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The environment of healthcare institutes (HCIs) potentially affects the internal microecology of medical workers, which is reflected not only in the well-studied gut microbiome but also in the more susceptible oral microbiome. We conducted a prospective cross-sectional cohort study in four hospital departments in Central China. Oropharyngeal swabs from 65 healthcare workers were collected and analyzed using 16S rRNA gene amplicon sequencing. The oral microbiome of healthcare workers exhibited prominent deviations in diversity, microbial structure, and predicted function. The coronary care unit (CCU) samples exhibited robust features and stability, with significantly higher abundances of genera such as Haemophilus, Fusobacterium, and Streptococcus, and a lower abundance of Prevotella. Functional prediction analysis showed that vitamin, nucleotide, and amino acid metabolisms were significantly different among the four departments. The CCU group was at a potential risk of developing periodontal disease owing to the increased abundance of F. nucleatum. Additionally, oral microbial diversification of healthcare workers was related to seniority. We described the oral microbiome profile of healthcare workers in different clinical scenarios and demonstrated that community diversity, structure, and potential functions differed markedly among departments. Intense modulation of the oral microbiome of healthcare workers occurs because of their original departments, especially in the CCU. [ABSTRACT FROM AUTHOR]

Leuconostoc mesenteroides strains were a type of epiphytic bacterium widely used in fermented foods and products in the biochemical and pharmaceutical industries but data on its presence in foods from Qinghai-Tibet Plateau in China was scarce. In this study, molecular analysis based on multilocus sequence typing (MLST) with eight housekeeping genes (pyrG, groeL, rpoB, recA, uvrC, murC , carB , and pheS) was carried out on 45 L. mesenteroides strains isolated from different plants and dairy products from Qinghai-Tibet Plateau in China. The objective of this study was to perform genetic diversity analysis and explore the relationship between strains and isolate samples or separate regions. A total of 25 sequence types (STs) were identified with a diversity of up to 55.6%, which were grouped into one clonal complexes (CCs), 3 doublets and 17 singletons by eBURST. The results of minimum spanning tree and clustering analysis indicated these L. mesenteroides strains from the Qinghai-Tibet Plateau were relatively weakly related to the isolated region. However, there was a close relationship between the genotypes of L. mesenteroides strains and the type of the isolated sample, which was consistent with the results of API 50CH. The MLST scheme presented in this study provides a shareable and comparable sequence database and enhances our knowledge of the population diversity of L. mesenteroides strains which will be further used for the selection of industrial strains. [ABSTRACT FROM AUTHOR]

Few studies in China have focused on advanced human immunodeficiency virus (HIV) disease (AHD) and late entry to HIV care, which are associated with increased morbidity and mortality. A population-based retrospective study was conducted using 980 national HIV surveillance reports from 1994 to February 2012 in Wuhan, China. AHD was defined as presence of a first-reported CD4 count <200 cells/μL or an acquired immune deficiency syndrome (AIDS)-defining event within 1 month of HIV diagnosis. Late entry to HIV care was defined as patients with a first-reported CD4 cell count >6 months after diagnosis. Non-conditional logistic regression analysis was used to identify factors associated with AHD, late entry to HIV care, and AIDS within 1 year of HIV diagnosis. The proportions of AHD, AIDS within 1 year of HIV diagnosis, and late entry to HIV care were 29.49%, 39.39%, and 20.84%, respectively. Most of the deaths (74.27%, 127/171) occurred within 1 year of diagnosis. Short-term mortality, proportion of AHD, and late entry to HIV care showed a similar downward trend from pre-2003 to 2011 ( p<0.001). Age, transmission category, sample source, and occupation were associated with AHD, late entry to HIV care, and AIDS within 1 year of HIV diagnosis in the multivariate logistic regression analysis. These findings indicate that AHD and late entry to HIV care were associated with an increased incidence of AIDS or death, particularly within 1 year of diagnosis. More effort should be made to assure early diagnosis and timely entry to care. [ABSTRACT FROM AUTHOR]

Background: Equitable access to basic public health services is a priority in China. However, primary healthcare workers’ competence to deliver public health services is relatively poor because they lack professional training. Since the availability of web-based training has increased in China, the current study explored stakeholders’ perceptions of a web-based training program on basic public health services to understand their thoughts, experiences, and attitudes about it. Methods: Six focus group discussions with primary healthcare workers and three with directors of township hospitals, county-level Health Bureaus, and county-level Centers for Disease Control and Prevention were conducted in Yichang City during 2013. Semi-structured topic guides were used to facilitate qualitative data collection. Audio recordings of the sessions were transcribed verbatim and theme analysis was performed. Results: Most of the study’s participants, especially the village doctors, had insufficient knowledge of basic public health services. The existing training program for primary healthcare workers consisted of ineffective traditional face-to-face sessions and often posed accessibility problems for the trainees. Most of the study’s participants had a positive attitude about web-based learning and expressed a strong desire to receive this novel training approach because of its flexibility and convenience. The perceived barriers to utilizing the web-based training method included poor computer literacy, lack of personal interaction, inadequate infrastructure, and lack of time and motivation. The facilitators of this approach included the training content applicability, the user-friendly and interactive learning format, and policy support. Conclusions: Web-based training on basic public health services is a promising option in rural China. The findings of the study will contribute knowledge to implementation of web-based training in similar settings. [ABSTRACT FROM AUTHOR]

[Display omitted] • Innovating and proposing the DPWSIR model based on the DPSIR model. • Clarifying the toughness index for each stage of the DPWSIR model. • Using the G1-entropy weighting method to assign weights to evaluation indicators. • Analyzing the correlation between the criteria stage and the indicator stage indicators. • Providing support for improving the social-ecological resilience of arid cities in northwest China. Assessment of social-ecological system resilience is a reliable means of characterizing the system's ability to respond and recover in response to crisis events. This study takes Northwest China as the research area and aims to assess the spatiotemporal evolutionary trends of social-ecological system resilience levels. Driving force-Pressure-Meteorological constraint-State-Impact-Response(DPWSIR) model is proposed to construct the social-ecological system resilience evaluation system innovatively. The G1 entropy weight method is used to determine the index weight, and the comprehensive index method is used to calculate the social-ecological system resilience level values, evaluate the resilience of arid cities social-ecological systems in Northwest China from 2015 to 2021, and determine the resilience grades. The results demonstrate that: (1) The core status of regional central cities is highlighted, in general, the "center-periphery" spatial structure characteristics gradually stabilize. The resilience levels of regional central cities, such as Hohhot, Baotou, Xi'an, Lanzhou, Xining, Yinchuan, and Urumqi, are as high as 0.37, 0.43, 0.414, 0.41, 0.43, 0.58, and 0.39, respectively. (2) In the study area, the meteorological constraint resilience index showed a "flat-to-sudden decline" trend, with the inflection point of the sharp decline occurring in 2020. The decline in the resilience index value in arid cities is caused by the increase in precipitation and temperature, which is manifested as the result of "warming and humidification". (3) Meteorological factors, as the direct influencing factors of sandstorms, are the most critical to the assessment of the resilience of arid cities social-ecological systems. The relative percentage difference (RPD) is used to characterize the relative difference between the traditional model (DPSIR) and the improved model (DPWSIR). In areas for example Jinchang(29%), which is close to the dust sources and greatly affected by sandstorms, the differences in the social-ecological systems resilience are large and the RPD values are significant. Therefore, the DPWSIR model is more suitable for arid cities. This study provides scientific reference for the formulation of ecological environment protection policies and resilience improvement strategies for cities affected by sandstorms. [ABSTRACT FROM AUTHOR]

In the process of exploiting mineral resources, dust enters the environment through air suspended particles and surface runoff, which has a serious impact on the atmospheric environment and human health. From all-year and seasonal scenarios, the migration trajectories and cumulative concentration based on the secondary development of Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) in four mining areas (SF, BC, SJZ, and MJT) in Northwest China are studied. The convergent cross mapping (CCM) method is used to study the causal relationship between concentration and meteorological factors. In this process, the problem of missing non-station meteorological data is solved with the help of the inverse distance weighted interpolation method, and the problem in which the convergence requirements of the CCM algorithm cannot meet the requirements is solved with the bootstrap method. The results indicated that the short path has the characteristics of slow movement, short migration path, low altitude(< 1 km), and high contribution rate, while the long path has the opposite characteristics. Furthermore, the results demonstrated that the concentration is centered on the pollution source and diffuses around, with a diffusion radius of 220-270 km, showing a serious pollution center and slight gradient settlement on the edge, but the overall distribution of accumulated concentration is uneven. The results also show that temperature (TEMP and S&#95;TEMP), evaporation, and air pressure are the main meteorological factors affecting the all-year concentration. The concentration and meteorological factors in the four mining areas also show significant seasonal characteristics, and the correlation in spring, summer, and autumn is stronger than that in winter. This study not only provides a reference for the green and sustainable exploitation of mineral resources but also provides theoretical support for the joint prevention and control of transboundary pollution., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Air pollution and pulmonary tuberculosis (PTB) are still serious worldwide problems, especially in areas of developing countries. Whether there is an association between high ambient air pollutant concentrations and PTB has not been fully explored., Methods: Bayesian spatial-temporal models were constructed to analyse the association between ambient air pollutants (particulate matter with aerodynamic diameters of ≤10 μm (PM 10 ), sulfur dioxide (SO 2 ) and nitrogen dioxide (NO 2 )) and PTB incidence, adjusting for socioeconomic covariates. We collected data on pulmonary TB, ambient air pollution (PM 10 , SO 2 and NO 2 ) concentrations and socioeconomic covariates from 17 prefectures in the central Chinese province of Hubei between Jan 1, 2006, and Dec 31, 2015., Results: For every annual 10 μg/m 3 increase in SO 2 , the relative risk (RR) of PTB incidence was 1.046 (95% credible interval [CI], 1.038-1.054) in the study area. Moreover, we found positive associations with each annual 10 μg/m 3 increase in ambient air pollutants (PM 10 , SO 2 and NO 2 ) in females but only with SO 2 in males. A significant association for each 10 μg/m 3 increase in SO 2 was observed in all the age groups, with a significant association for PM 10 only in children under 14 years of age. A significant response relationship was also observed at a 0-1 month moving average lag for each 10 μg/m 3 increase in SO 2 ., Conclusions: High ambient air pollution concentrations in areas of developing countries might increase the risk of regional PTB incidence, especially for women and young people. Precautions and protective measures and efforts to reduce ambient air pollutant concentrations should be strengthened in developing countries.

The aim of this study was to present a definition of late presentation according to different time periods between initial diagnosis of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) diagnosis which would reliably identify individuals with high risk of mortality within 1 year of diagnosis, and could be used as a suggested common definition.Data of individuals diagnosed from 1994 to February 2012 in Wuhan, China were extracted retrospectively from the national HIV surveillance system. Four time periods (1, 3, 6, and 12 months) combined with the European consensus definition of advanced HIV disease (AHD) were compared. The predictive ability of each definition for identifying an individual who died within 1 year after HIV diagnosis was assessed.A total of 980 patients were included, of whom 289 (29.49%), 324 (33.06%), 353 (36.02%), and 387 (39.49%) were defined as AHD according to the definition of a CD4 count <200 cells/μL or AIDS-defining event (ADE) within 1, 3, 6, and 12 months of HIV diagnosis, respectively. One hundred twenty-seven (12.96%) patients died within 1 year of diagnosis. The highest Youden's index and largest area under the curve were presented in time period within 3 months. Time period within 1 month presented the highest consistency rate, positive likelihood ratio, and kappa value. Longer time periods increased the sensitivity but decreased the specificity.Given the European consensus definitions and the current results, we suggested that AHD could be defined as "a first-reported CD4 count <200 cells/μL or an ADE within 1 month after HIV diagnosis." "Late presentation" could be defined as "a first-reported CD4 count <350 cells/μL or an ADE within 1 month after HIV diagnosis."

Background: School absenteeism is a common data source in syndromic surveillance, which allows for the detection of outbreaks at an early stage. Previous studies focused on its correlation with other data sources. In this study, we evaluated the effectiveness of control measures based on early warning signals from school absenteeism surveillance in rural Chinese schools., Methods: A school absenteeism surveillance system was established in all 17 primary schools in 3 adjacent towns in the Chinese region of Hubei. Three outbreaks (varicella, mumps, and influenza-like illness) were detected and controlled successfully from April 1, 2012, to January 15, 2014. An impulse susceptible-exposed-infectious-recovered model was used to fit the epidemics of these three outbreaks. Moreover, it simulated the potential epidemics under interventions resulting from traditional surveillance signals. The effectiveness of the absenteeism-based control measures was evaluated by comparing the simulated datasets., Results: The school absenteeism system generated 52 signals. Three outbreaks were verified through epidemiological investigation. Compared to traditional surveillance, the school absenteeism system generated simultaneous signals for the varicella outbreak, but 3 days in advance for the mumps outbreak and 2-4 days in advance for the influenza-like illness outbreak. The estimated excess protection rates of control measures based on early signals were 0.0%, 19.0-44.1%, and 29.0-37.0% for the three outbreaks, respectively., Conclusions: Although not all outbreak control measures can benefit from early signals through school absenteeism surveillance, the effectiveness of early signal-based interventions is obvious. School absenteeism surveillance plays an important role in reducing outbreak spread.