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BackgroundThe cluster detection of health care–associated infections (HAIs) is crucial for identifying HAI outbreaks in the early stages. ObjectiveWe aimed to verify whether multisource surveillance based on the process data in an area network can be effective in detecting HAI clusters. MethodsWe retrospectively analyzed the incidence of HAIs and 3 indicators of process data relative to infection, namely, antibiotic utilization rate in combination, inspection rate of bacterial specimens, and positive rate of bacterial specimens, from 4 independent high-risk units in a tertiary hospital in China. We utilized the Shewhart warning model to detect the peaks of the time-series data. Subsequently, we designed 5 surveillance strategies based on the process data for the HAI cluster detection: (1) antibiotic utilization rate in combination only, (2) inspection rate of bacterial specimens only, (3) positive rate of bacterial specimens only, (4) antibiotic utilization rate in combination + inspection rate of bacterial specimens + positive rate of bacterial specimens in parallel, and (5) antibiotic utilization rate in combination + inspection rate of bacterial specimens + positive rate of bacterial specimens in series. We used the receiver operating characteristic (ROC) curve and Youden index to evaluate the warning performance of these surveillance strategies for the detection of HAI clusters. ResultsThe ROC curves of the 5 surveillance strategies were located above the standard line, and the area under the curve of the ROC was larger in the parallel strategy than in the series strategy and the single-indicator strategies. The optimal Youden indexes were 0.48 (95% CI 0.29-0.67) at a threshold of 1.5 in the antibiotic utilization rate in combination–only strategy, 0.49 (95% CI 0.45-0.53) at a threshold of 0.5 in the inspection rate of bacterial specimens–only strategy, 0.50 (95% CI 0.28-0.71) at a threshold of 1.1 in the positive rate of bacterial specimens–only strategy, 0.63 (95% CI 0.49-0.77) at a threshold of 2.6 in the parallel strategy, and 0.32 (95% CI 0.00-0.65) at a threshold of 0.0 in the series strategy. The warning performance of the parallel strategy was greater than that of the single-indicator strategies when the threshold exceeded 1.5. ConclusionsThe multisource surveillance of process data in the area network is an effective method for the early detection of HAI clusters. The combination of multisource data and the threshold of the warning model are 2 important factors that influence the performance of the model.

Background As population ageing accelerates and life expectancy increases, multimorbidity and disability pose challenges to health and social care systems worldwide. Although multimorbidity is closely related to disability, there is still a lack of research on the impact of multimorbidity on disability in rural middle-aged and elderly people. Objective To evaluate the influence of multimorbidity on disability in rural middle-aged and elderly people using the propensity-score matching (PSM) , providing a reference for formulating strategies for the management of multimorbidity and disability in this population. Methods The data of 11 088 rural middle-aged and elderly people (≥45 years old) were collected from the 2018 China Health and Retirement Longitudinal Study in March 2022, including demographics, chronic disease prevalence, and disability measured by activities of daily living (ADLs) , and instrumental activities of daily living (IADLs) . Participants were divided into multimorbidity and non-multimorbidity groups by the prevalence of multimorbidity (defined as having ≥2 chronic conditions) , and then matched using PSM with a 1∶1 ratio. Conditional Logistic regression model for paired binary data was used to assess the impact of multimorbidity on ADL disability and IADL disability. Results Of 11 088 ural middle-aged and elderly people with chronic diseases, 2 711 (24.45%) had ADL disability, 4 216 (38.02%) had IADL disability, and 7 673 (69.20%) were multimorbidity patients. The prevalence of ADL disability or IADL disability differed significantly by gender, age, marital status, education level, sleep duration, smoking, drinking, disability status, participation in social activities, and prevalence of multimorbidity (P

Background: The human papillomavirus (HPV) vaccines have been widely introduced in immunization programs worldwide, however, it is not accepted in mainland China. We aimed to investigate the awareness and knowledge about HPV vaccines and explore the acceptability of vaccination among the Chinese population.Methods: A meta-analysis was conducted across two English (PubMed, EMBASE) and three Chinese (China National Knowledge Infrastructure, Wan Fang Database and VIP Database for Chinese Technical Periodicals) electronic databases in order to identify HPV vaccination studies conducted in mainland China. We conducted and reported the analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: Fifty-eight unique studies representing 19 provinces and municipalities in mainland China were assessed. The pooled awareness and knowledge rates about HPV vaccination were 15.95 % (95 % CI: 12.87-19.29, I (2)  = 98.9 %) and 17.55 % (95 % CI: 12.38-24.88, I (2)  = 99.8 %), respectively. The female population (17.39 %; 95 % CI: 13.06-22.20, I (2) = 98.8 %) and mixed population (18.55 %; 95 % CI: 14.14-23.42, I (2) = 98.8 %) exhibited higher HPV vaccine awareness than the male population (1.82 %; 95 % CI: 0.50-11.20, I (2) = 98.5 %). Populations of mixed ethnicity had lower HPV vaccine awareness (9.61 %; 95 % CI: 5.95-14.03, I (2) = 99.0 %) than the Han population (20.17 %; 95 % CI: 16.42-24.20, I (2) = 98.3 %). Among different regions, the HPV vaccine awareness was higher in EDA (17.57 %; 95 % CI: 13.36-22.21, I (2) = 98.0 %) and CLDA (17.78 %; 95 % CI: 12.18-24.19, I (2) = 97.6 %) than in WUDA (1.80 %; 95 % CI: 0.02-6.33, I (2) = 98.9 %). Furthermore, 67.25 % (95 % CI: 58.75-75.21, I (2)  = 99.8 %) of participants were willing to be vaccinated, while this number was lower for their daughters (60.32 %; 95 % CI: 51.25-69.04, I (2)  = 99.2 %). The general adult population (64.72 %; 95 % CI: 55.57-73.36, I (2) = 99.2 %) was more willing to vaccinate their daughters than the parent population (33.78 %; 95 % CI: 26.26-41.74, I (2) = 88.3 %). Safety (50.46 %; 95 % CI: 40.00-60.89, I (2)  = 96.6 %) was the main concern about vaccination among the adult population whereas the safety and efficacy (68.19 %; 95 % CI: 53.13-81.52, I (2)  = 98.6 %) were the main concerns for unwillingness to vaccinate their daughters.Conclusions: Low HPV vaccine awareness and knowledge was observed among the Chinese population. HPV vaccine awareness differed across sexes, ethnicities, and regions. Given the limited quality and number of studies included, further research with improved study designis necessary. [ABSTRACT FROM AUTHOR]

JFD ( N-isoleucyl-4-methyl-1,1-cyclopropyl-1-(4-chlorine)phenyl-2-amylamine·HCl) is a novel investigational anti-obesity drug without obvious cardiotoxicity. The objective of this study was to characterize the key physicochemical properties of JFD, including solution-state characterization (ionization constant, partition coefficient, aqueous and pH-solubility profile), solid-state characterization (particle size, thermal analysis, crystallinity and hygroscopicity) and drug-excipient chemical compatibility. A supporting in vivo absorption study was also carried out in beagle dogs. JFD bulk powders are prismatic crystals with a low degree of crystallinity, particle sizes of which are within 2-10 μm. JFD is highly hygroscopic, easily deliquesces to an amorphous glass solid and changes subsequently to another crystal form under an elevated moisture/temperature condition. Similar physical instability was also observed in real-time CheqSol solubility assay. p Ka (7.49 ± 0.01), log P (5.10 ± 0.02) and intrinsic solubility ( S0) (1.75 μg/ml) at 37 °C of JFD were obtained using potentiometric titration method. Based on these solution-state properties, JFD was estimated to be classified as BCS II, thus its dissolution rate may be an absorption-limiting step. Moreover, JFD was more chemically compatible with dibasic calcium phosphate, mannitol, hypromellose and colloidal silicon dioxide than with lactose and magnesium stearate. Further, JFD exhibited an acceptable pharmacokinetic profiling in beagle dogs and the pharmacokinetic parameters Tmax, Cmax, AUC0-t and absolute bioavailability were 1.60 ± 0.81 h, 0.78 ± 0.47 μg/ml, 3.77 ± 1.85 μg·h/ml and 52.30 ± 19.39%, respectively. The preformulation characterization provides valuable information for further development of oral administration of JFD. [ABSTRACT FROM AUTHOR]

Objective: To analyze absentees due to injury among primary school pupils in Hubei, 2012-2013; and to provide theoretical basis for the prevention and control of injuries., Methods: A total of 32 primary schools in Qianjiang city and Shayang county were sampled to conduct injury absenteeism surveillance, and the total number of students was 21 493. The surveillance contents included absent dates, genders, grades, initial or return absent, and the detailed absent reasons. The classification of injury was based on the 10th Revision of the international classification of diseases developed by WHO. Data from 2012-2013 school-year were extracted from the surveillance system for analysis. The total surveillance period was 182 days, of which the fall semester was 98 days and the spring semester was 84 days. The absenteeism rate and injury rate in different characteristics of primary school students were compared by χ² test, and the possible risk factors of injury were preliminary explored by calculating the RR (95% CI) value., Results: The total daily injury absenteeism rate was 8.26/100 100 during 2012-2013 school-year in 32 primary schools in Hubei province, which was higher in fall semester (9.16/100 000), Qianjiang area (9.63/100 000), rural primary schools (13.44/100 000), boys (9.57/100 000), 1-2 grades (10.41/100 000), and the differences were significant (P < 0.05). The total injury rate was 0.46%. Rural primary schools (RR = 2.32, 95% CI: 1.46-3.70), boys (RR = 1.88, 95% CI: 1.23-2.87), and 3-4 grades (RR = 1.85, 95% CI: 1.10-3.09) were identified as high-risk factors, while using city primary schools, girls, and 5-6 grades as references, respectively., Conclusion: The injury absenteeism rate and injury rate were more higher in rural primary schools, boys and low or middle grades in Hubei province during 2012 to 2013 school year, so monitoring and preventive measures should be focused on those students.