Epidemic characteristics, high-risk townships and space-time clusters of human brucellosis in Shanxi Province of China, 2005–2014

BACKGROUND: Brucellosis, one of the world's most important zoonosis, has been re-emerging in China. Shanxi Province, located in northern China, where husbandry development has been accelerated in recent years, has a rather high incidence of human brucellosis but drew little attention from the researchers. This study aimed to describe the changing epidemiology of human brucellosis in Shanxi Province from 2005 to 2014 and explore high-risk towns and space-time clusters for elucidating the necessity of decentralizing disease control resource to township level in epidemic regions, particularly in hotspot areas.METHODS: We extracted data from the Chinese National Notifiable Infectious Disease Reporting System to describe the incidence and spatiotemporal distribution of human brucellosis in Shanxi Province. Geographic information system was used to identify townships at high risk for the disease. Space-Time Scan Statistic was applied to detect the space-time clusters of human brucellosis during the past decade.RESULTS: From 2005 to 2014, a total of 50,002 cases of human brucellosis were recorded in Shanxi, with a male-to-female ratio of 3.9:1. The reported incidence rate increased dramatically from 7.0/100,000 in 2005 to 23.5/100,000 in 2014, with an average annual increase of 14.5%. There were still 33.8% cases delaying diagnosis in 2014. The proportion of the affected towns increased from 31.5% in 2005 to 82.5% in 2014. High-risk towns spread from the north to the center and then south of Shanxi Province, which were basins and adjacent highlands suitable for livestock cultivation. During the past decade, there were 55 space-time clusters of human brucellosis detected in high risk towns; the clusters could happen in any season. Some clusters' location maintained stable over time.CONCLUSIONS: During the last decade, Shanxi province's human brucellosis epidemic had been aggravated and high-risk areas concentrated in some towns located in basins and adjacent highlands. Space-time clusters existed and some located steadily over time. Quite a few cases still missed timely diagnosis. Greater resources should be allocated and decentralized to mitigate the momentum of rise and improve the accessibility of prompt diagnosis treatment in the high-risk townships

Epidemiology of human anthrax in China, 1955-2014

Using national surveillance data for 120,111 human anthrax cases recorded during 1955-2014, we analyzed the temporal, seasonal, geographic, and demographic distribution of this disease in China. After 1978, incidence decreased until 2013, when it reached a low of 0.014 cases/100,000 population. The case-fatality rate, cumulatively 3.6% during the study period, has also decreased since 1990. Cases occurred throughout the year, peaking in August. Geographic distribution decreased overall from west to east, but the cumulative number of affected counties increased during 2005-2014. The disease has shifted from industrial to agricultural workers; 86.7% of cases occurred in farmers and herdsmen. Most (97.7%) reported cases were the cutaneous form. Although progress has been made in reducing incidence, this study highlights areas that need improvement. Adequate laboratory diagnosis is lacking; only 7.6% of cases received laboratory confirmation. Geographic expansion of the disease indicates that livestock control programs will be essential in eradicating anthrax

Grazing weakens competitive interactions between active methanotrophs and nitrifiers modulating greenhouse-gas emissions in grassland soils

This work was financially supported by Natural Science Foundation of China (41977033, 41907026, and 41721001), Fundamental Research Funds for the Central Universities (2019QNA6011), National Key Basic Research Program of China (2014CB138801), Shandong Provincial Natural Science Foundation (ZR2019BD032), China Postdoctoral Science Foundation (2020T130387 and 2019M652448). CG-R was funded by a Royal Society University Research Fellowship (UF150571). Special thanks to ChunMei Meng, Yu Luo, and Yan Zheng for their assistance in laboratory analyses.Peer reviewedPublisher PD

Efficacy of Metformin for Benign Thyroid Nodules in Subjects With Insulin Resistance: A Systematic Review and Meta-Analysis

Background: To evaluate the effect of metformin therapy on decreasing benign thyroid nodule volume in subjects with insulin resistance (IR).Method: Randomized controlled trials (RCTs) and self-controlled trials for the meta-analysis published, before January 31, 2018 were selected from the PubMed, Cochrane Library, Embase, Web of Science, Chinese Biomedical Literature Database, National Knowledge Infrastructure, WANFANG and VIP Database. Pooled standard mean difference with 95% confidence interval was estimated by fixed- or random-effects model depending on heterogeneity. The risk of bias using the Cochrane Collaboration's tool was used to assess the quality of the RCTs contained. The quality of self-controlled studies was evaluated using the Methodological index for non-randomized studies (MINORS) method.Results: 7 studies (3 RCTs and 4 prospective self-controlled studies) with 240 patients were considered to be appropriate for the meta-analysis. The results of the meta-analysis indicated that the volume of thyroid nodule decreased significantly after metformin therapy (SMD −0.62, 95% CI −0.98 ~ −0.27). 6 studies reported the changes of the level of TSH. TSH levels decreased significantly after metformin therapy (SMD −0.27, 95% CI −0.47 ~ −0.07). The pooled data indicated an increase in FT3 level, and an unchanged FT4 level after metformin therapy (FT3, SMD 0.25, 95% CI 0.05 ~ 0.45; FT4, SMD −0.07, 95% CI −0.27 ~ 0.13). HOMA-IR levels decreased significantly after metformin therapy based on the pooled results of 3 RCTs and 3 prospective self-controlled studies (SMD −1.08, 95% CI −1.69 ~ −0.47).Conclusion: The meta-analysis demonstrated that metformin was safe and useful in shrinking benign thyroid nodules volume, improving thyroid function and IR. A large number of high-quality prospective studies still need to be carried out

On the L_p-solvability of higher order parabolic and elliptic systems with BMO coefficients

We prove the solvability in Sobolev spaces for both divergence and non-divergence form higher order parabolic and elliptic systems in the whole space, on a half space, and on a bounded domain. The leading coefficients are assumed to be merely measurable in the time variable and have small mean oscillations with respect to the spatial variables in small balls or cylinders. For the proof, we develop a set of new techniques to produce mean oscillation estimates for systems on a half space.Comment: 44 pages, introduction revised, references expanded. To appear in Arch. Rational Mech. Ana

Impact of grazing on shaping abundance and composition of active methanotrophs and methane oxidation activity in a grassland soil

The effect of grazing on the abundance, composition, and methane (CH4) uptake of methanotrophs in grasslands has been well documented in the past few decades, but the dominant communities of active methanotrophs responsible for CH4 oxidation activity in grazed soils are still poorly understood. In this study, we characterized the metabolically active, aerobic methanotrophs in grasslands with three different levels of grazing (light, medium, and heavy) by combining DNA-stable isotope probing (SIP) and quantitative PCR (qPCR) for methane monooxygenase (pmoA) gene– and 16S rRNA gene–based amplicon sequencing. The CH4 oxidation potential was as low as 0.51 μmol g dry weight−1 day−1 in the ungrazed control, while it decreased as grazing intensity increased in grazed fields, ranging from 2.25 μmol g dry weight−1 day−1 in light grazed fields to 1.59 in heavily grazed fields. Increased CH4 oxidation activity was paralleled by twofold increases in abundance of pmoA genes and relative abundance of methanotroph-affiliated 16S rRNA genes in the total microbial community in grazed soils. SIP and sequencing revealed that the genera Methylobacter and Methylosarcina (type I; Gammaproteobacteria) and Methylocystis (type II; Alphaproteobacteria) were active methanotrophs responsible for CH4 oxidation in grazed soils. Light and intermediate grazing stimulated the growth and activity of methanotrophs, while heavy grazing decreased the abundance and diversity of the active methanotrophs in the typical steppe. Redundancy and correlation analysis further indicated that the variation of bulk density and soil C and N induced by grazing determined the abundance, diversity of active methanotrophs, and methane oxidation activity in the long-term grazed grassland soil

Knowledge, Attitudes and Practices (KAP) related to the Pandemic (H1N1) 2009 among Chinese General Population: a Telephone Survey

<p>Abstract</p> <p>Background</p> <p>China is at greatest risk of the Pandemic (H1N1) 2009 due to its huge population and high residential density. The unclear comprehension and negative attitudes towards the emerging infectious disease among general population may lead to unnecessary worry and even panic. The objective of this study was to investigate the Chinese public response to H1N1 pandemic and provide baseline data to develop public education campaigns in response to future outbreaks.</p> <p>Methods</p> <p>A close-ended questionnaire developed by the Chinese Center for Disease Control and Prevention was applied to assess the knowledge, attitudes and practices (KAP) of pandemic (H1N1) 2009 among 10,669 responders recruited from seven urban and two rural areas of China sampled by using the probability proportional to size (PPS) method.</p> <p>Results</p> <p>30.0% respondents were not clear whether food spread H1N1 virusand. 65.7% reported that the pandemic had no impact on their life. The immunization rates of the seasonal flu and H1N1vaccine were 7.5% and 10.8%, respectively. Farmers and those with lower education level were less likely to know the main transmission route (cough or talk face to face). Female and those with college and above education had higher perception of risk and more compliance with preventive behaviors. Relationships between knowledge and risk perception (OR = 1.69; 95%CI 1.54-1.86), and knowledge and practices (OR = 1.57; 95%CI 1.42-1.73) were found among the study subjects. With regard to the behavior of taking up A/H1N1 vaccination, there are several related factors found in the current study population, including the perception of life disturbed (OR = 1.29; 95%CI 1.11-1.50), the safety of A/H1N1 vaccine (OR = 0.07; 95%CI 0.04-0.11), the knowledge of free vaccination policy (OR = 7.20; 95%CI 5.91-8.78), the state's priority vaccination strategy(OR = 1.33; 95%CI 1.08-1.64), and taking up seasonal influenza vaccine behavior (OR = 4.69; 95%CI 3.53-6.23).</p> <p>Conclusions</p> <p>This A/H1N1 epidemic has not caused public panic yet, but the knowledge of A/H1N1 in residents is not optimistic. Public education campaign may take the side effects of vaccine and the knowledge about the state's vaccination strategy into account.</p

Knowledge, attitudes and practices (KAP) relating to avian influenza in urban and rural areas of China

<p>Abstract</p> <p>Background</p> <p>Studies have revealed that visiting poultry markets and direct contact with sick or dead poultry are significant risk factors for H5N1 infection, the practices of which could possibly be influenced by people's knowledge, attitudes and practices (KAPs) associated with avian influenza (AI). To determine the KAPs associated with AI among the Chinese general population, a cross-sectional survey was conducted in China.</p> <p>Methods</p> <p>We used standardized, structured questionnaires distributed in both an urban area (Shenzhen, Guangdong Province; n = 1,826) and a rural area (Xiuning, Anhui Province; n = 2,572) using the probability proportional to size (PPS) sampling technique.</p> <p>Results</p> <p>Approximately three-quarters of participants in both groups requested more information about AI. The preferred source of information for both groups was television. Almost three-quarters of all participants were aware of AI as an infectious disease; the urban group was more aware that it could be transmitted through poultry, that it could be prevented, and was more familiar with the relationship between AI and human infection. The villagers in Xiuning were more concerned than Shenzhen residents about human AI viral infection. Regarding preventative measures, a higher percentage of the urban group used soap for hand washing whereas the rural group preferred water only. Almost half of the participants in both groups had continued to eat poultry after being informed about the disease.</p> <p>Conclusions</p> <p>Our study shows a high degree of awareness of human AI in both urban and rural populations, and could provide scientific support to assist the Chinese government in developing strategies and health-education campaigns to prevent AI infection among the general population.</p