High genetic diversity of the himalayan marmot relative to plague outbreaks in the Qinghai-Tibet Plateau, China

Plague, as an ancient zoonotic disease caused by Yersinia pestis, has brought great disasters. The natural plague focus of Marmota himalayana in the Qinghai-Tibet Plateau is the largest, which has been constantly active and the leading source of human plague in China for decades. Understanding the population genetics of M. himalayana and relating that information to the biogeographic distribution of Yersinia pestis and plague outbreaks are greatly beneficial for the knowledge of plague spillover and arecrucial for pandemic prevention. In the present research, we assessed the population genetics of M. himalayana. We carried out a comparative study of plague outbreaks and the population genetics of M. himalayana on the Qinghai-Tibet Plateau. We found that M. himalayana populations are divided into two main clusters located in the south and north of the Qinghai-Tibet Plateau. Fourteen DFR genomovars of Y. pestis were found and exhibited a significant region-specific distribution. Additionally, the increased genetic diversity of plague hosts is positively associated with human plague outbreaks. This insight gained can improve our understanding of biodiversity for pathogen spillover and provide municipally directed targets for One Health surveillance development, which will be an informative next step toward increased monitoring of M. himalayana dynamics.

Clinical and Dosimetric Risk Factors Associated With Radiation-Induced Lung Toxicities After Multiple Courses of Lung Stereotactic Body Radiation Therapy

Purpose

Data are limited on radiation-induced lung toxicities (RILT) after multiple courses of lung stereotactic body radiation therapy (SBRT). We herein analyze a large cohort of patients to explore the clinical and dosimetric risk factors associated with RILT in such settings.

Methods and Materials

A single institutional database of patients treated with multiple courses of lung SBRT between January 2014 and December 2019 was analyzed. Grade 2 or higher (G2+) RILT after the last course of SBRT was the primary endpoint. Composite plans were generated with advanced algorithms including deformable registration and equivalent dose adjustment. Logistic regression analyses were performed to examine correlations between patient or treatment factors including dosimetry and G2+ RILT. Risk stratification of patients and lung constraints based on acceptable normal tissue complication probability were calculated based on risk factors identified.

Results

Among 110 eligible patients (56 female and 54 male), there were 64 synchronous (58.2%; defined as 2 courses of SBRT delivered within 30 days) and 46 metachronous (41.8%) courses of SBRT. The composite median lung V20, lung V5, and mean lung dose were 9.9% (interquartile range [IQR], 7.3%-12.4%), 32.2% (IQR, 25.5%-40.1%), and 7.0 Gy (IQR, 5.5 Gy-8.6 Gy), respectively. With a median follow-up of 21.1 months, 30 patients (27.3%) experienced G2+ RILT. Five patients (4.5%) developed G3 RILT, and 1 patient (0.9%) developed G4 RILT, and no patients developed G5 RILT. On multivariable regression analysis, female sex (odds ratio [OR], 4.35; 95% CI, 1.49%-14.3%; P = .01), synchronous SBRT (OR, 8.78; 95% CI, 2.27%-47.8%; P = .004), prior G2+ RILT (OR, 29.8; 95% CI, 2.93%-437%; P = .007) and higher composite lung V20 (OR, 1.18; 95% CI, 1.02%-1.38%; P = .030) were associated with significantly higher likelihood of G2+ RILT.

Conclusions

Our data suggest an acceptable incidence of G2+ RILT after multiple courses of lung SBRT. Female sex, synchronous SBRT, prior G2+ RILT, and higher composite lung V20 may be risk factors for G2+ RILT.

Spatial and temporal distribution of endotoxins, antibiotic resistance genes and mobile genetic elements in the air of a dairy farm in Germany

Antimicrobial resistance (AMR) is a serious issue that is continuously growing and spreading, leading to a dwindling number of effective treatments for infections that were easily treatable with antibiotics in the past. Animal farms are a major hotspot for AMR, where antimicrobials are often overused, misused, and abused, in addition to overcrowding of animals. In this study, we investigated the risk of AMR transmission from a farm to nearby residential areas by examining the overall occurrence of endotoxins, antibiotic resistance genes (ARGs), and mobile genetic elements (MGEs) in the air of a cattle farm. We assessed various factors, including the season and year, day and nighttime, and different locations within the farm building and its vicinity. The most abundant ARGs detected were tetW, aadA1, and sul2, genes that encode for resistances towards antibiotics commonly used in veterinary medicine. While there was a clear concentration gradient for endotoxin from the middle of the farm building to the outside areas, the abundance of ARGs and MGEs was relatively uniform among all locations within the farm and its vicinity. This suggests that endotoxins preferentially accumulated in the coarse particle fraction, which deposited quickly, as opposed to the ARGs and MGEs, which might concentrate in the fine particle fraction and remain longer in the aerosol phase. The occurrence of the same genes found in the air samples and in the manure indicated that ARGs and MGEs in the air mostly originated from the cows, continuously being released from the manure to the air. Although our atmospheric dispersion model indicated a relatively low risk for nearby residential areas, farm workers might be at greater risk of getting infected with resistant bacteria and experiencing overall respiratory tract issues due to continuous exposure to elevated concentrations of endotoxins, ARGs and MGEs in the air of the farm.

Pulse Oximetry and Perfusion Index Screening for Congenital Heart Defects: A Systematic Review and Meta-analysis

Congenital heart defects (CHDs) are the most common neonatal malformations and are a leading cause of infant death in developed countries. Finding safe and effective diagnostic methods to screen for CHDs is important. The aim of this study was to evaluate the effectiveness of pulse oximetry (PO) and perfusion index (PI) in screening CHD. We conducted a systematic review of studies in PubMed, Embase, and the Cochrane Library published on or before October 1, 2021. Studies based on PICOS were included in this systematic review. The flow chart is made by PRISMA software. The quality of included studies was assessed by RevMan5 software (QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies-2). The sensitivity, specificity, and other measurements of accuracy were pooled using Stata/SE 12.0 software. Five studies containing 46,965 neonates were included in this study. A randomized-effects model was used for the meta-analysis because of significant heterogeneity. The combined sensitivity and specificity were 0.82 (95% confidence interval [CI], 0.53-0.95) and 0.97 (95% CI, 0.57-1.00), respectively. The area under the curve was 0.92 (95% CI, 0.89-0.94). The combination PO and PI was significant in CHD screening. Once diagnosed by the combined method, it means that the neonate is most likely to have a CHD. KEY POINTS: · Pulse oximetry and PI screening.. · Congenital heart defects.. · A systematic review and meta-analysis..

Dose Coverage Variation Caused by Setup Uncertainties in VMAT-TBI Treatment

PURPOSE/OBJECTIVE(S)

Volumetric Modulated Arc Therapy Total Body Irradiation (VMAT TBI) offers several advantages over conventional TBI techniques, including reduced cost of the treatment room (a normal-sized vault versus a large shielded vault), increased patient comfort during treatment, lung sparing without the need for physical blocks, and a more homogeneous dose distribution. In VMAT-TBI treatment, plans at multiple isocenters are utilized to cover the entire body, and patients are positioned with the aid of image guidance. However, aligning the patient's entire body during setup can be challenging due to its pliability, and the setup time is heavily dependent on the tolerance allowed by the image guidance. Therefore, studying the variation in dose coverage caused by setup uncertainties in VMAT-TBI treatments can help optimize the clinical workflow and determine the optimal tolerance for patient positioning.

MATERIALS/METHODS

New plans were generated to simulate the uncertainties that occur during treatment setup for each patient. These plans were created by shifting the original VMAT TBI plans at the head, chest, abdomen (or pelvis) isocenters by 5mm and 1cm in the left-right (LR), inferior-superior (IS), and anterior-posterior (AP) directions, respectively. Dose DicomRT files were exported, and the dose change due to the shifts was analyzed. The statistical quantification of the percentage of the body that experienced a dose change of over 2%, 5%, and 10% of the prescription due to the shifts from the original plans was calculated for all patients. Histograms were generated, showing the percentage of body getting dose change of 1-2%, 2-3%, 3-5%, 5-7%, 7-10%, 10-15%.

RESULTS

The table below displays the percent volume receiving a dose change of 2%, 5%, and 10% of the prescription for a 5mm shift. Among the shift directions, the dose change is most sensitive in the IS direction, with similar impact observed the in LR and AP directions. Among different sites, the chest experiences the largest dose change, followed by the pelvis. For a 5mm shift in the IS direction, the average percent volume receiving a dose change of 2%, 5%, and 10% in the chest is 9.25%, 2.64%, and 0.27%, respectively. For a 1cm shift, the numbers are 12.23%, 6.75%, and 1.29%. In the pelvis (abdomen), these values are 9.03%, 1.67%, and 0.17% for a 5mm shift and 13.28%, 6.1%, and 0.85% for a 1cm shift. For head plans, the values are 2.72%, 0.9%, and 0.14% for a 5mm shift and 3.77%, 1.66%, and 0.53% for a 1cm shift.

CONCLUSION

Accurate alignment in the chest region is crucial in VMAT TBI treatment. Efforts should be made to minimize shifts over 1cm in the IS direction.

Dosimetric Impact of Seed Segmentation in GammaTile Surgically Targeted Radiation Therapy for Gliomas and Brain Metastases Cases

PURPOSE/OBJECTIVE(S)

To assess the variability of dose reporting variability due to uncertainty in segmentation of Cs-131 seeds in GammaTile therapy for gliomas and brain metastases.

MATERIALS/METHODS

Ten patients with either glioma or brain metastases had 4-11 GammaTiles placed along resection bed during craniotomy. A dose of 60 Gy is prescribed to 5 mm depth. Each GammaTile has four Cs-131 seeds imbedded in a biodegradable collagen sponge. GammaTile Post-Op workflow in MIM Symphony software is used for post-implant dose evaluation and reporting. This workflow requires a post-surgery CT to identify seeds, and a post-surgery MR for residual disease and OAR contours. Seeds are segmented using a threshold tool. Threshold levels may change depending on the CT used, thus users need to manually change the HU threshold value in each data set. Since GammaTiles are lined along the resection bed, PTVs are generated automatically by adding 8 mm expansion on the seed contours and later combined with residual disease contours. We simulate the seed contour uncertainty by applying -0.5 mm, -1.0 mm, +0.5 mm & +1.0 mm concentric margins to the current seed contours to create 4 new seed contours per patient. New PTVs are generated by adding 8 mm expansion on the new seed contours combined with residual disease contours. PTV volume, PTV volume receiving 100% and 150% of prescription dose (V100, V150), and percentage of the prescription dose received by 90% of the PTV (D90) are calculated to evaluate dose reporting variability due to seed segmentation uncertainty.

RESULTS

Mean PTV volume decreases by 8.4 cc & 10.2 cc for PTVs generated from seed contours with -0.5 mm & -1.0 mm margin, respectively, and increases by 5.8 cc & 8.2 cc, respectively, when +0.5 mm & +1 mm margins are applied to the original seed contours. We observe up to 10% change in V100 due to seed segmentation uncertainty. Mean V100 increases by 4.0% (range: 0.2% - 8.9%) & 4.9% (range: 0.5% - 11.0%) for cases with -0.5 m & -1.0 mm seed margin, respectively, and reduces by 4.2% (range: 0.5% - 6.7%) & 5.9% (range: 0.6% - 10.4%) for cases with +0.5 mm and +1.0 mm seed margin, respectively. Mean D90 increases by 7.7% (range: 4.0% - 12.6%) & 9.9% (range: 4.0% - 17.4%) for cases with -0.5 m & -1.0 mm seed margin, respectively, and reduces by 5.5% (range: 3.6% - 7.8%) & 7.4% (range: 5.2% - 9.6%) for cases with +0.5 mm and +1.0 mm seed margin, respectively. We also observe up to 8.0% changes in mean V150 when margins are applied to the seed contours.

CONCLUSION

Our results show significant impact of seed segmentation uncertainty on dose reporting in GammaTile therapy. Variability in dose reporting parameters highlight the need for a more standardized and automated approach to seed segmentation to ensure consistent and accurate dose reporting. The current manual threshold adjustment method is subject to user dependence and therefore unreliable. Development of a more robust tool could help to minimize variability and improve reliability of dose reporting.

The patterns and driving forces of dengue invasions in China

BACKGROUND

Global connectivity and environmental change pose continuous threats to dengue invasions from worldwide to China. However, the intrinsic relationship on introduction and outbreak risks of dengue driven by the landscape features are still unknown. This study aimed to map the patterns on source-sink relation of dengue cases and assess the driving forces for dengue invasions in China.

METHODS

We identified the local and imported cases (2006-2020) and assembled the datasets on environmental conditions. The vector auto-regression model was applied to detect the cross-relations of source-sink patterns. We selected the major environmental drivers via the Boruta algorithm to assess the driving forces in dengue outbreak dynamics by applying generalized additive models. We reconstructed the internal connections among imported cases, local cases, and external environmental drivers using the structural equation modeling.

RESULTS

From 2006 to 2020, 81,652 local dengue cases and 12,701 imported dengue cases in China were reported. The hotspots of dengue introductions and outbreaks were in southeast and southwest China, originating from South and Southeast Asia. Oversea-imported dengue cases, as the Granger-cause, were the initial driver of the dengue dynamic; the suitable local bio-socioecological environment is the fundamental factor for dengue epidemics. The Bio8 [odds ratio (OR) = 2.11, 95% confidence interval (CI): 1.67-2.68], Bio9 (OR = 291.62, 95% CI: 125.63-676.89), Bio15 (OR = 4.15, 95% CI: 3.30-5.24), normalized difference vegetation index in March (OR = 1.27, 95% CI: 1.06-1.51) and July (OR = 1.04, 95% CI: 1.00-1.07), and the imported cases are the major drivers of dengue local transmissions (OR = 4.79, 95% CI: 4.34-5.28). The intermediary effect of an index on population and economic development to local cases via the path of imported cases was detected in the dengue dynamic system.

CONCLUSIONS

Dengue outbreaks in China are triggered by introductions of imported cases and boosted by landscape features and connectivity. Our research will contribute to developing nature-based solutions for dengue surveillance, mitigation, and control from a socio-ecological perspective based on invasion ecology theories to control and prevent future dengue invasion and localization.

The epidemiology and evolutionary dynamics of massive dengue outbreak in China, 2019

Introduction

In 2019, China experienced massive dengue outbreaks with high incidence and expanded outbreak areas. The study aims to depict dengue's epidemiology and evolutionary dynamics in China and explore the possible origin of these outbreaks.

Methods

Records of confirmed dengue cases in 2019 were obtained from the China Notifiable Disease Surveillance System. The sequences of complete envelope gene detected from the outbreak provinces in China in 2019 were retrieved from GenBank. Maximum Likelihood trees were constructed to genotype the viruses. The median-joining network was used to visualize fine-scale genetic relationships. Four methods were used to estimate the selective pressure.

Results

A total of 22,688 dengue cases were reported, 71.4% of which were indigenous cases and 28.6% were imported cases (including from abroad and from other domestic provinces). The abroad cases were predominantly imported from Southeast Asia countries (94.6%), with Cambodia (3,234 cases, 58.9%), and Myanmar (1,097 cases, 20.0%) ranked as the top two. A total of 11 provinces with dengue outbreaks were identified in the central-south of China, of which Yunnan and Guangdong provinces had the highest number of imported and indigenous cases. The primary source of imported cases in Yunnan was from Myanmar, while in the other ten provinces, the majority of imported cases were from Cambodia. Guangdong, Yunnan and Guangxi provinces were China's primary sources of domestically imported cases. Phylogenetic analysis of the viruses in outbreak provinces revealed three genotypes: (I, IV, and V) in DENV 1, Cosmopolitan and Asian I genotypes in DENV 2, and two genotypes (I and III) in DENV 3. Some genotypes concurrently circulated in different outbreak provinces. Most of the viruses were clustered with those from Southeast Asia. Haplotype network analysis showed that Southeast Asia, possibly Cambodia and Thailand, was the respective origin of the viruses in clade 1 and 4 for DENV 1. Positive selection was detected at codon 386 in clade 1.

Conclusion

Dengue importation from abroad, especially from Southeast Asia, resulted in the dengue epidemic in China in 2019. Domestic transmission between provinces and positive selection on virus evolution may contribute to the massive dengue outbreaks.

A Descriptive Analysis of Human Rabies in Mainland China, 2005-2020

Epidemiological characteristics of human rabies in mainland China, 2005-2020 were analyzed to evaluate the effect of rabies control in China in recent years. A total of 24,319 human rabies cases were recorded in 2097 counties in 321 cities of 31 provinces in mainland China. Only 202 cases, located in 143 counties, were recorded in 2020, compared with 3305 cases in 992 counties in 2007; however, rabies was still relatively severe in Hunan Province even in 2020. Peak periods occurred in July-November; August was often the month with the most cases. Guizhou, Hunan, Guangdong, and Guangxi Provinces, in the central and southern regions, accounted for 50.0% of the cases in 2005-2020. Cases occurred almost exclusively in rural areas with 96.7% versus 3.3% in urban areas. A paradoxical relative expansion from southern, eastern, and central towards southwestern, northwestern, northern, and northeastern regions was observed along with the overall reduction of cases. Some regions witnessed complete elimination. The male-to-female ratio was 2.33:1; 66.8% of all cases were reported in the 0-10 (13.8%) and 41-70 (53.0%) age groups. Farmers (68.3%), followed by students (12.2), and diaspora children (6.5%) were most frequently involved. Our results provide objective information for the improvement of rabies prevention and control efforts. This will aid policymakers in China and elsewhere achieve the "Zero human deaths from dog-mediated rabies by 2030" global goal.

Horizontal transmission of cytomegalovirus in a rhesus model despite high-level, vaccine-elicited neutralizing antibody and T cell responses

The development of a vaccine to prevent congenital human cytomegalovirus (HCMV) disease is a public health priority. We tested rhesus CMV (RhCMV) prototypes of HCMV vaccine candidates in a seronegative macaque oral challenge model. Immunogens included a recombinant pentameric complex (PC; gH/gL/pUL128/pUL130/pUL131A), a postfusion gB ectodomain, and a DNA plasmid that encodes pp65-2. Immunization with QS21-adjuvanted PC alone or with the other immunogens elicited neutralizing titers comparable to those elicited by RhCMV infection. Similarly, immunization with all three immunogens elicited pp65-specific cytotoxic T cell responses comparable to those elicited by RhCMV infection. RhCMV readily infected immunized animals and was detected in saliva, blood and urine after challenge in quantities similar to those in placebo-immunized animals. If HCMV evades vaccine-elicited immunity in humans as RhCMV evaded immunity in macaques, a HCMV vaccine must elicit immunity superior to, or different from, that elicited by the prototype RhCMV vaccine to block horizontal transmission.

[Analysis on the imported Coronavirus Disease 2019 related cluster epidemic in rural areas of Chengdu]

An epidemiological investigation was carried out on a local cluster of outbreak caused by imported cases of Coronavirus Disease 2019 (COVID-19) in rural areas of Chengdu in December 2020, to find out the source of infection and the chain of transmission. According to Prevention and Control Protocol for COVID-19 (Version 7), field epidemiological investigation was adopted, combined with big data technology, video image investigation, gene sequencing and other methods to carry out investigation into COVID-19 cases and infections source tracing, analyze the epidemiological association, and map the chain of transmission. From December 7 to 17, 2020, 13 local COVID-19 confirmed cases and 1 asymptomatic case were diagnosed in Chengdu, of which 12 cases (85.71%) had a history of residence and activity in the village courtyard of Taiping (TP), Pidu (P) District, Chengdu. From November 8, 2020 to November 28, 2020, a group of inbound people form Nepal were transferred to the designated entry personnel quarantine hotel of P District which was adjacent to the TP village. During quarantine, there were 5 cases who tested positive for COVID-19. Through gene sequencing alignment, genes of local cases and Nepalese imported cases from the same period are homologous, all belong to the lineage of L2.2.3 (B.1.36 according to Pangolin lineage typing method). According to the results of field epidemiological investigation and gene sequencing analysis, the index case was most likely infected by contact with household waste of quarantine site. Under the situation of normalization prevention and control of COVID-19, sentinel monitoring of fever clinics in primary medical institutions is the key to early detection of the epidemic. The multi-department joint epidemiological investigation and the application of gene technology are the core links of the investigation and traceability of modern infectious diseases. The allocation of public health resources in rural areas needs to be strengthened. We need to improve the capacity for early surveillance and early warning of the epidemic in rural areas.

A survey of a COVID-19 cluster of charter flight importation

OBJECTIVES

Although a number of cases of importation with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported, there are still no data available concerning the characteristics in the coronavirus disease 2019 (COVID-19) cluster of charter flight importation. Here, we provide an analysis of COVID-19 cases and their close contacts who worked for the same company on a project in Karbala, Iraq, and returned back to Chengdu, China, by a charter flight.

METHODS

The data of imported COVID-19 cases and their close contacts were obtained from National Notifiable Disease Report System of Chinese Center for Disease Control and Prevention and field epidemiological investigation reports by Centers for Disease Control and Prevention (CDCs) in Chengdu. The information of general characteristics and laboratory findings of this cluster were collected and summarized.

RESULTS

One hundred and six (66.67%) of 159 charter flight passengers tested positive for COVID-19 before entry. Through treatment, all 159 people tested negative and meet the requirements of taking flights bound for China before boarding. However, there has been still 36 (22.64%) of them tested positive after entry. The median time from entry to confirmation was 1.0 day (Interquartile Range (IQR): 0-4.3). The Cycle threshold value (Ct value) of 36 patients' positive samples are all above 30 and most values are above 35.

CONCLUSIONS

In conclusion, there is still a risk that a number of COVID-19 cases can be imported through charter flight. However, the infectivity of confirmed patients of the charter flight was considered to be low.

[Influence of SARS-CoV-2 vaccination on the epidemiological and clinical characteristics of imported COVID-19 cases in Chengdu]

Objective: To analyze the epidemiological and clinical characteristics of imported COVID-19 cases after SARS-CoV-2 vaccination and to provide evidence for the prevention and control of COVID-19. Methods: The imported COVID-19 cases in Chengdu as of April 15, 2021 were divided into the vaccinated group and unvaccinated group according to the history of SARS-CoV-2 vaccination. The epidemiological and clinical data of the cases were collected retrospectively, and the differences in epidemiological and clinical characteristics of the two groups were compared. Laboratory tests consisted of nucleic acid test, clinical index test, serum antibody test and lymphocyte test. Software WPS2019 was used for data management and software R 4.0.3 was used for statistical analysis. Results: A total of 75 COVID-19 cases were included in the analysis, in which 20 had received SARS-CoV-2 vaccination and only 4 with clinical symptoms, 55 patients did not receive SARS-CoV-2 vaccination, and 16 had clinical symptoms. In vaccinated group, the first injection time of vaccination ranged from July to November 2020, and 10 cases received two doses of vaccine simultaneously and 10 cases received two doses of vaccine at intervals of 14-57 days. The intervals between the completion of vaccination and the onset ranged from 87 days to 224 days. The differences in classification and clinical type between the two groups were significant. Significant differences were observed in case classification and clinical type between vaccinated group and unvaccinated group (P<0.05). The vaccinated group had a relatively high proportion of asymptomatic infections (40.00%, 8/20), while mild infections were mainly observed in the unvaccinated group(76.36%,42/55). The differences in Ct values (ORF1ab gene and N gene) at the diagnosis were not significant between vaccinated group and unvaccinated group (P>0.05), similar results were also observed in lymphocyte subtypes, procalcitonin and C-reactive protein level comparisons. Serum amyloid A level was higher in unvaccinated group than in vaccinated group (P<0.05). However, the SARS-CoV-2 related serum antibody of IgM, IgG and total antibody levels were significantly higher in vaccinated group (P<0.05). Conclusions: Risk of infection still exists with SARS-CoV-2 after vaccination, which can facilitate the production of specific serum antibody of IgM and IgG when people are exposed to the virus. It has a certain protective effect on SARS-CoV-2 infected persons. Vaccination can reduce the clinical symptoms and mitigate disease severity.

Comparative analyses on epidemiological characteristics of dengue fever in Guangdong and Yunnan, China, 2004-2018

Background

In China, Guangdong and Yunnan are the two most dengue-affected provinces. This study aimed to compare the epidemiological characteristics of dengue fever in Guangdong and Yunnan during 2004–2018.

Methods

Descriptive analyses were used to explore the temporal, spatial, and demographic distribution of dengue fever.

Results

Of the 73,761 dengue cases reported in mainland China during 2004–2018, 93.7% indigenous and 65.9% imported cases occurred in Guangdong and Yunnan, respectively. A total of 55,970 and 5938 indigenous cases occurred in 108 Guangdong and 8 Yunnan counties, respectively during 2004–2018. Whereas 1146 and 3050 imported cases occurred in 84 Guangdong and 72 Yunnan counties, respectively during 2004–2018. Guangdong had a much higher average yearly indigenous incidence rate (3.65 (1/100000) vs 0.86 (1/100000)), but a much lower average yearly imported incidence rate (0.07 (1/100000) vs 0.44(1/100000)) compared with Yunnan in 2004–2018. Furthermore, dengue fever occurred more widely in space and more frequently in time in Guangdong. Guangdong and Yunnan had similar seasonal characteristics for dengue fever, but Guangdong had a longer peak period. Most dengue cases were clustered in the south-western border of Yunnan and the Pearl River Delta region in Guangdong. Most of the imported cases (93.9%) in Guangdong and Yunnan were from 9 Southeast Asian countries. Thailand, Cambodia, and Malaysia imported mainly into Guangdong while Myanmar and Laos imported into Yunnan. There was a strong male predominance among imported cases and an almost equal gender distribution among indigenous cases. Most dengue cases occurred in individuals aged 21–50 years, accounting for 57.3% (Guangdong) vs. 62.8% (Yunnan) of indigenous and 83.2% (Guangdong) vs. 62.6% (Yunnan) of imported cases. The associated major occupations (house worker or unemployed, retiree, and businessman, for indigenous cases; and businessman, for imported cases), were similar. However, farmers accounted for a larger proportion of dengue cases in Yunnan.

Conclusions

Identifying the different epidemiological characteristics of dengue fever in Guangdong and Yunnan can be helpful to formulate targeted, strategic plans, and implement effective public health prevention measures in China.

Entomological and Molecular Surveillance of Anopheles Mosquitoes in Freetown, Sierra Leone, 2019

Background: Malaria is endemic in Sierra Leone, with stable and perennial transmission in all parts of the country. At present, the main prevention and control measures for mosquito vectors here involve insecticide treated nets (ITN) and indoor residual spraying (IRS). The most recent entomological surveillance was conducted prior to the civil war, between 1990 and 1994. Therefore, a new entomological surveillance required to support targeted malaria control strategies.

Methods:Anopheles mosquitoes were collected between June and December 2019 using the light trap method. On these, we conducted species identification, analyzed seasonal fluctuation and Plasmodium infection rate, and monitored insecticide resistance.

Results: Surveillance of seasonal fluctuation showed that there were two peak of Anopheles density in July (mean 13.67 mosquitoes/trap/night) and October (mean 13.00 mosquitoes/trap/night). Meanwhile, the lowest Anopheles density was seen in early September. Ninety-one representatives of Anopheles gambiae s.l. were selected and identified as An. coluzzii (n = 35) and An. gambiae s.s. (n = 56) using PCR. An. coluzzii and An. gambiae s.s. were found to be heterozygous resistant to the knockdown resistance (kdr) L1014F mutation (100%). Meanwhile, the East African mutation (kdr L1014S) was absent in the tested mosquitoes. Three mosquitoes that tested positive for the parasite, had an individual Plasmodium falciparum infection rate of 12.50, 16.67, and 14.29%. The sampling dates of positive mosquitoes were distributed in the two periods of peak Anopheles mosquito density.

Conclusion: This study identified the dominant Anopheles species in Freetown as An. gambiae while the predominant species within the An. gambiae complex was An. gambiae sensu stricto. Surveillance of seasonal fluctuations and high P. falciparum infection rates in Anopheles indicate that the alternation of drought and rainy seasons from June to July, and from October to November, are the key periods for malaria control and prevention in Freetown, Sierra Leone. The high frequency of kdr allele mutations in An. gambiae calls for close monitoring of vector susceptibility to insecticides and tracing of resistance mechanisms in order to develop more effective vector control measures and strategies.

Multiple-camera defocus imaging of ultracold atomic gases

In cold atom experiments, each image of light refracted and absorbed by an atomic ensemble carries a remarkable amount of information. Numerous imaging techniques including absorption, fluorescence, and phase-contrast are commonly used. Other techniques such as off-resonance defocused imaging (ORDI, [1-4]), where an in-focus image is deconvolved from a defocused image, have been demonstrated but find only niche applications. The ORDI inversion process introduces systematic artifacts because it relies on regularization to account for missing information at some spatial frequencies. In the present work, we extend ORDI to use multiple cameras simultaneously at degrees of defocus, eliminating the need for regularization and its attendant artifacts. We demonstrate this technique by imaging Bose-Einstein condensates, and show that the statistical uncertainties in the measured column density using the multiple-camera off-resonance defocused (McORD) imaging method are competitive with absorption imaging near resonance and phase contrast imaging far from resonance. Experimentally, the McORD method may be incorporated into existing set-ups with minimal additional equipment.

A Systematic Review of the Development and Validation of the Heat Vulnerability Index: Major Factors, Methods, and Spatial Units

PURPOSE OF REVIEW

This review aims to identify the key factors, methods, and spatial units used in the development and validation of the heat vulnerability index (HVI) and discuss the underlying limitations of the data and methods by evaluating the performance of the HVI.

RECENT FINDINGS

Thirteen studies characterizing the factors of the HVI development and relating the index with validation data were identified. Five types of factors (i.e., hazard exposure, demographic characteristics, socioeconomic conditions, built environment, and underlying health) of the HVI development were identified, and the top five were social cohesion, race, and/or ethnicity, landscape, age, and economic status. The principal component analysis/factor analysis (PCA/FA) was often used in index development, and four types of spatial units (i.e., census tracts, administrative area, postal code, grid) were used for establishing the relationship between factors and the HVI. Moreover, although most studies showed that a higher HVI was often associated with the increase in health risk, the strength of the relationship was weak.

SUMMARY

This review provides a retrospect of the major factors, methods, and spatial units used in development and validation of the HVI and helps to define the framework for future studies. In the future, more information on the hazard exposure, underlying health, governance, and protection awareness should be considered in the HVI development, and the duration and location of validation data should be strengthened to verify the reliability of HVI.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40641-021-00173-3.

Prospective evaluation of dietary and lifestyle pattern indices with risk of colorectal cancer in a cohort of younger women

BACKGROUND

Although colorectal cancer (CRC) incidence in the USA is declining overall, its incidence is increasing among those younger than 50 years of age. The reasons underlying the increasing trend are largely unknown, although behavioral changes, such as unhealthy diet and lifestyle factors, may be partially responsible.

DESIGN

A prospective cohort study included 94 217 women aged 26-45 years at baseline. Validated anthropometric measures and lifestyle information were self-reported biennially. Exposures were four recommendation-based dietary indices-the prime diet quality score and three plant-based dietary indices; and two mechanism-based indices-the empirical dietary and lifestyle index for hyperinsulinemia (EDIH and ELIH). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for overall CRC and for early-onset (before age 50) and after age 50 CRC separately.

RESULTS

We documented 332 cases of CRC during 24 years of follow-up (2 113 655 person-years), with an average age of 52 ± 7 years at diagnosis. Hyperinsulinemic dietary and lifestyle patterns were associated with a higher risk of CRC. Multivariable-adjusted HRs (95% CIs) comparing participants in the highest versus lowest quartile were: 1.67 for EDIH (95% CI: 1.15-2.44, P-trend = 0.01) and 1.51 for ELIH (95% CI: 1.10-2.08, P-trend = 0.01). Moreover, per 75% increment in rank, ELIH appeared to be a stronger risk factor for early-onset CRC (HR = 1.86, 95% CI: 1.12-3.07) than after age 50 CRC (HR = 1.20, 95% CI: 0.83-1.73, P-heterogeneity = 0.16). The four recommendation-based indices were not significantly associated with overall, early-onset, or after age 50 CRC risk (per 75% increment in rank, HRs ranged from 0.75 to 1.28).

CONCLUSION

Dietary and lifestyle patterns contributing to hyperinsulinemia were associated with greater CRC risk in younger women. Moreover, the hyperinsulinemic lifestyle showed a suggestively stronger positive association with early-onset CRC risk, compared with after age 50 CRC. Our findings suggest that dietary and lifestyle interventions to reduce insulinemic potential may be effective for CRC prevention among younger women.

Spatial Dynamics of Dengue Fever in Mainland China, 2019

New spatial characteristics of dengue fever in mainland China during 2019 were analyzed. There was a dengue fever outbreak in mainland China in 2019, with 15,187 indigenous cases in 13 provinces, 1281 domestic imported cases from 12 provinces and 5778 overseas imported cases from 47 countries, more than the previous cases during the period 2005–2018, except for in 2014. Indigenous cases occurred in Sichuan, Hubei and Chongqing in 2019. There have been big changes in the spatial distribution and proportion of dengue cases. Indigenous cases were not only located in the southwestern border and southeastern coastal provinces of Yunnan, Guangdong, Guangxi and Fujian but also in the central provinces of Jiangxi and Chongqing. Domestic imported cases were not only from Guangdong, but also from Yunnan. There were five new sources of importation of cases. Overseas imported cases were mainly from Cambodia and Myanmar in 2019. Understanding the new spatial characteristics of dengue fever in China helps to formulate targeted, strategic plans and implement effective public health prevention and control measures.

Superimposing hip extension on knee flexion evokes higher activation in biceps femoris than knee flexion alone

Hamstring muscle function during knee flexion has been linked to hamstring injury and performance. However, it is unclear whether knee flexion alone (KF) requires similar hamstring electromyography (EMG) activity pattern to simultaneous hip extension and knee flexion (HE-KF), a combination that occurs in the late swing phase of sprinting. This study examined whether HE-KF maximal voluntary isometric contraction (MVIC) evokes higher (EMG) activity in biceps femoris long head (BFlh) and semitendinosus (ST) than KF alone. Effects of shank rotation angles were also tested. Twenty-one males performed the above-mentioned MVICs while EMG activity was measured along ST and BFlh. Conditions were compared using a one-way mixed functional ANOVA model under a fully Bayesian framework. Higher EMG activity was found in HE-KF in all shank rotation positions than in KF in the middle region of BFlh (highest in the 9th channel, by 0.022 mV [95%CrI 0.014 to 0.030] in neutral shank position). For ST, this was only observed in the neutral shank position and in the most proximal channel (by 0.013 mV [95%CrI 0.001 to 0.025]). We observed muscle- and region-specific responses to HE-KF. Future studies should examine whether hamstring activation in this task is related to injury risk and sprint performance.

Determination of Factors Affecting Dengue Occurrence in Representative Areas of China: A Principal Component Regression Analysis

Background: Determination of the key factors affecting dengue occurrence is of significant importance for the successful response to its outbreak. Yunnan and Guangdong Provinces in China are hotspots of dengue outbreak during recent years. However, few studies focused on the drive of multi-dimensional factors on dengue occurrence failing to consider the possible multicollinearity of the studied factors, which may bias the results.

Methods: In this study, multiple linear regression analysis was utilized to explore the effect of multicollinearity among dengue occurrences and related natural and social factors. A principal component regression (PCR) analysis was utilized to determine the key dengue-driven factors in Guangzhou city of Guangdong Province and Xishuangbanna prefecture of Yunnan Province, respectively.

Results: The effect of multicollinearity existed in both Guangzhou city and Xishuangbanna prefecture, respectively. PCR model revealed that the top three contributing factors to dengue occurrence in Guangzhou were Breteau Index (BI) (positive correlation), the number of imported dengue cases lagged by 1 month (positive correlation), and monthly average of maximum temperature lagged by 1 month (negative correlation). In contrast, the top three factors contributing to dengue occurrence in Xishuangbanna included monthly average of minimum temperature lagged by 1 month (positive correlation), monthly average of maximum temperature (positive correlation), monthly average of relative humidity (positive correlation), respectively.

Conclusion: Meteorological factors presented stronger impacts on dengue occurrence in Xishuangbanna, Yunnan, while BI and the number of imported cases lagged by 1 month played important roles on dengue transmission in Guangzhou, Guangdong. Our findings could help to facilitate the formulation of tailored dengue response mechanism in representative areas of China in the future.

In vitro and in vivo characterization of a recombinant rhesus cytomegalovirus containing a complete genome

Cytomegaloviruses (CMVs) are highly adapted to their host species resulting in strict species specificity. Hence, in vivo examination of all aspects of CMV biology employs animal models using host-specific CMVs. Infection of rhesus macaques (RM) with rhesus CMV (RhCMV) has been established as a representative model for infection of humans with HCMV due to the close evolutionary relationships of both host and virus. However, the only available RhCMV clone that permits genetic modifications is based on the 68-1 strain which has been passaged in fibroblasts for decades resulting in multiple genomic changes due to tissue culture adaptations. As a result, 68-1 displays reduced viremia in RhCMV-naïve animals and limited shedding compared to non-clonal, low passage isolates. To overcome this limitation, we used sequence information from primary RhCMV isolates to construct a full-length (FL) RhCMV by repairing all mutations affecting open reading frames (ORFs) in the 68-1 bacterial artificial chromosome (BAC). Inoculation of adult, immunocompetent, RhCMV-naïve RM with the reconstituted virus resulted in significant viremia in the blood similar to primary isolates of RhCMV and furthermore led to high viral genome copy numbers in many tissues at day 14 post infection. In contrast, viral dissemination was greatly reduced upon deletion of genes also lacking in 68-1. Transcriptome analysis of infected tissues further revealed that chemokine-like genes deleted in 68-1 are among the most highly expressed viral transcripts both in vitro and in vivo consistent with an important immunomodulatory function of the respective proteins. We conclude that FL-RhCMV displays in vitro and in vivo characteristics of a wildtype virus while being amenable to genetic modifications through BAC recombineering techniques.

Enhanced transport of spin-orbit-coupled Bose gases in disordered potentials

Anderson localization is a single-particle localization phenomena in disordered media that is accompanied by an absence of diffusion. Spin-orbit coupling (SOC) describes an interaction between a particle's spin and its momentum that directly affects its energy dispersion, for example, creating dispersion relations with gaps and multiple local minima. We show theoretically that combining one-dimensional spin-orbit coupling with a transverse Zeeman field suppresses the effects of disorder, thereby increasing the localization length and conductivity. This increase results from a suppression of backscattering between states in the gap of the SOC dispersion relation. Here, we focus specifically on the interplay of disorder from an optical speckle potential and SOC generated by two-photon Raman processes in quasi-one-dimensional Bose-Einstein condensates. We first describe backscattering by using a Fermi golden rule approach, and then numerically confirm this picture by solving the time-dependent one-dimensional Gross-Pitaevskii equation for a weakly interacting Bose-Einstein condensate with SOC and disorder. We find that on the tens of millisecond timescale of typical cold atom experiments moving in harmonic traps, initial states with momentum in the zero-momentum SOC gap evolve with negligible backscattering, while without SOC these same states rapidly localize.

Activation of the STAT1 Pathway Accelerates Periodontitis in Nos3-/- Mice

Early studies on the etiology and pathogenesis of hypertension have shown that it has a considerable association with inflammation and the immune response as well as periodontitis. Clinical studies have also shown that hypertension can promote the periodontal tissue destruction caused by periodontitis. However, the underlying mechanisms remain unclear. This study aimed to explore the possible mechanisms of how hypertension aggravates periodontitis. Treatment with or without the signal transducer and activator of transcription 1 (STAT1) inhibitor fludarabine was performed in an endothelial nitric oxide synthase gene knockout-related (Nos3^-/-) mouse model with the hypertension phenotype of periodontitis induced by bacteria. Micro-computed tomography, immunohistochemistry, Western blot, quantitative reverse transcription polymerase chain reaction, immunofluorescence, and ELISA were performed. We demonstrated that Nos3^-/--related hypertension increases bone resorption and periodontal destruction in periodontitis lesion areas, which can be inhibited by the STAT1 inhibitor. Experimental data also showed that Nos3^-/- significantly increased macrophage infiltration and proinflammatory cytokine expression in the periodontitis lesion area, which is dependent on the angiotensin II-induced STAT1 pathway. Inhibition of STAT1 in vivo can decrease the expression of proinflammatory cytokines and macrophage infiltration. Furthermore, data in this study showed that Nos3^-/--related hypertension further downregulated the STAT3 anti-inflammatory function and its downstream chemokine expression in a STAT1-dependent manner. By applying RAW 264.7 and L929 cell lines and monocytes isolated from Nos3^-/- mice, we confirmed that activation of the STAT1 pathway inhibits STAT3 and its downstream pathway and promotes inflammatory cytokine expression in vitro. Collectively, our current study demonstrated that STAT1 plays an indispensable role in the Nos3^-/--related hypertension with aggravation of periodontitis, suggesting that STAT1 may be a key target for the treatment of periodontitis with hypertension.

Follicle stimulating hormone and estradiol trajectories from menopausal transition to late postmenopause in indigenous Chinese women

OBJECTIVE

The aim of this study was to examine follicle stimulating hormone (FSH) and estradiol (E2) trajectories in indigenous Chinese women through the ovarian aging process from 10 years before the final menstrual period (FMP) to 20 years after.

METHODS

A prospective community-based longitudinal cohort study of 362 Chinese middle-aged women with a clearly determined FMP was performed.

RESULTS

FSH and E2 trajectories were identified according to years from FMP and the Stages of Reproductive Aging Workshop + 10 (STRAW + 10), and further classified by body mass index. E2 decreases relatively steadily from Stage -2 to +1c, while FSH stabilizes quickly from Stage -2 to +1a. Obese women have higher E2 levels and lower FSH levels during menopausal transition, which last for decades after the FMP. There was no obvious decline in FSH levels for at least 20 years after the FMP.

CONCLUSIONS

The FSH and E2 trajectories in this indigenous Chinese cohort appear similar to those discussed in the Study of Women's Health Across the Nation, with ethnic differences. STRAW + 10 criteria may be used to ascertain the ovarian aging process in Chinese women. Obese women may experience different levels of hormonal fluctuations during the menopause transition, while FSH levels in all women appear to remain high even at late postmenopause.

Climate factors driven typhus group rickettsiosis incidence dynamics in Xishuangbanna Dai autonomous prefecture of Yunnan province in China, 2005-2017

BACKGROUND

Typhus group rickettsiosis (TGR), which is a neglected vector-borne infectious disease, including epidemic typhus and endemic typhus. We explored the lag effects and nonlinear association between meteorological factors and TGR incidence in Xishuangbanna Dai autonomous prefecture from 2005 to 2017, China.

METHODS

A Poisson regression with a distributed lag nonlinear model (DLNM) was utilized to analyze TGR cases data and the contemporaneous meteorological data.

RESULTS

A J-shaped nonlinear association between weekly mean temperature and TGR incidence was found. The cumulative exposure to weekly mean temperature indicated that the RR increased with the increment of temperature. Taking the median value as the reference, lower temperatures could decrease the risk of TGR incidence, while higher temperatures could increase the risk of TGR incidence and last for 21 weeks. We also found a reversed U-shaped nonlinear association between weekly mean precipitation and TGR incidence. Precipitation between 5 mm and 13 mm could increase the risk of TGR incidence. Taking the median value as the reference, no precipitation and lower precipitation could decrease the risk of TGR incidence, while higher precipitation could increase the risk of TGR incidence and last for 18 weeks.

CONCLUSIONS

The prevention and control measures of TGR should be implemented according to climatic conditions by the local government and health departments in order to improve the efficiency.

Spatio-temporal patterns of scrub typhus in mainland China, 2006-2017

Background

Scrub typhus, a serious public health problem in the Asia-Pacific area, is endemic in the “tsutsugamushi triangle” area. Scrub typhus has been widespread and has become a significant health concern in China. However, spatiotemporal patterns need to be investigated further.

Objective

This study aims to explore spatiotemporal patterns, diffusion characteristics and regional distribution differences of scrub typhus cases in mainland China from January 2006 to December 2017.

Method

Monthly cases of scrub typhus reported at the county level during 2006–2017 were obtained. Time-series analyses, spatial distribution analyses, spatial diffusion analyses, spatial autocorrelation analyses and space-time scan statistic analyses were used to explore spatiotemporal characteristics of scrub typhus.

Results

A total of 121 251 scrub typhus cases were reported in 30 provinces (or municipalities) of mainland China during 2006–2017, which rose exponentially. There were seasonal characteristics from June to November for scrub typhus. Scrub typhus had been diffused from south, southwest, southeast and eastern coasts to center, north, northeast and northwest in mainland China. Scrub typhus occurrences were from point to surrounding regions, and from south to north every year. The peak periods of scrub typhus became longer and longer from north to southwest to south in mainland China. There existed a single peak in Southwest region and North region, respectively, but existed a bimodal peak for South region. Scrub typhus cases were clustered in Yunnan, Guangdong, Guangxi, Fujian and Anhui among June to November. The scrub typhus epidemics in Guangdong and Yunnan were the most serious.

Conclusions

The results in this study can be guide targeted public health interventions against scrub typhus at the county level.

Scrub typhus is a bacterial zoonosis caused by Orientia tsutsugamushi and is popular in the Asia-Pacific area. Nowadays scrub typhus has been widespread and causes a considerable burden on public health and economy in China. We investigated spatiotemporal patterns, diffusion characteristics and regional distribution differences of scrub typhus cases in mainland China from 2006 to 2017. The majority of scrub typhus cases were reported in June to November, and 98.3% of the total scrub typhus cases during 2006–2017 were reported in South region, Southwest region and North region. Scrub typhus had been diffused in mainland China except Qinghai. Scrub typhus occurrences were from point to surrounding regions, and from south to north every year. The peak periods of scrub typhus turn longer, and there existed a single peak to a bimodal peak from north to south. Scrub typhus cases were clustered in Yunnan, Guangdong, Guangxi, Fujian and Anhui during June to November. The scrub typhus epidemics in Guangdong and Yunnan were the most serious.

Epidemiological characteristics and spatiotemporal patterns of typhus group rickettsiosis at the county level in China, 2005-2017

OBJECTIVE

To explore the epidemiological characteristics and spatiotemporal patterns of typhus group rickettsiosis (TGR) in mainland China.

METHODS

A chi-squared test was used to compare the differences in the age and occupation distributions across the different years. Time-series analyses, spatial clustering analyses, and spatiotemporal scan statistics were used to detect the spatiotemporal patterns of the TGR incidence.

RESULTS

A total of 29,211 TGR cases were collected. Of these cases, 63.1% occurred from May to October, and 88.4% occurred in individuals between 0 and 59 years old. There was a significant spatial TGR heterogeneity from 2005 to 2017. The hotspots were located mainly in the southwestern, southern, and circum-Bohai Sea regions of northern China. Eighteen spatiotemporal clusters were observed using Kulldorff's space-time scan statistic, and the primary cluster included three counties, Jinghong city, Menghai county, and Mengla county.

CONCLUSIONS

TGR is widely distributed in China, and it is a serious threat to public health. The hotspots were located mainly in the southwestern, southern, and circum-Bohai Sea regions of northern China, and the primary spatiotemporal cluster showed a trend shifting from circum-Bohai Sea regions to the southwestern regions. Targeted interventions should be executed in high-risk regions for precise prevention and control.

Long non-coding RNA expression profile in permanent atrial fibrillation patients with rheumatic heart disease

OBJECTIVE

Atrial fibrillation (AF) is the most common type of arrhythmia, especially in rheumatic heart disease (RHD) patients. The differences in structural remodeling and electrical remodeling between the left and right atrium associated with AF in RHD patients are well known, and alterations in the expression profiles of long noncoding RNAs (lncRNAs) in the left atrium have also been investigated. However, the role of lncRNAs in the right atrium (RA) remains largely unknown.

PATIENTS AND METHODS

We identified differentially expressed lncRNAs in RA tissues of RHD patients with AF or a normal sinus rhythm (NSR) using microarray analysis. Then, we performed gene ontology (GO) and KEGG pathway analyses for functional annotation of the deregulated lncRNAs. Finally, we constructed a lncRNA-mRNA co-expression network.

RESULTS

Of the 22,829 human non-coding RNAs analyzed, a total of 1,909 long non-coding RNAs were detected. A total of 182 lncRNAs (117 downregulated and 65 upregulated) were shown to be differentially expressed (fold-change > 1.5) in AF patients compared with NSR patients. Many lncRNAs might be partially involved in an AF-related pathway.

CONCLUSIONS

AF dysregulates the expression of lncRNAs in the RA of RHD patients. These findings may be useful for exploring potential therapeutic treatments for AF in RHD patients.

Two linked TBXT (brachyury) gene polymorphisms are associated with the tailless phenotype in fat-rumped sheep

T‐box transcription factor T (TBXT), encoding the brachyury protein, is an embryonic nuclear transcription factor involved in mesoderm formation and differentiation. Previous studies indicate that TBXT mutations are responsible for the tailless or short‐tailed phenotype of many vertebrates. To verify whether the tailless phenotype in fat‐rumped sheep is associated with TBXT mutations, exon 2 of the TBXT gene for 301 individuals belonging to 13 Chinese and Iranian sheep breeds was directly sequenced. Meanwhile, 380 samples were used to detect the genotypes of the candidate variations by mapping to their reads databases in the Sequence Read Archive repository of GenBank. The results showed that one missense mutation, c.334G>T (GGG>TGG) with a completely linked synonymous variant c.333G>C (CCG>CCC) was found to be associated with the ‘tailless’ characteristic in typical fat‐rumped sheep breeds. The c.334G>T transversion led to the conversion of glycine to tryptophan at the 112th amino acid in the T‐box domain of the brachyury protein. In addition, crossbreeding experiments for long‐tailed and tailless sheep showed that CT/CT allele of nucleotides (nt) 333 and 334, a recessive mutation, would cause sheep tails to be shorter, suggesting that these two linked variants at nucleotides 333 and 334 in TBXT are probably causative mutations responsible for the tailless phenotype in sheep.

Epidemiological dynamics of dengue fever in mainland China, 2014-2018

OBJECTIVE

To explore the epidemiological dynamics of dengue fever.

METHODS

Epidemiological dynamics of imported and indigenous dengue cases during 2014-2018, including demographic, time-series, spatial and spatio-temporal features, were analyzed.

RESULTS

There were 5 458 imported dengue cases and 59 183 indigenous dengue cases during 2014-2018. Both imported and indigenous dengue cases show seasonal patterns from August to November. 12.9% (12.9/100) of dengue cases were from businessmen. 58.2% (58.2/100) of dengue cases were from individuals between 21-50 years old. Imported dengue cases, mainly from Southeastern Asia, had doubled, and were distributed in 734 counties, 29 provinces, with 50% (50/100) in Yunnan. Except in 2014, indigenous dengue cases were under 5 000 every year, but the number in counties increased dramatically from 51 to 127. The total cases were distributed in 314 districts, 13 provinces. They were clustered in Yunnan border and southern Guangdong. They emerged gradually from southwestern and southern provinces to southeastern coastal provinces, and then to central and northern provinces every year. They spread from the southern regions to the central and northern regions in 2014-2018.

CONCLUSIONS

The findings of epidemiological dynamics of dengue fever are helpful to formulate targeted, strategic plans and implement effective public health prevention and control measures.

[The comparison of preemptive analgesic efficacy between short-acting ketamine and long-acting parecoxib]

Objective: To compare the analgesic efficacy between preoperative single-dose ketamine, a short-acting medicine and parecoxib, a long-acting medicine for reducing analgesic consumption in the first 24 h after-operation. Methods: Eighty-one patients from Beijing Chaoyang Hospital undergoing laparoscopic uterus surgery between April and December 2015 were randomly divided into three groups: control group (group C), ketamine group (group K) and parecoxib sodium group (group P). All patients were anesthetized with general anesthesia and received sufentanil-based patient-controlled intravenous analgesia (PCIA). After induction and 10 min before incision, patients in group K, P and C were injected with intravenous 0.5 mg/kg ketamine, 40 mg parecoxib and 2 ml normal saline, respectively. The primary outcome was sufentanil consumption within 1 h and 24 h after surgery. Other outcomes included the visual analog scale (VAS) pain score at 0, 15, 30, 45min and 1, 2, 4, 8, 24 h after surgery, PCIA effective trigger times, and adverse reactions. Results: The postoperative sufentanil consumptions within 1 h in group K and P were(4.420±1.836)μg and (2.878±1.984)μg, respectively, and consumptions within 24 h were(28.200±3.712)μg and (25.511±4.037)μg, respectively, which were significantly less than that in group C with (6.144±2.346)μg within 1 h and (31.505±7.042)μg within 24 h (F=15.360, 8.406, all P<0.05). Patients in group P needed less sufentanil than group K in 1 h after surgery (P<0.05), however, the difference was not statistically significant in 24 h(P>0.05). The PCIA trigger times were 2(3.75) in group C, 0(1.50) in group K, and 0(1.00) in group P. Group K and P had less PCIA trigger times compared to group C (all P<0.05). Compared to group C, group K and P had lower VAS scores at 0, 15, 30 min after surgery and group P had lower VAS scores at 1, 15, 30, 45 min, 2 h after surgery, respectively (all P<0.05). There were no differences between groups in the incidence of any adverse effects(all P>0.05). Conclusion: A single injection of short-acting ketamine before laparoscopic uterus surgery, has the same efficacy as long-acting parecoxib for opioid-sparing effect in the first 24 h after-operation. However, parecoxib has better analgesic effect in the early postoperative period.

Accuracy of interferon-γ-induced protein 10 for diagnosing latent tuberculosis infection: a systematic review and meta-analysis

BACKGROUND

Effective diagnostic methods for detecting latent tuberculosis infection (LTBI) are important for its eradication. A number of studies have evaluated the use of interferon-γ-induced protein 10 (IP-10), which is elevated after tuberculosis infection, as a biomarker for LTBI, but conclusive results regarding its effectiveness have not been reported.

OBJECTIVES

Our objective was to assess the diagnostic value of IP-10 for LTBI.

DATA SOURCES

We searched the PubMed, Embase, the Cochrane Library and Web of Science databases to find eligible studies.

STUDY ELIGIBILITY CRITERIA

We included cohort, case-control and cross-sectional studies that evaluated IP-10 in LTBI participants in comparison with tuberculin skin tests (TST) and interferon-γ release assays (IGRA).

PARTICIPANTS

Individuals with LTBI and uninfected participants.

INTERVENTIONS

IP-10 (index test) compared with TST and IGRA (reference standard) for diagnosing LTBI.

METHODS

PubMed, Embase, the Cochrane Library, and Web of Science databases were searched up to June 2018. A hierarchical summary receiver operating characteristic (HSROC) model was used to evaluate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and HSROC curve for the diagnostic efficiency of IP-10.

RESULTS

Twelve studies including 1023 participants and 1122 samples were included. The overall pooled sensitivity was 0.85 (95% CI 0.80-0.88), specificity was 0.89 (95% CI 0.84-0.92), PLR was 7.55 (95% CI 5.20-10.97), NLR was 0.17 (95% CI 0.13-0.22) and DOR was 44.23 (95% CI 28.86-67.79), indicating a high accuracy for diagnosing LTBI. Based on a meta-regression analysis, high-burden countries, study design, IP-10 method, reference standard and the IP-10 cut-off could not explain the heterogeneity (p >0.05).

CONCLUSIONS

Our results suggested that IP-10 is a promising biomarker for the diagnosis of LTBI.

Spatial analysis of dengue fever and exploration of its environmental and socio-economic risk factors using ordinary least squares: A case study in five districts of Guangzhou City, China, 2014

OBJECTIVE

Spatial patterns and environmental and socio-economic risk factors of dengue fever have been studied widely on a coarse scale; however, there are few such quantitative studies on a fine scale. There is a need to investigate these factors on a fine scale for dengue fever.

METHODS

In this study, a dataset of dengue fever cases and environmental and socio-economic factors was constructed at 1-km spatial resolution, in particular 'land types' (LT), obtained from the first high resolution remote sensing satellite launched from China (GF-1 satellite), and 'land surface temperature', obtained from moderate resolution imaging spectroradiometer (MODIS) images. Spatial analysis methods, including point density, average nearest neighbor, spatial autocorrelation, and hot spot analysis, were used to analyze spatial patterns of dengue fever. Spearman rank correlation and ordinary least squares (OLS) were used to explore associated environmental and socio-economic risk factors of dengue fever in five districts of Guangzhou City, China in 2014.

RESULTS

A total of 30553 dengue fever cases were reported in the districts of Baiyun, Haizhu, Yuexiu, Liwan, and Tianhe of Guangzhou, China in 2014. Dengue fever cases showed strong seasonal variation. The cases from August to October accounted for 96.3% of the total cases in 2014. The top three districts for dengue fever morbidity were Baiyun (1.32%), Liwan (0.62%), and Haizhu (0.60%). Strong spatial clusters of dengue fever cases were observed. Areas of high density for dengue fever were located at the district junctions. The dengue fever outbreak was significantly correlated with LT, normalized difference water index (NDWI), land surface temperature of daytime (LSTD), land surface temperature of nighttime (LSTN), population density (PD), and gross domestic product (GDP) (correlation coefficients of 0.483, 0.456, 0.612, 0.699, 0.705, and 0.205, respectively). The OLS equation was built with dengue fever cases as the dependent variable and LT, LSTN, and PD as explanatory variables. The residuals were not spatially autocorrelated. The adjusted R-squared was 0.320.

CONCLUSIONS

The findings of spatio-temporal patterns and risk factors of dengue fever can provide scientific information for public health practitioners to formulate targeted, strategic plans and implement effective public health prevention and control measures.

MSX1 induces G0/G1 arrest and apoptosis by suppressing Notch signaling and is frequently methylated in cervical cancer

PURPOSE

The objectives of this study were to investigate the expression of MSX1 in cervical cells and tissues, the methylation status of the MSX1 promoter, the influence of overexpression of gene MSX1 on the proliferation, migration, and invasion of HeLa and SiHa cells, and finally the possible molecular mechanisms responsible for the suppressive effects of MSX1 upon cervical cancer cells.

PATIENTS AND METHODS

Semi-quantitative and quantitative reverse transcription-polymerase chain reactions were used to investigate the expression levels of MSX1, and methylation-specific polymerase chain reaction (MSP) was performed to investigate promoter methylation status in cervical cancer cell lines, primary cervical tissues, and normal cervical tissues. Clone formation, Cell Counting Kit-8 (CCK-8), cell wound scratch, and transwell assays were performed to verify whether MSX1 could inhibit the proliferation and migration of cervical cancer cells. Western blot was used to analyze the effect of MSX1 upon Notch1, Jagged1, c-Myc, cleaved PARP, cleaved caspse-3, and cyclin D1 (CCND1).

RESULTS

MSX1 was frequently downregulated or silenced in 60.0% (3/5) of cervical cancer cell lines. The promoter methylation of MSX1 was detected in 42.0% (42/100) of primary tumor tissues, while no methylation was observed in normal cervical tissues. Pharmacological demethylation reduced MSX1 promoter methylation levels and restored the expression of MSX1. The overexpression of MSX1 in cervical cancer cells thus inhibited the proliferation and migration of cervical cancer cells. The overexpression of MSX1 in cervical cancer cells downregulated the expression levels of Notch1, Jagged1, and c-Myc but upregulated the expression levels of CCND1, cleaved PARP, and cleaved caspase-3.

CONCLUSION

MSX1 appears to be a functional tumor suppressor that regulates tumorigenesis in cervical cancer by antagonizing Notch signaling.

Administration of activated lymphocyte-derived DNA accelerates and aggravates lupus nephritis in B6/lpr mice: a new approach to modify a lupus murine model

B6/lpr mouse strain is a well-known systemic lupus erythematosus murine model characterized by uncontrolled lymphoproliferation and autoantibody production. However, it displays a delayed and mild development of lupus nephritis (LN), which is not conducive to the research of the pathogenesis and therapeutic strategies of this condition. Our previous study demonstrated that activated lymphocyte-derived DNA (ALD-DNA) could induce high urine protein levels and severe glomerulonephritis (GN) in BALB/c mice. In the present study, we tried to remedy delayed urine protein production and mild GN in B6/lpr mice via ALD-DNA immunization. We found that urine protein levels were enhanced significantly in B6/lpr mice 4 weeks after ALD-DNA immunization compared with those in unactivated lymphocyte-derived (UnALD)-DNA- and phosphate-buffered saline (PBS)-treated controls. Moreover, more serious GN and glomerular immune complex were observed in ALD-DNA-immunized B6/lpr mice. We further explored the mechanism, and found that ALD-DNA immunization promoted T helper type 17 (Th17) cell enrichment remarkably, which enhanced the proportion of autoantibody-secreting plasma cells and promoted the production of anti-dsDNA autoantibodies, leading to accelerated and aggravated LN. Our data demonstrated that ALD-DNA immunization could remedy delayed urine protein production and mild GN in B6/lpr mouse, which makes it more suitable for studies on the pathogenesis of and therapeutic strategies against LN.

Homeobox protein MSX1 inhibits the growth and metastasis of breast cancer cells and is frequently silenced by promoter methylation

Deregulation of msh homeobox 1 (MSX1) has been identified to be associated with multiple human malignant neoplasms. However, the association of the expression and biological function of MSX1 with breast tumorigenesis, and the underlying mechanism remain largely unknown. Therefore, the present study examined the expression and promoter methylation of MSX1 in breast tumor cell lines, primary breast tumors and normal breast tissues using semi-quantitative, quantitative and methylation-specific reverse transcription‑polymerase chain reaction. Colony formation assays, flow cytometric analysis, and wound healing and Transwell assays were used to assess various functions of MSX1. Western blot analyses were also conducted to explore the mechanism of MSX1. The results revealed that MSX1 was broadly expressed in normal human tissues, including breast tissues, but was frequently downregulated or silenced in breast cancer cell lines and primary tumors by promoter methylation. Methylation of the MSX1 promoter was observed in 7/9 (77.8%) breast cancer cell lines and 47/99 (47.5%) primary tumors, but not in normal breast tissues or surgical margin tissues, suggesting that tumor-specific methylation of MSX1 occurs in breast cancer. Pharmacological demethylation reduced MSX1 promoter methylation levels and restored the expression of MSX1. The ectopic expression of MSX1, induced by transfection with a lentiviral vector, significantly inhibited the clonogenicity, proliferation, migration and invasion of breast tumor cells by inducing G1/S cell cycle arrest and apoptosis. Ectopic MSX1 expression also inhibited the expression of active β-catenin and its downstream targets c-Myc and cyclin D1, and also increased the cleavage of caspase-3 and poly (ADP-ribose) polymerase. In conclusion, MSX1 exerts tumor-suppressive functions by inducing G1/S cell cycle arrest and apoptosis in breast tumorigenesis. Its methylation may be used as an epigenetic biomarker for the early detection and diagnosis of breast cancer.