CA-based urban growth model considering the temporal dynamic adjustment of local spatial driving factors: An application in Wuhan City

Cellular Automaton (CA) is widely used because of its ability to simulate complex spatiotemporal dynamic processes through applying simple rules. The basis of the CA model is the definition of transformation rules. During a simulation process, the rules determine the change of the cell state. However, existing processing methods calculate the driving factors based on single-point time (start time or end time), making it difficult to reflect the fact that numerous driving factors affecting the cell conversion dynamically change with time. Based on the time dynamics perspective and the data set of multiple time series, this paper designs a method of dynamic adjustment of driving factors of urban expansion on the local cell-scale. It uses linear, exponential, logarithmic, and polynomial fitting to develop a CA model of dynamic adjustment that conforms to the characteristics of local spatial evolution. The main conclusions of the paper are as follows: (1) The polynomial fitting has the highest average R2, indicating that the driving factors experiences large fluctuations over time; (2) Secondly, the simulation result kappa obtained by the four fitting methods is between 0.781-0.810, which is higher than the simulation accuracy obtained by using only a single time point. In other words, the factor does not dynamically fit with time and (3) The fitting accuracy of road density is a key indicator of correct and incorrect simulation parts of construction land. Our results demonstrate that the precision of the CA model may be significantly improved by capturing the time development law of environmental variables affecting urban development at the micro-scale.

Surveillance for rhabdomyolysis after the consumption of crayfish in Wuhan, China, 2016-2022

Objectives

To analyze the epidemiological characteristics and etiology of crayfish-related rhabdomyolysis.

Methods

Cases of crayfish-related rhabdomyolysis in Wuhan were monitored, and professional training of city's surveillance personnel was conducted. Unified questionnaires were used to collect data.

Results

The first case of crayfish-related rhabdomyolysis occurred on July 12, 2016. Subsequently, 423 patients were reported over the next 7 years, with muscle pain, weakness, and chest distress as main symptoms. In total, 64.54% (273/423) of patients were females, and young adults (aged 20-49 years) account for 86.22% (363/423) of patients. The primary clinical presentations were muscle pain, muscle weakness, and chest discomfort. The median incubation time was 6 h. And the number of cases may be related to water levels in Yangzi river. Laboratory tests revealed elevated creatine kinase and myoglobin levels. In total, 95.16% (236/248) of patients had consumed crayfish tail shrimp and 91.53% (227/248) had consumed crayfish liver and pancreas (Female crayfish also contain ovaries). Only 25.00% (62/248) of patients had a history of alcohol consumption. On average, 227 patients consumed 15 (3-50) crayfish, of whom 84.14% (191/227) consumed more than 10 crayfish. All patients had a favorable prognosis.

Conclusion

Crayfish-related rhabdomyolysis is a kind of a case or cluster of patients present with severe myalgia or weakness of unknown etiology and mechanism disease in Wuhan, China, 2016-2022. Excessive consumption of crayfish may be a risk factor for the disease. The relationship between the specific parts of crayfish consumed and the onset of the disease is unclear, suggesting further research is needed to identify the relevant risk factors for the disease.

Transport accessibility and hospital attributes: A nonlinear analysis of their impact on Women's prenatal care seeking behavior

Ensuring women receive vital prenatal care is crucial for maternal and newborn health. Limited research explores factors influencing prenatal care-seeking from a geospatial perspective. This study, based on a substantial Wuhan dataset (23,947 samples), investigates factors influencing prenatal care-seeking, focusing on transport accessibility and hospital attributes. Findings indicate a nuanced relationship: (1) A non-linear trend, resembling an inverted "U," reveals the complex interplay between transport accessibility, hospital attributes, and prenatal care visits. Hospital attributes have a more pronounced impact than transport accessibility. (2) Interaction analysis underscores that lower prenatal care visits relate to low-income and education levels, despite reasonable public transport accessibility. (3) Spatial disparities are significant, with suburban areas facing increased obstacles compared to urban areas, particularly for those in suburban rural areas. This study enhances understanding by emphasizing threshold effects and spatial heterogeneity, offering valuable perspectives for refining prenatal care policies and practices.

Scenario-based assessment of emergency management of urban infectious disease outbreaks

Infectious diseases pose a severe threat to human health and are accompanied by significant economic losses. Studies of urban outbreaks of infectious diseases are diverse. However, previous studies have neglected the identification of critical events and the evaluation of scenario-based modeling of urban infectious disease outbreak emergency management mechanisms. In this paper, we aim to conduct an empirical analysis and scenario extrapolation using a questionnaire survey of 18 experts, based on the CIA-ISM method and scenario theory, to identify the key factors influencing urban infectious disease outbreaks. Subsequently, we evaluate the effectiveness of urban infectious disease outbreak emergency management mechanisms. Finally, we compare and verify the actual situation of COVID-19 in China, drawing the following conclusions and recommendations. (1) The scenario-based urban infectious disease emergency management model can effectively replicate the development of urban infectious diseases. (2) The establishment of an emergency command center and the isolation and observation of individuals exposed to infectious diseases are crucial factors in the emergency management of urban outbreaks of infectious disease.

Increased Yangtze finless porpoise presence in urban Wuhan waters of the Yangtze River during fishing closures

Wuhan, a highly urbanized and rapidly growing region within China's Yangtze Economic Zone, has historically been identified as a gap area for the critically endangered Yangtze finless porpoise (Neophocaena asiaeorientalis asiaeorientalis) based on daytime visual surveys. However, there has been a noticeable increase in porpoise sightings since 2020. This study employed passive acoustic monitoring to investigate porpoise distribution in Wuhan between 2020 and 2022. Generalized linear models were used to explore the relationship between shipping, hydrological patterns, light intensity, and porpoise biosonar activity. Over 603 days of effective monitoring, the daily positive rate for porpoise biosonar detection reached 43%, with feeding-related buzz signals accounting for 55% of all porpoise biosonar signals. However, the proportion of minutes during which porpoise presence was detected was 0.18%, suggesting that while porpoises may frequent the area, their visits were brief and mainly focused on feeding. A significant temporal trend emerged, showing higher porpoise biosonar detection during winter (especially in February) and 2022. Additionally, periods without boat traffic correlated with increased porpoise activity. Hydrological conditions and light levels exhibited significant negative correlations with porpoise activity. Specifically, porpoise sonar detections were notably higher during the night, twilight, and new moon phases. It is highly conceivable that both fishing bans and COVID-19 pandemic-related lockdowns contributed to the heightened presence of porpoises in Wuhan. The rapid development of municipal transportation and shipping in Wuhan and resulting underwater noise pollution have emerged as a significant threat to the local porpoise population. Accordingly, it is imperative for regulatory bodies to effectively address this environmental stressor and formulate targeted protection measures to ensure the conservation of the finless porpoise.

Revisiting the impact of public spaces on the mental health of rural migrants in Wuhan: an integrated multi-source data analysis

Current research on public spaces and mental health often focuses on the independent relationship of one or more social mediators, neglecting the nuanced implications and serial mechanisms inherent in the progressive social process. Using Wuhan city, China, as a study case with multi-source data, this research applies Multilevel Generalized Structural Equation Modeling and deep learning techniques to explore the differential effects of public spaces with varying degrees of publicness (i.e., typical, semi-, and privately owned) on rural migrants' mental health. Crucially, this study scrutinizes both explicit (social interaction) and implicit (perceived integration) social mechanisms to revisit the relationships. The findings reveal that not all public spaces equally influence mental health, with typical and privately owned public spaces conferring profound benefits. Notably, public spaces impact mental health chiefly through perceived integration instead of through direct social interaction. Social interaction improves mental health primarily by enhancing perceived integration, suggesting that meaningful connections beyond superficial encounters are critical. In particular, we observed significant social effects in typical and privately owned public spaces but limited social functionality in semi-public spaces. This evidence contributes to the knowledge required to create supportive social environments within public spaces, integral to nurturing inclusive urban development.

Acceptance of peer physical examination in medical students in Wuhan, China: A cross-sectional study

Background

Peer physical examination (PPE) is an essential part of the education of medical students. This study aimed to assess the acceptance level of PPE in Chinese society as well as other related factors. While there have been numerous studies on PPE acceptance in Western societies, there have been relatively few studies on this topic in China.

Methods

A questionnaire was distributed via social media to clinical-year medical students in China. With 1890 students participating overall, the response rate was 86.9%. The questionnaire collected demographic information and previous experience with PPE, and utilized a 5-point Likert scale to assess acceptance of PPE and factors influencing it.

Results

One thousand six hundred and forty-four percent of Chinese medical students accepted PPE, with 13% rejecting it and 19% neutral. Males were more accepting of PPE than females, and females were less accepting of being examined by someone of the opposite gender. The groin/thigh and breast areas were the most rejected for examination. There were no significant differences in acceptance rates between universities or academic performance groups. However, society had a significant impact on the acceptance of PPE.

Conclusions

With a 67% acceptance rate of PPE among Chinese medical students, it could be considered a viable alternative to absent life models in Chinses universities. However, implementing PPE may come with its own set of difficulties, so it is recommended that a supervisor is present and that single-gender groups are formed, with friends paired together if possible.

Research on evaluation of Wuhan air pollution emission level based on entropy weight method

For the lack of precise monitoring and accurate assessment models for air quality, this paper fully considers such constraints and establishes an evaluation model of air pollution emission level to evaluate the air pollution emission level of Wuhan-a city in central China. The model uses entropy weight method including important indicators of air pollution into the integrated optimization of air quality assessment, laying the basis for sources of pollution and the reasonable and effective city development. The total emissions of air pollution for Wuhan shows a gradual upward trend over time, mainly coming from industrial pollution. The government can reduce air pollution by focusing on detecting major polluting industries, promoting industrial technological progress and innovation, and strengthening the effective implementation of emission trading system.

Plaque Reduction Neutralization Test (PRNT) Accuracy in Evaluating Humoral Immune Response to SARS-CoV-2

Massive vaccination positively impacted the SARS-CoV-2 pandemic, being a strategy to increase the titers of neutralizing antibodies (NAbs) in the population. Assessing NAb levels and understanding the kinetics of NAb responses is critical for evaluating immune protection. In this study, we optimized and validated a PRNT50 assay to assess 50% virus neutralization and evaluated its accuracy to measure NAbs to the original strain or variant of SARS-CoV-2. The optimal settings were selected, such as the cell (2 × 105 cells/well) and CMC (1.5%) concentrations and the viral input (~60 PFU/well) for PRNT-SARS-CoV-2 with cut-off point = 1.64 log5 based on the ROC curve (AUC = 0.999). The validated PRNT-SARS-CoV-2 assay presented high accuracy with an intraassay precision of 100% for testing samples with different NAb levels (low, medium, and high titers). The method displays high selectivity without cross-reactivity with dengue (DENV), measles (MV), zika (ZIKV), and yellow fever (YFV) viruses. In addition, the standardized PRNT-SARS-CoV-2 assay presented robustness when submitted to controlled variations. The validated PRNT assay was employed to test over 1000 specimens from subjects with positive or negative diagnoses for SARS-CoV-2 infection. Patients with severe COVID-19 exhibited higher levels of NAbs than those presenting mild symptoms for both the Wuhan strain and Omicron. In conclusion, this study provides a detailed description of an optimized and validated PRNT50 assay to monitor immune protection and to subsidize surveillance policies applied to epidemiologic studies of COVID-19.

Evaluation of air quality changes in a Chinese megacity over a 15-year period (2006-2021) using PM2.5 receptor modelling

Air quality impairment has a massive impact on human health, with atmospheric particulate matter (PM) playing a major role. The People's Republic of China experienced a trend of increasing PM2.5 concentrations from 2000 to 2013. However, after the application of the Air Pollution Prevention and Control Action Plan and other related control measures, sharp decreases in air pollutant concentrations were particularly evident in the city of Wuhan (central China). This study analysed major changes in PM2.5 concentrations, composition and source apportionment (using receptor modelling) based on Wuhan's PM2.5 chemical speciation datasets from 2006 to 2007, 2019-2021 and contemporaneous gaseous pollutant values. Average SO2 concentrations decreased by 88%, from the first to the second period, mostly due to measures that reduced coal combustion. However, NO2 only declined by 25%, with policy measures likely being undermined by an increased number of vehicles. PM2.5 concentrations decreased by 65%, with the PM constituents each being affected differently. Coal combustion-related element concentrations, OC, SO42-, NH4+, EC, Cl-, Al, Ca, Cu, Fe, Co and NO3- decreased by 22-90%. Secondary inorganic aerosol (SIA) was initially dominated by (NH4)2SO4 (73%) in 2006, but later dominated by NH4NO3 (52%) in 2021. Receptor modelling identified major sources contributing to PM2.5: Mineral, road and desert dust (MRDD), Secondary sulphate (SECS), Secondary nitrate (SECN), Tungsten industry (W), Toxic Elements of Coal (TEC), Iron and Steel (IRONS), Coal Combustion (CC), Residential Heating (RH), Refinery (REF) and Traffic (TRF). In relative proportions, TEC (-83%), SECS (-64%) and SECN (-48%) reduced their contributions to PM2.5 whilst MRDD increased (+62.5%). Thus, the results indicate not only a drastic abatement of PM pollution in Wuhan but also a change in the sources of pollution, which requires further actions to reduce PM2.5 concentrations to health protective values. Secondary PM and fugitive emissions are key components to abate.

What we can and cannot learn from SARS-CoV-2 and animals in metagenomic samples from the Huanan market

While the exact context of the emergence of SARS-CoV-2 remains uncertain, data accumulated since 2020 have provided an increasingly more precise picture of Wuhan's Huanan Seafood Wholesale Market, to which the earliest clusters of human cases of Covid-19 were linked. After the market closed on January 1st 2020, teams from the Chinese Center for Disease Control and Prevention collected environmental samples, and sequenced them. Metagenomic sequencing data from these samples were shared in early 2023. These data confirmed that non-human animals susceptible to SARS-CoV-2 were present in the market before it closed, but also that these animals were located in the side of the market with most human cases, and in a corner with comparatively more SARS-CoV-2-positive environmental samples. The environmental samples were however collected after abundant human-to-human transmission had taken place in the market, precluding any identification of a non-human animal host. Jesse Bloom recently investigated associations between SARS-CoV-2 and non-human animals, concluding that the data failed to indicate whether non-human animals were infected by SARS-CoV-2, despite this being an already acknowledged limitation of the data. Here I explain why a correlation analysis could not confidently conclude which hosts(s) may have shed SARS-CoV-2 in the market, and I rebut the suggestion that such analyses had been encouraged. I show that Bloom's investigation ignores the temporal and spatial structure of the data, which led to incorrect interpretations. Finally, I show that criteria put forward by Bloom to identify the host(s) that shed environmental SARS-CoV-2 would also exclude humans. Progress on the topic of SARS-CoV-2's origin requires a clear distinction between scientific studies and news articles (mis)interpreting them.

Design guidelines for healing gardens in the general hospital

Introduction

Despite being recognized as a cost-effective method to enhance physical and mental health, Healing Gardens remain insufficiently popularized in outdoor spaces of hospitals. This paper aims to introduce a new perspective and offer guidelines for their implementation within general hospitals.

Methods

A methodology is proposed for formulating hospital-specific guidelines, encompassing the extraction of successful Healing Garden features from case studies, definition of key components grounded in theoretical frameworks, validation of essential features through user questionnaires, and comprehensive site analyses.

Results

The methodology was applied in a case study at Zhongnan Hospital in Wuhan. This research presents a novel perspective and robust methodology for implementing Healing Gardens in general hospital settings, potentially improving physical and mental health in a cost-efficient manner.

Discussion

This work aims to encourage the adoption of Healing Gardens as preventive medical tools in more healthcare settings. By providing a comprehensive methodology and a case study illustration, this research endeavors to stimulate broader acceptance and utilization of Healing Gardens in healthcare environments.

Incorporating carbon sequestration into lake management: A potential perspective on climate change

Exploring the carbon sequestration capacity of water ecosystems would contribute to coping with climate change. This study conducted an integrated method framework to achieve an improved understanding of the relationship between carbon sequestration and lake ecosystem components, as well as provide a new perspective on climate change for policymakers. The vertically generalized production model revealed the carbon sequestration capacity of lakes. The hierarchical linear model identified the cross-scale factors affecting phytoplankton. Then a developed multi-agents-based model with scenario analysis provided adaptive management strategies for carbon sequestration. Furthermore, we applied the integrated framework in the 63 polluted lakes of Wuhan. The results showed that the average carbon sequestration per unit area was at 0.87 kgC·m-2·a-1, which was greater than that of the ocean and forest ecosystems, indicating that the lakes had a potential capacity for carbon sequestration. Total phosphorus had the strongest effect on the Chl-a (chlorophyll a) concentration (fixed effect (γ) =6.82, P < 0.1), followed by total nitrogen (γ = 6.38, P < 0.05), Rotifer biomass (γ = 1.95, P < 0.01) and water temperature (γ = 1.27, P < 0.05). These results indicated that the bottom-up effect of chemical factors on phytoplankton was greater than the top-down effect of zooplankton. The proportion of grassland at the whole-lakes level would have a negative synergistic impact on the Chl-a with changing the micro water temperature at the part-lakes level (γ = -46.64, P < 0.05). There was no significant interaction effect between land cover change and total nitrogen (phosphorus) on the Chl-a. Therefore, we could indirectly confirm that point source pollution emissions would synergistically affect the Chl-a and carbon sequestration along with the effects of physical-chemical conditions. The coordinated proportional control of nitrogen and phosphorus and the artificial controlling biomass of zooplankton-feeding fish were proposed to improve carbon sequestration and water quality for lake management.

A Survey of Airborne Fungi and Their Sensitization Profile in Wuhan, China

INTRODUCTION

Airborne fungi induce allergic symptoms in 3-10% of the population worldwide. To better prevent and manage fungi-related allergic diseases, it is essential to identify the genus and the distribution profile of airborne fungi.

METHODS

With this purpose in mind, we carried out a 12-month volumetric sampling study to monitor the airborne fungi and retrospectively analyzed the sensitization profile of four dominant fungi (Cladosporium, Alternaria, Aspergillus, and Penicillium) among respiratory allergies during the same study period in Wuhan, China.

RESULTS

A total of 29 different fungal genuses were identified, and the peak fungal concentration period was found to be in September and October, followed by May and June. The most prevalent fungi in this area were Cladosporium (36.36%), Ustilago (20.12%), and Alternaria (13.87%). In addition, the skin prick test data from 1,365 respiratory allergies patients showed that 202 (14.80%) of them were sensitized to fungi. The sensitization rates to Cladosporium, Alternaria, Aspergillus, and Penicillium were 11.72%, 4.69%, 1.98%, and 4.76%, respectively. The seasonal fluctuation of Alternaria and Aspergillus correlated with their sensitization rates. Among the fungal sensitized patients, 76 (37.62%) were sensitized to two or more kinds of fungi. The serum-specific IgE tests suggested low to high correlations existed between these fungi; however, these correlations were not found between fungi and other allergens.

CONCLUSION

Our study provides the distribution profile and reveals the clinical significance of the airborne fungi in Wuhan, which will facilitate the precise management of fungal allergy.

Urban growth boundaries optimization under low-carbon development: Combining multi-objective programming and patch cellular automata models

Urban Growth Boundaries (UGBs) are a tool to control urban sprawl. However, the way to optimize future urban land uses and fix their boundaries is not clear. This paper presents a new framework to delimit UGBs while accounting for ecological, economic, and carbon storage benefits. Aggregate land-use constraints are included in a multi-objective optimization algorithm to capture non-inferior solutions on the Pareto Surface (PS) under different objective scenarios. A patch-level cellular automata simulation model is then used to spatially allocate these land uses, followed by a new two-step adjustment method to delineate the UGBs. This modeling is applied to Wuhan, China. The results show that: (1) One district (Caidian) will have a strong economic growth under low-carbon development. (2) The maximization of carbon storage reduces losses in ecological benefits, suggesting that carbon storage be considered in urban growth planning. (3) The combined model framework and two-step boundary adjustment method can help urban planners define different UGB scenarios and make science-based policy decisions.

Urban epidemic governance: An event system analysis of the outbreak and control of COVID-19 in Wuhan, China

The outbreak of a virus such as COVID-19 is composed of a series of seemingly random incidents which are nevertheless interconnected. In a novel approach, this article adopts the event system theory (EST), established in organisational behaviour science, to investigate the mechanism of epidemic governance in Wuhan, the city which reported the first case of COVID-19 and thereafter successfully controlled the outbreak. The event system analysis divided Wuhan's response mechanism to COVID-19 into four dimensions: the graded response systems, the interactive relationship between multilevel entities of epidemic governance, the quarantine regulations and the governance of public sentiment. There are numerous lessons learned and effective measures developed from the 'Wuhan experience'. These lessons and measures can assist other cities around the world to cope with the current COVID-19 crisis and prepare their urban governance systems for similar infectious diseases in the future. We urgently advocate the addition of more scholarly discussion on urban epidemic governance by incorporating interdisciplinary approaches like EST in particular.

Neighborhood Governance and Happiness during the COVID-19 Pandemic: An Empirical Analysis of Wuhan's Lockdown

The outbreak of COVID-19 posed a challenge to global governance, residents' happiness, and economic systems around the world. Since the crux of previous research centers on the reactions of both local and national governments, studies on how governance arrangement at the neighborhood level influences people's happiness during the crisis response remain insufficient. This paper aims to explore the relationship between neighborhood governance and residents' happiness based on first-hand data collected during Wuhan's first lockdown. This study highlights the significance of neighborhood governance in crisis response, which includes providing diverse public services, ensuring access to life's necessities, and offering prompt medical treatment. All of these factors are essential for maintaining overall satisfaction with governance and contributing to the happiness of individuals within the community. However, active governance actions do not always lead to favorable results. For example, increased group participation may lead to social conflicts among those involved, ultimately diminishing one's happiness. Furthermore, the COVID-19 pandemic has acted as a risk 'amplifier', exposing and exacerbating pre-existing hukou-based social inequalities in the governance process. The impact of the pandemic on citizen happiness is the cumulative effect of both the immediate social crisis brought on by the pandemic and long-standing structural inequalities. To improve people's happiness and establish inclusive policies, this paper advocates for a 'people-centered' urban governance that enhances public satisfaction and addresses the needs and priorities of migrant populations.

SARS-CoV-2 Omicron variant causes brain infection with lymphoid depletion in a mouse COVID-19 model

BACKGROUND

The Omicron variant has become the most prevalent SARS-CoV-2 variant. Omicron is known to induce milder lesions compared to the original Wuhan strain. Fatal infection of the Wuhan strain into the brain has been well documented in COVID-19 mouse models and human COVID-19 cases, but apparent infections into the brain by Omicron have not been reported in human adult cases or animal models. In this study, we investigated whether Omicron could spread to the brain using K18-hACE2 mice susceptible to SARS-CoV-2 infection.

RESULTS

K18-hACE2 mice were intranasally infected with 1 × 10⁵ PFU of the original Wuhan strain and the Omicron variant of SARS-CoV-2. A follow-up was conducted 7 days post infection. All Wuhan-infected mice showed > 20% body weight loss, defined as the lethal condition, whereas two out of five Omicron-infected mice (40%) lost > 20% body weight. Histopathological analysis based on H&E staining revealed inflammatory responses in the brains of these two Omicron-infected mice. Immunostaining analysis of viral nucleocapsid protein revealed severe infection of neuron cells in the brains of these two Omicron-infected mice. Lymphoid depletion and apoptosis were observed in the spleen of Omicron-infected mice with brain infection.

CONCLUSION

Lethal conditions, such as severe body weight loss and encephalopathy, can occur in Omicron-infected K18-hACE2 mice. Our study reports, for the first time, that Omicron can induce brain infection with lymphoid depletion in the mouse COVID-19 model.

Characterization of red eye cases presented to the eye emergency clinic at a tertiary care hospital during COVID-19 Pandemic

BACKGROUND

The World Health Organization (WHO) was notified by China on December 31, 2019, of a pneumonia outbreak severe acute respiratory syndrome-associated coronavirus-19 virus infection in Wuhan. This outbreak was declared by the WHO from the Public Health Emergency of International Concern to formal declaration as a pandemic on March 11, 2020. Because the public health measures like lockdown, the eye care delivery system was markedly impacted. The aim of this study was to find out if any pattern change of red eye cases among patients who attended eye accident and emergency (A and E) in a tertiary care hospital during COVID-19 pandemic in 2020 compared to 2019 and 2018.

MATERIALS AND METHODS

This was a cohort retrospective study which included all patients who presented to eye A and E clinic with red eye from March 1 to July 31 in 2018, 2019, and 2020. Data were analyzed using statistical tools in the SPSS software. Furthermore, the clinical records of 578 inpatients with proven COVID-19 were reviewed for any red eye problem.

RESULTS

Out of 7895 eye patients attended eye A and E clinic during March-July of 2018, 2019, and 2020, 1573 (19.9%) patients had red eye. Males were slightly dominant with 59%, and unilateral cases were the majority among them. The most common causes of red eye in 2018 and 2019 were injury, conjunctivitis, and keratitis; whereas in 2020, a clear dominance of injury and keratitis cases was found. Only 10 (2.03%) patients out of the 493 outpatients with red eye during the 5-month period in 2020 reported a prior contact to a COVID-19 positive case; of whom nine patients had conjunctivitis, and one had a right eye open globe injury. Of the 578 inpatients with proven COVID-19, only 1 (0.17%) patient had red eye with the diagnosis of conjunctivitis.

CONCLUSION

There was relatively increased number of adults reporting with red eye in 2020. Eye injuries were the most common among all years, followed by conjunctivitis and keratitis. Ocular problems, however, might be a primary or secondary COVID-19 complaint and seem to be relatively uncommon in COVID-19 individuals.

Betel Nut Consumption and the Reasons for Its Rise among Chinese Migrant Workers

Background: In China, betel nut users were initially concentrated in specific regions and ethnic groups. However, in recent years, public health concerns have been raised because betel nuts, addictive substances, have become largely used by Chinese migrant workers. Methods: This study adopts an anthropological fieldwork research methodology to investigate the rise in betel nut consumption among Chinese migrant workers. We observe the everyday lives of migrant workers in the rural-urban area of Wuhan. We use in-depth interviews to understand their psychology and behaviors toward betel nut consumption. Discussion: The study's results indicate that the observed increase in betel nut consumption among migrant workers is not only the result of the spread of betel nuts across regions and groups, but more importantly, it is related to the working and living conditions, social interaction, consumption culture, and masculinity image of migrant workers. The consumption of betel nuts reflects the political-economic structure and socio-cultural background to which Chinese migrant workers belong. Conclusion: The increasing consumption of betel nuts is a social issue that requires thorough research and government engagement. We contend that anthropology research may help identify the social mechanisms incentivizing betel nut consumption and solve the related public health issues among Chinese migrant workers from public policy and social governance perspectives.

Equity evaluation of urban green space in the main urban area of Wuhan based on green view index

Green space is a kind of resource welfare. The evaluation of green space equity based on green view index (GVI) is important to ensure the equitable distribution of green resources. Taking the central urban area of Wuhan as the research object, based on multi-source data such as Baidu Street View Map, Baidu Thermal Map, and satellite remote sensing images, we evaluated the equity of spatial distribution of GVI in Wuhan by using the locational entropy, Gini coefficient and Lorenz curve. The results showed that 87.6% of the points in the central urban area of Wuhan were below the level of poor green vision, which mainly concentrated in Wuhan Iron and Steel Industrial Base of Qingshan District and south of Yandong Lake. The number of points reaching an excellent level was the least (0.4%), mainly concentrated around the East Lake. The overall Gini coefficient of GVI in the central urban area of Wuhan was 0.49, which indicated that the distribution of GVI was heterogeneous. The Gini coefficient of Hongshan District was the largest at 0.64, indicating a huge gap in the distribution of GVI, while the Gini coefficient of Jianghan District was the smallest at 0.47, with a large gap in the distribution. The central urban area of Wuhan had the most low-entropy areas for 29.7% and the least high-entropy areas for 15.4%. There were two-level differences in entropy distribution within Hongshan District, Qingshan District, and Wuchang District. The nature of land use and the role of linear greenery were the main factors affecting the equity of green space in the study area. Our results could provide theoretical basis and planning reference for optimizing urban green space layout.

Epidemiological features of traumatic spinal cord injury in Wuhan, China

BACKGROUND

Spinal cord injuries are extremely debilitating and fatal injuries. There is currently little research focusing on traumatic spinal cord injuries, and there is little information available about the epidemiological characteristics of patients with traumatic spinal cord injury (TSCI).

OBJECTIVE

To describe the epidemiological features of traumatic spinal cord injury in Wuhan, China.

DESIGN

A retrospective hospital-based study.

SETTING

Rehabilitation department of Wuhan's Tongji Hospital.

PARTICIPANTS

People who had been diagnosed with a traumatic spinal cord injury (TSCI) were admitted to Tongji Hospital from 2016 to 2021 (n = 463).

INTERVENTIONS

Not applicable.

OUTCOME MEASURES

Epidemiological features such as sex, age, marital status, etiology, occupation, neurological level of injury, and the American Spinal Injury Association Impairment Scale on admission, hospitalization, and concomitant injuries were collected.

RESULTS

The mean age of patients with TSCI was 39.4 ± 14.3 years, and the male/female ratio was 3:1. The leading causes of TSCIs were traffic accidents (38.4%), followed by falls (low falls 24.0%, high falls 13.2%). The most common injury site was the cervical spinal cord, followed by the thoracolumbar level. Of all patients, 463 patients (67.2%) had complications and other injuries. During the hospitalization period, a total of 217 patients experienced complications, with a percentage of 46.9%. Urinary tract infection was the most common (15.6%), followed by pulmonary infection (14.0%).

CONCLUSION

The results found that the proportion of males was greater, and the first two main reasons were falls and traffic accidents. Farmers and workers are the occupations most vulnerable to SCI. We need to pay more attention to the elderly's risk of falling. These findings suggested that preventive strategies should be based on the features of different types of TSCI patients. Finally, the importance of SCI rehabilitation must be highlighted.

Analysing the global and local spatial associations of medical resources across Wuhan city using POI data

BACKGROUND

There is a sharp contradiction between the supply and demand of medical resources in the provincial capitals of China. Understanding the spatial patterns of medical resources and identifying their spatial association and heterogeneity is a prerequisite to ensuring that limited resources are allocated fairly and optimally, which, along with improvements to urban residents' quality of life, is a key aim of healthy city planning. However, the existing studies on medical resources pattern mainly focus on their spatial distribution and evolution characteristics, and lack the analyses of the spatial co-location between medical resources from the global and local perspectives. It is worth noting that the research on the spatial relationship between medical resources is an important way to realize the spatial equity and operation efficiency of urban medical resources.

METHODS

Localized colocation quotient (LCLQ) analysis has been used successfully to measure directional spatial associations and heterogeneity between categorical point data. Using point of interest (POI) data and the LCLQ method, this paper presents the first analysis of spatial patterns and directional spatial associations between six medical resources across Wuhan city.

RESULTS

(1) Pharmacies, clinics and community hospitals show "multicentre + multicircle", "centre + axis + dot" and "banded" distribution characteristics, respectively, but specialized hospitals and general hospitals present "single core" and "double core" modes. (2) Overall, medical resources show agglomeration characteristics. The degrees of spatial agglomeration of the five medical resources, are ranked from high to low as follows: pharmacy, clinic, community hospital, special hospital, general hospital and 3A hospital. (3) Although pharmacies, clinics, and community hospitals of basic medical resources are interdependent, specialized hospitals, general hospitals and 3A hospitals of professional medical resources are also interdependent; furthermore, basic medical resources and professional medical resources are mutually exclusive.

CONCLUSIONS

Government and urban planners should pay great attention to the spatial distribution characteristics and association intensity of medical resources when formulating relevant policies. The findings of this study contribute to health equity and health policy discussions around basic medical services and professional medical services.

Secular Trends of Liver Cancer Mortality and Years of Life Lost in Wuhan, China 2010-2019

BACKGROUND

Liver cancer has caused a heavy burden worldwide. This study aimed to estimate the trends in the mortality and years of life lost (YLL) due to liver cancer and decompose the total deaths into three contributors: population growth, population aging, and mortality change.

METHODS

Our study used data from the cause-of-death surveillance system in Wuhan. The mortality and YLL rates were standardized according to the sixth national population census in China. This study calculated the estimated annual percentage change (EAPC) to estimate the trends in the age-standardized mortality rate (ASMR) and age-standardized YLL rate (ASYR). Meanwhile, a decomposition analysis was used to explore the effect of population growth, population aging, and age-specific mortality change on the change in liver cancer deaths.

RESULTS

The ASMR of liver cancer declined at an annual rate of 4.6% from 30.87 per 100,000 people in 2010 to 20.29 per 100,000 people in 2019, while the ASYR was at an annual rate of 5.6% from 969.35 per 100,000 people in 2010 to 581.82 per 100,000 people in 2019. Similar downward trends were seen in men and women. The decomposition analysis found that total deaths number changed by -12.42% from 2010 to 2019, of which population growth and population aging caused the total death numbers to increase by 9.75% and 21.15%, while the age-specific mortality change caused the total death numbers to decrease by 43.32%.

CONCLUSION

Although the ASMR of liver cancer has declined in recent years in Wuhan, it still causes a heavy burden with the increasing population and rapid population aging and remains an essential public health issue. The government should take measures to reduce the burden of liver cancer, especially among men.

Joint Exposure to Ambient Air Pollutants Might Elevate the Risk of Small for Gestational Age (SGA) Infants in Wuhan: Evidence From a Cross-Sectional Study

Objective: To investigate the effect of exposure to multiple ambient air pollutants during pregnancy on the risk of children being born small for gestational age (SGA). Methods: An Air Pollution Score (APS) was constructed to assess the effects of being exposed to six air pollutants simultaneously, PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃ (referred to as joint exposure). A logistic regression model was applied to estimate the associations of APS and SGA. Results: The adjusted odds ratios (ORs) of SGA per 10 ug/m³ increased in APS during the first and second trimesters and the entire pregnancy were 1.003 [95% confidence intervals (CIs): 1.000, 1.007], 1.018 (1.012, 1.025), and 1.020 (1.009, 1.031), respectively. The ORs of SGA for each 10 μg/m³ elevated in APS during the whole pregnancy were 1.025 (1.005, 1.046) for mothers aged over 35 years old vs. 1.018 (1.005, 1.031) for mothers aged under 35 years old. Women who were pregnant for the first time were more vulnerable to joint ambient air pollution. Conclusion: In summary, the results of the present study suggested that joint exposure to ambient air pollutants was associated with the increment in the risks of SGA.