Identification of key factors affecting neonicotinoid residues in crops and risk of dietary exposure

Neonicotinoids, widely used on farmland, are ubiquitous in food; however, their distribution among various crops and associated exposure risks at the provincial level in China remain unclear. We collected 19 types of crop samples (fruits, vegetables, and tea) from farmland in nine prefectural cities in Zhejiang Province, China. We analyzed nine commonly used neonicotinoids in the edible portions of these crops. A notable detection rate (42.1 %-82.9 %) and high residual neonicotinoid concentrations (278 ± 357 ng/g) were observed. Tea exhibited the highest residue, followed by fruits, and vegetables showed the lowest (P < 0.05). Neonicotinoid ratios in crops to soil (R_C/S) and soil to water (R_S/W) were defined to discern insecticide distribution across different environments. Increased water solubility leads to increased migration of neonicotinoids (R_S/W) from agricultural soils to water through runoff, thereby increasing the relative contribution of nitenpyram and dinotefuran in water. In comparison with other studied compounds, all crops demonstrated the strongest soil uptake of thiamethoxam, denoted by the highest R_C/S value. Elevated R_C/S values in tea, pickled cabbage, and celery suggest increased susceptibility of these crops to neonicotinoid absorption from the soil (P < 0.05). Estimated dietary intake for teenagers, adults and elders was 8.9 ± 0.5, 8.9 ± 0.6, and 8.8 ± 0.3 μg/kg/d, respectively, below the reference dose (57 μg/kg/d). Teenagers, compared to adults and elders, exhibited significantly higher neonicotinoid exposure through fruit consumption, emphasizing the need for increased attention to neonicotinoid exposure among vulnerable populations.

Study on the trajectory of depression among middle-aged and elderly disabled people in China: Based on group-based trajectory model

Background

Previous studies have shown that middle-aged and elderly adults with disabilities are at higher risk for depressive symptoms. However, there are few studies on the long-term trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population.

Objective

This study aimed to identify the different development trajectories of depressive symptoms and their influencing factors in middle-aged and elderly people with disabilities in China.

Methods

Using data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018, a longitudinal cohort was formed for the study. A total of 2053 participants underwent at least two measures of depressive symptoms, assessed using the Center for Epidemiological Studies Depression Scale (CES-D10), a depression symptom assessment scale. We constructed a Group-Based Trajectory Model (GBTM) to identify the development trajectory of depressive symptoms in 2053 middle-aged and elderly disabled individuals, screened the potential predictors using lasso regression, and analyzed the factors affecting the development trajectory of depression through multivariate logistic regression.

Results

We identified four depression symptom trajectories throughout the follow-up process: "low depressive symptom group", "worsening depressive symptom group", "relieved depressive symptom group", and "high depressive symptom group". We found that there were differences in basic characteristics among different subgroups of depression trajectory. However, middle-aged and elderly disabled women living in rural areas, with limited ADL or IADL, physical pain, poor self-reported health and self-reported memory, short sleep time, and no relatives and friends to take care of them were the key groups for the prevention and treatment of depressive symptoms.

Conclusion

There is heterogeneity in the trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population, it is necessary to focus on the characteristics of the trajectories of different subgroups.

Prevalence of preconception TORCH infections and its influential factors: evidence from over 2 million women with fertility desire in southern China

BACKGROUND

TORCH (Toxoplasma gondii [TOX], Cytomegalovirus [CMV], Rubella virus [RV], and Herpes simplex virus [HSV]) represents pathogens known to traverse the maternal-fetal barrier and cause severe neonatal anomalies. We aimed to assess the prevalence of preconception TOX, CMV, and RV infections among women with fertility desire in southern China, and identify related risk factors.

METHODS

Data were obtained from a population-based cross-sectional study conducted as part of the National Free Preconception Health Examination Project. Women planning to conceive within the next 6 months in Guangdong Province were enrolled between 2014 and 2019. Information on sociodemographic, gynecological, and obstetric characteristics was collected. Sera were analyzed for TOX IgG, CMV IgG, and RV IgG antibodies using an enzyme-linked immunosorbent assay. Descriptive, univariate, and multivariate logistic regression analyses were performed to assess the association between TORCH infections and related factors.

RESULTS

Among 2,409,137 participants, the prevalence of IgG antibodies for TOX, CMV, and RV was 3.20% (95% CI: 3.18-3.22%), 77.67% (95% CI: 77.62-77.71%) and 76.03% (95% CI: 75.98-76.07%), respectively. Of all participants, 141,047 women (5.85%, 95% CI:5.83-5.88%) reported a history of immunization for RV. Women living in the Pearl River Delta, a more developed region, have significantly lower vaccination rates than those living in other regions. The seropositivity of TOX IgG was highest among women aged 35 years and above, with primary or lower education levels, and rural registration. Factors such as being older, having a higher educational level, and being of other ethnicities were associated with a higher prevalence of naturally acquired CMV and RV infections. Women living in the Pearl River Delta showed a higher risk of TOX, CMV, and RV infections, with aORs of 2.21, 4.45, and 1.76, respectively. A history of pregnancy, gynecological diseases, and sexually transmitted infections were potentially associated with TORCH infections, but this association varied across pathogens.

CONCLUSION

The findings of this study update the baseline of preconception TORCH infections among women with fertility desire in southern China, helping to estimate the risk of congenital infection and guide the development and implementation of effective prevention measures for preconception TORCH infections.

Regional heterogeneity and driving factors of road runoff pollution from urban areas in China

Due to the multiple influences of natural and anthropogenic factors, stormwater runoff from urban roads generally presents heterogeneous pollution among cities. The identification of regional heterogeneity and related driving factors of road runoff pollution is of significance for the optimal management of road runoff pollution according to the local circumstances. In this study, the regional heterogeneity of urban road runoff pollution from fourteen representative cities in China is analyzed for four typical pollutants including total suspended solids (TSS), chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP). The results show wide variations in TSS, COD, TN and TP pollution among cities, with the average event mean concentrations ranging from 77.0 to 1347.9, 31.4 to 488.1, 0.81 to 8.46, 0.139 to 1.930 mg/L, respectively. One-way ANOVA analyses demonstrate significant differences in road runoff pollution among cities. The TSS pollution is significantly heavier for northern and northwestern inland cities than that for eastern and southern cities. Pearson correlation analysis and Stepwise linear regression analysis are performed to identify and rank the influence of climate, population, economy, industry structure, traffic and environmental quality. Direct relationships of road runoff pollution are detected with PM_2.5, PM₁₀, secondary industry, tertiary industry, annual rainfall, and urban green coverage, among which PM₁₀ and urban green coverage are the most important and common factors exerting positive and negative influences on road runoff pollution, respectively. Based on the findings of this work, improvement of atmospheric particulate pollution and increase in urban greenness are recommended measures to manage the road runoff pollution. Furthermore, the traffic-related emissions accompanying the upgrading of industry structure should be effectively controlled to attenuate the TSS and COD pollution in road runoff.

The prevalence of soil transmitted helminths and its influential factors in Shandong Province, China: an analysis of surveillance data from 2016 to 2020

BACKGROUND

Soil-transmitted helminths (STHs) were previously endemic in Shandong Province, China. This study aimed to analyze the STHs prevalence trend and the natural, social, and human cognitive and behavioural factors influencing the discrepancies between high and low infection levels from 2016 to 2020 in Shandong Province in eastern China.

METHODS

STHs surveillance data of Shandong Province from 2016 to 2020 were obtained from China Information Management System for Prevention and Control of Parasitic Diseases. STHs infections were detected by modified Kato-Katz method. Comprehensive information on the natural and social factors, STHs-related knowledge and behaviours were collected through questionnaire surveys. Retrospective spatial scan analysis was performed using SaTScan v10.1 to evaluate any identified spatial clusters of STHs infection for statistical significance and Bayes discriminant analysis was used to discriminate the high or low infection groups of the villages.

RESULTS

In total, 72,160 participants were involved in our survey from 2016 to 2020. The overall STHs prevalence rate was 1.13%, with the eastern region of Shandong Province having the highest rate (2.02%). The predominant species was T. trichiura, with the prevalence rate of 0.99% and the ≥ 70-year age group possessed the highest rate of 2.21%. The STHs prevalence rate showed an annual linear downward trend from 2016 to 2020 ([Formula: see text] = 127.600, P < 0.001). Respondents aged ≥ 60 years had the lowest awareness level of STHs-related prevention knowledge (all P < 0.05), and were the most likely to adopt the practice of fertilizing with fresh stool (χ² = 28.354, P < 0.001). Furthermore, the southern region demonstrated the highest temperature and rainfall level and the lowest GNP and annual net income per capita (all P < 0.05).

CONCLUSIONS

There is a remarkable declining in STHs prevalence in Shandong Province from 2016 to 2020. However, the prevalence rates of STHs especially T. trichiura in the southern and eastern regions were still high, and the elderly were more susceptible to be infected with STHs owning to their low awareness level of STHS-related prevention knowledge and high adoption rate of dangerous production and living behaviours. Integrated approaches of health education, environment improvement and behaviour change should be strengthened to obtain a further reduction of STHs prevalence in China.

Endangered plant species under differing anthropogenic interventions: how to preserve Pterygopleurum neurophyllum in Wondong wetland?

Endangered wetland plants are important as the potential keystone species and mediators for plant-soil interactions. Establishing conservation strategies for endangered plants is also prioritized because of the elevating extinction risk by human-induced wetland disturbances. The present study examined the factors controlling the incidence of Pterygopleurum neurophyllum, the endangered wetland plant experiencing severe habitat loss throughout Northeast Asia. Here, P. neurophyllum populations and their surrounding environments were addressed in the last natural Korean habitat to assess the possible influential factors (vegetation coverage, species richness, exotic plant species, coarse rock content, soil bulk density, and soil electroconductivity and pH) under anthropogenic wetland interventions (with or without soil disturbance). Our results showed that P. neurophyllum occurred 6 out of 32 plots in the study area. All P. neurophyllum were found in Miscanthus-dominated area, but preferred microhabitats featuring reduced vegetation coverage, increased species richness, and undisturbed soils under vegetation removal. Multimodel inference also indicated that vegetation coverage (relative importance = 1.00) and coarse rock content (relative importance = 0.70) were the major influential factors for P. neurophyllum population size, and the surviving P. neurophyllum were strictly limited to where both of them were kept lowered. Furthermore, the wetland intervention with soil disturbance had a negative effect on P. neurophyllum by creating the rocky and compacted soil surface as a result of land reclamation treatments. Conversely, the wetland intervention without soil disturbance enhanced the P. neurophyllum incidence by decreasing vegetation coverage of the overcrowding competitive plants. Overall findings reflect that the strategies to counteract habitat loss and manage the overly dense competitive plants should be necessary for conserving P. neurophyllum, as well as other wetland plants threatened by the human-induced disturbances and excessive competition intensities.

Hidden blood loss of total knee arthroplasty in hemophilia arthritis: an analysis of influencing factors

BACKGROUND

Total knee arthroplasty is the leading way to treat hemophilia arthritis. At present, there is a lack of research on the influencing factors of blood loss in total knee arthroplasty for hemophilia arthritis. This study comprehensively explores the definite factors affecting the hidden blood loss in total knee arthroplasty for hemophilia patients.

MATERIALS AND METHODS

Ninety-two hemophilia A patients who underwent total knee arthroplasty in our center were included. Demographics, laboratory data, surgical data, and complications were collected. The Gross equation and Sehat equation were used to calculate the estimated value of hidden blood loss. Multivariate linear regression analysis was used to determine the influencing factors of hidden blood loss.

RESULT

The hidden blood loss of hemophilia A patients undergoing total knee arthroplasty was 1069.51 ± 341.99 mL, and the age was positively correlated with the hidden blood loss (P < 0.001), while tranexamic acid, FVIII prophylaxis, and incremental invivo recovery were negatively correlated with the hidden blood loss (P < 0.001, P = 0.008, P = 0.017).

CONCLUSION

Elderly patients have a greater risk of blood loss, and additional preventive measures can be appropriately added. Intraoperative intra-articular injection of tranexamic acid is recommended to reduce hidden blood loss, FVIII prophylaxis is recommended for every patient. We recommend that all HA patients measure the incremental invivo recovery and develop a personalized infusion regimen of coagulation factor.

Exploration on the coordinated development of urbanization and the eco-environmental system in central China

Scientific evaluation of the interaction between urbanization and the eco-environmental system in Central China is of great significance. To optimizing the quality of urbanization and improving the eco-environmental state. As a case study of Central China, this research attempts to build a set of analytical systems to realize the integrated deconstruction from analyzing comprehensive evaluation indexes, quantification of coupling coordination, spatiotemporal evolution traits, decoupling path exploration to influential factor analysis. It tries to clarify the differences between cities, identify problematic areas, and propose targeted improvement measures. The outcomes show that the urbanization level of the cities in Central China has been improved significantly. In contrast, their eco-environmental levels are fluctuating, with the growth rate lower than that of urbanization. The coordination level between the two systems is rising, changing from primary dysfunction to intermediate coordination. The coordination level is characterized by obvious spatial association dominated by Types H-H and L-L and ever-increasing agglomeration. The decoupling between the two systems only falls into two types: strong decoupling and relative decoupling with expansion, indicating a negative effect between them. There is a problem regarding negative urbanization development. The factors including energy consumption, investment in fixed assets, opening to the outside world, technological progress, and government management capabilities all have an impact on the coordination of the two with divergent significances.

Temporal triggers of N2O emissions during cyclical and seasonal variations of a full-scale sequencing batch reactor treating municipal wastewater

To investigate the major triggers of nitrous oxide (N₂O) production in a full-scale wastewater treatment plant, N₂O emissions and wastewater characteristics (ammonia, nitrite, nitrate, total nitrogen, dissolved inorganic carbon, dissolved organic carbon, pH, temperature, dissolved oxygen and specific oxygen uptake rate), the results of variations in the cycling of a sequential batch reactor (SBR, where only full nitrification was performed), were monitored seasonally for 16 months. Major triggers of N₂O production were investigated based on a seasonal measured database using a random forest (RF) model and sensitivity analysis, which was applied to identify important input variables. As the result of seasonal monitoring in the full-scale SBR, the N₂O emission factor relative to daily total nitrogen removal ranged from 0.05 to 2.68%, corresponding to a range of N₂O production rate from 0.02 to 0.70 kg-N/day. Results from the RF model and sensitivity analysis revealed that emissions during nitrification were directly or indirectly related to nitrite accumulation, temperature, ammonia loading rate and the specific oxygen uptake rate ratio between ammonia oxidizing bacteria and nitrite oxidizing bacteria (sOUR-ratio). However, changes in the microbial community did not significantly impact N₂O emissions. Based on these results, the sOUR-ratio could represent the major trigger for N₂O emission in a full-scale BNR system: a higher sOUR-ratio value with an average of 3.13 ± 0.23 was linked to a higher N₂O production rate with an average value of 1.27 ± 0.12 kg-N/day (corresponding to 3.96 ± 1.20% of N₂O emission factor relative to daily TN removal), while a lower sOUR-ratio with an average value of 2.39 ± 0.27 was correlated with a lower N₂O production average rate of 0.17 ± 0.11 kg-N/day (corresponding to 0.74 ± 0.69% of N₂O emission factor) (p-value = 0.00001, Mann-Whitney test).

Spatial interpolation of red bed soil moisture in Nanxiong basin, South China

Soil moisture is an important indicator for monitoring land degradation and plays an important role in soil biogeochemistry. Mapping the spatial distribution of soil moisture provides fundamental information for soil management and agricultural production. In this study, 225 sampling points in the study area, Nanxiong basin, were investigated to map the spatial distribution of soil moisture in the typical ecological degradation red beds area. Four interpolation methods including inverse distance weighting (IDW), ordinary kriging (OK), radial basis function (RBF) and empirical bayesian kriging (EBF) were used to estimate the continuous soil moisture distribution. The results showed that the soil moisture of the study area ranged from 8.12% to 32.82% with an average of 18.42% and a median of 18.20%. The annual average temperature and soil bulk density had significantly negative correlations with soil moisture, of-0.53 and - 0.31, respectively. The regional soil moisture had a moderate variation with the variation coefficient of 21.66% and strong spatial dependence with the nugget-to-sill ratios of 32.23%. The IDW method obtained a more accurate estimation on the spatial variability of soil moisture in the Nanxiong basin. The spatial distribution of soil moisture in the study area was drawn by different interpolation methods. The results show that the red bed degradation in the eastern part of the Nanxiong basin is more severe than in other areas, in which the geomorphic characteristics of red bed desert have appeared with the lowest soil moisture in this study. In addition, the spatial heterogeneity of soil moisture is also pertinent to human disturbance and land use. The results of spatial soil moisture distribution are of great significance for monitoring land degradation and agricultural drought in the red bed area.

Analysis of influencing factors of viral load in patients with high-risk human papillomavirus

Background

High-risk human papillomavirus (HR-HPV) load is thought to be influenced by many factors, and the relationship between viral load and the degree of cervical lesion is controversial. This study explored the possible influencing factors of HR-HPV viral load in the uterine cervix.

Methods

A total of 605 women who needed colposcopic evaluation for abnormal cervical screening at the Affiliated Hospital of Weifang Medical University, China, between November 2017 and September 2018 were enrolled. Cervical specimens were collected from the endo- and ectocervix separately using two different cervical brushes. The hybrid capture II test was used to measure HR-HPV load. Age, histological severity, number of viral types, and area and location of cervical lesions were recorded. The correlations between viral load and influencing factors were analysed using univariate and multivariate analyses.

Results

HR-HPV load was positively correlated with age, histological severity, multiple HPV types and area of cervical lesions (P < 0.05). Viral load with the combination of endo- and ectocervical sampling was significantly higher than simple endocervical sampling (P < 0.001). Multivariate analysis showed that age, multiple HPV types and area of cervical lesions were independent factors for HR-HPV load with a combination of endo- and ectocervical sampling (P < 0.05). However, only age and area of cervical lesions were independent factors for viral load with simple endocervical sampling (P < 0.05). No significant association was found between viral load and lesion severity in multivariate analysis (P > 0.05).

Conclusion

HR-HPV load is influenced by age, histological severity, multiple viral types, area of cervical lesion and sampling methods. Age and area of cervical lesions are independent factors for viral load.

Internet use and need for digital health technology among the elderly: a cross-sectional survey in China

Background

China is becoming an aging society at the fastest pace in history, and there are a large number of empty nesters in the country. With economic and social development, internal support systems among families are gradually weakening. Supporting the elderly is thus emerging as a significant issue, and promoting digital health technologies is an effective way to help address it. Encouraging the application of Internet to elderly care and Internet use among the elderly are important means of promoting digital health technologies. This paper examines the current state of the use of the Internet by the elderly and factors influencing it (including physical, psychological, and social) as well as demand among the elderly for smart services.

Methods

A total of 669 subjects over the age of 60 years were randomly selected from 13 cities in Heilongjiang province and surveyed using questionnaires from May 1 to July 31, 2018. The questionnaires were collected for descriptive statistics, the chi-square test, and the analysis of influential factors.

Results

Of the people surveyed, 38.6% used the Internet. Their favorite online activity was online dating (74.2%), and the health information they obtained through the Internet was mainly related to diet (63.1%) and exercise (47.1%). The subjects demanded smart bracelets (MD = 2.80) and emergency callers (MD = 2.77). Gender, age, education, monthly income, quality of life, number of friends, and social participation were found to have an impact on Internet use.

Conclusions

More measures are needed to reduce barriers to the use of the Internet and promote digital health technologies. The society, equipment manufacturers, and family members of the elderly should work together to enable them to reap the benefits of online technologies.

Factors influencing postoperative outcomes in patients with symptomatic discoid lateral meniscus

BACKGROUND

Due to its abnormal morphology and ultrastructure, discoid lateral meniscus (DLM) is prone to tear and degeneration, leading to clinical symptoms. Arthroscopy is the main treatment for symptomatic DLM; however, postoperative outcomes vary widely due to the effects of diverse factors. This research aims to explore the factors influencing postoperative outcomes of symptomatic DLM.

METHODS

Patients with DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were enrolled according to the inclusion and exclusion criteria. Fourteen variables, including sex, body mass index (BMI) and other variables, were chosen as factors for study. Knee function was assessed using the International Knee Documentation Committee (IKDC) score. Univariate analyses (Mann-Whitney U test or Kruskall-Wallis rank sum test) and multivariate analyses (ordinal logistic regression) were used to identify the factors that influenced postoperative outcomes. P < 0.05 was considered statistically significant.

RESULTS

A total of 502 patients, including 353 females (70.3%) and 149 males (29.7%), were enrolled. The median IKDC score postoperatively (87.4; range, 41.4 ~ 97.7; IQR, 14.6) was higher than that preoperatively (57.6; range, 26.9 ~ 64.9; IQR, 9.7) (P < 0.001). Male sex was predictive of a higher IKDC score (P = 0.023, OR = 1.702). Compared with BMI ≥25 kg/m², < 18.5 kg/m² was associated with better IKDC score (P = 0.026, OR = 3.016). Contrasting with age of onset ≥45 years, ≤14 years (P < 0.001, OR = 20.780) and 14 ~ 25 years (P < 0.001, OR = 8.516) were associated with better IKDC score. In comparison with symptoms duration> 24 months, IKDC scores for patients with symptoms duration ≤1 month (P = 0.001, OR = 3.511), 1 ~ 6 months (P < 0.001, OR = 3.463) and 6 ~ 24 months (P < 0.001, OR = 3.254) were significantly elevated. Compared to Outerbridge grade III ~ IV, no injury (P < 0.001, OR = 6.379) and grade I (P = 0.01, OR = 4.332) were associated with higher IKDC score.

CONCLUSIONS

Arthroscopic treatment of symptomatic DLM is safe and effective, but its clinical efficacy is affected by many factors. Specifically, male sex, BMI < 18.5 kg/m², age of onset < 25 years (especially < 14 years) and symptoms duration < 24 months are conducive to good postoperative outcomes. However, combined articular cartilage injury (Outbridge grade ≥ 2) reduces postoperative effect.

Prevalence of poultry red mite (Dermanyssus gallinae) in Korean layer farms and the presence of avian pathogens in the mite

The poultry red mite, Dermanyssus gallinae, is a blood-feeding parasite of layer hens and a potential vector of several avian infectious agents. High infestation with D. gallinae in layer farm buildings could result in economic losses, and the mites may act as a reservoir of avian pathogens within farms. This study aimed to assess the prevalence of D. gallinae in layer farm buildings in Korea and to investigate avian pathogens in the collected mites. The mite samples were collected from 36 Korean layer farm buildings on 21 farms nationwide. Information obtained from each farm building included the flock size, flock age, methods for controlling D. gallinae, and cleaning status. Association between these variables and the population density of D. gallinae was analyzed. Additionally, the presence of 10 avian pathogens was assessed using DNA samples from mites collected in 16 farm buildings. The prevalence of D. gallinae was 75% at the farm building level (90.5% at the farm level). Repetitive cleaning procedures for each building were significantly related with the mite infestation level, and the most influential factor for determining the mite population in the layer farm buildings. In the 16 DNA samples, we detected avian pathogenic Escherichia coli (n = 6), wild-type fowlpox virus (n = 3), wild-type Marek's disease virus (n = 2), chicken anemia virus (n = 1), and fowl adenovirus (n = 1). These findings suggest that repetitive cleaning procedures for the layer farm buildings could decrease the numbers of D. gallinae which may transmit avian pathogens within the farm.

Informal Emptying Business in Mandalay: Its Reasons and Financial Impacts

Globally, 2.8 billion people use on-site sanitation facilities, which need regular emptying of accumulated fecal sludge. Illegal dumping from informal emptying businesses, one of the major challenges in environmental management, is widely observed. Considering Mandalay, Myanmar, this study aimed to determine why informal emptying businesses are selected and estimate the lost revenue for a formal emptying service provider (FP) due to the informal businesses. We interviewed 400 households on their recognition and experiences regarding emptying services and willingness-to-pay for improved service. Revenue loss was estimated by comparing the present and theoretical maximum revenues. Results showed that 91.0% of households recognized FP only. Among 134 emptying-experienced households, 32.8%, 59.7%, and 4.5% chose FP with legal contact, FP with illegal contact, and informal service providers, respectively. The service fees from FP with illegal contact did not become revenue for FP; this was a major informal emptying business in the city. Differently from previous studies, the major illegal dumping was done by FP in this area. A great financial loss was estimated that FP lost 76.5% of the theoretical maximum revenue due to informal business. Logistic regression analysis indicated people's intention to shorten the waiting time through illegal contact, even by paying a higher fee. As emptying services are typically required immediately after fecal sludge is over-accumulated, shorter waiting times and faster contact methods were the reasons why the informal business was selected. Less bureaucratic and more customer friendly system could reduce revenue loss, charge more, and increase profits.

[Qualitative research on factors of HIV testing among men who have sex with men in China based on Blued]

Objective: To understand the cognition and attitudes of men who have sex with men (MSM) towards HIV testing and explore in-depth reasons preventing them from testing. Methods: The function of "opinion" in Blued, a gay geo-social networking application (GSN), was adopted to collect qualitative data of ideas and attitudes towards HIV testing of the users between December 2017 and January 2018. The data was analyzed based on grounded theory approach. Results: 28 269 Blued users participated in the activity and 1 977 posted comments. Four key themes were identified, i.e. no/low risk of contracting HIV, stigmatization of HIV testing, long-term relationship and conventional impediments of HIV testing. Conclusion: The cognition and attitudes of the target population derived from the analysis of "opinion" function in Blued, such as the stigmatization of the behavior of HIV testing influencing the attitude of HIV testing, could help researchers build a more accurate detection and promotion strategy instead of a very general intervention on the public.

Blood loss of total knee arthroplasty in osteoarthritis: an analysis of influential factors

BACKGROUND

Total knee arthroplasty is regarded as the most effective treatment for severe knee osteoarthritis. The influential factors of blood loss in total knee arthroplasty remain controversial. The study aims to explore the influential factors of blood loss in total knee arthroplasty comprehensively.

MATERIAL AND METHODS

Three hundred and four osteoarthritis patients undergoing unilateral primary total knee arthroplasty were enrolled. Demographic characteristics, laboratory results, surgical protocol, and hemostatic and anticoagulation drugs were collected. Estimation of blood loss was calculated using the Gross equation. Multivariable stepwise linear regression analysis was performed to find out the influential factors.

RESULTS

Total blood loss reached the biggest volume (1346 ± 671 mL) in the post-operative third day. Hidden blood loss reached 465 ± 358 mL. Gender, tranexamic acid, prosthesis type, and drainage were proven to be positively correlated with the total blood loss (all P < 0.05). Male appeared to suffer more surgical blood loss than female. Posterior cruciate stabilizing prosthesis might lead to more surgical blood loss than posterior cruciate retaining prosthesis. Tranexamic acid could effectively reduce total blood loss while drainage might increase bleeding. Gender and anticoagulation drugs were correlated with hidden blood loss (both P < 0.05). Low molecular weight heparin resulted in less hidden blood loss than rivaroxaban.

CONCLUSIONS

Posterior cruciate retaining prosthesis and topical use of tranexamic acid were preferred to reduce total blood loss. Drainage was not recommended due to the risk of increasing bleeding. Low molecular weight heparin was recommended to prevent venous thrombosis.

Drivers and assemblies of soil eukaryotic microbes among different soil habitat types in a semi-arid mountain in China

The effects of environmental and species structure on soil eukaryotic microbes inhabiting semi-arid mountains remain unclear. Furthermore, whether community assembly differs in a variety of soil habitat types, for example, artificial forest, artificial bush, farmland, and natural grassland, is not well understood. Here, we explored species diversity and composition of soil eukaryotic microbes south of the Taihang Mountains (mid-western region of China) using Illumina sequencing of the 18S rRNA gene (V4) region on the MiSeq platform. The results suggest that the forest soil habitat type improved the diversity and abundance of soil eukaryotic microbes that will benefit the restoration of degraded soil. The SAR (Stramenopiles, Alveolates, Rhizaria) supergroup and Metazoa were the dominant soil eukaryotic microbial groups at the phylum level. About 26% of all operational taxonomic units were common among the different soil habitat types. The O-elements, water content, soil organic matter, and elevation significantly influenced the abundance of soil eukaryote communities (P < 0.05). Our findings provide some reference for the effectiveness of local ecological restoration and the establishment of a soil eukaryotic microbe resource databases in a semi-arid area.

[Analyais of Toxoplasma gondii infection and related factors among special population in Changzhou City, Jiangsu Province]

OBJECTIVE

To understand the prevalence of Toxoplasma gondii infection and related factors among special population in Changzhou City, so as to provide the evidence for formulating toxoplasmosis prevention measures.

METHODS

The venous blood was collected from participants in Changzhou City for detecting IgG and IgM antibodies against T. gondii by ELISA; and an epidemiological questionnaire investigation was also conducted.

RESULTS

Among the total 400 respondents detected, the prevalence of T. gondii infection was 15.0% and the positive rates of IgG and IgM were 15.0% and 0.8%, respectively. The T. gondii infection rates of pregnant women, HIV/AIDS patients, patients with neoplasia, and livestock and poultry breeding and processing workers were 11.0%, 11.0%, 24.0% and 14.0%, respectively. As the age increased, the infection rate of T. gondii showed an upward trend, with the highest infection rate (21.6%) among the group of respondents aged above 50 years. The infection rates of groups with different education levels were statistically different (χ² = 11.443, P < 0.05), and there was a trend that the infection rate decreased with the increase of education level. The prevalence of T. gondii infection in pregnant women was not significantly associated with the number of pregnancies and gestational age. The infection rate of T. gondii in the live-stock and poultry breeding and processing workers increased with the length of their working years.

CONCLUSIONS

The prevalence of T. gondii infection among the special population in Changzhou City is high. Therefore, it is necessary to enhance the health education on the knowledge and information of prevention and control of toxoplasmosis, and to improve the awareness of personal protection, the hygiene practices and diet habits. In addition, more attention should be paid to T. gondii monitoring in the special population.

Career choice and perceptions of nursing among healthcare students in higher educational institutions

BACKGROUND

Due to the ageing population and competition from other healthcare courses, a greater demand in the healthcare workforce has made it challenging for educational institutions to attract school leavers to enter nursing courses. Understanding the considerations of students who have chosen non-nursing healthcare courses and their perceptions of nursing can help identify specific strategies to enhance the attractiveness of nursing course. This study aims to examine the differences between healthcare career choices and perceptions of nursing as a career choice among first-year non-nursing healthcare students.

METHOD

A descriptive survey design was conducted at the beginning of the healthcare courses of seven healthcare groups and from four higher educational institutions in Singapore. A total of 451 students responded, yielding an overall response rate of 52.7%. The online survey was administered using a valid and reliable 35-item parallel scale, known as the Healthcare Career Choice and Nursing Career Choice.

RESULTS

The participants perceived prior healthcare exposure as the most influential factor and self-efficacy as the least influential factor when choosing nursing as a career. In comparison to their own healthcare career choices, nursing was perceived to have greater gender stigma and, as nurses, they would be less likely to achieve higher qualifications and career advancements, and they would be less likely to enjoy fulfilling careers. They also perceived that they would be less likely to gain their parents' support to pursue nursing and to make their parents proud.

CONCLUSIONS

This study provides educators and policy-makers with vital information to develop key strategies to improve nursing enrolment in educational institutions. These strategies include early exposure to nursing as a rewarding career during school years, addressing the issue of gender stigma, and promoting information on the career and educational advancement of a registered nurse to parents of school leavers.

A review of groundwater contamination near municipal solid waste landfill sites in China

Landfills are the most widely used method for municipal solid waste (MSW) disposal method in China. However, these facilities have caused serious groundwater contamination due to the leakage of leachate. This study, analyzed 32 scientific papers, a field survey and an environmental assessment report related to groundwater contamination caused by landfills in China. The groundwater quality in the vicinity of landfills was assessed as "very bad" by a comprehensive score (FI) of 7.85 by the Grading Method in China. Variety of pollutants consisting of 96 groundwater pollutants, 3 organic matter indicators, 2 visual pollutants and 6 aggregative pollutants had been detected in the various studies. Twenty-two kinds of pollutants were considered to be dominant. According to the Kruskal-Wallis test and the median test, groundwater contamination differed significantly between regions in China, but there were no significant differences between dry season and wet season measurements, except for some pollutants in a few landfill sites. Generally, the groundwater contamination appeared in the initial landfill stage after five years and peaked some years afterward. In this stage, the Nemerow Index (PI) of groundwater increased exponentially as landfill age increased at some sites, but afterwards decreased exponentially with increasing age at others. After 25years, the groundwater contamination was very low at selected landfills. The PI values of landfills decreased exponentially as the pollutant migration distance increased. Therefore, the groundwater contamination mainly appeared within 1000m of a landfill and most of serious groundwater contamination occurred within 200m. The results not only indicate that the groundwater contamination near MSW landfills should be a concern, but also are valuable to remediate the groundwater contamination near MSW landfills and to prevent the MSW landfill from secondary pollutions, especially for developing countries considering the similar situation of MSW disposal.

Analysis of the influential factors of maximal-effort expiratory capacity of elderly women

[Purpose] The purpose of this study was to find the influential factors of maximal-effort expiratory capacity of elderly women. [Subjects and Methods] The subjects of this study were 83 healthy elderly women. The study’s methods and purpose were explained and these women agreed to participate. The maximal-effort expiratory capacity was measured using spirometry (Pony FX, COSMED Inc., Italy). We measured forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity, maximal expiratory flow 75%, maximal expiratory flow 50%, and maximal expiratory flow 25%. [Results] Regarding forced vital capacity and forced expiratory volume in 1 second, it was found that height and age were influential factors. Regarding forced expiratory volume in 1 second/forced vital capacity %, maximal expiratory flow 75%, maximal expiratory flow 50%, and maximal expiratory flow 25%, it was found that only age was an influential factor. [Conclusion] This study demonstrated that the most influential factors of maximal-effort expiratory capacity of elderly women were age, and the second influential factor was height. We noticed that weight was the least influential factor among them.

Healthcare professional-patient relationships: Systematic review of theoretical models from a community pharmacy perspective

OBJECTIVE

To identify health care professional-patient relationship theoretical models and individual factors that may have an influence on this relationship and be relevant to community pharmacy practice.

METHODS

Using the recommended methodology by Prisma Statement, a search was undertaken in PubMed for health care professional-patient relationship theoretical models that included individual factors.

RESULTS

Eight theoretical models met the inclusion criteria. These models were classified based on their aim, their focus on the interaction process, external factors influencing the process, and their practical applications. The most common influential modifiable factors were knowledge, needs, values, expectations, beliefs and perceptions.

CONCLUSION

'The Theory of Goal Attainment' (TGA) appears to be the most useful model for community pharmacy practice. The perceptions and expectations of both patients and pharmacists could be the two most interesting modifiable factors to apply in pharmacy practice. These modifiable influential factors could be altered by specific training such as behavioral aspects.

PRACTICE IMPLICATIONS

No theoretical model has been specifically developed for analyzing the community pharmacist-patient relationship. TGA may be appropriate for community pharmacy practice, since it takes into consideration both, attaining patients health outcomes, as well as improving patient-pharmacist relationship.