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The Queen Elizabeth II recently made her fifth public speech on COVID-19 since taking office. Through the use of systemic functional linguistics to analyze her speech text, this article mainly analyzes the text from the perspective of the concept of function and finds this speech text involves only four processes: material process, metal process, relational process and verbal process. This article discusses the political, economic and cultural characteristics of the UK's response to COVID-19. In addition, this paper compares China and the UK, and discusses the different measures taken in the face of the epidemic and the underlying cultural background. This study found out that the Queen's speech is mainly aimed at expressing gratitude to those working on the front lines of the fight against the epidemic and encouraging people to respond to the call of the British government and face the epidemic positively. The analysis of speech with the transitivity can enrich and update the study contents of transitivity.

This paper aims to conduct the SD-CBL (study design with the case based learning, SD-CBL) in Epidemiology teaching and evaluate its effect. Students from five classes were recruited, and a combined comprehensive teaching model of SD-CBL was used in the "Injury Epidemiology" chapter, while other chapters in "Epidemiology" curriculum were using a teaching model of case based learning (CBL) only or single PowerPoint (ppt) teaching (it was considered as a traditional teaching in many universities). In the final of the semester, the effects of these three teaching models were compared in different majors and different students source. We found that SD-CBL comprehensive teaching model was better than ppt only and CBL teaching methods (P<0.001, P = 0.007), and the significant differences were found in the increased scoring rate between different majors and different students source (P<0.001, P = 0.015). Thus, we concluded that the SD-CBL teaching model is effective and worth to promote in "Epidemiology" teaching, especial in chapters of epidemiology application. Moreover, it is recommended to conduct SD-CBL teaching model in students, who are major in medicine and have good science basis.

The purpose of this study was to explore the needs and challenges reported by caregivers and teachers of children with autism spectrum disorders (ASD) in China. The study group consisted of a random sample of 108 caregivers and 98 teachers of children with ASD. Analysis of epidemiological data produced results consistent with those reported in the Western literature. Many Chinese children with ASD in this study lived with their extended families with support from older generations and the majority of the families had only one child. Financial factors were particularly important for both families and teachers. Limited professional training and social support were reported as barriers to a quality education for these children. Caregivers considered deteriorated family relationships as a predominant source of stress, whereas low employment salary and benefits appeared to be the main source of stress that diminished the teachers' commitment to educating children with special needs. Teachers with higher levels of education reported higher levels of dissatisfaction with employment salary, benefits, and home environment. In addition, the findings highlighted social-cultural influences on parenting stress and coping mechanisms. (Contains 6 tables.)

Lymphatic filariasis (LF) is an endemic parasitic disease and a major cause of acute and chronic morbidity and incapacitation with devastating public health and socio-economic consequences. It exacerbates poor conditions of afflicted persons and endemic communities through reduced or lost labour supply and productivity. Stigmatisation and discrimination are byproducts of LF that lead to reduced prospects of both marriage and a normal sexual life. LF causes absenteeism from school and poor academic performance. Socioeconomic factors and the cost of treatment for LF are presented. Additionally, our discussion includes the description of a two-drug combination introduced in endemic communities to suppress circulating microfilariae and interrupt spread of the disease. An argument is also made for collective support of the current Global Programme for the elimination of lymphatic filariasis as a public health problem and obstacle to socioeconomic development.

Background: Capsaicin is the main component of chili peppers and is believed to have antidiabetic effects. However, the association between spicy food consumption and the incidence of diabetes remains unclear. Methods: A cohort of 20,490 Han residents aged 30–79 without diabetes at baseline were followed from enrollment to June 2, 2023. The consumption of spicy food was obtained through face-to-face surveys conducted during the baseline survey from October 2018 to February 2019. The definition of type 2 diabetes onset was based on the ICD-10 code of E11 in the diabetes case reporting system and death system; Additionally, self-reported diagnosis of diabetes by a physician in active follow-ups, or a fasting blood glucose level of ≥ 7 mmol/L or a glycated hemoglobin percentage of ≥ 6.5% found on-site during the resurvey. Both Cox proportional hazard regression and competing risk regression were used to calculate hazard ratios (HRs) and confidence intervals (CIs). Results: During the follow-up period (53.5 ± 3.0 months), 182 individuals (1.1%) were newly diagnosed with T2D with an incidence rate of 246.2 per 100,000 person-years. Cox regression analyses revealed that spicy food consumers had a 34% reduced risk of developing type 2 diabetes (HR: 0.66, 95% CI: 0.48, 0.91) compared to non-consumers. The HRs (95% CIs) for participants consuming spicy food 3–5 days/week, 6–7 days/week, and with weak pungency were 0.45 (95% CI: 0.25, 0.81), 0.69 (0.49, 0.98), and 0.64 (0.46, 0.90), respectively. However, little significant protective effect was observed among those who consumed spicy food for 1–2 days/week, with moderate pungency, or with strong pungency (all P > 0.05). Conclusions: Consuming spicy food may lower the risk of developing type 2 diabetes, particularly at a frequency of 3–5 days/week, and with weak pungency. Further multicenter prospective studies or interventional studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate Human papillomavirus (HPV) infection and genotyping in men from Chongqing and analyze age-related trends to provide insights for HPV prevention and vaccination plans tailored for men in Chongqing, China. Methods: This study is an observational study. We investigated male patients who underwent HPV screening at two hospitals in Chongqing from 2017 to 2022, totaling 4,381 cases, aged 18 to 85. HPV genotyping was conducted using the Hybribio Rapid GenoArray kit. Results: Among the 4,381 men, the overall HPV prevalence was 14.9%, peaking at 19.3% in 2022. Single HPV infection was 11.5%, and multiple infection was 3.4%. The most prevalent genotypes were HPV-52, HPV-16, and HPV-58. Single high-risk HPV infection peaked in the 36–45 age group, while multiple high-risk HPV infection decreased with age (P-trend < 0.01). Prevalence in the ≤ 25 age group was 3.7%. Single low-risk HPV infection also decreased with age (P-trend = 0.03). Genotypes covered by the nonavalent vaccine had the highest prevalence, increasing with age. Co-infection of HPV-16 with HPV-52 and HPV-58 was common. Single HPV infections were prevalent in cases of urethritis (30.8%), anogenital warts (36.4%), and genital warts (26.3%), while multiple HPV infections were significant in anogenital warts (18.2%). Conclusions: Single HPV infection was predominant in Chongqing, with HPV-52, HPV-16, HPV-58, HPV-53, and HPV-39 being the most prevalent genotypes. The prevalence of genotypes covered by the nonavalent vaccine increased with age. This study offers valuable insights for developing male-specific HPV prevention strategies in Chongqing. [ABSTRACT FROM AUTHOR]

This study aims to analyze the prevalence trend of esophageal cancer in Japan and China to provide suggestions for the prevention and treatment of esophageal cancer. The results showed that the incidence rate for the years 2010–2018 significantly decreased with an APC of 5.66%, and the mortality rate from 2010 to 2015 had an APC of −5.87% in China. However, the incidence rate of Japanese women showed an upward trend, with an APC of 4.09% from 2010 to 2019. The mortality rate of esophageal cancer in Japan showed a downward trend, with an APC of −2.96% from 2010 to 2021. From 2010 to 2018, Chinese esophageal squamous cell carcinoma accounted for the highest proportion, accounting for 85.96%, with the largest distribution in the middle, accounting for 47.25%. Patients are mostly diagnosed at stage III, and the relative survival rate from 2012 to 2015 was 30.3%. Japan also has the highest proportion of squamous cell carcinoma, and the lesions are also mostly located in the middle segment. While Japanese esophageal cancer patients are mostly diagnosed at stage I, and the relative survival rate was 41.5% in Japan from 2009 to 2011. The results of this article indicate that the current prevalence of esophageal cancer in China and Japan is generally declining, and the quality of life of patients is gradually improving, but effective screening and prevention strategies are still needed to reduce the burden of this disease. [ABSTRACT FROM AUTHOR]

Objective: Uterine cancer (UC) is one of the prevalent malignancies in the female reproductive system. Estimating the burden trends of UC is crucial for developing effective prevention strategies at the national level. However, there has been no comprehensive analysis of the UC burden in China. We focused on the evaluation of the burden trends of UC in China over the past 32 years to provide a 15-year projection, comparing it with global levels. Methods: Data on incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were extracted from Global Burden of Disease (GBD) 2021 to describe the burden of UC in China. Joinpoint regression analysis was employed to describe the temporal trends of UC in China and globally over the past 32 years. A Bayesian age-period-cohort model was utilized to predict the trends of UC in the next 15 years. Spearman correlation analysis was used to compare the relationship between ASIR, ASPR, ASMR, ASDR, and SDI in UC in China and globally. Changes in ASMR and ASDR in UC caused by high BMI in China and globally from 1990 to 2021 were explored. Results: In 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of UC in China were 6.65, 46.52, 1.24, and 37.86 (per 100,000 population) respectively. Compared to 1990, the ASMR and ASDR decreased by 48.63% and 48.15% respectively, while the ASIR and ASPR increased by 17.79% and 37.67% respectively. Globally, the burden of UC followed a similar trend in China, with increasing ASIR and ASPR, and decreasing ASMR and ASDR, although the magnitude of increase and decrease was smaller than in China. Joinpoint regression analysis results showed an overall upward trend in ASIR and ASPR for both China and global UC, while an overall downward trend was observed in ASMR and ASDR. Age-specific analysis revealed that during the period from 1990 to 2021, the age groups with the highest incidence, prevalence, mortality, and DALYs for UC in China generally occurred at earlier ages compared to the global pattern. It is projected that over the next 15 years, the burden of UC in China will continue to increase at a higher rate than the global level. Spearman correlation analysis showed that ASIR and ASPR of UC in China and the world were significantly positively correlated with SDI (p < 0.05), and ASMR and ASDR were significantly negatively correlated with SDI (p < 0.001). High BMI is a risk factor affecting the mortality rate and DALYs of UC in both China and globally, with the increase in ASMR and ASDR due to high BMI being greater in China than globally. Conclusion: The incidence and prevalence burden of UC among Chinese and global women have shown an increasing trend over the past 32 years, while the mortality and DALYs have decreased. The projected burden of UC in China is anticipated to continue rising at a higher rate than the global level over the next 15 years. Given the large population in China, the government needs to strengthen screening and prevention strategies to mitigate the burden of UC. [ABSTRACT FROM AUTHOR]

Objective: The role of lifestyle habits in patients with laryngopharyngeal reflux disease (LPRD) is comparatively underexplored. We aim to examine the specific lifestyle habits in patients with LPRD. METHODS: Systematic sampling was applied to select respondents aged 18 through 80 years in otorhinolaryngology-head and neck surgery (OHNS) clinics in Nan Fang Hospital during August 2017–July 2018, 1658 eligible participants were included by a systematic sampling method. Subjects with RSI score>13 were considered as LPRD patients. The risk of reflux symptoms was estimated and multivariate calculated as odds ratios in relation to exposure to tobacco smoking, alcohol, coffee, tea, carbonated drinks, chocolate, spicy food, night sleep time, dinner-to-bed time, subjective sleep quality, and physical exercise. Results: There was a significant dose-response association between carbonated beverage and LPRD. Among people who had drinking carbonated drinks the odds ratio was 1.76 (OR 1.77, 95% CI 1.24–2.50, P =.002) compared with non-carbonated drinker. A similar positive association was found for poor subjective sleep quality and shorter night sleeping time, the odds ratio for reflux was 1.58 (95% CI 1.14 to 2.18) among those who always have poor subjective sleep quality compared with those whose have good subjective sleep quality. The odds ratio for reflux was 2.29 (95% CI 1.23–4.28, P =.015) among those who always sleep 3–5 hours every night compared with those who sleep more than 8 hours every night. Beyond that, we found high BMI may have a negative correlation with LPRD, the odds ratio for reflux was.61 (95% CI 0.39 to.95, P =.054) among those whose BMI >25 kg/m2 compared with those BMI ≤ 20 kg/m2. Conclusions: Patients with LPRD may have certain lifestyle habits, avoid carbonated beverage, poor subjective sleep quality, and lack of sleep should be advised in treatment of LPRD. [ABSTRACT FROM AUTHOR]

Background: To systematically evaluate the prevalence of scoliosis in adolescents aged 10–18 years in China, and to provide evidence-based evidence for the early identification, prevention, and management of scoliosis in adolescents. Methods: We searched 7 databases of CNKI, Wanfang, VIP, PubMed, Web of Science, Embase, and Cochrane Library from January 2000 to June 2024, and included related studies on scoliosis among Chinese adolescents aged 10–18. The quality evaluation criteria of cross-sectional studies recommended by the Agency for Healthcare Research and Quality (AHRQ) were used for literature quality evaluation. Stata 18.0 software was used for statistical analysis. Results: We finally included 42 studies, involving a total of 1,149,330 subjects from 30 regions. The results showed that the prevalence of scoliosis in Chinese adolescents aged 10–18 years was 1.2% [95%CI (1.1%, 1.4%)]. The results of the subgroup analyses are as follows: ① The prevalence of scoliosis in adolescent women (1.6%) was higher than that in men (1.0%). ② The prevalence of scoliosis in adolescents aged 16–18 (1.3%) was higher than that in adolescents aged 10–15 (1.1%). ③ By region, the prevalence of scoliosis was slightly higher in the North (1.3%) than that in the South (1.2%). ④ According to the time of publication, the prevalence of scoliosis in Chinese adolescents increased from 0.9% during 2000–2015 to 1.6% during 2016–2024. ⑤ According to the degree of the Cobb angle, the curve magnitude was mainly mild (Cobb angle: 10°-19°), and the prevalence rate was 0.7%; the second was moderate (Cobb angle: 20°-39°), with a prevalence of 0.2%. Conclusion: The prevalence of scoliosis in adolescents aged 10–18 years in China is 1.2%, suggesting that the prevalence may be gradually increasing in recent years. In addition, the degree of scoliosis is mainly mild, and timely intervention and prevention are necessary. [ABSTRACT FROM AUTHOR]

Background: Rifampicin-resistant pulmonary tuberculosis (RR-PTB) presents a significant threat to global public health security. China bears a substantial burden of RR-PTB cases globally, with Guizhou Province experiencing particularly alarming trends, marked by a continual increase in patient numbers. Understanding the population characteristics and treatment modalities for RR-PTB is crucial for mitigating morbidity and mortality associated with this disease. Methods: We gathered epidemiological, diagnostic, and treatment data of all RR-PTB cases recorded in Guizhou Province from January 1, 2017 to December 31, 2023. Utilizing composition ratios as the analytical metric, we employed Chi-square tests to examine the spatiotemporal distribution patterns of RR-PTB patients and the evolving trends among different patient classifications over the study period. Results: In our study, 3396 cases of RR-PTB were analyzed, with an average age of 45 years. The number of RR-PTB patients rose significantly from 176 in 2017 to 960 in 2023, peaking notably among individuals aged 23–28 and 44–54, with a rising proportion in the 51–80 age group (P < 0.001). Since 2021, there has been a notable increase in the proportion of female patients. While individuals of Han ethnic group comprised the largest group, their proportion decreased over time (P < 0.001). Conversely, the Miao ethnicity showed an increasing trend (P < 0.05). The majority of patients were farmers, with their proportion showing an upward trajectory (P < 0.001), while students represented 4.33% of the cases. Geographically, most patients were registered in Guiyang and Zunyi, with a declining trend (P < 0.001), yet household addresses primarily clustered in Bijie, Tongren, and Zunyi. The proportion of floating population patients gradually decreased, alongside an increase in newly treated patients and those without prior anti-tuberculosis therapy. Additionally, there was a notable rise in molecular biological diagnostic drug sensitivity (real-time PCR and melting curve analysis) (P < 0.001). However, the cure rate declined, coupled with an increasing proportion of RR-PTB patients lost to follow-up and untreated (P < 0.05). Conclusions: Enhanced surveillance is crucial for detecting tuberculosis patients aged 23–28 and 44–54 years. The distribution of cases varies among nationalities and occupations, potentially influenced by cultural and environmental factors. Regional patterns in RR-PTB incidence suggest tailored prevention and control strategies are necessary. Despite molecular tests advances, challenges persist with low cure rates and high loss to follow-up. Strengthening long-term management, resource allocation, and social support systems for RR-PTB patients is essential. [ABSTRACT FROM AUTHOR]

Background: Dysphagia is common, but there is limited information about its prevalence and patient preferences regarding dosage forms (oral solids, liquids, topical, etc.) in Brazil, China, the United Kingdom (UK), and Indonesia. Methods: We conducted an online survey of 1000 adults from each country, without any required disease, to estimate the prevalence of dysphagia in these four nations and the dosage form preferences among UK patients. Results: A total of 36.9%, 40.5%, 54.9%, and 64.5% from the UK, Indonesia, Brazil, and China, respectively, had an Eating Assessment Tool (EAT-10) score of ≥3 (indicative of dysphagia). Only 2% of UK respondents and 5% of Brazilian respondents reported a formal diagnosis of dysphagia. Indonesian (74%) and Chinese respondents (77%) were more likely than Brazilian (52%) and UK respondents (45%) to report that their swallowing problems affected their ability to adhere to medication instructions. Liquids were the oral medication formulation most preferred by those who reported difficulty swallowing. Conclusions: To conclude, substantial populations have difficulty swallowing, which can translate into an access issue for medical treatment. The availability of people's preferred dosage forms may help alleviate the adherence issues associated with difficulty swallowing and the concomitant effects on health outcomes. [ABSTRACT FROM AUTHOR]

Disordered eating (DE) is associated with elevated cardiometabolic risk (CMR) factors, yet little is known about this association in non-Western countries. We examined the association between DE characteristics and CMR and tested the potential mediating role of BMI. This cross-sectional study included 2005 Chinese women (aged 18–50 years) from the 2015 China Health and Nutrition Survey. Loss of control, restraint, shape concern and weight concern were assessed using selected questions from the SCOFF questionnaire and the Eating Disorder Examination-Questionnaire. Eight CMR were measured by trained staff. Generalised linear models examined associations between DE characteristics with CMR accounting for dependencies between individuals in the same household. We tested whether BMI potentially mediated significant associations using structural equation modelling. Shape concern was associated with systolic blood pressure (β (95 % CI) 0·06 (0·01, 0·10)), diastolic blood pressure (DBP) (0·07 (95 % CI 0·03, 0·11)) and high-density lipoprotein (HDL)-cholesterol (–0·08 (95 % CI –0·12, −0·04)). Weight concern was associated with DBP (0·06 (95 % CI 0·02, 0·10)), triglyceride (0·06 (95 % CI 0·02, 0·10)) and HDL-cholesterol (–0·10 (95 % CI –0·14, −0·07)). Higher scores on DE characteristics were associated with higher BMI, and higher BMI was further associated with lower HDL-cholesterol and higher other CMR. In summary, we observed significant associations between shape and weight concerns with some CMR in Chinese women, and these associations were potentially partially mediated by BMI. Our findings suggest that prevention and intervention strategies focusing on addressing DE could potentially help reduce the burden of CMR in China, possibly through controlling BMI. [ABSTRACT FROM AUTHOR]

This study examines tuberculosis (TB) incidence among students in Jilin Province, China, focusing on spatial, temporal, and demographic dynamics in areas of social inequality. Variation in incidence rate of TB was analyzed using the joinpoint regression method. Spatial analyses techniques included the global and local Moran indices and Getis-Ord Gi* analysis. Demographic changes in new cases were analyzed descriptively, and the Geodetector method measured the influence of risk factors on student TB incidence. The analysis revealed a declining trend in TB cases, particularly among male students. TB incidence showed geographical heterogeneity, with lower rates in underdeveloped rural areas compared to urban regions. Significant spatial correlations were observed, with high-high clusters forming in central Jilin Province. Hotspots of student TB transmission were primarily concentrated in the southwestern and central regions from 2008 to 2018. Socio-economic factors exhibited nonlinear enhancement effects on incidence rates, with a dominant bifactor effect. High-risk zones were predominantly located in urban centers, with university and high school students showing higher incidences than other educational stages. The study revealed economic determinants as being especially important in affecting TB incidence among students, with these factors having nonlinear interacting effects on student TB incidence. [ABSTRACT FROM AUTHOR]

Background: Exposure to particles with an aerodynamic diameter of ≤2.5 μm (PM2.5) is associated with the occurrence of thyroid dysfunction among pregnant women and neonates, but it is not known if this association occurs in the general population. We aimed to determine the association of prolonged exposure to PM2.5 with the prevalence of thyroid disorders among adults in China. Methods: A nationally representative cross-sectional study of thyroid disorders, iodine status, and diabetes status was carried out in all 31 provinces across China from 2015 to 2017. In total, 73,900 adults aged 18 years and older were included. Serum concentrations of thyroid hormones, thyrotropin, and thyroid antibodies and the urine iodine concentration were measured. The environmental concentration of PM2.5 for each participant's residential address at a spatial resolution of 1 × 1 km was estimated. Results: The average long-term exposure to PM2.5 at residential addresses was 66.41 μg/m3, ranging from 17.58 μg/m3 to 120.40 μg/m3. Compared with that of individuals with lower exposure levels, the prevalence of thyroid diseases such as autoimmune thyroiditis and subclinical hypothyroidism was greater in those with PM2.5 concentrations within the third quartile range (60.18 to 73.78 μg/m3). Compared with those in the first quartile (17.58 to 46.38 μg/m3), participants in the highest PM2.5 quartile (73.78 to 120.40 μg/m3) presented an increased risk of overt hypothyroidism (OR 1.23 [CI 0.94–1.61]), subclinical hypothyroidism (1.10 [1.01–1.21]), autoimmune thyroiditis (1.09 [1.00–1.18]), and thyroglobulin antibody positivity (1.17 [1.07–1.29]). However, there was no association between PM2.5 exposure and overt hyperthyroidism, subclinical hyperthyroidism, Graves' disease, or thyroid peroxidase antibody positivity (p > 0.05). Each 10 μg/m³ increase in the PM2.5 concentration was associated with an increased risk of overt hypothyroidism (OR 1.05 [1.00–1.11]), subclinical hypothyroidism (1.02 [1.00–1.03]), and thyroglobulin antibody positivity (1.02 [1.00–1.04]). Furthermore, a nearly linear exposure–response relationship was observed between long-term PM2.5 exposure and thyroglobulin antibody positivity. Conclusions: PM2.5 exposure was associated with thyroid disorders among Chinese adults. A dose–response relationship between PM2.5 exposure and autoimmune thyroiditis, as well as thyroglobulin antibody positivity, was also observed. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the trends in rheumatoid arthritis (RA) in China from 1990 to 2021 by analyzing data from the Global Burden of Disease (GBD) 2021 study and to predict the trends for the next 25 years. Age-standardized incidence rates (ASIR) and age-standardized mortality rates (ASMR) were calculated, and the estimated annual percentage change was used to illustrate differences in age distribution among various populations. Age-period-cohort (APC) analysis and Bayesian APC (BAPC) models were employed to forecast the burden of RA in China from 2022 to 2046. From 1990 to 2021, the ASIR of RA in China increased from 11.6 to 13.7, with a significantly higher ASIR in females than in males. Despite the increase in incidence, the ASMR related to RA decreased from 0.7 to 0.5. Predictions using the BAPC model indicate that the incidence of RA will continue to rise, with an expected ASIR of approximately 16.4 by 2046, and the total number of RA cases is projected to reach around 342,000. In terms of mortality, the ASMR is expected to decline to 0.3 by 2046, although the total number of deaths might reach about 40,000. The incidence of RA in China has significantly increased over the past 30 years. Although the incidence rate and the total number of RA cases may continue to rise in the future, the mortality rate of RA has been consistently declining. Key Points • Over the past 30 years, the incidence of RA in China has significantly increased; although the incidence rate and total number of cases may continue to rise, the mortality rate has been consistently declining. [ABSTRACT FROM AUTHOR]

This study aimed to assess the burden of early-onset gastrointestinal (GI) cancers in China over three decades. A comprehensive analysis was performed using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Data on early-onset GI cancers in 2020 and from 1990 to 2019 were extracted from GLOBOCAN 2020 database and GBD 2019, respectively. The average annual percent change (AAPC) was calculated to analyze the temporal trends using the Joinpoint Regression Program. The Bayesian age-period-cohort (BAPC) model was used to predict future trends up to 2030. In China, there were 185,980 incident cases and 119,116 deaths of early-onset GI cancer in 2020, with the highest incidence and mortality observed in liver cancer (new cases: 71,662; deaths: 62,412). The spectrum of early-onset GI cancers in China has transitioned over the last 30 years. The age-standardized rates of incidence, mortality, and disability-adjusted life years for colorectal and pancreatic cancers exhibited rapid increases (AAPC >0, P ≤ 0.001). The fastest-growing incidence rate was found in colorectal cancer (AAPC: 3.06, P < 0.001). Despite the decreases in liver, gastric, and esophageal cancers, these trends have been reversed or flattened in recent years. High body mass index was found to be the fastest-growing risk factor for early-onset GI cancers (estimated annual percentage change: 2.75–4.19, P < 0.05). Projection analyses showed an increasing trend in age-standardized incidence rates for almost all early-onset GI cancers during 2020–2030. The transitioning pattern of early-onset GI cancers in China emphasizes the urgency of addressing this public health challenge. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the spatial characteristics of myopia and identify the socioeconomic and environmental factors influencing its prevalence. Myopia prevalence among children of school age of Han ethnicity in China was 56.6% in 2019, with the highest and lowest prevalence's in Shandong (66.8%) and Guizhou (47.3%), respectively. There was a spatial aggregation of myopia prevalence in China. Environmental factors (atmospheric PM2.5 concentration and forest coverage) and socioeconomic factors (gross domestic product per capita, per capita disposable income, hospital beds per thousand people, and Engel coefficient) have significant influences on myopia prevalence. The interaction of each factor on myopia showed nonlinear enhancement. Myopia prevalence among children of school age was spatially clustered, and environmental and socioeconomic conditions are associated with myopia prevalence. Our findings provide novel perspectives for the comprehensive prevention and control of myopia. [ABSTRACT FROM AUTHOR]

Purpose: Mental disorders remain the leading causes of disability worldwide. We aimed to determine the burden and trends of mental disorders in China from 1990 to 2019. Methods: The incidence, prevalence, and disability-adjusted life years (DALYs) of mental disorders at national level of China were examined by age, sex, and subcategories. Temporal trends in the age-standardized rates for incidence, prevalence, and DALYs were assessed by the average annual percentage change (AAPC). All estimates are presented as numbers and age-standardized rates, with 95% uncertainty intervals (UIs). Results: The number of incident cases due to mental disorders increased from 42.90 million to 52.72 million, the number of prevalent cases increased from 132.63 million to 160.16 million, and the number of DALYs increased from 15.64 million to 20.29 million during 1990–2019. Decreasing trends were observed in the age-standardized rates for incidence, prevalence and DALYs. Anxiety and depressive disorders were more frequent in women, while ADHD, conduct disorder, and autism spectrum disorders were more common in men. Compared with 1990, the age-specific incidence rates were higher in individuals under 14 years and over 55 years, whereas rates were lower in those aged 15–49 years in 2019. Conclusion: The number of incident cases, prevalent cases, and DALYs due to mental disorders gradually increased in China from 1990 to 2019. Anxiety and depressive disorders were the leading causes of burden due to mental disorders, which affected women more than men. Mental disorders deserve greater attention in health policy decision making. [ABSTRACT FROM AUTHOR]

Background: After the removal of the three-year epidemic control restrictions, Chinese children were confronted with heightened risks of respiratory infections. We aimed to investigate the post-pandemic (2023) epidemiology of respiratory infections among pediatric inpatients in a tertiary hospital in Shanghai, China, and compare it with the pre-pandemic (2019) levels. Methods: A total of 2644 pediatric inpatients were enrolled based on discharge time and divided into group 2019 (n = 1442) and group 2023 (n = 1202). Information on the demographic characteristics, diagnoses, and pathogen test results (Mycoplasma pneumoniae, MP; Chlamydia pneumoniae, CP; Legionella pneumophila, LP; Influenza A, IFA; Influenza B, IFB; Parainfluenza virus, PIV; respiratory syncytial virus, RSV; Coxsackie virus, COX; Adenovirus, ADV; Epstein–Barr virus, EBV) was collected and analyzed. Results: Significant increases were found in the overall test positivity rates (64.6% vs. 46.7%), mixed infection rates (17.4% vs. 9%), and proportion of severe cases (25.5% vs. 3.7%) after the pandemic than those before it. Compared with 2019, the incidences of MP, IFA, LP, RSV, and ADV remarkably increased, while those of IFB and COX decreased, with no obvious differences noted for CP, PIV, and EBV in 2023. A significantly higher MP-positive detection rate was noticed in children aged 1–6 years in 2023 than in 2019. The incidence of RSV infection began to rise in August 2023, earlier than the conventional epidemic season. Conclusions: Compared with the pre-pandemic levels, the overall test positivity rates of atypical pathogens and viruses among pediatric inpatients significantly increased, and alterations in the disease spectrum, epidemic season, and age of prevalence were observed after the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objectives: The prevalence of the co-occurrence of depressive and anxious symptoms (CO) and their influence on perceived overall health were not clear in community dwelling Chinese older adults. The aims of the study were to investigate the prevalence of CO and to explore its influence on self-rated health (SRH). Method: This study included 12301 individuals aged ≥65 years from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative survey of older adults in mainland China. Participants received face-to-face interviews and assessments of depressive symptoms and anxious symptoms via 10-item of the Center for Epidemiologic Studies Depression Scale (CES-D-10) and 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), respectively. SRH was measured by self-reported. A logistic regression model was used to examine the association between CO and SRH after adjusting for confounding variables. Results: The average age was 83.4 (SD: 11.0) years and there were 6576 (53.5%) females. The age- and sex-standardized prevalence of depressive symptoms only (DSO) was 38.6%, anxious symptoms only (ASO) was 1.5%, and CO was 10.8%. Compared with those without depressive and anxious symptoms, the older adults with DSO or ASO were more likely to have significant influence on SRH. And particularly, CO was likely to produce the greatest decrement in the level of SRH. Conclusion: CO was not rare in Chinese older adults nationwide. The older adults having CO had increased risk for lower level of SRH than having DSO or ASO. More attention should be given to CO among the older adults. [ABSTRACT FROM AUTHOR]

Background: The prevalence of oral diseases is subject to change over time. In 2021, Guangdong Province conducted its fourth survey assessing the oral health status of individuals aged 65–74. Materials and methods: Evaluation criteria and potential influencing factors were identified. A sample of residents aged 65–74 from 13 designated monitoring sites in Guangdong Province was randomly selected for the study. Spearman correlation analysis was employed to investigate the clinical correlation between influencing factors and evaluation criteria. Negative binomial and zero-inflated negative binomial regression models were utilized to examine the factors influencing caries prevalence. In contrast, logistic regression was employed to identify the risk factors for caries occurrence. A p-value of ≤0.05 was considered statistically significant. Results: The prevalence of caries rate of crowns, roots, and teeth were 76.36%, 52.25%, and 79.2%, respectively. Individuals with periodontal pockets exhibited a significantly higher risk of root caries. The presence of dental calculus significantly exacerbated the occurrence of crown, root, and dental caries, and increased the risk of crown and dental caries. Consuming sweet foods once or more a week notably increased the average root decayed score (D of roots), the prevalence rate of root caries, and the D score of the Decayed, Missing, and Filled teeth [DMFT] index in individuals already afflicted with this condition. Similarly, the consumption of sweetened drinks significantly elevated the risk of crown and root caries, exacerbating overall caries progression. Frequencies of manual toothbrush and toothpick cleaning showed a negative correlation with average tooth missing score (MT). In contrast, the frequency of manual/electric toothbrush and toothpick cleaning was negatively correlated with the DMFT index. Engaging in dental diagnosis and treatment behaviors significantly increased the number of filled crowns (F), MT, and DMFT scores while reducing the prevalence of dental caries. Conclusions: In Guangdong Province, caries prevalence among older individuals aged 65–74 remains substantial. Relevant professionals and institutions must provide comprehensive guidance and assistance to the older population, emphasizing the importance of reducing the consumption of sweets and sweetened beverages, adopting correct tooth brushing techniques and frequency (at least twice daily), timely treatment of periodontal diseases, conducting regular epidemiological caries surveys, and addressing economic barriers to accessing caries diagnosis and treatment services. [ABSTRACT FROM AUTHOR]

Background/Aim: Mandibular condylar fractures in pediatric patients may exhibit distinct epidemiological characteristics attributed to their unique growth and development phase, as well as various anatomical, physiological, biomechanical, and behavioral factors that differentiate them from adults. This study aimed to investigate the demographics, injurious factors, classifications, clinical manifestations, and treatments of pediatric mandibular condylar fractures, as well as the concomitant injuries in maxillofacial and other body parts. Materials and Methods: This retrospective study analyzed the clinical data of 189 pediatric patients with mandibular condylar fractures between 2011 and 2022. Variables investigated included age, gender, timing of onset, causes, classification of condylar fracture, concomitant injuries, clinical manifestations, and treatment modalities. Results: A total of 189 patients, a higher proportion of boys compared to girls was observed, with the highest incidence rate in children aged 1–3 years. They occurred primarily in July, June, and September as well as on Saturdays and Sundays. The most prevalent cause of mandibular condylar fractures was falls from heights in 73 patients (38.62%). Pediatric patients exhibited a higher susceptibility to condylar head fractures. A significant majority (81.48%) of these fractures were accompanied by soft tissue injuries in the maxillofacial region, with the chin being particularly vulnerable to injury. In addition, 61.90% of pediatric patients experienced fractures in other areas of the maxillofacial region, with the mandibular symphysis being the most commonly affected site. Dental trauma predominantly occurred in the anterior region (44.97%). Notably, a substantial proportion (28.04%) of cases also presented with multiple systemic injuries. Conclusions: The characteristics of pediatric mandibular condylar fractures exhibit distinct features in terms of age, gender, timing of onset, etiology, location and type, the presence of concomitant maxillofacial soft/hard tissue injuries and multiple systemic injuries, as well as clinical manifestations and treatment modalities. Therefore, clinicians should pay special attention to the diagnosis and treatment of pediatric condylar fractures. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that the inflammatory potential of the diet is associated with a variety of chronic noncommunicable diseases characterized by a chronic low-grade inflammatory response. However, the relationships between dietary inflammatory potential and organismal inflammatory status and osteoporosis have been less studied. This study aimed to investigate the relationships among inflammatory diet, inflammatory state and osteoporosis in the Xinjiang multiethnic population. Methods: The participants consisted of 4452 adults aged 35 to 74 years from Xinjiang, China. The dietary inflammatory index (DII) was calculated using dietary data collected with a semiquantitative food frequency questionnaire, and information about osteoporosis was derived from quantitative ultrasound measurements. The relationships of the DII score and inflammatory factors with the risk of osteoporosis were analysed using multivariate logistic regression, and the nonlinear associations between DII and osteoporosis were further analysed using restricted cubic splines. Results: The results showed that proinflammatory diets were associated with a greater risk of osteoporosis (T3 vs. T1: OR = 1.87; 95% CI = 1.44, 2.45) and that there was no nonlinear relationship between the DII and the risk of osteoporosis. Increased concentrations of the inflammatory factors IL-6, IL-10, IL-12p70, IL-17, and IL-23 were associated with a greater risk of osteoporosis. Conclusions: The risk of osteoporosis can be reduced by increasing the consumption of an appropriate anti-inflammatory diet. [ABSTRACT FROM AUTHOR]

Background: Canine circovirus (CanineCV), a non-enveloped virus with a circular DNA genome, has been identified in various avian and mammalian species, including domestic and wild canids. This study aimed to comprehensively analyze the prevalence of CanineCV across diverse animal species in 11 provinces of China. Results: A total of 1,666 serum samples were collected, revealing a 5.82% prevalence of CanineCV in dogs, with the highest rates being observed in southern and eastern China. Phylogenetic analysis of 266 global CanineCV genomes sourced from the NCBI identified six distinct genotypes, elucidating the complex dynamics of their evolution. Evidence suggested a potential bat origin for CanineCV, with positive selection and high rates of evolution being observed. Recombination analysis revealed dynamic genetic exchange, highlighting the intricate nature of CanineCV evolution. Mutational analysis identified key amino acid substitutions likely to influence the virus's adaptation. Additionally, glycosylation, palmitoylation, and SUMOylation sites were predicted, shedding light on crucial functional properties of the virus. Conclusions: This study provides a global perspective on the origin, genetic diversity, and evolutionary dynamics of CanineCV. Understanding these factors is crucial for elucidating its epidemiology and potential health risks. [ABSTRACT FROM AUTHOR]

Background Objective Materials and methods Results Conclusion Despite cryptorchidism being a common genital abnormality in male newborns with significant prevalence variations globally, there is a notable scarcity of epidemiological data on this condition in China.This study aimed to delineate the prevalence pattern of cryptorchidism in Chinese population over the past 15 years using nationwide surveillance data.Data from the China National Population‐based Birth Defects Surveillance System (2007–2021) were analyzed to calculate the prevalence rates of cryptorchidism, stratified by birth year, maternal age, maternal residence, and geographic region. Adjusted prevalence rate ratios were computed using Poisson regression, while trends in prevalence and average annual percent change (AAPC) were assessed using the joinpoint regression model.During the study period, a total of 1,833 cases of cryptorchidism were identified among 2,565,964 full‐term male births, resulting in prevalence rates of 7.14, 5.60, and 1.54 per 10,000 births for overall, isolated, and associated cryptorchidism, respectively. The overall prevalence increased from 3.86 to 11.20 per 10,000 births, with an AAPC of 7.9% (95% confidence interval: 5.5–11.0). Significant variations were observed across maternal age (< 20 years, 7.62/10,000; 20–24 years, 6.14/10,000; 25–29 years, 6.96/10,000; 30–34 years, 7.48/10,000; ≥35 years, 9.22/10,000), maternal residence (urban vs. rural, 10.99/10,000 vs. 2.86/10,000), and geographic region (eastern, 12.38/10,000; central, 2.36/10,000; western, 2.63/10,000). Approximately one‐third of cryptorchidism cases were bilaterally, while two‐thirds were unilateral. Commonly observed associated abnormalities included congenital hydrocele testis, as well as anomalies in the genital organs, circulatory system, and musculoskeletal system.Despite lower rates compared to other countries, the increasing trend in prevalence of cryptorchidism necessitates further investigation and intervention. [ABSTRACT FROM AUTHOR]

The early diagnosis and treatment of foreign body aspiration (FBA) can significantly improve the overall prognosis of children. There are significant differences in the epidemiology and clinical characteristics of FBA in different regions. Therefore, we conducted a real-world study in the western region of China with over 4000 patients. The aim of this study was to improve the understanding of FBA in terms of its types, the specific months of its occurrence, and the distribution of primary caregiver characteristics in western China. We collected the clinical and epidemiological data of children who were diagnosed with FBA in our hospital over the past 20 years through a big data centre. We matched the data of healthy children who underwent routine physical examinations at the paediatric health clinic during the same period to analyse the differences in the data of actual guardians. A total of 4227 patients from five provinces were included in this study. Foreign bodies were removed by rigid bronchoscopy in 99.4% (4202/4227) of patients, with a median age of 19 months and a median surgical duration 16 min. January was the most common month of onset for 1725 patients, followed by February, with 1027 patients. The most common types of foreign objects were melon peanuts, seeds and walnuts, accounting for 47.2%, 15.3%, and 10.2%, respectively. In the FBA group, the proportion of grandparents who were primary caregivers was 70.33% (2973/4227), which was significantly greater than the 63.05% in the healthy group (2665/4227) (P < 0.01). FBA most commonly occurs in January and February. More than 60% of FBAs occur between the ages of 1 and 2 years, and the incidence of FBA may be greater in children who are cared for by grandparents. A rigid bronchoscope can be used to remove most aspirated foreign bodies in a median of 16 min. [ABSTRACT FROM AUTHOR]

Background: Epstein-Barr virus-associated lymphoproliferative disorders (EBV-LPDs) are a group of disorders involving lymphoid tissues or lymphocytes. The epidemiology and economic burden of hospitalized children with EBV-LPDs in China have not been well studied. This study aimed to reveal the epidemic characteristics and disease burden of EBV-LPDs among the Chinese hospitalized children, providing strategies for the prevention and management. Methods: This study was based on the FUTang Updating medical REcords (FUTURE) database of China and collected the medical records from 27 tertiary children's hospitals between January 2016 and December 2021 in China, counting five types of EBV-LPDs, namely EBV-positive T-cell lymphoproliferative disease, NK/T cell lymphoma, extranodal NK/T-cell lymphoma (nasal type), systemic EBV-positive T-cell lymphoproliferative disease of childhood and posttransplant lymphoproliferative disorders. We conducted a retrospective syhthesis and analysis of the epidemiological characteristics, expenses, length of stay (LOS), as well as complications among hospitalized children diagnosed with five types of EBV-LPDs and compared parameters using appropriate statistical tests. Results: The study described 153 children aged 0–18 years hospitalized with EBV-LPDs from 2016 to 2021 in the FUTURE database. The male-to-female ratio was 1.10:1, and more than half of the age distribution was in the 6–12 y group. Among EBV-LPDs cases, EBV+ T-LPD accounted for the largest proportion (65.36%). Complications were presented in 93 children with EBV-LPDs, mainly hemophagocytic lymphohistiocytosis (HLH). The median LOS of NKTL was 26.5 days [interquartile range (IQR) = 3–42], which was the longest among EBV-LPDs. The median hospitalization cost of PTLD was 10 785.74 United States dollars (IQR = 7 329.38–16 531.18), which was the heaviest among EBV-LPDs. Conclusions: Compared with the total number of hospitalized children in China during the same period and in the same age group, the proportion of EBV-LPD is very low. EBV-LPD can develop in all age groups, but it is more common in school-age children. Among 5 EBV-LPDs, the disease with the highest proportion is EBV+ T-LPD. The overall disease burden of EBV-LPD was heavy, especially the economic burden. HLH was one of the most common complications, which could directly affect the burden of patients because of prolonged hospitalization. These data are taken from a very large database, illustrating the epidemiological and economic burden of EBV-LPDs hospitalized children in China, which enriched the existing epidemiological and disease burden content of EBV-LPDs. [ABSTRACT FROM AUTHOR]

Background: This study investigates the distribution and characteristics of linezolid and vancomycin susceptibilities among Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E. faecium) and explores the underlying resistance mechanisms. Methods: A total of 2842 Enterococcus clinical isolates from patients were retrospectively collected, and their clinical data were further analyzed. The minimum inhibitory concentrations (MICs) of vancomycin and linezolid were validated by broth dilution method. The resistance genes optrA, cfr, vanA, vanB and vanM were investigated using polymerase chain reaction (PCR). Housekeeping genes and resistance genes were obtianed through whole-genome sequencing (WGS). Results: Of the 2842 Enterococcus isolates, 88.5% (2516) originated from urine, with E. faecium accounted for 60.1% of these. The vanA gene was identified in 27/28 vancomycin resistant Enterococcus (VRE) isolates, 4 of which carried both vanA and vanM genes. The remaining strain was vanM positive. The optrA gene was identified in all E. faecalis isolates among linezolid resistant Enterococcus (LRE). E. faecium showed a higher multiple antibiotic resistance index (MAR index) compared to E. faecalis. The multi-locus sequence typing (MLST) showed the sequence type of E. faecium mainly belongs to clonal complex (CC) 17, nearly E. faecalis isolates analyzed were differentiated into 7 characteristics of sequence types (STs), among which ST16 of CC16 were the major lineage. Conclusion: Urine was the primary source of VRE and LRE isolates in this study. E. faecium showed higher levels of resistance compared to E. faecalis. OptrA gene was detected in 91.6% of LRE, which could explain linezolid resistance, and van genes were detected in all vancomycin resistant Enterococcus strains, while vanA was a key resistance mechanism in VRE identified in this study. [ABSTRACT FROM AUTHOR]

Background and Aims: Burn and scald injuries are the fourth most common type of trauma. Pediatric burns account for a high proportion of the total number of burn patients and impose a high burden on public health. Understanding the epidemiology of pediatric burns can help improve science education and reduce the incidence of burn injuries. Methods: This study is a single‐center retrospective study. One thousand five hundred and twenty‐seven pediatric burn patients admitted to our burn center from January 2016 to December 2020 were included. Demographic and epidemiological data of included patients were extracted and analyzed. The correlations of categorical data were tested by the Chi‐square tests, and differences of continuous data were tested by the Kruskal–Wallis tests. A p‐value of less than 0.05 was considered to be statistically significant. Results: The results showed that children under 3 years of age were most susceptible to burn and scald injuries. Burn injuries were most likely to occur in the season of winter and at the place of home. 56.6% of included patients did receive first aid measures, while 1.8% received gold‐standard first aid. Clinical variables related to the severity of injuries were statistically different between patients with and without cooling measures in first aid. Linear regression models showed that emergency treatment of burns in children and adolescents was associated with outcome indicators, including number of operations, total operation duration per total burn surface area (TBSA), cost per TBSA, and length of stay per TBSA. Conclusions: This study summarized the epidemiology and outcomes of pediatric burn patients admitted to a burn center in northern China. Adopting cooling measures in first aid can reduce the severity of injuries and reduce the burden on the medical system. Education on burn prevention and first aid measures to caregivers of children, especially preschool children, should be strengthened. Key points: Understanding the epidemiology of pediatric burns can help improve science education and reduce the incidence of burn injuries.This study aimed to analyze epidemiological and clinical variables of pediatric burn patients in a burn center in northern China.Children under 3 years of age were most susceptible to burn and scald injuries.Burn injuries in pediatric patients were most likely to occur in the season of winter and at the place of home.Adopting cooling measures in first aid can reduce the severity of burn injuries. [ABSTRACT FROM AUTHOR]

Objective: To assess the effects of COVID-19 pandemic on the epidemiology of neonatal sepsis and the antibiotic resistance profiles of pathogens involved. Methods: This retrospective cohort study analyzed infants diagnosed with culture-proven sepsis at the neonatal department of a tertiary children's hospital in East China from January 2016 to December 2022. We compared the clinical and microbiological characteristics of neonatal sepsis cases between the pre-pandemic Phase I (2016-2019) and during the COVID-19 pandemic Phase II (2020-2022). Results: A total of 507 infants with 525 sepsis episodes were included, with 343 episodes in Phase I and 182 in Phase II. The incidence of early-onset sepsis (EOS) was significantly lower during Phase II (p < 0.05). Infants in Phase II had lower gestational ages and birth weights compared to Phase I. Clinical signs such as mottled skin, severe anemia, thrombocytopenia were more prevalent in Phase II, alongside a higher incidence of complications. Notably, necrotizing enterocolitis (NEC) (p < 0.05) and meningitis (p < 0.1) occurred more frequently during Phase II. Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) were the predominant pathogens isolated from infants of death and cases with complications. A significant decrease in the proportion of K. pneumoniae was observed in Phase II, alongside increased antibiotic resistance in both E. coli and K. pneumoniae. The period of the COVID-19 pandemic (Phase II) was identified as an independent risk factor for complications in infants with neonatal sepsis. Conclusion: COVID-19 pandemic response measures correlated with a decrease in EOS and an increase in neonatal sepsis complications and antibiotic resistance. [ABSTRACT FROM AUTHOR]

Background: The role of red blood cell (RBC) counts as potential independent risk factors for deep vein thrombosis (DVT) in patients with spinal cord injury (SCI) remains uncertain. This study aims to clarify the associations between RBC counts and DVT incidence among this population. Methods: A retrospective analysis was performed on 576 patients with SCI admitted to the rehabilitation medicine department from January 1, 2017 to December 31, 2021. After exclusions, 319 patients were analyzed, among which 94 cases of DVT were identified. Results: Mode of injury, D-dimer and anticoagulant therapy were significant covariates (P < 0.05). Age, fibrinogen, D-dimer, anticoagulant therapy and American Spinal Cord Injury Association impairment scale (AIS) grades were associated with RBC counts and DVT incidence (P < 0.05). Adjusting for these factors, a 1.00 × 10^12/L increase in RBC counts correlated with a 45% decrease in DVT incidence (P = 0.042), revealing a "U" shaped relationship with a pivot at 4.56 × 10^12/L (P < 0.05). Conclusion: RBC counts below 4.56 × 10^12/L serve as a protective factor against DVT, while counts above this threshold pose a risk. These findings could inform the development of DVT prevention strategies for patients with SCI, emphasizing the need for targeted monitoring and management of RBC counts. [ABSTRACT FROM AUTHOR]

Objective: To explore the risk factors for maternal near-miss (MNM) using the WHO near-miss approach. Methods: Data were obtained from the Maternal Near-Miss Surveillance System in Hunan Province, China, 2012–2022. Multivariate logistic regression analysis (method: Forward, Wald, α = 0.05) and adjusted odds ratios (aORs) were used to identify risk factors for MNM. Results: Our study included 780,359 women with 731,185 live births, a total of 2461 (0.32%) MNMs, 777,846 (99.68%) non-MNMs, and 52 (0.006%) maternal deaths were identified. The MNM ratio was 3.37‰ (95%CI: 3.23–3.50). Coagulation/hematological dysfunction was the most common cause of MNM (75.66%). Results of multivariate logistic regression analysis showed risk factors for MNM: maternal age > = 30 years old (aOR > 1, P < 0.05), unmarried women (aOR = 2.21, 95%CI: 1.71–2.85), number of pregnancies > = 2 (aOR > 1, P < 0.05), nulliparity (aOR = 1.51, 95%CI: 1.32–1.72) or parity > = 3 (aOR = 1.95, 95%CI: 1.50–2.55), prenatal examinations < 5 times (aOR = 1.13, 95%CI: 1.01–1.27), and number of cesarean sections was 1 (aOR = 1.83, 95%CI: 1.64–2.04) or > = 2 (aOR = 2.48, 95%CI: 1.99–3.09). Conclusion: The MNM ratio was relatively low in Hunan Province. Advanced maternal age, unmarried status, a high number of pregnancies, nulliparity or high parity, a low number of prenatal examinations, and cesarean sections were risk factors for MNM. Our study is essential for improving the quality of maternal health care and preventing MNM. [ABSTRACT FROM AUTHOR]

Objective • This study aims to understand the characteristics and current situation of pulmonary tuberculosis (PTB) data of Ganxian District, Ganzhou City, Jiangxi Province, China from 2011 to 2021, and to provide data support and a scientific basis for the prevention and control of PTB in the county. Methods • The data were collected from the National Notifiable Disease Reporting System (NNDRS), which included information reported such as the gender, ethnicity, age, occupation, and diagnostic classification of reported PTB cases. Descriptive statistics were used to describe the characteristics of PTB patients. The SPSS 21.0 data analysis tool was used to analyze patient data, investigating the epidemiological characteristics of PTB in the region. Results • There were 4962 PTB cases reported from 2011 to 2021 in Ganxian District, with a decreasing trend. In terms of months, March and September had the highest cumulative number of reported cases, with 511 cases (10.3%) and 515 cases (10.4%), respectively. In terms of reported cases by area, Meilin Town and Jiangkou Town had the highest number, with 603 and 519 cases, respectively. In terms of gender, there were more male patients (3743 cases) than female patients (1,219 cases), which had statistically significant differences (χ² = 27.0, P < .001). The majority of cases were secondary PTB, with farmers being the most affected (a total of 4287 cases) compared to other occupations. In addition, most patients were aged between 40 and 70 years (a total of 2790 cases). Regarding treatment outcomes, out of 4,962 PTB patients, 2088 were cured, with a cure rate of 42.1%. Conclusion • Based on the characteristics of PTB in the area, future prevention and control work should focus on males, farmers, young students, and the elderly, while also focusing on the prevention and control of secondary PTB. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to estimate and predict the burden of osteoarthritis (OA) and site-specific OA (hip, knee, hand, and others) from 1990 to 2030 and their attributable risk factors in China. Method: Data were obtained from the Global Burden of Diseases 2019. The burden was estimated by analyzing the trends of prevalence, incidence, and disability-adjusted life years (DALY). Population attributable risk (PAR) was calculated to assess the impact of high body mass index (BMI). The prediction from 2020 to 2030 was implemented by Bayesian age–period–cohort analysis. Results: In China, prevalent cases, DALY, and incident cases of OA increased to 132.81 million, 4.72 million, and 10.68 million, respectively. Age-standardized rates (ASRs) of prevalence, DALYs, and incidence increased for OA and site-specific OA, especially for hip OA. Site-specific OA showed different susceptible peaking ages, and the burden for those over 50 years old became serious. Female preference existed in the trends for knee OA but not in those for hip, hand, and other OA. PARs of high BMI continued to increase, impacting knee OA more than hip OA and showing female preference. In the next decade, incident cases for OA and site-specific OA will continue to increase, despite that the ASR of OA incidence will decrease. Conclusions: OA and site-specific OA remain huge public health challenges in China. The burden of OA and site-specific OA is increasing, especially among people over 50 years old. Health education, exercise, and removing modifiable risk factors contribute to alleviate the growing burden. Key Points • In China, the burden of osteoarthritis and site-specific osteoarthritis (hip, knee, hand, and others) as well as the Risk Factor (high body mass index) increased greatly from 1990 to 2019. • It is estimated that incident cases for OA and site-specific OA will continue to increase, despite that the ASR of OA incidence will decrease. [ABSTRACT FROM AUTHOR]

Background: Kerion is a severe type of tinea capitis that is difficult to treat and remains a public health problem. Objectives: To evaluate the epidemiologic features and efficacy of different treatment schemes from real‐world experience. Methods: From 2019 to 2021, 316 patients diagnosed with kerion at 32 tertiary Chinese hospitals were enrolled. We analysed the data of each patient, including clinical characteristics, causative pathogens, treatments and outcomes. Results: Preschool children were predominantly affected and were more likely to have zoophilic infection. The most common pathogen in China was Microsporum canis. Atopic dermatitis (AD), animal contact, endothrix infection and geophilic pathogens were linked with kerion occurrence. In terms of treatment, itraconazole was the most applied antifungal agent and reduced the time to mycological cure. A total of 22.5% of patients received systemic glucocorticoids simultaneously, which reduced the time to complete symptom relief. Furthermore, glucocorticoids combined with itraconazole had better treatment efficacy, with a higher rate and shorter time to achieving mycological cure. Conclusions: Kerion often affects preschoolers and leads to serious sequelae, with AD, animal contact, and endothrix infection as potential risk factors. Glucocorticoids, especially those combined with itraconazole, had better treatment efficacy. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has notably altered the infection dynamics of various pathogens. This study aimed to evaluate the pandemic's impact on the infection spectrum of Mycoplasma pneumoniae (M. pneumoniae) among children with community acquired pneumonia (CAP). Methods: We enrolled pediatric CAP patients admitted to a tertiary hospital in southwest China to compare the prevalence and characteristics of M. pneumoniae infections before (2018–2019) and during (2020–2022) the COVID-19 pandemic. Detection of M. pneumoniae IgM antibodies in serum were conducted using either indirect immunofluorescence or passive agglutination methods. Results: The study included 1505 M. pneumoniae-positive and 3160 M. pneumoniae-negative CAP patients. Notable findings were the higher age and frequency of pneumonia-associated symptoms in M. pneumoniae-positive patients, alongside a lower male proportion and fewer respiratory co-infections. The year 2019 saw a notable increase in M. pneumoniae infections compared to 2018, followed by a decline from 2020 to 2022. The COVID-19 pandemic period witnessed significant alterations in age distribution, male proportion, and co-infections with specific pathogens in both M. pneumoniae-positive and negative patients. The M. pneumoniae infections were predominantly seasonal, peaking in autumn and winter during 2018 and 2019. Although there was a sharp drop in February 2020, the infection still peaked in cold months of 2020 and 2021. However, the typical seasonal pattern was nearly absent in 2022. Conclusions: The COVID-19 pandemic has markedly changed the infection landscape of M. pneumoniae in pediatric CAP patients, with shifts observed in infection rates, demographic profiles, co-infections, and seasonal patterns. [ABSTRACT FROM AUTHOR]

Background: Protothecosis is an infection of humans and animals caused by a rare conditionally pathogenic fungus (prototheca). It can occur in immunocompromised or normal patients. Aims: To describe the epidemiology of prototheca infection in China. Methods: We report a case of successful treatment of cutaneous protothecosis with fluconazole and analyzed the epidemiological characteristics, risk factors, clinical manifestations, diagnosis, treatment and prognosis of prototheca infections in China. Results: We describe this case and 29 cases of prototheca infections in China. At present, Prototheca wickerhamii (Pw) infection is the most common infection in China, and single or combined itraconazole is the preferred treatment. Conclusions: These results provide detailed information and relevant clinical treatment strategies for the diagnosis and treatment of protothecosis in China. [ABSTRACT FROM AUTHOR]

Mycoplasma pneumoniae (MP) is known to be a common pathogen causing human respiratory infections. On December 7, 2022, the Chinese government announced 10 new measures of Prevention and Control of COVID-19, marking the onset of the post-COVID-19 era. This study aimed to investigate the epidemiological characteristics of MP infections among children from January 2021 to June 2023. Children with respiratory tract infection were enrolled in the study with fever and one or more respiratory symptoms. A serological diagnosis was confirmed with MP IgM antibodies. A total of 18,763 patients were enrolled, of whom 4,867 cases were MP-positive, resulting in a positivity rate of 25.9 %. The MP positivity rate increased annually, with 18.6, 26.7, and 33.2 % in 2021, 2022, and 2023, respectively. The main disease type of MP infection was Mycoplasma pneumoniae pneumonia (MPP), with 74.0, 87.8, and 86.4 % in 2021, 2022, and 2023, respectively. Higher positivity rates were concentrated in children aged 6 years and older, and the positivity rate in children under 1 year of age in 2023 is the largest increase among all age groups. The positivity rate of MP increased significantly after the adjustment of COVID-19 prevention and control in China, and the most significant increase was seen in the infant group. Effective prevention and control measures should be implemented to reduce the prevalence of MP infection among children aged 6 years older and the infant group (<1 year). [ABSTRACT FROM AUTHOR]

Objective: Pseudomoans plecoglossicida has been identified as a fish pathogen since 2000 and has caused serious infections in cultured Large Yellow Croakers Larimiththys crocea in coastal eastern China during recent years. Methods: Published literatures of this pathogen have been reviewed. Result: Several strains with high genomic similarity have been isolated and identified; the bacteria induce natural infection at lower water temperatures (12.0–25.5°C) and induce numerous granulomas and nodules in the visceral organs of croakers. Researchers have investigated the epidemiology of P. plecoglossicida infection, identified major virulence factors, searched for pathogenic genes, analyzed host‐pathogen interactions, and endeavored to develop efficient vaccines. Conclusion: This paper provides an overview of these research advances to elucidate the virulence mechanisms of the pathogen and to promote vaccine development against infection. Impact statementPseudomonas plecoglossicida has been identified as an important fish pathogen in recent years, causing severe economic loss in aquaculture with no efficient preventive and control measures available. This paper provides an overview of the research advances of this pathogen and may throw some light on developing new methods to control the infection. [ABSTRACT FROM AUTHOR]

Introduction: The increasing incidence of Klebsiella pneumoniae and carbapenem-resistant Klebsiella pneumoniae (CRKP) has posed great challenges for the clinical anti-infective treatment. Here, we describe the molecular epidemiology and antimicrobial resistance profiles of K. pneumoniae and CRKP isolates from hospitalized patients in different regions of China. Methods: A total of 219 K. pneumoniae isolates from 26 hospitals in 19 provinces of China were collected during 2019-2020. Antimicrobial susceptibility tests, multilocus sequence typing were performed, antimicrobial resistance genes were detected by polymerase chain reaction (PCR). Antimicrobial resistance profiles were compared between different groups. Results: The resistance rates of K. pneumoniae isolates to imipenem, meropenem, and ertapenem were 20.1%, 20.1%, and 22.4%, respectively. A total of 45 CRKP isolates were identified. There was a significant difference in antimicrobial resistance between 45 CRKP and 174 carbapenem-sensitive Klebsiella pneumoniae (CSKP) strains, and the CRKP isolates were characterized by the multiple-drug resistance phenotype. There were regional differences among antimicrobial resistance rates of K. pneumoniae to cefazolin, chloramphenicol, and sulfamethoxazole, which were lower in the northwest than those in north and south of China. The mostcommon sequence type (ST) was ST11 (66.7% of the strains). In addition, we detected 13 other STs. There were differences between ST11 and non-ST11 isolates in the resistance rate to amikacin, gentamicin, latamoxef, ciprofloxacin, levofloxacin, aztreonam, nitrofurantoin, fosfomycin, and ceftazidime/avibactam. In terms of molecular resistance mechanisms, the majority of the CRKP strains (71.1%, 32/45) harbored blaKPC-2, followed by blaNDM (22.2%, 10/45). Strains harboring blaKPC or blaNDM genes showed different sensitivities to some antibiotics. Conclusion: Our analysis emphasizes the importance of surveilling carbapenemresistant determinants and analyzing their molecular characteristics for better management of antimicrobial agents in clinical use. [ABSTRACT FROM AUTHOR]

Background: Feline herpesvirus type 1 (FHV-1) is a life threatening highly contagious virus in cats and typically causes upper respiratory tract infections as well as conjunctival and corneal ulcers. Genetic variability could alter the severity of diseases and clinical signs. Despite regular vaccine practices against FHV-1 in China, new FHV-1 cases still commonly occur. The genetic and phylogenetic characteristics of FHV-1 in Kunshan city of China has not been studied yet. Therefore, this study was planned to investigate the prevalence, molecular characteristics of circulating strains, and phylogenetic analyses of FHV-1. This is the first report of molecular epidemiology and phylogenetic characteristics of FHV-1 from naturally infected cats in Kunshan, China. Methods: The occulo-nasal swabs were collected from diseased cats showing respiratory distress, conjunctivitis, and corneal ulcers at different veterinary clinics in Kunshan from 2022 to 2023. Clinical data and general information were recorded. Swab samples were processed for preliminary detection of FHV-1. Thymidine kinase (TK), glycoprotein B (gB) and glycoprotein D (gD) genes were sequenced and analyzed to investigate genetic diversity and evolution of FHV-1. Results: The FHV-1 genome was detected in 43 (43/200, 21.5%) samples using RT-PCR targeting the TK gene. Statistical analysis showed a significant correlation between age, vaccination status and living environment (p < 0.05) with FHV-1 positivity, while a non-significant correlation was observed for FHV-1 positivity and sex of cats (p > 0.05). Additionally, eight FHV-1 positive cats were co-infected with feline calicivirus (8/43,18.6%). FHV-1 identified in the present study was confirmed as FHV-1 based on phylogenetic analyses. The sequence analyses revealed that 43 FHV-1 strains identified in the present study did not differ much with reference strains within China and worldwide. A nucleotide homology of 99-100% was determined among gB, TK and gD genes nucleotide sequences when compared with standard strain C-27 and vaccine strains. Amino acid analysis showed some amino acid substitutions in TK, gB and gD protein sequences. A potential N-linked glycosylation site was observed in all TK protein sequences. Phylogenetic analyses revealed minor variations and short evolutionary distance among FHV-1 strains detected in this study. Conclusions: Our findings indicate that genomes of 43 FHV-1 strains are highly homogenous and antigenically similar, and the degree of variation in major envelope proteins between strains is low. This study demonstrated some useful data about prevalence, genetic characteristics, and evolution of FHV-1 in Kunshan, which may aid in future vaccine development. [ABSTRACT FROM AUTHOR]

The genus Hepacivirus comprises a diverse range of genetically distinct viruses that infect both mammalian and non-mammalian hosts, with some posing significant risks to human and animal health. Members of the genus Hepacivirus are typically classified into fourteen species (Hepacivirus A-N), with ongoing discoveries of novel hepaciviruses like Hepacivirus P and Hepacivirus Q. In this study, a novel Hepacivirus was identified in duck liver samples collected from live poultry markets in Hunan province, China, using unbiased high-throughput sequencing and meta-transcriptomic analysis. Through sequence comparison and phylogenetic analysis, it was determined that this newly discovered Hepacivirus belongs to a new subspecies of Hepacivirus Q. Moreover, molecular screening revealed the widespread circulation of this novel virus among duck populations in various regions of Hunan province, with an overall prevalence of 13.3%. These findings significantly enhence our understanding of the genetic diversity and evolution of hepaciviruses, emphasizing the presence of genetically diverse hepaciviruses duck populations in China. Given the broad geographical distribution and relatively high positive rate, further investigations are essential to explore any potential associations between Hepacivirus Q and duck-related diseases. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of metabolic syndrome (MetS) in people living with HIV is significantly higher than in people without HIV. MetS is not only a major driver of cardiovascular disease (CVD) but is also closely related to the development of chronic kidney disease (CKD). The aim of this study was to investigate the prevalence of and risk factors for MetS and to further understand the degree of damage to target organs. Methods: This was a cross‐sectional descriptive study conducted at Chongqing Public Health Medical Center, China. Information was collected via questionnaire survey, physical examination, and laboratory tests. We used the China Diabetes Society guidelines to define MetS. Pooled cohort equations were calculated to compare CVD risk in the next 10 years in people living with HIV aged ≥40 years with or without MetS. We used Student's t‐test, the chi‐squared test, Fisher's exact test, binary logistic regression, and multiple linear regression in the statistical analysis. Results: The study included 979 people living with HIV, including 13 who have experienced CVD, receiving antiretroviral therapy (ART). The median age was 43.0 years, 20.9% were female, and the median ART time was 45.0 months. The prevalence of MetS was 33.9%. The components of MetS criteria were hyperglycaemia (50.4%), hypertriglyceridaemia (48.4%), hypertension (46.8%), low concentrations of high‐density lipoprotein cholesterol (28.2%), and abdominal obesity (25.0%). Higher body mass index (odds ratio [OR] 1.266; 95% confidence interval [CI] 1.203–1.333), higher total cholesterol (OR 1.267; 95% CI 1.011–1.588), high alcohol consumption (OR 1.973; 95% CI 1.009–3.859), and family history of diabetes (OR 1.726; 95% CI 1.075–2.770) were independent risk factors for MetS. Compared with the non‐MetS group, the MetS group had a higher rate of urine albumin (23.8% vs 14.8%, p = 0.001), and the estimated glomerular filtration rate <90 mL/min/1.73 m2 (18.37% vs. 12.8%, p = 0.020) and β2‐microglobin (p = 0.004) increased more markedly in the MetS group. Regarding the risk of developing CVD events in the next 10 years, 38.5% of those in the MetS group were at high or very high risk, which was significantly higher than in the non‐MetS group (p < 0.001). In addition, age (p < 0.001) and sex (p = 0.002) are independent risk factors for developing CVD events in the next 10 years. Conclusions: The prevalence of MetS in people living with HIV on ART is high in Chongqing, China. Risk factors for the development of MetS are high alcohol consumption, family history of diabetes, higher body mass index, and higher total cholesterol levels. In addition, MetS is associated with a risk of CKD and the incidence of 10‐year CVD. [ABSTRACT FROM AUTHOR]

Purpose: In order to better understand the imaging of severe trauma in sport, this study describes the imaging modalities utilized to image athletes who experienced severe traumatic injuries at the Beijing Winter Olympic Games 2022, the distribution of these modalities in relation to the sporting facilities, and the types of injuries imaged in each sport. Methods: This is a retrospective analysis with descriptive tables and figures, performed on a single population (athletes of the Beijing Winter Olympic Games 2022). Results: Of the 2871 athletes in the Beijing Winter Olympic Games, there were 40 athletes with severe injuries who underwent medical imaging. MRI was used more often than Radiography or CT. Athletes at venues without MRI on site had to be transferred to adjacent hospitals for care. Alpine and Freestyle skiing athletes experienced the majority of severe traumatic injuries at this Olympic Games, and the majority of injuries were to the lower limb. Conclusions: Access to medical imaging for severely injured athletes is a critical consideration in the organization of any sporting event. MRI in particular is highly utilized in this population. [ABSTRACT FROM AUTHOR]

Background: Acute gastroenteritis (AGE) causes significant morbidity in children worldwide; however, the disease burden of children hospitalized with viral gastroenteritis in China has been rarely described. Through this study, we analyzed the data of hospitalized children with viral gastroenteritis to explore the changes in the epidemiology and clinical characteristics of viral gastroenteritis in the mainland of China. Methods: Data were extracted from Futang Children's Medical Development Research Center (FRCPD), between 2016 and 2020, across 27 hospitals in 7 regions. The demographics, geographic distribution, pathogenic examination results, complications, hospital admission date, length of hospital stays, hospitalization charges and outcomes were collected and analyzed. Results: Viral etiological agents included rotavirus (RV), adenovirus (ADV), norovirus (NV) and coxsackievirus (CV) that were detected in 25,274 (89.6%), 1,047 (3.7%), 441 (1.5%) and 83 (0.3%) cases. There was a higher prevalence of RV and NV infection among children younger than 3 years of age. RV and NV had the highest detection rates in winter, while ADV in summer. Children with viral gastroenteritis were often accompanied by other diseases, such as myocardial diseases (10.98–31.04%), upper respiratory tract diseases (1.20–20.15%), and seizures (2.41–14.51%). Among those cases, the co-infection rate with other pathogens was 6.28%, with Mycoplasma pneumoniae (M. pneumoniae), Epstein-Barr virus (EBV), and influenza virus (FLU) being the most common pathogens. The median length of stay was 5 days, and the median cost of hospitalization corresponded to587 US dollars. Conclusions: This finding suggests that viral gastroenteritis, especially those caused by RV, is a prevalent illness among younger children. Co-infections and the presence of other diseases are common. The seasonality and regional variation of viral etiological agents highlight the need for targeted prevention and control measures. Although viral gastroenteritis rarely leads to death, it also results in a significant economic burden on healthcare systems. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the epidemiological features of sexual dysfunction in people aged more than 65 years in parts of China, and to investigate the independent significant risk factors. Methods: According to the population distribution of five communities in Xiamen and Chongqing, we have randomly enrolled 2403 people more than 65 years-of-age. We collected data information through a questionnaire survey. Then demonstrated the current condition of sexual dysfunction in the samples by statistical analysis, and multivariable logistic regression was used to disclose the risk factors of sexual dysfunction in the older adults. Results: According to this study, about 10.48% of the elderly had sexual dysfunctions of different degrees and duration. The proportion of men was about twice that of women (14.5% of males and 7.3% of females). During the course of the disease, 3.19% (43/1344) of women and 3.31% (35/1059) of men had more than 15 years duration of sexual dysfunction. In severity, 5.7% (77/1344) of women and 7.0% (74/1059) of men had very severe sexual dysfunction. There were statistically significant differences in BMI, smoking, drinking history, hypertension, depression incidence or median (p< 0.05). Alcohol consumption history [OR = 1.711, 95% CI: 1.124– 2.604, p = 0.012] and depression [OR = 2.107, 95% CI: 1.109– 4.356, p =0.044] were independent risk factors for sexual dysfunction. Conclusion: The prevalence of sexual dysfunction was low among elderly in the southern part of China. But the course of the disease is long and the degree of the disease is very severe. Elderly with a history of drinking and depression are more prone to sexual dysfunction. [ABSTRACT FROM AUTHOR]

Purpose: Klebsiella variicola has emerged as a human pathogen in the past decade. Here, we present findings related to a K. variicola strain carrying the blaNDM-1 gene, which was isolated from a urinary tract infection in China. Global transmission dynamics and genomic epidemiology of blaNDM-carrying K. variicola were further investigated. Material and Methods: The complete genome sequence of the strain was determined using the Illumina NovaSeq 6000 and Nanopore MinION sequencer. Genomic features and resistance mechanisms were analyzed through diverse bioinformatics approaches. Additionally, genome sequences of K. variicola strains carrying blaNDM were retrieved from the NCBI database, and a comprehensive analysis of the global dissemination trends of these strains was conducted. Results: K. variicola strain 353 demonstrated resistance to multiple antimicrobials, including carbapenems. Within its genome, we identified fourteen antimicrobial resistance genes associated with β-lactam, aminoglycoside, fosfomycin, quinolone, trimethoprim, rifamycin, and sulfonamide resistance. The carbapenem-resistant gene blaNDM-1 was located on an IncU-type plasmid spanning 294,608 bp and flanked by ISCR1 and IS 26. Downstream of blaNDM-1, we identified an Intl1 element housing numerous antibiotic resistance genes. A comprehensive search of the NCBI database revealed 72 K. variicola strains carrying blaNDM from twelve different countries, predominantly from clinical sources, with the highest prevalence observed in the USA and China. A total of 28 distinct sequence types (STs) were identified, with ST115 being the most prevalent, followed by ST60. Conclusion: In summary, this study presents the genomic characterization of a K. variicola strain carrying blaNDM-1 on an IncU-type plasmid. The research highlights the global dissemination of blaNDM-carrying K. variicola, observed in both healthcare settings and natural environments. Our data have revealed a diverse array of antimicrobial resistance determinants in K. variicola, providing valuable insights that could aid in the development of strategies for the prevention, diagnosis, and treatment of K. variicola infections. [ABSTRACT FROM AUTHOR]