Objective:To investigate the prevalence and risk factors associated with long COVID symptoms among children and adolescents who have recovered from COVID-19.Methods:This study applied a cross-sectional approach within...Objective:To investigate the prevalence and risk factors associated with long COVID symptoms among children and adolescents who have recovered from COVID-19.Methods:This study applied a cross-sectional approach within community settings in a southern province of Vietnam.A structured questionnaire featuring socio-demographic information and common long COVID symptoms was employed.Phi correlation coefficients assessed associations among pairs of long COVID symptoms.Additionally,multivariable logistic regression models were performed to investigate the risk factors of long COVID in recovered COVID-19 children and adolescents.Results:Among 422 participants,39.3%reported long COVID symptoms,with a prevalence of 45.2%(SD=0.5)in children and 22.2%(SD=0.4)in adolescents.Common symptoms reported were cough 34.6%(SD=0.5),fatigue 20.6%(SD=0.4),shortness of breath 10.9%(SD=0.3),and lack of appetite 6.6%(SD=0.3).Concerning risk factors of long COVID,a higher risk was observed among demographic groups,including girls(OR 1.25,95%CI 1.15-1.37;P<0.001,reference:boys),children compared to adolescents(OR 1.24,95%CI 1.12-1.37;P<0.001),overweight individuals(OR 1.14,95%CI 1.02-1.27;P=0.018,reference:healthy weight),and participants without any COVID-19 vaccination(OR 1.36,95%CI 1.20-1.54;P<0.001),or have received only one single dose(OR 1.35,95%CI 1.10-1.64;P=0.004)compared to those who have received two doses.Besides,patients with a COVID-19 treatment duration exceeding two weeks also had a higher risk of long COVID(OR 1.32,95%CI 1.09-1.60;P=0.003)than those who recovered less than seven days.Conclusions:The insights from this study provide crucial guidance for predicting the factors associated with the occurrence of long COVID in pediatric patients,contributing to strategic interventions aimed at mitigating the long COVID risks among children and adolescents in Vietnam.展开更多
Antioxidant activities of W and E extracts obtained from dried boxthorn (Lycium chinensis) fruit were measured based on DPPH radical scavenging and reducing powers, and their relationships with total phenolics, flavon...Antioxidant activities of W and E extracts obtained from dried boxthorn (Lycium chinensis) fruit were measured based on DPPH radical scavenging and reducing powers, and their relationships with total phenolics, flavonoid content, and antioxidant activity were investigated. A linear correlation among antioxidant activity, total phenolics, and flavonoid content was observed in concentration-dependent mode. Both extracts showed > 95% DPPH radical-scavenging activity and the higher reducing power of 3200 ppm at the same concentration. The antioxidant potential of both extracts were compared with those of commercial antioxidants such as BHA, BHT, TBHQ, ferulic acid, and α-tocopherol using H2O2 scavenging activity, inhibition of linoleic acid peroxidation, inhibition of hemolysis of rat erythrocyte induced by peroxyl radicals, and inhibition of Fe2+-induced lipid peroxidation using rat brain tissue. In the H2O2 scavenging activity, E extract showed a comparable significant antioxidant power, comparable to commercial antioxidants, and no signifi-cant difference (P > 0.05) was found between W and E extracts on inhibition of the linoleic acid peroxidation. Whereas W extract exhibited a significant power in the hemolysis of rat erythrocytes, none was observed in E extract. In the Fe-induced lipid peroxidation using rat brain tissue, no significant difference (P > 0.05) was found between both ex-tracts, showing a comparable activity with those of synthetic antioxidants. Both W and E extracts of dried boxthorn (Lycium chinensis) fruit may have a potential as natural antioxidants to replace synthetic antioxidants.展开更多
Point and nonpoint sources of phosphorus (P) and nitrogen (N) can cause reductions in water quality, including eutrophication. Nonpoint pollution represents a special challenge because of dispersed not easily identifi...Point and nonpoint sources of phosphorus (P) and nitrogen (N) can cause reductions in water quality, including eutrophication. Nonpoint pollution represents a special challenge because of dispersed not easily identifiable sources such as the runoff from soil, nutrients, and other chemicals from agricultural fields and residential areas. Laguna Cartagena is a tropical freshwater wetland, situated in southwestern Puerto Rico. It is a eutrophic ecosystem, and its eutrophication is caused by both external nutrient loading and internal, mainly by phosphorus. This wetland has been affected by phosphorus loading from inorganic agricultural fertilizer in this historically oligotrophic wetland system until the end of subsidized fertilizer use and sugar cane cultivation in the late 1990s. This study identifies: 1) nonpoint sources of phosphorus (SRP, Soluble Reactive Phosphorus and TP, Total Phosphorus) and nitrogen (nitrate, nitrite, and ammonia) that enter Laguna Cartagena;and 2) the role of precipitation events on the contributions of phosphorus and nitrogen loading to ecosystems. Herein we assess water samples from five channelized external sources of P and N that enter Laguna Cartagena at two-week intervals from October 2013 through November 2014. Rainfall data were obtained weekly from a rain gauge. Standard methods were used for all chemical analyses. Results showed that the channelized waterways that carry water to the lagoon can be classified as hypereutrophic (>100 μg/L) for TP concentrations and oligotrophic (<200 μg/L) for nitrogen concentrations. Currently agriculture (rice and cattle) is the predominant land use at the nearby University of Puerto Rico (UPR) Lajas Agricultural Experiment Substation, the predominant nonpoint source of nutrient pollution (SRP, TP and ammonia) in the principal channelized water sources to the lagoon. Current nutrient loads are likely derived from fertilizers applied to the Substation’s rice fields, and a high density livestock. The second important cause of external surface water degradation (SRP, TP and ammonia) is the discharge from rural households in the drainage basin that discharge greywater directly to the environment, as indicated by the results from Cerro Alto hills immediately to the north of the lagoon. Precipitation also was associated with SRP, TP and ammonia loads.展开更多
Maintaining the water quality of lakes and reservoirs is part of the 2030 Agenda for Sustainable Development, an initiative promoted by the United Nations, including anthropogenic and natural factors that may influenc...Maintaining the water quality of lakes and reservoirs is part of the 2030 Agenda for Sustainable Development, an initiative promoted by the United Nations, including anthropogenic and natural factors that may influence water quality. The water reservoirs of Puerto Rico were built in watersheds to provide runoff control and for primary uses. The Cerrillos Reservoir is one of the largest water reservoirs in southern Puerto Rico, and is used as a source of potable water and for recreational activities. After hurricane Maria, in September 2017, many communities were without public water service and have obtained their drinking water from local rivers or their tributaries, without filtration or purification treatment. This research explored the physical-chemical parameters of Cerrillos Reservoir’s surface water from May 2018 to January 2019. The objective of the present study is to assess seasonal variations in surface water quality with respect to physical (temperature, turbidity, and conductivity), chemical (nutrient concentrations: (Phosphorus (P) (Soluble Reactive Phosphorus, phosphate, or orthophosphate) and Nitrogen (N) (nitrate, nitrite, and ammonia)), pH, and dissolved oxygen), and biological (total coliforms and <em>Escherichia coli</em>) parameters. Results suggest that Cerrillos Reservoir did not exceed the parameters of temperature, turbidity, conductivity, pH and DO, established by the Puerto Rico Department of Natural and Environmental Resources (PRDNER). The reservoir showed a stable trophic state in relation to inorganic phosphorus and nitrogen as N and P concentrations did not increase sufficiently to disrupt this ecosystem. However, total coliforms exceeded the maximum parameter (23 MPN/100mL - 994 MPN/100mL) established for the Puerto Rico Department of Natural and Environmental Resources and are likely to be the results of the disruption caused by hurricane Maria.展开更多
Objectives: Obesity rates in US are substantially higher among African-Americans than Whites. Racial disparities in obesity are sometimes ascribed to racial differences in socio-economic-status (SES). We used data fro...Objectives: Obesity rates in US are substantially higher among African-Americans than Whites. Racial disparities in obesity are sometimes ascribed to racial differences in socio-economic-status (SES). We used data from three states in the southern region of the US with high rates of obesity, to examine the extent of racial disparities within SES categories, particularly examining whether disparities grow smaller at higher levels of income and education. Methods: We used data (2001-2009) from the Behavioral Risk Factor Surveillance System (BRFSS) for 79,676 respondents, African-American and white, from Mississippi, Alabama, and Louisiana. Multivariate logistic regressions were estimated. Analyses were conducted separately for males and females, for the full sample and by levels of education, income and aggregate SES. Risk-differences (RD), and Relative-Risk-Ratios (RR) were reported to enable inspection of magnitudes of racial gaps, which more conventional odds-ratios does not allow researchers to do. Results: The obesity-gap between African-Americans and Whites is larger for females than males. For males the gap becomes smaller and insignificant in higher education and income categories. For females, the gap remains statistically significant and is of comparable magnitude across all education and income categories. Conclusions: Racial disparities in obesity among males can be largely attributed to SES differences. However, racial disparities among females cannot simply be attributed to racial disparities in SES. Thus, reducing racial differences in income and education may not help reduce disparities in obesity risk among White and African-American females. Further research is required to understand why racial disparities in obesity exist within specific SES categories for females.展开更多
Objective:To detect and identify filarial parasites in dried blood spots(DBS)collected from domestic cats using high resolution melting real-time PCR(HRM RT-PCR).Methods:A total of 208 DBS were collected from domestic...Objective:To detect and identify filarial parasites in dried blood spots(DBS)collected from domestic cats using high resolution melting real-time PCR(HRM RT-PCR).Methods:A total of 208 DBS were collected from domestic cats in a brugian filariasis endemic areas in Surat Thani Province,southern Thailand.Microfilariae were found in 9 blood slides using Giemsa-stained thick blood film.The extracted DNA from blood spot volumes of 10 and 20μL DBS with positive filarial parasites in cats were performed using HRM RT-PCR method.The primers were designed based on the partial mitochondrial 12S rRNA gene for identifying Brugia malayi,Brugia pahangi,Dirofilaria immitis.All purified samples were then detected.Results:Using different volumes of 10μL and 20μL DBS could easily distinguish filarial parasites and showed similar results.PCR amplicons of Brugia malayi,Brugia pahangi and Dirofilaria immitis were determined at melting peak(temperature)of 75.70℃,77.46℃,and 73.56℃,respectively.All 9 positive DBS samples showed positive Brugia pahangi and similar nucleotide sequences.Conclusions:This HRM RT-PCR method is able to diagnose,identify and discriminate filarial parasites collected from DBS,which is simple and inexpensive compared with other probe-based genotyping methods.Furthermore,this method is useful to survey,prevent and control filariasis.展开更多
Background and aims:Indonesian government is regulating a family planning program to restricted fertility among reproductive aged.However,participated of married male for using contraceptive is very lowest in Indonesi...Background and aims:Indonesian government is regulating a family planning program to restricted fertility among reproductive aged.However,participated of married male for using contraceptive is very lowest in Indonesia.Methods:A cross-sectional study was conducted among 168 of married male(84 of condom method and 84 of vasectomy method)from April to August 2019 in Jember regency of East Java,Indonesia using purposive sampling method.A self-administered questionnaire was used to measure sociodemographic and contraceptive method of participants.Chi square test was performed to analyze the differences of characteristic of contraceptive method of condom and vasectomy among married male(P<0.05).Results:There were a significant differenced ethnic(χ^2=7.664,P-value=0.006)and access of information(χ^2=8.111,P-value=0.044)between condom and vasectomy method among married male.Conclusion:Characteristics of ethnic and access information are related with contraceptive method choosing for using condom and vasectomy among married male in Indonesia.Therefore,accessibility of contraceptive method through health education should be implemented for married male in Indonesia setting regarding their social and cultural context.展开更多
Leptospirosis is a bacterial disease disseminated through the centuries in the whole world which causes symptoms that go from self-limited diseases to hemorrhagic manifestations and organ failure,including acute kidne...Leptospirosis is a bacterial disease disseminated through the centuries in the whole world which causes symptoms that go from self-limited diseases to hemorrhagic manifestations and organ failure,including acute kidney injury(AKI),composing the severe disease known as the Weil's syndrome.Mortality rates varies according to the clinical presentation and usually increases when kidney injury is present,and is even higher in the setting of pulmonary hemorrhage.There are recent advances in the search for novel biomarkers of renal involvement and early detection of AKI in leptospirosis,as well as in its pathophysiology.We review in this article the clinical aspects of leptospirosis-associated AKI and the perspectives for future research.展开更多
Background: Several studies indicate that depression is associated with non-viral suppression among persons living with HIV (PLWH) using antiretroviral therapy (ART) worldwide. However, among PLWH with major depressiv...Background: Several studies indicate that depression is associated with non-viral suppression among persons living with HIV (PLWH) using antiretroviral therapy (ART) worldwide. However, among PLWH with major depressive disorder, factors associated with non-viral suppression remain uncertain. We determined the prevalence and identified the factors associated with viral non-suppression among PLWH with major depressive disorder using ART in Northern Uganda. Method: A total of 30 primary care HIV clinics across three northern districts (Gulu, Kitgum, Pader) participated in the study. Using baseline data from the SEEK-GSP study, a cluster-randomized trial in northern Uganda (2016-2019) that involved 1140 PLWH with mild to moderate major depressive disorder;we examined the demographic, clinical, and psychosocial factors using standardized questionnaires. Data on viral load was abstracted from clinic records and dichotomized into suppressed (Results: We recruited 1140 PLWH. The viral non-suppression prevalence was 12.2%. In multivariable analysis, the only baseline psychosocial variable independently associated with non-viral suppression was suicide risk (PRR = 1.56, 95% CI: 1.05 - 2.32, p-value = 0.029). The prevalence odds for non-viral suppression were 56% higher among depressed PLWH with moderate to high suicide risk than those with low suicide risk. Among clinical variables, duration on ART ≥ 4 years was independently associated with non-viral suppression (PRR = 1.62, 95% CI: 1.09 - 2.32, p-value = 0.015). Conclusions: Suicide risk and longer duration on ART are associated with non-viral suppression among anti-retroviral therapy users with mild to moderate major depressive disorder in Uganda. As ART is scaled up across Sub-Saharan Africa, first-line psychological care for depression and its complications is urgently needed in established HIV treatment centers.展开更多
Objective:To study the efficacy of acupuncture combined with Tuina(Chinese therapeutic massage)compared to acupuncture alone and sham acupuncture in aspects of symptom control and mobility functions in farmers sufferi...Objective:To study the efficacy of acupuncture combined with Tuina(Chinese therapeutic massage)compared to acupuncture alone and sham acupuncture in aspects of symptom control and mobility functions in farmers suffering from knee osteoarthrosis(KOA).Methods:Individuals enrolled at a community hospital in Thailand were extended invitations to take part in the research project.Those who volunteered provided informed consent and were then randomly assigned to one of three groups,namely the combined group,the acupuncture group,and the control group.Thirty-four cases in the combined group received acupuncture and Tuina treatments;32 cases in the acupuncture group received acupuncture alone;and 30 cases in the control group received sham acupuncture intervention.Each group underwent therapeutic sessions once daily for 10 d.As the main outcome measured,the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)was used to assess pain,stiffness,and function.The secondary outcomes included movement angles measured with a goniometer and balance function evaluated by the timed up and go test.Results:A total of 96 patients were analyzed.After the intervention,WOMAC total score and pain,stiffness,and function scores were significantly reduced and the joint range of motion was improved in both the combined group and the acupuncture group when compared to the control group(P<0.05);there were no significant differences between the combined group and the acupuncture group.Compared to the acupuncture group,a lowered balance score was observed in the combined group(P<0.05).Conclusion:After once-daily interventions for 10 consecutive days in KOA patients,both the combination of acupuncture and Tuina and acupuncture alone proved effective in alleviating pain and improving the range of motion compared to the control group.展开更多
Objective WHO recommends that every pregnant woman and newborn receive quality care throughout the pregnancy,delivery and postnatal periods.However,Maternal Mortality Ratio in Indonesia for 2015 reached 305 per 100000...Objective WHO recommends that every pregnant woman and newborn receive quality care throughout the pregnancy,delivery and postnatal periods.However,Maternal Mortality Ratio in Indonesia for 2015 reached 305 per 100000 live births,which exceeds the target of Sustainable Development Goals(<70 per 100000 live births).Receiving at least four times antenatal care(ANC4+)and skilled birth attendant(SBA)during childbirth is crucial for preventing maternal and neonatal deaths.The study aims to assess the determinants of ANC4+and SBA independently,evaluate the distribution of utilisation of ANC4+and SBA services,and further investigate the associations of two levels of continuity of services utilisation in Indonesia Design Data from the Indonesia Demographic and Health Survey,a cross-sectional and large-scale national survey conducted in 2017 were used.Setting This study was set in Indonesia.Participants The study involved ever-married women of reproductive age(15-49 years)and had given birth in the last 5 years prior to the survey(n=15288).The dependent variables are the use of ANC4+and SBA.Individual,family and community factors,such as age,age at first birth,level of education,employment status,parity,autonomy in healthcare decision-making,level of education,employment status of spouses,household income,mass media consumption residence and distance from health facilities were also measured.Results Results showed that 11632(76.1%)women received ANC4+and SBA during childbirth.Multivariate analysis revealed that age,age at first birth,and parity have a statistically significant association with continuity of services utilisation.The odds of using continuity of services were higher among women older than 34 years(adjusted OR(aOR)1.54;95%CI 1.31 to 1.80)compared with women aged 15-24 years.Women with a favourable distance from health facilities were more likely to receive continuity of services utilisation(aOR 1.39;95%CI 1.24 to 1.57).Conclusions The continuity of services utilisation is associated with age,reproductive status,family influence and accessibility-related factors.Findings demonstrated the importance of enhancing early reproductive health education for men and women.The health system reinforcement,community empowerment and multisectoral engagement enhance accessibility to health facilities,reduce financial and geographical barriers,and produce strong quality care.展开更多
In the 1950s,shortly after the founding of the People’s Republic of China(PRC),the central government created the Patriotic Health Campaign(PHC)in order to standardize and disseminate healthfocused educational materi...In the 1950s,shortly after the founding of the People’s Republic of China(PRC),the central government created the Patriotic Health Campaign(PHC)in order to standardize and disseminate healthfocused educational materials intended to control and prevent infectious diseases(1).“Water improvement”,meaning measures aimed at providing safe drinking water for households in China,was an important part of the PHC.After 60 years of water improvement policies.展开更多
Objective:This study explored the relationship between menopause and metabolic syndrome(MetS),stroke,hyperlipidemia,diabetes and hypertension.Study design:This cross-sectional study surveyed 440 women in Yuci,China in...Objective:This study explored the relationship between menopause and metabolic syndrome(MetS),stroke,hyperlipidemia,diabetes and hypertension.Study design:This cross-sectional study surveyed 440 women in Yuci,China in 2012.Main outcome measures:MetS,diabetes,hypertension,hyperlipidemia,stroke,and behavioral and demographic variables.Results:The prevalence of MetS in this study was 40.28%to 49.66%(p=0.065)among preand post-menopausal women,respectively,after adjusting for age.Conclusions:The prevalence of diabetes,stroke,hypertension,and hyperlipidemia was higher among post-than pre-menopausal women.Health screenings for women in China should consider the increased risk for metabolic disorders during the postmenopausal stage of life.展开更多
Background:Chagas disease is one of the neglected tropical diseases(NTDs).International goals for its control involve elimination of vector-borne transmission.Central American countries face challenges in establishing...Background:Chagas disease is one of the neglected tropical diseases(NTDs).International goals for its control involve elimination of vector-borne transmission.Central American countries face challenges in establishing sustainable vector control programmes,since the main vector,Triatoma dimidiata,cannot be eliminated.In 2012,the Ministry of Health in Nicaragua started a field test of a vector surveillance-response system to control domestic vector infestation.This paper reports the main findings from this pilot study.Methods:This study was carried out from 2012 to 2015 in the Municipality of Totogalpa.The Japan International Cooperation Agency provided technical cooperation in designing and monitoring the surveillance-response system until 2014.This system involved 1)vector reports by householders to health facilities,2)data analysis and planning of responses at the municipal health centre and 3)house visits or insecticide spraying by health personnel as a response.We registered all vector reports and responses in a digital database.The collected data were used to describe and analyse the system performance in terms of amount of vector reports as well as rates and timeliness of responses.Results:During the study period,T.dimidiata was reported 396 times.Spatiotemporal analysis identified some high-risk clusters.All houses reported to be infested were visited by health personnel in 2013 and this response rate dropped to 39%in 2015.Rates of insecticide spraying rose above 80%in 2013 but no spraying was carried out in the following 2 years.The timeliness of house visits improved significantly after the responsibility was transferred from a vector control technician to primary health care staff.Conclusions:We argue that the proposed vector surveillance-response system is workable within the resourceconstrained health system in Nicaragua.Integration to the primary health care services was a key to improve the system performance.Continual efforts are necessary to keep adapting the surveillance-response system to the dynamic health systems.We also discuss that the goal of eliminating vector-borne transmission remains unachievable.This paper provides lessons not only for Chagas disease control in Central America,but also for control efforts for other NTDs that need a sustainable surveillance-response system to support elimination.展开更多
Background: On 23 February 2018,the Uganda Ministry of Health(MOH)declared a cholera outbreak affecting more than 60 persons in Kyangwali Refugee Settlement,Hoima District,bordering the Democratic Republic of Congo(DR...Background: On 23 February 2018,the Uganda Ministry of Health(MOH)declared a cholera outbreak affecting more than 60 persons in Kyangwali Refugee Settlement,Hoima District,bordering the Democratic Republic of Congo(DRC).We investigated to determine the outbreak scope and risk factors for transmission,and recommend evidence-based control measures.Methods:: We defined a suspected case as sudden onset of watery diarrhoea in any person aged≥2 years in Hoima District,1 February–9 May 2018.A confirmed case was a suspected case with Vibrio cholerae cultured from a stool sample.We found cases by active community search and record reviews at Cholera Treatment Centres.We calculated case-fatality rates(CFR)and attack rates(AR)by sub-county and nationality.In a case-control study,we compared exposure factors among case-and control-households.We estimated the association between the exposures and outcome using Mantel-Haenszel method.We conducted an environmental assessment in the refugee settlement,including testing samples of stream water,tank water,and spring water for presence of fecal coliforms.We tested suspected cholera cases using cholera rapid diagnostic test(RDT)kits followed by culture for confirmation.Results: We identified 2122 case-patients and 44 deaths(CFR=2.1%).Case-patients originating from Demographic Republic of Congo were the most affected(AR=15/1000).The overall attack rate in Hoima District was 3.2/1000,with Kyangwali sub-county being the most affected(AR=13/1000).The outbreak lasted 4 months,which was a multiple point-source.Environmental assessment showed that a stream separating two villages in Kyangwali Refugee Settlement was a site of open defecation for refugees.Among three water sources tested,only stream water was feacally-contaminated,yielding>100 CFU/100 ml.Of 130 stool samples tested,124(95%)yielded V.cholerae by culture.Stream water was most strongly associated with illness(odds ratio[OR]=14.2,95%CI:1.5–133),although tank water also appeared to be independently associated with illness(OR=11.6,95%CI:1.4–94).Persons who drank tank and stream water had a 17-fold higher odds of illness compared with persons who drank from other sources(OR=17.3,95%CI:2.2–137).Conclusions: Our investigation demonstrated that this was a prolonged cholera outbreak that affected four sub-counties and two divisions in Hoima District,and was associated with drinking of contaminated stream water.In addition,tank water also appears to be unsafe.We recommended boiling drinking water,increasing latrine coverage,and provision of safe water by the District and entire High Commission for refugees.展开更多
文摘Objective:To investigate the prevalence and risk factors associated with long COVID symptoms among children and adolescents who have recovered from COVID-19.Methods:This study applied a cross-sectional approach within community settings in a southern province of Vietnam.A structured questionnaire featuring socio-demographic information and common long COVID symptoms was employed.Phi correlation coefficients assessed associations among pairs of long COVID symptoms.Additionally,multivariable logistic regression models were performed to investigate the risk factors of long COVID in recovered COVID-19 children and adolescents.Results:Among 422 participants,39.3%reported long COVID symptoms,with a prevalence of 45.2%(SD=0.5)in children and 22.2%(SD=0.4)in adolescents.Common symptoms reported were cough 34.6%(SD=0.5),fatigue 20.6%(SD=0.4),shortness of breath 10.9%(SD=0.3),and lack of appetite 6.6%(SD=0.3).Concerning risk factors of long COVID,a higher risk was observed among demographic groups,including girls(OR 1.25,95%CI 1.15-1.37;P<0.001,reference:boys),children compared to adolescents(OR 1.24,95%CI 1.12-1.37;P<0.001),overweight individuals(OR 1.14,95%CI 1.02-1.27;P=0.018,reference:healthy weight),and participants without any COVID-19 vaccination(OR 1.36,95%CI 1.20-1.54;P<0.001),or have received only one single dose(OR 1.35,95%CI 1.10-1.64;P=0.004)compared to those who have received two doses.Besides,patients with a COVID-19 treatment duration exceeding two weeks also had a higher risk of long COVID(OR 1.32,95%CI 1.09-1.60;P=0.003)than those who recovered less than seven days.Conclusions:The insights from this study provide crucial guidance for predicting the factors associated with the occurrence of long COVID in pediatric patients,contributing to strategic interventions aimed at mitigating the long COVID risks among children and adolescents in Vietnam.
文摘Antioxidant activities of W and E extracts obtained from dried boxthorn (Lycium chinensis) fruit were measured based on DPPH radical scavenging and reducing powers, and their relationships with total phenolics, flavonoid content, and antioxidant activity were investigated. A linear correlation among antioxidant activity, total phenolics, and flavonoid content was observed in concentration-dependent mode. Both extracts showed > 95% DPPH radical-scavenging activity and the higher reducing power of 3200 ppm at the same concentration. The antioxidant potential of both extracts were compared with those of commercial antioxidants such as BHA, BHT, TBHQ, ferulic acid, and α-tocopherol using H2O2 scavenging activity, inhibition of linoleic acid peroxidation, inhibition of hemolysis of rat erythrocyte induced by peroxyl radicals, and inhibition of Fe2+-induced lipid peroxidation using rat brain tissue. In the H2O2 scavenging activity, E extract showed a comparable significant antioxidant power, comparable to commercial antioxidants, and no signifi-cant difference (P > 0.05) was found between W and E extracts on inhibition of the linoleic acid peroxidation. Whereas W extract exhibited a significant power in the hemolysis of rat erythrocytes, none was observed in E extract. In the Fe-induced lipid peroxidation using rat brain tissue, no significant difference (P > 0.05) was found between both ex-tracts, showing a comparable activity with those of synthetic antioxidants. Both W and E extracts of dried boxthorn (Lycium chinensis) fruit may have a potential as natural antioxidants to replace synthetic antioxidants.
文摘Point and nonpoint sources of phosphorus (P) and nitrogen (N) can cause reductions in water quality, including eutrophication. Nonpoint pollution represents a special challenge because of dispersed not easily identifiable sources such as the runoff from soil, nutrients, and other chemicals from agricultural fields and residential areas. Laguna Cartagena is a tropical freshwater wetland, situated in southwestern Puerto Rico. It is a eutrophic ecosystem, and its eutrophication is caused by both external nutrient loading and internal, mainly by phosphorus. This wetland has been affected by phosphorus loading from inorganic agricultural fertilizer in this historically oligotrophic wetland system until the end of subsidized fertilizer use and sugar cane cultivation in the late 1990s. This study identifies: 1) nonpoint sources of phosphorus (SRP, Soluble Reactive Phosphorus and TP, Total Phosphorus) and nitrogen (nitrate, nitrite, and ammonia) that enter Laguna Cartagena;and 2) the role of precipitation events on the contributions of phosphorus and nitrogen loading to ecosystems. Herein we assess water samples from five channelized external sources of P and N that enter Laguna Cartagena at two-week intervals from October 2013 through November 2014. Rainfall data were obtained weekly from a rain gauge. Standard methods were used for all chemical analyses. Results showed that the channelized waterways that carry water to the lagoon can be classified as hypereutrophic (>100 μg/L) for TP concentrations and oligotrophic (<200 μg/L) for nitrogen concentrations. Currently agriculture (rice and cattle) is the predominant land use at the nearby University of Puerto Rico (UPR) Lajas Agricultural Experiment Substation, the predominant nonpoint source of nutrient pollution (SRP, TP and ammonia) in the principal channelized water sources to the lagoon. Current nutrient loads are likely derived from fertilizers applied to the Substation’s rice fields, and a high density livestock. The second important cause of external surface water degradation (SRP, TP and ammonia) is the discharge from rural households in the drainage basin that discharge greywater directly to the environment, as indicated by the results from Cerro Alto hills immediately to the north of the lagoon. Precipitation also was associated with SRP, TP and ammonia loads.
文摘Maintaining the water quality of lakes and reservoirs is part of the 2030 Agenda for Sustainable Development, an initiative promoted by the United Nations, including anthropogenic and natural factors that may influence water quality. The water reservoirs of Puerto Rico were built in watersheds to provide runoff control and for primary uses. The Cerrillos Reservoir is one of the largest water reservoirs in southern Puerto Rico, and is used as a source of potable water and for recreational activities. After hurricane Maria, in September 2017, many communities were without public water service and have obtained their drinking water from local rivers or their tributaries, without filtration or purification treatment. This research explored the physical-chemical parameters of Cerrillos Reservoir’s surface water from May 2018 to January 2019. The objective of the present study is to assess seasonal variations in surface water quality with respect to physical (temperature, turbidity, and conductivity), chemical (nutrient concentrations: (Phosphorus (P) (Soluble Reactive Phosphorus, phosphate, or orthophosphate) and Nitrogen (N) (nitrate, nitrite, and ammonia)), pH, and dissolved oxygen), and biological (total coliforms and <em>Escherichia coli</em>) parameters. Results suggest that Cerrillos Reservoir did not exceed the parameters of temperature, turbidity, conductivity, pH and DO, established by the Puerto Rico Department of Natural and Environmental Resources (PRDNER). The reservoir showed a stable trophic state in relation to inorganic phosphorus and nitrogen as N and P concentrations did not increase sufficiently to disrupt this ecosystem. However, total coliforms exceeded the maximum parameter (23 MPN/100mL - 994 MPN/100mL) established for the Puerto Rico Department of Natural and Environmental Resources and are likely to be the results of the disruption caused by hurricane Maria.
文摘Objectives: Obesity rates in US are substantially higher among African-Americans than Whites. Racial disparities in obesity are sometimes ascribed to racial differences in socio-economic-status (SES). We used data from three states in the southern region of the US with high rates of obesity, to examine the extent of racial disparities within SES categories, particularly examining whether disparities grow smaller at higher levels of income and education. Methods: We used data (2001-2009) from the Behavioral Risk Factor Surveillance System (BRFSS) for 79,676 respondents, African-American and white, from Mississippi, Alabama, and Louisiana. Multivariate logistic regressions were estimated. Analyses were conducted separately for males and females, for the full sample and by levels of education, income and aggregate SES. Risk-differences (RD), and Relative-Risk-Ratios (RR) were reported to enable inspection of magnitudes of racial gaps, which more conventional odds-ratios does not allow researchers to do. Results: The obesity-gap between African-Americans and Whites is larger for females than males. For males the gap becomes smaller and insignificant in higher education and income categories. For females, the gap remains statistically significant and is of comparable magnitude across all education and income categories. Conclusions: Racial disparities in obesity among males can be largely attributed to SES differences. However, racial disparities among females cannot simply be attributed to racial disparities in SES. Thus, reducing racial differences in income and education may not help reduce disparities in obesity risk among White and African-American females. Further research is required to understand why racial disparities in obesity exist within specific SES categories for females.
文摘Objective:To detect and identify filarial parasites in dried blood spots(DBS)collected from domestic cats using high resolution melting real-time PCR(HRM RT-PCR).Methods:A total of 208 DBS were collected from domestic cats in a brugian filariasis endemic areas in Surat Thani Province,southern Thailand.Microfilariae were found in 9 blood slides using Giemsa-stained thick blood film.The extracted DNA from blood spot volumes of 10 and 20μL DBS with positive filarial parasites in cats were performed using HRM RT-PCR method.The primers were designed based on the partial mitochondrial 12S rRNA gene for identifying Brugia malayi,Brugia pahangi,Dirofilaria immitis.All purified samples were then detected.Results:Using different volumes of 10μL and 20μL DBS could easily distinguish filarial parasites and showed similar results.PCR amplicons of Brugia malayi,Brugia pahangi and Dirofilaria immitis were determined at melting peak(temperature)of 75.70℃,77.46℃,and 73.56℃,respectively.All 9 positive DBS samples showed positive Brugia pahangi and similar nucleotide sequences.Conclusions:This HRM RT-PCR method is able to diagnose,identify and discriminate filarial parasites collected from DBS,which is simple and inexpensive compared with other probe-based genotyping methods.Furthermore,this method is useful to survey,prevent and control filariasis.
文摘Background and aims:Indonesian government is regulating a family planning program to restricted fertility among reproductive aged.However,participated of married male for using contraceptive is very lowest in Indonesia.Methods:A cross-sectional study was conducted among 168 of married male(84 of condom method and 84 of vasectomy method)from April to August 2019 in Jember regency of East Java,Indonesia using purposive sampling method.A self-administered questionnaire was used to measure sociodemographic and contraceptive method of participants.Chi square test was performed to analyze the differences of characteristic of contraceptive method of condom and vasectomy among married male(P<0.05).Results:There were a significant differenced ethnic(χ^2=7.664,P-value=0.006)and access of information(χ^2=8.111,P-value=0.044)between condom and vasectomy method among married male.Conclusion:Characteristics of ethnic and access information are related with contraceptive method choosing for using condom and vasectomy among married male in Indonesia.Therefore,accessibility of contraceptive method through health education should be implemented for married male in Indonesia setting regarding their social and cultural context.
基金supported by the Brazilian Research Council(Conselho Nacional de Desenvolvimento Científico e Tecnológico–CNPq),grant number 301174/2017-2
文摘Leptospirosis is a bacterial disease disseminated through the centuries in the whole world which causes symptoms that go from self-limited diseases to hemorrhagic manifestations and organ failure,including acute kidney injury(AKI),composing the severe disease known as the Weil's syndrome.Mortality rates varies according to the clinical presentation and usually increases when kidney injury is present,and is even higher in the setting of pulmonary hemorrhage.There are recent advances in the search for novel biomarkers of renal involvement and early detection of AKI in leptospirosis,as well as in its pathophysiology.We review in this article the clinical aspects of leptospirosis-associated AKI and the perspectives for future research.
文摘Background: Several studies indicate that depression is associated with non-viral suppression among persons living with HIV (PLWH) using antiretroviral therapy (ART) worldwide. However, among PLWH with major depressive disorder, factors associated with non-viral suppression remain uncertain. We determined the prevalence and identified the factors associated with viral non-suppression among PLWH with major depressive disorder using ART in Northern Uganda. Method: A total of 30 primary care HIV clinics across three northern districts (Gulu, Kitgum, Pader) participated in the study. Using baseline data from the SEEK-GSP study, a cluster-randomized trial in northern Uganda (2016-2019) that involved 1140 PLWH with mild to moderate major depressive disorder;we examined the demographic, clinical, and psychosocial factors using standardized questionnaires. Data on viral load was abstracted from clinic records and dichotomized into suppressed (Results: We recruited 1140 PLWH. The viral non-suppression prevalence was 12.2%. In multivariable analysis, the only baseline psychosocial variable independently associated with non-viral suppression was suicide risk (PRR = 1.56, 95% CI: 1.05 - 2.32, p-value = 0.029). The prevalence odds for non-viral suppression were 56% higher among depressed PLWH with moderate to high suicide risk than those with low suicide risk. Among clinical variables, duration on ART ≥ 4 years was independently associated with non-viral suppression (PRR = 1.62, 95% CI: 1.09 - 2.32, p-value = 0.015). Conclusions: Suicide risk and longer duration on ART are associated with non-viral suppression among anti-retroviral therapy users with mild to moderate major depressive disorder in Uganda. As ART is scaled up across Sub-Saharan Africa, first-line psychological care for depression and its complications is urgently needed in established HIV treatment centers.
基金registered in the Thai Clinical Trials Registry(No.TCTR20221129004)approved by the Institutional Review Board of the University of Phayao(No.1.2/024/65)。
文摘Objective:To study the efficacy of acupuncture combined with Tuina(Chinese therapeutic massage)compared to acupuncture alone and sham acupuncture in aspects of symptom control and mobility functions in farmers suffering from knee osteoarthrosis(KOA).Methods:Individuals enrolled at a community hospital in Thailand were extended invitations to take part in the research project.Those who volunteered provided informed consent and were then randomly assigned to one of three groups,namely the combined group,the acupuncture group,and the control group.Thirty-four cases in the combined group received acupuncture and Tuina treatments;32 cases in the acupuncture group received acupuncture alone;and 30 cases in the control group received sham acupuncture intervention.Each group underwent therapeutic sessions once daily for 10 d.As the main outcome measured,the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)was used to assess pain,stiffness,and function.The secondary outcomes included movement angles measured with a goniometer and balance function evaluated by the timed up and go test.Results:A total of 96 patients were analyzed.After the intervention,WOMAC total score and pain,stiffness,and function scores were significantly reduced and the joint range of motion was improved in both the combined group and the acupuncture group when compared to the control group(P<0.05);there were no significant differences between the combined group and the acupuncture group.Compared to the acupuncture group,a lowered balance score was observed in the combined group(P<0.05).Conclusion:After once-daily interventions for 10 consecutive days in KOA patients,both the combination of acupuncture and Tuina and acupuncture alone proved effective in alleviating pain and improving the range of motion compared to the control group.
基金funded by the Directorate of Research and Community Engagement of Universitas Indonesia(NKB-773/UN2.RST/HKP.05.00/2020).
文摘Objective WHO recommends that every pregnant woman and newborn receive quality care throughout the pregnancy,delivery and postnatal periods.However,Maternal Mortality Ratio in Indonesia for 2015 reached 305 per 100000 live births,which exceeds the target of Sustainable Development Goals(<70 per 100000 live births).Receiving at least four times antenatal care(ANC4+)and skilled birth attendant(SBA)during childbirth is crucial for preventing maternal and neonatal deaths.The study aims to assess the determinants of ANC4+and SBA independently,evaluate the distribution of utilisation of ANC4+and SBA services,and further investigate the associations of two levels of continuity of services utilisation in Indonesia Design Data from the Indonesia Demographic and Health Survey,a cross-sectional and large-scale national survey conducted in 2017 were used.Setting This study was set in Indonesia.Participants The study involved ever-married women of reproductive age(15-49 years)and had given birth in the last 5 years prior to the survey(n=15288).The dependent variables are the use of ANC4+and SBA.Individual,family and community factors,such as age,age at first birth,level of education,employment status,parity,autonomy in healthcare decision-making,level of education,employment status of spouses,household income,mass media consumption residence and distance from health facilities were also measured.Results Results showed that 11632(76.1%)women received ANC4+and SBA during childbirth.Multivariate analysis revealed that age,age at first birth,and parity have a statistically significant association with continuity of services utilisation.The odds of using continuity of services were higher among women older than 34 years(adjusted OR(aOR)1.54;95%CI 1.31 to 1.80)compared with women aged 15-24 years.Women with a favourable distance from health facilities were more likely to receive continuity of services utilisation(aOR 1.39;95%CI 1.24 to 1.57).Conclusions The continuity of services utilisation is associated with age,reproductive status,family influence and accessibility-related factors.Findings demonstrated the importance of enhancing early reproductive health education for men and women.The health system reinforcement,community empowerment and multisectoral engagement enhance accessibility to health facilities,reduce financial and geographical barriers,and produce strong quality care.
文摘In the 1950s,shortly after the founding of the People’s Republic of China(PRC),the central government created the Patriotic Health Campaign(PHC)in order to standardize and disseminate healthfocused educational materials intended to control and prevent infectious diseases(1).“Water improvement”,meaning measures aimed at providing safe drinking water for households in China,was an important part of the PHC.After 60 years of water improvement policies.
基金Partial funding for this research was provided by the Cedar Fund(Hong Kong,SAR).
文摘Objective:This study explored the relationship between menopause and metabolic syndrome(MetS),stroke,hyperlipidemia,diabetes and hypertension.Study design:This cross-sectional study surveyed 440 women in Yuci,China in 2012.Main outcome measures:MetS,diabetes,hypertension,hyperlipidemia,stroke,and behavioral and demographic variables.Results:The prevalence of MetS in this study was 40.28%to 49.66%(p=0.065)among preand post-menopausal women,respectively,after adjusting for age.Conclusions:The prevalence of diabetes,stroke,hypertension,and hyperlipidemia was higher among post-than pre-menopausal women.Health screenings for women in China should consider the increased risk for metabolic disorders during the postmenopausal stage of life.
基金This study used funding from the Ministry of Health in Nicaragua(MoH)and Japan International Cooperation Agency(JICA)The MoH played an important role in the design of the study and data collection as described in the paper.Neither organization were not involved in analysing and interpreting data or in writing the manuscript.
文摘Background:Chagas disease is one of the neglected tropical diseases(NTDs).International goals for its control involve elimination of vector-borne transmission.Central American countries face challenges in establishing sustainable vector control programmes,since the main vector,Triatoma dimidiata,cannot be eliminated.In 2012,the Ministry of Health in Nicaragua started a field test of a vector surveillance-response system to control domestic vector infestation.This paper reports the main findings from this pilot study.Methods:This study was carried out from 2012 to 2015 in the Municipality of Totogalpa.The Japan International Cooperation Agency provided technical cooperation in designing and monitoring the surveillance-response system until 2014.This system involved 1)vector reports by householders to health facilities,2)data analysis and planning of responses at the municipal health centre and 3)house visits or insecticide spraying by health personnel as a response.We registered all vector reports and responses in a digital database.The collected data were used to describe and analyse the system performance in terms of amount of vector reports as well as rates and timeliness of responses.Results:During the study period,T.dimidiata was reported 396 times.Spatiotemporal analysis identified some high-risk clusters.All houses reported to be infested were visited by health personnel in 2013 and this response rate dropped to 39%in 2015.Rates of insecticide spraying rose above 80%in 2013 but no spraying was carried out in the following 2 years.The timeliness of house visits improved significantly after the responsibility was transferred from a vector control technician to primary health care staff.Conclusions:We argue that the proposed vector surveillance-response system is workable within the resourceconstrained health system in Nicaragua.Integration to the primary health care services was a key to improve the system performance.Continual efforts are necessary to keep adapting the surveillance-response system to the dynamic health systems.We also discuss that the goal of eliminating vector-borne transmission remains unachievable.This paper provides lessons not only for Chagas disease control in Central America,but also for control efforts for other NTDs that need a sustainable surveillance-response system to support elimination.
文摘Background: On 23 February 2018,the Uganda Ministry of Health(MOH)declared a cholera outbreak affecting more than 60 persons in Kyangwali Refugee Settlement,Hoima District,bordering the Democratic Republic of Congo(DRC).We investigated to determine the outbreak scope and risk factors for transmission,and recommend evidence-based control measures.Methods:: We defined a suspected case as sudden onset of watery diarrhoea in any person aged≥2 years in Hoima District,1 February–9 May 2018.A confirmed case was a suspected case with Vibrio cholerae cultured from a stool sample.We found cases by active community search and record reviews at Cholera Treatment Centres.We calculated case-fatality rates(CFR)and attack rates(AR)by sub-county and nationality.In a case-control study,we compared exposure factors among case-and control-households.We estimated the association between the exposures and outcome using Mantel-Haenszel method.We conducted an environmental assessment in the refugee settlement,including testing samples of stream water,tank water,and spring water for presence of fecal coliforms.We tested suspected cholera cases using cholera rapid diagnostic test(RDT)kits followed by culture for confirmation.Results: We identified 2122 case-patients and 44 deaths(CFR=2.1%).Case-patients originating from Demographic Republic of Congo were the most affected(AR=15/1000).The overall attack rate in Hoima District was 3.2/1000,with Kyangwali sub-county being the most affected(AR=13/1000).The outbreak lasted 4 months,which was a multiple point-source.Environmental assessment showed that a stream separating two villages in Kyangwali Refugee Settlement was a site of open defecation for refugees.Among three water sources tested,only stream water was feacally-contaminated,yielding>100 CFU/100 ml.Of 130 stool samples tested,124(95%)yielded V.cholerae by culture.Stream water was most strongly associated with illness(odds ratio[OR]=14.2,95%CI:1.5–133),although tank water also appeared to be independently associated with illness(OR=11.6,95%CI:1.4–94).Persons who drank tank and stream water had a 17-fold higher odds of illness compared with persons who drank from other sources(OR=17.3,95%CI:2.2–137).Conclusions: Our investigation demonstrated that this was a prolonged cholera outbreak that affected four sub-counties and two divisions in Hoima District,and was associated with drinking of contaminated stream water.In addition,tank water also appears to be unsafe.We recommended boiling drinking water,increasing latrine coverage,and provision of safe water by the District and entire High Commission for refugees.
