Factors associated with diagnostic delay of pulmonary tuberculosis among children and adolescents in Quzhou, China: results from the surveillance data 2011–2021

Abstract Purpose Tuberculosis is a high-burden disease and a major health concern in China, especially among children and adolescents. The purpose of this study was to assess risk factors for diagnostic delay in students with pulmonary tuberculosis in Quzhou City in eastern China. Patients and methods Cases of PTB in students and relevant information in Quzhou from 2011 to 2021 were collected using the TB Management Information System. The outcome of interest was diagnostic delay (i.e. ≥ 28 days between symptom onset and treatment initiation). Risk factors for diagnostic delay were identified using multivariable logistic regression. Results A total of 629 students in Quzhou were diagnosed with PTB during the study period, of whom 55.5% were male. The median diagnostic delay was 18 days (Inter Quartile Range, [IQR]: 8–38) and 38.0% of the students had a diagnostic delay. Living in a rural area (adjusted odds ratio, [AOR]: 1.56, 95% confidence interval [CI:] 1.11–2.19), developing PTB symptoms in the first quarter of the year (AOR: 2.18, 95% CI: 1.40–3.40), and no sputum smear result (AOR: 8.73, 95% CI: 1.68–45.30) were significantly associated with a diagnostic delay. Discovery through health examinations (AOR: 0.33, 95% CI: 0.17–0.63) was associated with reduced risk of diagnostic delay. Conclusion Schools in rural areas should pay special attention to increasing student awareness of the symptoms of tuberculosis and provide health education on tuberculosis prevention and control to students and staff

Provider patient-sharing networks and multiple-provider prescribing of benzodiazepines

Background: Prescription benzodiazepine overdose continues to cause significant morbidity and mortality in the US. Multiple-provider prescribing, due to either fragmented care or "doctor-shopping," contributes to the problem. Objective: To elucidate the effect of provider professional relationships on multiple-provider prescribing of benzodiazepines, using social network analytics. Design: A retrospective analysis of commercial healthcare claims spanning the years 2008 through 2011. Provider patient-sharing networks were modelled using social network analytics. Care team cohesion was measured using care density, defined as the ratio between the total number of patients shared by provider pairs within a patient's care team and the total number of provider pairs in the care team. Relationships within provider pairs were further quantified using a range of network metrics, including the number and proportion of patients or collaborators shared. Main measures: The relationship between patient-sharing network metrics and the likelihood of multiple prescribing of benzodiazepines. Participants: Patients between the ages of 18 and 64 years who received two or more benzodiazepine prescriptions from multiple providers, with overlapping coverage of more than 14 days. Results: A total of 5659 patients and 1448 provider pairs were included in our study. Among these, 1028 patients (18.2 %) received multiple prescriptions of benzodiazepines, involving 445 provider pairs (30.7 %). Patients whose providers rarely shared patients had a higher risk of being prescribed overlapping benzodiazepines; the median care density was 8.1 for patients who were prescribed overlapping benzodiazepines and 10.1 for those who were not (p < 0.0001). Provider pairs who shared a greater number of patients and collaborators were less likely to co-prescribe overlapping benzodiazepines. Conclusions: Our findings demonstrate the importance of care team cohesion in addressing multiple-provider prescribing of controlled substances. Furthermore, we illustrate the potential of the provider network as a surveillance tool to detect and prevent adverse events that could arise due to fragmentation of care. [an Erratum exists for this article and can be found at DOI: 10.1007/s11606-015-3533-x]8 page(s

Data_Sheet_1_Epidemiological characteristics and prediction model construction of hemorrhagic fever with renal syndrome in Quzhou City, China, 2005–2022.docx

BackgroundHemorrhagic fever with renal syndrome (HFRS) is one of the 10 major infectious diseases that jeopardize human health and is distributed in more than 30 countries around the world. China is the country with the highest number of reported HFRS cases worldwide, accounting for 90% of global cases. The incidence level of HFRS in Quzhou is at the forefront of Zhejiang Province, and there is no specific treatment for it yet. Therefore, it is crucial to grasp the epidemiological characteristics of HFRS in Quzhou and establish a prediction model for HFRS to lay the foundation for early warning of HFRS.MethodsDescriptive epidemiological methods were used to analyze the epidemic characteristics of HFRS, the incidence map was drawn by ArcGIS software, the Seasonal AutoRegressive Integrated Moving Average (SARIMA) and Prophet model were established by R software. Then, root mean square error (RMSE) and mean absolute error (MAE) were used to evaluate the fitting and prediction performances of the model.ResultsA total of 843 HFRS cases were reported in Quzhou City from 2005 to 2022, with the highest annual incidence rate in 2007 (3.93/100,000) and the lowest in 2022 (1.05/100,000) (P trendConclusionFrom 2005 to 2022, the incidence of HFRS in Quzhou City showed an overall downward trend, but the epidemic in high-incidence areas was still serious. In the future, the dynamics of HFRS outbreaks and host animal surveillance should be continuously strengthened in combination with the Prophet model. During the peak season, HFRS vaccination and health education are promoted with farmers as the key groups.</p

Surgery combined with anlotinib for local control of patients with resectable extremity desmoid fibromatosis: a retrospective study

Background: Desmoid fibromatosis (DF) is a pathological intermediate fibroblastoma that is difficult to control locally due to its invasive nature, especially in the extremities. Although anlotinib demonstrated efficacy in treating DF with tolerable safety, the impact of surgical intervention in conjunction with anlotinib administration on local control in patients with extremity DF remains undetermined.Methods: We conducted a retrospective examination of the clinical medical documentation belonging to patients with resectable DF of the extremities who were treated with surgery between January 2010 and June 2022. The patients were divided into two cohorts: surgery alone cohort and surgery combined with anlotinib group (surgery plus anlotinib cohort), crossover to surgery plus anlotinib cohort was admissible for patients in the surgery alone cohort who experienced disease recurrence postoperatively. Clinical data such as basic information, tumor location, anlotinib toxicity, time to recurrence, surgical complications, follow-up time, visual analogue scale (VAS) score and Musculoskeletal Tumor Society (MSTS) score at the last follow-up were collected.Results: In total, 48 consecutive patients (19 males and 29 females) with resectable DF of the extremities, including 25 patients in the surgery alone cohort, 23 patients in the surgery plus anlotinib cohort, and 10 patients who were transferred from the surgery alone cohort to the surgery plus anlotinib cohort. The VAS score at the last follow-up was 5 (IQR, 3–6) in the surgery alone cohort and 2 (IQR, 1–3) in the surgery plus anlotinib cohort, respectively; the MSTS score at the last follow-up was 19 (IQR, 16.5–24) in the surgery alone cohort and 27 (IQR, 25–28) in the surgery plus anlotinib cohort, respectively; these characteristics were statistically different between the two cohorts. The 3-year recurrence-free survival (RFS) of the surgery alone cohort and the surgery plus anlotinib cohort were 37.7% and 72.6%, respectively, and the difference was statistically significant (p = 0.022).Conclusion: Surgery combined with anlotinib appears to be effective in controlling local recurrence in patients with resectable DF of the extremities, and the side effects were acceptable

Metabonomic Evaluation of Chronic Unpredictable Mild Stress-Induced Changes in Rats by Intervention of Fluoxetine by HILIC-UHPLC/MS

<div><p>Hydrophilic interaction-ultra high performance liquid chromatography (HILIC-UHPLC) allows the analysis of highly polar metabolites, providing complementary information to reversed-phase (RP) chromatography. By optimization of the preparation and analytical conditions in HILIC mode, HILIC-UHPLC/MS was applied for the global metabolic profiling of rat plasma samples generated in an experimental model of chronic unpredictable mild stress (CUMS), and the concomitant investigation of the protective effect of fluoxetine was also evaluated. Identification of plasma metabolic profiles indicated that significant changes in specific metabolites occurred after fluoxetine exposure, including increased phenylalanine, serine, acetyl-L-carnitine, carnitine and decreased creatine, betaine, proline, tryptophan, tyrosine, C16:0 LPC. Some novel biomarkers from this HILIC-UHPLC/MS approach were betaine, proline, tyrosine creatine and serine compared with the results of RP-UHPLC/MS. The complementary nature of this technique is confirmed and is on agreement with previously published studies.</p></div

Extracted ion chromatograms of proline from plasma metabolite profiles measured by (a) RP-UPLC-MS and (b) HILIC-UPLC-MS.

<p>Extracted ion chromatograms of proline from plasma metabolite profiles measured by (a) RP-UPLC-MS and (b) HILIC-UPLC-MS.</p

Biomarkers related to antidepressant mechanism of fluoxetine based on plasma metabolite profiles measured by HILIC-UHPLC/MS.

<p>^aMetabolites identified by comparing with database and authentic standards</p><p>^bMetabolites identified by comparing with literatures and database resources</p><p>*<i>p</i> < 0.05</p><p>**<i>p</i> < 0.01 and</p><p>***<i>p</i> < 0.001.</p><p>Biomarkers related to antidepressant mechanism of fluoxetine based on plasma metabolite profiles measured by HILIC-UHPLC/MS.</p

Base peak intensity (BPI) chromatograms of plasma metabolite profiles from (A) a control rat and (B) a model rat measured by HILIC-UHPLC/MS.

<p>Base peak intensity (BPI) chromatograms of plasma metabolite profiles from (A) a control rat and (B) a model rat measured by HILIC-UHPLC/MS.</p