was analyzed. A partial least squares structural equation model (PLS-SEM) was used to decouple the driving mechanism affecting ESV. The results show that over the past two decades, with the implementation of various ecological restoration projects, the total ESV has increased. The ESV for natural development scenarios, ecological conservation scenarios, economic development scenarios, and sustainable development scenarios are CNY 238.278 billion, CNY 400.514 billion, CNY 283.201 billion, and CNY 323.615 billion, respectively. The direct impacts of karst surface characteristic factors (KSCF), meteorological factors (MF), socio-economic factors (SEF) and transportation location factors (TLF) on ESV are positive (0.098), negative (-0.098), positive (0.336), and positive (0.109) respectively. The total effect of KSCF on ESV through influencing socio-economic factors and LULC is (-0.738), with SEF playing a complete mediating role. MF indirectly affect ESV by influencing LULC, with LULC playing a complete mediating role in this process. The PLS-SEM model shows that under the dominant position of LULC, the interaction between natural environmental factors and socio-economic factors on ESV is very complex. This study offers valuable insights that can guide managers in this region, as well as in other karst regions globally, in the development of sustainable land use policies.

Genomic formation of Tibeto-Burman speaking populations in Guizhou, Southwest China.

Sino-Tibetan is the most prominent language family in East Asia. Previous genetic studies mainly focused on the Tibetan and Han Chinese populations. However, due to the sparse sampling, the genetic structure and admixture history of Tibeto-Burman-speaking populations in the low-altitude region of Southwest China still need to be clarified. We collected DNA from 157 individuals from four Tibeto-Burman-speaking groups from the Guizhou province in Southwest China. We genotyped the samples at about 700,000 genome-wide single nucleotide polymorphisms. Our results indicate that the genetic variation of the four Tibeto-Burman-speaking groups in Guizhou is at the intermediate position in the modern Tibetan-Tai-Kadai/Austronesian genetic cline. This suggests that the formation of Tibetan-Burman groups involved a large-scale gene flow from lowland southern Chinese. The southern ancestry could be further modelled as deriving from Vietnam's Late Neolithic-related inland Southeast Asia agricultural populations and Taiwan's Iron Age-related coastal rice-farming populations. Compared to the Tibeto-Burman speakers in the Tibetan-Yi Corridor reported previously, the Tibeto-Burman groups in the Guizhou region received additional gene flow from the southeast coastal area of China. We show a difference between the genetic profiles of the Tibeto-Burman speakers of the Tibetan-Yi Corridor and the Guizhou province. Vast mountain ranges and rivers in Southwest China may have decelerated the westward expansion of the southeast coastal East Asians. Our results demonstrate the complex genetic profile in the Guizhou region in Southwest China and support the multiple waves of human migration in the southern area of East Asia.

Incidence, associated factors, and outcomes of delirium in critically ill children in china: a prospective cohort study.

BACKGROUND: Delirium occurs frequently in critically ill children and has been reported in many countries, but delirium is not well-characterized in China. The aim of this study was to represent the incidence of delirium in critically ill children in China, its associated factors, and the influence of delirium on in-hospital outcomes. METHODS: This observational prospective cohort study was set up in a large academic medical center with a 57-bed PICU in southwestern China. Critically ill children who required PICU stays over 24 h and were admitted between November 2019 and February 2022 were included in this study. The Cornell Assessment of Pediatric Delirium was used twice daily for delirium evaluation by bedside nurses, and twenty-four clinical features were collected from medical and nursing records during hospitalization. RESULTS: The incidence of delirium was 26.0% (n = 410/1576). Multivariate analysis revealed that seven independent risk factors including days of mechanical ventilation and physical restraints, admission diagnosis (neurologic disorder), sleep deprivation, use of benzodiazepines and dexmedetomidine, liver failure/liver dysfunction associated with delirium in critically ill children. One potentially protective factor was the watching television /listening to music/playing with toys. Children with delirium had longer lengths of stay in the PICU (median 11 vs. 10 days, p < 0.001) and hospital (median 18 vs. 15 days, p < 0.001) compared to those without delirium. Additionally, the in-hospital mortality rates were 4.63% and 0.77% in patients with and without delirium (p < 0.05). CONCLUSIONS: Delirium is common in critically ill children in China and related to poor outcomes. Interventional studies are warranted to determine the best practices to reduce delirium exposure in at-risk children.

Redefinition of the Glyptonsternine genus Pareuchiloglanis (Teleostei: Sisoridae), with descriptions of three new genera.

The genus Pareuchiloglanis (Sisoridae) contains 20 valid species and 5 species with uncertain taxonomic status. Previous morphological and molecular studies indicated that Pareuchiloglanis was non-monophyletic; nonetheless, no change was made to correct the taxonomy of the genus. Therefore, the authors conducted a systematic morphological comparison and molecular phylogenetic study on Pareuchiloglanis. The results showed that Pareuchiloglanis is a polyphyletic group. Species previously identified as Pareuchiloglanis can be divided into four groups, of which Pareuchiloglanis poilanei alone has the genus name Pareuchiloglanis. The remaining three groups of species are contained within new genera named Barbeuchiloglanis, Sineuchiloglanis and Tremeuchiloglanis. Each genus has a distinct distribution that does not cross or overlap. The molecular results supported the reliability of morphological classification and indicated that the four genera were not directly related to one another. Specifically, Sineuchiloglanis and Tremeuchiloglanis shared no recent common ancestor. In contrast, Sineuchiloglanis formed a sister group with Chimarrichthys, and Tremeuchiloglanis formed a sister group with Creteuchiloglanis and Pseudexostoma.

Species diversity and related ecology of chiggers on small mammals in a unique geographical area of Yunnan Province, southwest China.

Chiggers are common ectoparasites and the exclusive vector of scrub typhus. Based on previous investigations from a unique geographical area in Yunnan Province of southwest China, the Three Parallel Rivers Area, we retrospectively studied the species diversity and related ecology of chiggers on rodents and other small mammals. A very high species diversity of 120 chigger species was identified. Five dominant chigger species accounted for 59.4% (5238/8965) of total chiggers, and among them Leptotrombidium scutellare is the second major vector of scrub typhus in China. Species diversity of the chigger community fluctuates greatly in different altitudinal and latitudinal gradients. There are significant differences in species composition, species diversity and dominant species of chiggers among hosts with apparent community heterogeneity. Based on the species abundance distribution, the expected total number of chigger species was estimated to be 170, 50 more than the number of actually collected species; this further indicates a very high chigger species diversity in this area. The bipartite ecological network analysis revealed the intricate relationships between chigger and host species-positive and negative correlations existed among some species of dominant and vector chiggers.

Functional diversity loss and change in nocturnal behavior of mammals under anthropogenic disturbance.

In the Anthropocene, understanding the impacts of anthropogenic influence on biodiversity and behavior of vulnerable wildlife communities is increasingly relevant to effective conservation. However, comparative studies aimed at disentangling the concurrent effect of different types of human disturbance on multifaceted biodiversity and on activity patterns of mammals are surprisingly rare. We applied a multiregion community model to separately estimate the effects of cumulative human modification (e.g., settlement, agriculture, and transportation) and human presence (aggregated presence of dogs, people, and livestock) on species richness and functional composition of medium- and large-bodied mammals based on camera trap data collected across 45 subtropical montane forests. We divided the detected mammal species into three trophic guilds-carnivores, herbivores, and omnivores-and assessed the nocturnal shifts of each guild in response to anthropogenic activities. Overall, species richness tended to increase (ß coefficient = 0.954) as human modification increased but richness decreased as human presence increased (ß = -1.054). Human modification was associated with significantly lower functional diversity (mean nearest taxon distance [MNTD], ß = -0.134; standardized effect sizes of MNTD, ß = -0.397), community average body mass (ß = -0.240), and proportion of carnivores (ß = -0.580). Human presence was associated with a strongly reduced proportion of herbivores (ß = -0.522), whereas proportion of omnivores significantly increased as human presence (ß = 0.378) and habitat modification (ß = 0.419) increased. In terms of activity patterns, omnivores (ß = 12.103) and carnivores (ß = 9.368) became more nocturnal in response to human modification. Our results suggest that human modification and human presence have differing effects on mammals and demonstrate that anthropogenic disturbances can lead to drastic loss of functional diversity and result in a shift to nocturnal behavior of mammals. Conservation planning should consider concurrent effects of different types of human disturbance on species richness, functional diversity, and behavior of wildlife communities.

Pérdidas en la Diversidad Funcional y Cambios en el Comportamiento Nocturno de los Mamíferos bajo la Perturbación Antropogénica Resumen En el Antropoceno, el conocimiento sobre la influencia antropogénica sobre la biodiversidad y el comportamiento de las comunidades vulnerables de fauna es cada vez más relevante para la conservación efectiva. Sin embargo, sorprende que los estudios comparativos dirigidos a desentrañar el efecto concurrente de los diferentes tipos de perturbación humana sobre la biodiversidad multifacética y sobre los patrones de actividad de los mamíferos son escasos. Aplicamos un modelo de comunidad multirregional para estimar de manera separada los efectos de la modificación humana (p. ej.: establecimientos, agricultura, transporte) y la presencia humana (presencia agregada de perros, gente y ganado) acumuladas sobre la riqueza de especies y la composición funcional de los mamíferos de tamaño mediano y grande con base en datos de fototrampas recolectados en 45 bosques montanos subtropicales. Dividimos las especies de mamíferos detectadas en tres gremios tróficos: carnívoros, herbívoros y omnívoros, y analizamos los cambios nocturnos de cada gremio como respuesta a las actividades antropogénicas. En general, la riqueza de especies tuvo una tendencia al incremento (coeficiente ß = 0.954) conforme aumentaron las modificaciones humanas, pero la riqueza disminuyó conforme incrementó la presencia humana (ß = −1.054). Las modificaciones humanas estuvieron asociadas con una diversidad funcional (distancia promedio al taxón más cercano [DPTC], ß = −0.134; tamaños del efecto estandarizado de la DPTC, ß = −0.397), masa corporal promedio de la comunidad (ß = −0.240) y proporción de carnívoros (ß = −0.580) significativamente más bajas. La presencia humana estuvo asociada con una proporción gravemente reducida de herbívoros (ß = −0.522), mientras que la proporción de omnívoros incrementó significativamente conforme aumentaron la presencia humana (ß = 0.378) y la modificación del hábitat (ß = 0.419). En cuanto a los patrones de actividad, los omnívoros (ß = 12.103) y los carnívoros (ß = 9.368) se volvieron más nocturnos como respuesta a las modificaciones humanas. Nuestros resultados sugieren que las modificaciones humanas y la presencia de personas tienen efectos diferentes sobre los mamíferos y demuestran que las perturbaciones antropogénicas pueden llevar a pérdidas drásticas de la diversidad funcional y resultar en un cambio hacia el comportamiento nocturno en los mamíferos. La planeación de la conservación debería considerar los efectos concurrentes de los diferentes tipos de perturbaciones humanas sobre la riqueza de especies, la diversidad funcional y el comportamiento de las comunidades faunísticas.

Factors predicting self-report adherence (SRA) behaviours among DS-TB patients under the "Integrated model": a survey in Southwest China.

BACKGROUND: China is one of 30 countries with a high tuberculosis (TB) burden, and poor adherence to TB treatment is one of the biggest challenges for TB control. We aimed to explore the barriers and facilitators of treatment adherence among drug-sensitive tuberculosis (DS-TB) patients under the "Integrated model" in Western China, to provide evidence-based treatment and control regimens for DS-TB patients to improve adherence behaviours. METHODS: Both qualitative and quantitative research methods were used to explore the factors associated with self-reported adherence (SRA) behaviours. Questionnaire surveys with DS-TB patients and in-depth interviews with leaders from the Centers for Disease Control and Prevention (CDC) and community health sectors (CHCs), healthcare workers (HCWs) from CHCs, and DS-TB patients were conducted. RESULTS: A total of 459 eligible patients were included in the quantitative survey, and two patients and 13 healthcare providers were included in the in-depth interviews. The percentage of patients who experienced a missed dose, lack of follow-up sputum examination, and interrupted treatment were 19.0%, 11.3%, and 9.2%, respectively. Patients aged 20-39 had a higher risk of missed dose [OR (95% CI): 2.302 (1.001-5.305)] and a lower risk of interrupted treatment [OR (95% CI): 0.278 (0.077-0.982)] than patients more than 60 years. Patients who were of Han ethnicity (OR [95% CI]: 0.524 [0.301-0.912]) received psychological support (OR [95% CI]: 0.379 [0.144-0.998]) from their family and had a lower risk of missed doses. Patients who had drug side effects had a higher risk of interrupted treatment (OR [95% CI]: 2.587 [1.237-5.412]). Patients who possessed higher knowledge had a lower risk of lack of follow-up sputum examination [OR (95% CI): 0.817 (0.673-0.991)]. The results of the qualitative study also reported that patients' poor TB knowledge was the main reason for their non-SRA behaviours. CONCLUSIONS: Patient-centred strategies should be implemented to improve health literacy and strengthen psychological support. More effective case management should be designed and implemented based on different patient characteristics to improve adherence behaviours in further studies.

Prevalence trends and risk factors associated with HIV, syphilis, and hepatitis C virus among pregnant women in Southwest China, 2009-2018.

OBJECTIVE: This study investigated prevalence trends and identified the associated factors of HIV, syphilis and hepatitis C virus (HCV) among pregnant women in the Guangxi Zhuang Autonomous Region (Guangxi), Southwest China. METHODS: Serial cross-sectional surveys were performed annually among pregnant women in Guangxi from 2009 to 2018. Blood specimens were collected to test the prevalence of HIV, syphilis and HCV. Cochran-Armitage analysis was used to assess the trends of HIV, syphilis and HCV prevalence, as well as the sociodemographic and behavioural data. In this study, we used zero-inflated negative binomial (ZINB) regression models to identify factors associated with HIV, syphilis and HCV infection. RESULTS: A total of 23,879 pregnant women were included in the study. The prevalence of HIV, syphilis and HCV was 0.24%, 0.85% and 0.19%, respectively. There was a decrease in HIV prevalence from 0.54% to 0.10%, a decrease in HCV prevalence from 0.40% to 0.05% and a decrease in syphilis prevalence from 1.53% to 0.30%. The findings based on the ZINB model revealed that pregnant women who had a history of STI had significantly increased risks of HIV (OR 6.63; 95% CI 1.33-32.90) and syphilis (OR 9.06; 95% CI 3.85-21.30) infection, while pregnant women who were unmarried/widowed/divorced were more likely to have HIV (OR 2.81; 95% CI 1.20-6.54) and HCV (OR 58.12; 95% CI, 3.14-1076.99) infection. Furthermore, pregnant women whose husband had a history of STI (OR 5.62; 95% CI 1.24-25.38) or drug use (OR 7.36; 95% CI 1.25-43.43) showed an increased risk of HIV infection. CONCLUSIONS: There was a relatively low prevalence of HIV, syphilis and HCV among pregnant women. Although decreasing trends in HIV, syphilis and HCV infections were observed, effort is needed to promote STI testing in both premarital medical check-ups and antenatal care, especially targeting couples with a history of STI or drug use.

Paediatric traumatic cataracts in Southwest China: epidemiological profile.

BACKGROUND: Paediatric traumatic cataracts are an important but preventable cause of acquired blindness. Understanding the epidemiology of paediatric traumatic cataracts is a prerequisite for prevention. This study aimed to characterize the epidemiological profile of paediatric traumatic cataracts in southwest China. METHODS: The medical records of children (age range, 0-14 years old) who developed traumatic cataracts following open-globe injuries and were hospitalized at the Department of Ophthalmology at West China Hospital, between January 2011 and December 2020 were retrospectively analyzed. The demographic data, causes of injuries, posttraumatic complications, and visual acuity were recorded and analysed. RESULTS: A total of 716 eyes from 716 patients were analysed in this study, including 521 (72.8%) males and 195 females in a gender ratio of 2.67:1; 117 of the patients were of ethnic minorities. Paediatric traumatic cataracts occurred more frequently in winter (32.5%). Sharp metal objects (scissors/knives/needles/sheet metal/nails/darts) - induced ocular injuries accounted for the highest proportion, followed by botanical sticks (wooden sticks /bamboo sticks /bamboo skewers)-induced injuries, and then stationery items (pencils/pens/rulers/paper)-induced injuries. The majority (68.7%) of the patients were aged 2-8 years, and the peak range of age was 4 - 6 years. The injuries were a result of penetrating trauma in 64.9% of patients, and blunt force trauma in the remainder (35.1%). Additionally, 131 (18.3%) cases developed posttraumatic infectious endophthalmitis after injuries. Patients with eye injuries caused by needles (P < 0.001), wooden sticks (P = 0.016), and bamboo skewers (P = 0.002) were at a greater risk of developing infectious endophthalmitis. The most common identified foreign organism was Streptococcus, which accounted for 42% (21/50) of all culture-positive specimens and was sensitive to vancomycin. Among the children who were younger than 5 years, 44.4% (55/124) of those with traumatic cataracts presented a corrected distance visual acuity less than or equal to 0.1 after undergoing cataract surgery, but among the children who were older than 5 years, this proportion was significantly smaller, just 20.4% of children aged 6-10 years (P < 0.001) and 18.4% of children aged 11-14 years (P < 0.001). CONCLUSION: The main causative agents of paediatric traumatic cataracts in southwest China were sharp metal objects, botanical sticks, and stationery items. Specific preventive measures are essential to reduce the incidence of paediatric traumatic cataract.

Heavy metals exposure is associated with early liver dysfunction among rural residents aged 40-75 years in southwest China.

Heavy metals exposure has been associated with liver dysfunction in recent reports, while the hepatoxicity of lead (Pb) and cadmium (Cd) has been well established. However, the combined effects of multi-metal in real-world scenario on liver dysfunction are still unclear. This cross-sectional study examined associations between 10 biomarkers of early liver injury and multiple heavy metals levels. The levels of heavy metals/metalloid (magnesium [Mg], calcium [Ca], iron [Fe], zinc [Zn], arsenic [As], Cd, copper [Cu], and Pb) were measured in blood and urinary sample collected from 725 participants in a Cd-polluted area and an unpolluted area in southwest China. The early liver dysfunction biomarkers included the liver enzymes (ALT, ALP, AST, and GGT), proteins (TP, ALB, and GLO), and bilirubin (TBIL, DBIL, and IBIL). Confounder-adjusted beta coefficients were determined using multiple linear regression model analysis for the group-classified and gender-classified samples. Our results showed that blood Fe, Cd, and Cu levels were found to be positively related to elevated ALT levels and blood Cu was positively associated with AST levels in the Cd-polluted area, while the highest blood Zn quartile in the polluted area and blood Mg quartile in the unpolluted area were associated with lower ALT levels. Our finding implies that industrial pollution results in heavy metals of Cd and Pb exposure and effects of Fe, Cd, Cu, and Pb in the Cd-polluted area may be the main contributors to increase the risk of liver dysfunction while Zn in the Cd-polluted area and Mg in the unpolluted area may be the protective factors.