Association between negative psychology and sleep quality in dialysis patients during the COVID‐19 pandemic

Abstract Aims and Objectives The aim of this study was to assess the sleep quality in dialysis patients during the COVID‐19 epidemic and explore the association between negative psychology (including depression, anxiety, and stress) and sleep quality in this population. Design A cross‐sectional study including three centres. Methods (Patients or Public Contribution) This cross‐sectional study included 378 dialysis patients from April to May 2022 in three dialysis centres in Shanghai. Methods. Depression, anxiety, stress, and sleep quality were measured by the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale‐14 (PSS‐14), and Pittsburgh sleep quality index (PSQI), respectively. With a threshold of 5 to classify participants into good and poor sleep quality, with HADS/PSS‐14 scores as independent variables (per standard deviation (SD) increment), respectively and binary Logistic regression model was constructed to explore the association between the three negative psychological aspects of depression, anxiety, and stress and sleep quality. Results The median PSQI score was 11.0 (mean ± SD: 11.8 ± 4.8). Among them, poor sleep quality (i.e., PSQI >5) was reported by 90.2% of participants. After adjusting for sociodemographic and disease‐related information, HADS‐depression was associated with a significant 49% (odds ratio (OR): 1.49; 95% CI 1.02–2.18) increase in the risk of poor sleep quality for each additional SD (2.4). Correspondingly, for each SD (7.1) increase in PSS‐14, the risk of poor sleep quality was significantly increased by 95% (OR: 1.95; 95% CI 1.35–2.82). Conclusion During the COVID‐19 pandemic, there was a significant negative association between negative psychology, such as depression and stress, and sleep quality in dialysis patients, and this relationship was independent of the dialysis modality. Relevance to Clinical Practice In the context of the rampant COVID‐19, the vast majority of dialysis‐dependent chronic kidney disease presents with severe sleep quality problems, and negative psychology is a potential influencing factor

A clonal group of nontypeable Haemophilus influenzae with two IgA proteases is adapted to infection in chronic obstructive pulmonary disease.

Strains of nontypeable Haemophilus influenzae show enormous genetic heterogeneity and display differential virulence potential in different clinical settings. The igaB gene, which encodes a newly identified IgA protease, is more likely to be present in the genome of COPD strains of H. influenzae than in otitis media strains. Analysis of igaB and surrounding sequences in the present study showed that H. influenzae likely acquired igaB from Neisseria meningitidis and that the acquisition was accompanied by a ~20 kb genomic inversion that is present only in strains that have igaB. As part of a long running prospective study of COPD, molecular typing of H. influenzae strains identified a clonally related group of strains, a surprising observation given the genetic heterogeneity that characterizes strains of nontypeable H. influenzae. Analysis of strains by 5 independent methods (polyacrylamide gel electrophoresis, multilocus sequence typing, igaB gene sequences, P2 gene sequences, pulsed field gel electrophoresis) established the clonal relationship among the strains. Analysis of 134 independent strains collected prospectively from a cohort of adults with COPD demonstrated that ~10% belonged to the clonal group. We conclude that a clonally related group of strains of nontypeable H. influenzae that has two IgA1 protease genes (iga and igaB) is adapted for colonization and infection in COPD. This observation has important implications in understanding population dynamics of H. influenzae in human infection and in understanding virulence mechanisms specifically in the setting of COPD

Factors associated with immunological non-response after ART initiation: a retrospective observational cohort study

Abstract Background Among people living with HIV (PLHIV) on antiretroviral therapy (ART), the mortality of immunological non-responders (INRs) is higher than that of immunological responders (IRs). However, factors associated with immunological non-response following ART are not well documented. Methods We obtained data for HIV patients from the National Free Antiretroviral Treatment Program database in China. Patients were grouped into IRs (CD4 cell count ≥ 350 cells/μl after 24 months’ treatment), immunological incomplete responders (ICRs) (200–350 cells/μl) and INRs (< 200 cells/μl). Multivariable logistic regression was used to assess factors associated with immunological non-response. Results A total of 3900 PLHIV were included, among whom 2309 (59.2%) were IRs, 1206 (30.9%) ICRs and 385 (9.9%) INRs. In multivariable analysis, immunological non-response was associated with being male (2.07, 1.39–3.09), older age [40–49 years (vs. 18–29 years): 2.05, 1.29–3.25; 50–59 years: 4.04, 2.33-7.00; ≥ 60 years: 5.51, 2.84–10.67], HBV co-infection (1.63, 1.14–2.34), HCV co-infection (2.01, 1.01–4.02), lower CD4 + T cell count [50–200 cells/μl (vs. 200–350 cells/μl): 40.20, 16.83–96.01; < 50 cells/μl: 215.67, 85.62-543.26] and lower CD4/CD8 ratio (2.93, 1.98–4.34) at baseline. Compared with patients treated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) based regimens, those receiving protease inhibitors (PIs) based regimens were less likely to be INRs (0.47, 0.26–0.82). Conclusions We found a sizable immunological non-response rate among HIV-infected patients. Being male, older age, coinfection with HBV and HCV, lower CD4 + T cell count and lower CD4/CD8 ratio are risk factors of immunological non-response, whereas PIs-based regimens is a protective factor

Dietary Lead Exposure and Associated Health Risks in Guangzhou, China

Lead exposure is associated with a wide range of adverse effects on human health. The principal exposure route in the general population is through the diet. In this study, we estimate the dietary lead intake and associated health risks among the residents of Guangzhou, China. Data on lead concentrations were derived from the food safety risk monitoring system, which included 6339 samples from 27 food categories collected in 2014&#8211;2017. Food consumption data were taken from a 2011 dietary survey of 2960 Guangzhou residents from 998 households. Dietary lead intake was estimated by age group (3&#8211;6, 7&#8211;17, 18&#8211;59, and &#8805;60 years), and relevant health risks were assessed using the margin of exposure (MOE) method. The mean and 95th percentiles (P95) of dietary lead intake were respectively 0.7466 and 2.4525 &#956;g/kg body weight per day for preschool children aged 3&#8211;6 years; 0.4739 and 1.5522 &#956;g/kg bw/day for school children aged 7&#8211;17 years; 0.3759 and 1.1832 &#956;g/kg bw/day for adults aged 18&#8211;59 years; and 0.4031 and 1.3589 &#956;g/kg bw/day for adults aged &#8805;60 years. The MOE value was less than 1 for preschool children at the mean exposure level and for all age groups at the P95 exposure level. Rice and its products, leafy vegetables, and wheat flour and its products were found to be the primary food sources of lead exposure. Our findings suggest that the health risk from dietary lead exposure is low for Guangzhou residents overall, but that young children and consumers of certain foods may be at increased risk. Continued efforts are needed to reduce the dietary lead exposure in Guangzhou