Publications by authors named "Yulan Lin"

52 Publications

Quarantine for the coronavirus disease (COVID-19) in Wuhan city: Support, understanding, compliance and psychological impact among lay public.

J Psychosom Res 2021 05 16;144:110420. Epub 2021 Mar 16.

Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China; Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya 50603, Kuala Lumpur, Malaysia. Electronic address:

Objective: Wuhan, the epicentre of the coronavirus diseases (COVID-19) outbreak, has been locked down on January 23, 2020. We conducted a study among the lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine.

Methods: We conducted a cross-sectional, online-based survey study between January 28, 2020, and February 2, 2020 among the adult lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine. Multivariable logistic analysis was used to identify factors associated with psychological impacts.

Results: Among the 4100 participants investigated, a total of 15.9% were compliant with all the five household prevention measures, whereas 74.4% were compliant with all the three community prevention measures investigated. By demographics, participants of younger age, higher income, residing in an urban area, knowing neighbors infected with COVID-19 reported significantly higher psychological impact score. Participants with a lower level of support for quarantine were more likely to have a higher psychological impact score (OR = 1.45, 95% CI 1.07-1.96). Participants with a lower level of compliance with preventive measures (score of 0-19) reported higher psychological impact (OR = 1.40, 95% CI 1.22-1.60 vs. score 20-24). Participants who had been out of house socializing and attended public events expressed higher psychological impact.

Conclusions: Support, understanding of the rationale for quarantine are essential in ensuring appropriate psychological well-being during the quarantine. Improvements in compliance with preventive measures are highly warranted and may bring about a reduction in psychological distress.
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http://dx.doi.org/10.1016/j.jpsychores.2021.110420DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962979PMC
May 2021

Effects of on the utilization of organic phosphorus in Abel.

Can J Microbiol 2021 Mar 26:1-9. Epub 2021 Mar 26.

Key Laboratory of State Forestry and Grassland Administration on Forest Ecosystem Protection and Restoration of Poyang Lake Watershed, Jiangxi Agricultural University, Nanchang 330045, China.

Arbuscular mycorrhizal (AM) fungi play an important role in the acquisition of phosphorus (P) by plants. The external hyphae of AM fungi function as an extension of plant roots and may downregulate related functions in the roots. It is not clear whether the ability of AM fungi to mineralize organic P affects root phosphatase activities. A pot experiment was conducted to investigate the effect of on soil organic P mineralization under phytate application and to explore root phosphatase activities, P uptake, and growth in Abel. The plants and their growth substrates were harvested 4 and 8 months after planting. The results showed that organic P application had no effect on the total dry mass of nonmycorrhizal plants, but differences in dry mass under P application were observed in mycorrhizal plants in both harvests. Inoculation with .  increased soil acid phosphatase, phytase, and alkaline phosphatase activities and reduced the soil organic P content. Mycorrhizal plants had higher root activity, shoot and root P contents and root acid phosphatase and phytase activities than nonmycorrhizal plants irrespective of organic P application. In conclusion, AM fungi enhanced the mineralization of soil organic P and positively affect root phosphatase activities.
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http://dx.doi.org/10.1139/cjm-2020-0227DOI Listing
March 2021

Behavioural responses and anxiety symptoms during the coronavirus disease 2019 (COVID-19) pandemic in Japan: A large scale cross-sectional study.

J Psychiatr Res 2021 04 13;136:296-305. Epub 2021 Feb 13.

Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, Fujian Province, China; Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. Electronic address:

Background: This study explored the behavioural responses and anxiety symptoms of the general adult population in Japan during the ongoing coronavirus disease 2019 (COVID-19) outbreak.

Methods: A web-based cross-sectional survey was conducted between 12th and May 13, 2020. Quota sampling was used to attain equal gender and age distributions representative of the Japanese population.

Results: A total of 4127 complete responses were analysed. Higher educational level (B = 0.045, p = 0.002) and household income (B = 0.04, p = 0.009) were associated with a higher increase in preventive measures when comparing before and after the state of emergency was declared. The highest reported social anxiety was a feeling of fear (65.6%), followed by embarrassment (43.8%), keeping infection a secret (41.3%), avoidance (41.3%), and stigma (25.5%). A total of 86.1% of the respondents reported moderate to severe anxiety. The partial least square-based structural equation modelling (PLS-SEM) revealed that being female has the greatest effect (B = 0.246, p < 0.0001) on higher current preventive measures, followed by social anxiety (B = 0.119; p = 0.001) and State-Trait Anxiety Inventory scores (B = 0.153; p < 0.001). Perceived susceptibility (B = 0.033, p = 0.020), knowing someone who have been diagnosed with COVID-19 (B = 0.097, p < 0.001), higher income (B = 0.079, p < 0.001) and educational level (B = 0.045; p = 0.004) all had a small but significant effect on influencing levels of preventive measures.

Conclusions: A moderate level of preventive practices found in this study indicates the need to encourage behavioural change to limit the spread of the coronavirus. The provision of mental health services is warranted as anxiety symptoms are prevalent.
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http://dx.doi.org/10.1016/j.jpsychires.2021.02.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880847PMC
April 2021

Development and external evaluation of predictions models for mortality of COVID-19 patients using machine learning method.

Neural Comput Appl 2021 Jan 5:1-10. Epub 2021 Jan 5.

Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

To predict the mortality of patients with coronavirus disease 2019 (COVID-19). We collected clinical data of COVID-19 patients between January 18 and March 29 2020 in Wuhan, China . Gradient boosting decision tree (GBDT), logistic regression (LR) model, and simplified LR were built to predict the mortality of COVID-19. We also evaluated different models by computing area under curve (AUC), accuracy, positive predictive value (PPV), and negative predictive value (NPV) under fivefold cross-validation. A total of 2924 patients were included in our evaluation, with 257 (8.8%) died and 2667 (91.2%) survived during hospitalization. Upon admission, there were 21 (0.7%) mild cases, 2051 (70.1%) moderate case, 779 (26.6%) severe cases, and 73 (2.5%) critically severe cases. The GBDT model exhibited the highest fivefold AUC, which was 0.941, followed by LR (0.928) and LR-5 (0.913). The diagnostic accuracies of GBDT, LR, and LR-5 were 0.889, 0.868, and 0.887, respectively. In particular, the GBDT model demonstrated the highest sensitivity (0.899) and specificity (0.889). The NPV of all three models exceeded 97%, while their PPV values were relatively low, resulting in 0.381 for LR, 0.402 for LR-5, and 0.432 for GBDT. Regarding severe and critically severe cases, the GBDT model also performed the best with a fivefold AUC of 0.918. In the external validation test of the LR-5 model using 72 cases of COVID-19 from Brunei, leukomonocyte (%) turned to show the highest fivefold AUC (0.917), followed by urea (0.867), age (0.826), and SPO2 (0.704). The findings confirm that the mortality prediction performance of the GBDT is better than the LR models in confirmed cases of COVID-19. The performance comparison seems independent of disease severity.

Supplementary Information: The online version contains supplementary material available at(10.1007/s00521-020-05592-1).
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http://dx.doi.org/10.1007/s00521-020-05592-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783503PMC
January 2021

Upregulated expression of serum exosomal hsa_circ_0026611 is associated with lymph node metastasis and poor prognosis of esophageal squamous cell carcinoma.

J Cancer 2021 1;12(3):918-926. Epub 2021 Jan 1.

Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, China.

To identify the diagnostic and prognostic values of serum exosomal hsa_circ_0026611 in esophageal squamous cell carcinoma (ESCC). ESCC serum exosome global circRNA expression was detected using a circRNA microarray. The expression levels of candidate serum exosome circRNAs were detected by quantitative polymerase chain reaction (qRT-PCR). A receiver operating characteristic curve (ROC) was generated to confirm the diagnostic value. Survival data and their differences were observed by the Kaplan-Meier method and log-rank tests. The Cox regression analysis was employed to identify prognostic factors. The expression levels of serum exosomal has_circ_0026611 in ESCC with lymph node metastasis were significantly higher than those in ESCC without lymph node metastasis ( =0.001). In addition, serum exosomal hsa_circ_0026611 expression could be used as a significant parameter to discriminate between non-lymph node-metastatic and lymph node-metastatic ESCC with an area under curve (AUC) of 0.724 (95% CI: 0.604~0.865). The multivariate Cox regression analysis indicated that survival was poor in patients with high serum exosomal hsa_circ_0026611 expression levels compared to those with low serum exosomal hsa_circ_0026611 levels (for OS, HR [95% CI]: 3.79 [1.27, 11.29], for DFS, HR [95% CI]: 2.77 [1.06, 7.22]). Serum exosomal hsa_circ_0026611 expression is significantly upregulated in ESCC with lymph node metastasis and is a predictor of ESCC prognosis.
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http://dx.doi.org/10.7150/jca.50548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7778553PMC
January 2021

Understanding COVID-19 vaccine demand and hesitancy: A nationwide online survey in China.

PLoS Negl Trop Dis 2020 12 17;14(12):e0008961. Epub 2020 Dec 17.

Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China.

Background: This study attempts to understand coronavirus disease 2019 (COVID-19) vaccine demand and hesitancy by assessing the public's vaccination intention and willingness-to-pay (WTP). Confidence in COVID-19 vaccines produced in China and preference for domestically-made or foreign-made vaccines was also investigated.

Methods: A nationwide cross-sectional, self-administered online survey was conducted on 1-19 May 2020. The health belief model (HBM) was used as a theoretical framework for understanding COVID-19 vaccination intent and WTP.

Results: A total of 3,541 complete responses were received. The majority reported a probably yes intent (54.6%), followed by a definite yes intent (28.7%). The perception that vaccination decreases the chances of getting COVID-19 under the perceived benefit construct (OR = 3.14, 95% CI 2.05-4.83) and not being concerned about the efficacy of new COVID-19 vaccines under the perceived barriers construct (OR = 1.65, 95% CI 1.31-2.09) were found to have the highest significant odds of a definite intention to take the COVID-19 vaccine. The median (interquartile range [IQR]) of WTP for COVID-19 vaccine was CNY¥200/US$28 (IQR CNY¥100-500/USD$14-72). The highest marginal WTP for the vaccine was influenced by socio-economic factors. The majority were confident (48.7%) and completely confident (46.1%) in domestically-made COVID-19 vaccine. 64.2% reported a preference for a domestically-made over foreign-made COVID-19 vaccine.

Conclusions: The findings demonstrate the utility of HBM constructs in understanding COVID-19 vaccination intent and WTP. It is important to improve health promotion and reduce the barriers to COVID-19 vaccination.
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http://dx.doi.org/10.1371/journal.pntd.0008961DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775119PMC
December 2020

Uncovering Physical and Attitudinal Barriers to Adherence to Precautions for Preventing the Transmission of COVID-19 and Anxiety Level of People in Wuhan: 2 Months After the Lockdown.

J Acad Consult Liaison Psychiatry 2021 Mar-Apr;62(2):201-210. Epub 2020 Sep 22.

Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China; Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Background: Wuhan, the epicenter of the coronavirus disease 2019 outbreak, was locked down on January 23, 2020. We aimed to investigate the barriers to the physical prevention, negative attitudes, and anxiety levels.

Methods: A online cross-sectional survey was conducted with the people living in Wuhan between March 12th and 23rd, 2020.

Results: Of a total of 2411 complete responses, the mean and standard deviation for the total physical prevention barriers score was 19.73 (standard deviation ± 5.3; range 12-45) out of a possible score of 48. Using a cut-off score of 44 for the State-Trait Inventory score, 79.9% (95% confidence interval [CI]: 78.2-81.5) of the participants reported moderate to severe anxiety during the early phase of the outbreak, and 51.3% (95% CI 49.2-53.3) reported moderate to severe anxiety after the peak of coronavirus disease 2019 was over (during the study period). Comparing anxiety levels in the early phase of the outbreak and after the peak of the outbreak, 58.5% (95% CI 56.5-60.5) recorded a decreased anxiety. Females reported a higher likelihood of having decreased levels of anxiety than males (odds ratio = 1.78, 95% CI 1.48-2.14). Low negative attitudes score were associated with a higher decrease in anxiety (odds ratio = 1.59, 95% CI 1.33-1.89).

Conclusions: The attitudinal barriers to prevention of transmission of coronavirus disease 2019 are more prominent than physical prevention barriers after the peak of coronavirus disease 2019. High anxiety levels even after the peak warrant serious attention.
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http://dx.doi.org/10.1016/j.psym.2020.09.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506304PMC
September 2020

Improving efficiency of measuring individual H coupling networks by pure shift 2D J-resolved NMR spectroscopy.

J Chem Phys 2020 Nov;153(17):174114

Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, State Key Laboratory for Physical Chemistry of Solid Surfaces, Xiamen University, Xiamen 361005, China.

The H coupling networks, including H-H correlation and J coupling values, provide the important information for structure elucidation and conformation analysis. However, the presence of a large number of couplings and the phase-twist lineshapes often prevents revealing H coupling networks. Here, we provide a clean absorption-mode 2D NMR method, SIMAJ (SImple Methods for 2D Absorption mode J-resolved spectrum), for a straightforward assignment and measurement of the coupling network involving the chosen proton. Relying on the pure shift element, H-H couplings and chemical shift evolution are totally separately demonstrating along the F and F dimensions, respectively. Processing with a single experiment dataset and free of 45° spectral shearing, an absorption-mode 2D J-resolved spectrum can be reconstructed. Two pulse sequences were proposed as examples. The SIMAJ signal processing method will be a general procedure for obtaining absorption-mode lineshapes when analyzing the experiment datasets with chemical shifts and J coupling multiplets in the orthogonal dimensions. With excellent sensitivity, high spectral purity, and ability of easily identifying H-H correlations, significant improvements are beneficial for structural, conformational, or complex composition analyses.
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http://dx.doi.org/10.1063/5.0025962DOI Listing
November 2020

Pickled Vegetables Intake Impacts the Metabolites for Gastric Cancer.

Cancer Manag Res 2020 9;12:8263-8273. Epub 2020 Sep 9.

School of Public Health, Fujian Medical University, Fuzhou, People's Republic of China.

Purpose: An increased risk of gastric cancer (GC) for pickled vegetables intake has been suggested, but a complete understanding of its pathogenic origin is still lacking, especially from a metabolic viewpoint. We investigated the plasma metabolites and metabolic pathway alteration of GC related to pickled vegetables intake.

Methods: We analyzed plasma samples collected from 365 gastric cancer patients and 347 healthy individuals, and divided them into three subgroups according to the intake of pickled vegetables. Plasma samples were detected by untargeted metabolomics.

Results: Nine metabolites were significantly altered in GC patients among pickled vegetables intake groups (FDR value<0.05). All of them were associated with the risk of gastric cancer adjusted for gender, age, smoking status, infection. Pathway analysis showed significant alteration in the folate biosynthesis pathway.

Conclusion: In short, we provide new insights from a metabolic perspective on the relationship between pickled vegetables intake and the occurrence of gastric cancer.
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http://dx.doi.org/10.2147/CMAR.S271277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490060PMC
September 2020

Five Serum Trace Elements Associated with Risk of Cardia and Noncardia Gastric Cancer in a Matched Case-Control Study.

Cancer Manag Res 2020 10;12:4441-4451. Epub 2020 Jun 10.

Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.

Background: Serum trace elements have for some time been suggested to influence the development of gastric cancer, but evidence is still lacking.

Methods: All newly diagnosed patients with gastric cancer were compared with healthy controls 1:1 matched by sex, age (±3 years), and place of residence during 2013-2015. The serum concentration of all trace elements was analyzed using inductively coupled plasma mass spectrometry. infections in cases were diagnosed using the rapid urease test, while in controls were detected using the colloidal gold method.

Results: A total of 122 cases of gastric cardia cancer (GCC) and 177 gastric noncardia cancer (NCGC), and 299 matched healthy controls were included. Positive associations were found between serum copper and copper/zinc ratio and risk of overall gastric cancer (OR: 2.42, 95% CI: 1.10-5.32 for copper; OR: 11.7, 95% CI: 3.83-35.6 for copper/zinc ratio), and for both GCC and NCGC subtypes. Serum selenium was inversely associated with the risk of NCGC (OR: 0.18, 95% CI: 0.07-0.51), while molybdenum seems to reduce the risk of GCC (OR: 0.12, 95% CI: 0.03-0.47). Strong inverse associations were also detected between serum calcium and risk of all groups of gastric cancer (all for trend<0.05).

Conclusion: The current study indicated statistically significant positive associations between serum copper, copper/zinc ratio, and gastric cancer, as well as inverse associations among selenium, molybdenum, and calcium. The results shall be carefully interpreted before further in vivo animal studies show definitive evidence.
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http://dx.doi.org/10.2147/CMAR.S250592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293905PMC
June 2020

Serum exosomal microRNA-766-3p expression is associated with poor prognosis of esophageal squamous cell carcinoma.

Cancer Sci 2020 Oct 13;111(10):3881-3892. Epub 2020 Aug 13.

Department of Epidemiology and Health Statistics, Fujian Medical University Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.

The aim was to analyze the association between exosomal microRNA (miR)-766-3p expression levels in serum and the prognosis of esophageal squamous cell carcinoma (ESCC). The serum global exosomal miRNA expression of ESCC patients was measured by microRNA microarray. Quantitative real-time PCR was used to analyze the expression levels of candidate miRNAs in both serum and tissues from ESCC patients. Wilcoxon tests were applied to evaluate clinical characteristics and their association with serum levels of exosomal miR-766-3p. A Cox regression model was used to identify prognostic factors. The effects of miR-766-3p expression on cell migration and invasion were examined using Transwell assays, and CCK-8 assays were carried out to measure cell proliferation. The TNM stage was associated with high serum exosomal miR-766-3p levels of ESCC patients (P = .030). Higher serum exosomal miR-766-3p expression levels were associated with poor prognosis (for overall survival, hazard ratio [HR] [95% confidence interval (CI)], 2.21 [1.00, 4.87]; for disease-free survival, HR [95% CI], 2.15 [1.01, 4.59]). However, we found no association between the expression of miR-766-3p in tissue and ESCC prognosis. In vitro results showed that miR-766-3p promotes cell migration and invasion, but not cell proliferation. By using dual-luciferase reporter assay, HOXA13 was confirmed as a direct target gene of miR-766-3p. The ESCC patients with highly expressed serum exosomal miR-766-3p had a significantly worse survival. Therefore, serum exosomal miR-766-3p could serve as a prognostic marker for the assessment of ESCC.
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http://dx.doi.org/10.1111/cas.14550DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540979PMC
October 2020

Influence of Mass and Social Media on Psychobehavioral Responses Among Medical Students During the Downward Trend of COVID-19 in Fujian, China: Cross-Sectional Study.

J Med Internet Res 2020 07 20;22(7):e19982. Epub 2020 Jul 20.

Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.

Background: An extensive amount of information related to the novel coronavirus (COVID-19) pandemic was disseminated by mass and social media in China. To date, there is limited evidence on how this infodemic may influence psychobehavioral responses to the crisis.

Objective: The aim of this study is to assess the psychobehavioral responses to the COVID-19 outbreak and examine their associations with mass and social media exposure.

Methods: A cross-sectional study among medical and health sciences students from the Fujian Medical University in Fuzhou, China, was conducted between April 6-22, 2020.

Results: A total of 2086 completed responses were received. Multivariable analyses demonstrated that four constructs of the Health Belief Model (HBM)-higher perception of susceptibility (odds ratio [OR] 1.44; 95% CI 1.07-1.94), severity (OR 1.32; 95% CI 1.10-1.59), self-efficacy (OR 1.61; 95% CI 1.21-2.15), and perceived control or intention to carry out prevention measures (OR 1.32; 95% CI 1.09-1.59)-were significantly associated with a higher mass media exposure score, whereas only three constructs-higher perception of severity (OR 1.43; 95% CI 1.19-1.72), self-efficacy (OR 1.85; 95% CI 1.38-2.48), and perceived control or intention to carry out prevention measures (OR 1.32; 95% CI 1.08-1.58)-were significantly associated with a higher social media exposure score. Lower emotional consequences and barriers to carry out prevention measures were also significantly associated with greater mass and social media exposure. Our findings on anxiety levels revealed that 38.1% (n=795; 95% CI 36.0-40.2) of respondents reported moderate-to-severe anxiety. A lower anxiety level was significantly associated with higher mass and social media exposure in the univariable analyses; however, the associations were not significant in the multivariable analyses.

Conclusions: In essence, both mass and social media are useful means of disseminating health messages and contribute to the betterment of psychobehavioral responses to COVID-19. Our findings stress the importance of the credibility of information shared through mass and social media outlets and viable strategies to counter misinformation during a pandemic.
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http://dx.doi.org/10.2196/19982DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373377PMC
July 2020

Knowledge, Attitudes, Impact, and Anxiety Regarding COVID-19 Infection Among the Public in China.

Front Public Health 2020 27;8:236. Epub 2020 May 27.

Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Sufficient knowledge and positive attitudes are crucial to the prevention of COVID-19. However, little is known about public awareness and attitudes regarding COVID-19 in China. The impact of COVID-19 on the societal well-being and anxiety levels of the public has never been documented. The aim of this study was to survey the knowledge, attitudes, impact, and anxiety levels of the people of China in relation to the COVID-19 outbreak. A cross-sectional population survey using an online questionnaire was undertaken between Jan 24 and Feb 24, 2020. The study participants were residents of mainland China over the age of 18 years. The attitude items in this study measured the perceived threat of COVID-19 based on the Health Belief Model. Anxiety was measured with the State-Trait Anxiety Inventory (STAI), a self-reported questionnaire that measure both state (STAI-S), and trait anxiety (STAI-T) A total of 2,446 completed responses were received. The mean and standard deviation (SD) for the total knowledge score was 20.3 ( ± 2.9) out of a possible score of 23. The social disruption and household economic impact were notable, particularly in provinces with higher cumulative confirmed cases. The majority of responses indicated a low perceived susceptibility of being infected (86.7% [95%CI 85.4-88.1]), with a fair proportion of respondents perceiving a higher severity (62.9% [95% CI 61.0-64.8]). The mean total impact score was 9.9 ( ± 3.8) out of a possible score of 15. The mean score for STAI-S was 48.7 ( ± 10.8), whereas the mean STAI-T score was 45.7 ( ± 8.5). By demographics, women reported significantly higher odds for higher levels of both STAI-S ( = 1.67) and STAI-T ( = 1.30) compared to men. People of a younger age were also more likely to experience higher STAI-S and STAI-T. Higher perceived susceptibility and severity and impact were strong predictors of higher levels of STAI-S and STAI-T. Our findings can assist in tailoring public communication to change people's knowledge and attitudes. The present study also underlined the importance of the promotion of mental health during infectious disease outbreaks to help in moderating the perceived threat, social and household economic impact, targeting the vulnerable segment of the population.
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http://dx.doi.org/10.3389/fpubh.2020.00236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266871PMC
January 2021

Multidimensional social and cultural norms influencing HPV vaccine hesitancy in Asia.

Hum Vaccin Immunother 2020 07 19;16(7):1611-1622. Epub 2020 May 19.

Department of Pediatrics, School of Medicine, Indiana University , Indianapolis, IN, U.S.

HPV vaccine hesitancy in Asia is unique compared to Western countries due to multidimensional social-cultural norms that influence beliefs regarding vaccination. Reviews on HPV vaccine hesitancy in Asia lack of in-depth discussion regarding the traditional and social-cultural norms dimensions. This paper puts forward opinions in which culture, normative beliefs, and religion influence HPV vaccine hesitancy in Asian countries. Issues surrounding HPV hesitancy among parents, young adult women, adult women, men and the sexual and gender minority people in Asian countries were highlighted. The shortage of HPV vaccine supply would soon be reduced as some Asian countries are on the way to producing the HPV vaccine which production is currently dominated by Western European countries. The culture of favoring imported Western products among many in Asia and in addition to long-existing fake vaccine crisis pose a challenge for the newly emerging HPV vaccine produced in Asia. Some recommendations, research gaps, and future research needs were discussed.
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http://dx.doi.org/10.1080/21645515.2020.1756670DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482900PMC
July 2020

Chinese mothers' intention to vaccinate daughters against human papillomavirus (HPV), and their vaccine preferences: a study in Fujian Province.

Hum Vaccin Immunother 2021 Jan 13;17(1):304-315. Epub 2020 May 13.

Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia.

Little is known regarding Chinese mothers' intention to vaccinate their daughters against human papillomavirus (HPV) since the HPV vaccine was approved for use in China in 2016. The aim was to explore maternal HPV vaccination acceptance, preference for 2-, 4- or 9-valent HPV vaccine and acceptance of domestically manufactured HPV vaccines. Study participants were mothers of primary school children in Southeastern region of Fujian. An online cross-sectional survey was undertaken between June and August 2019. Among the total of 3,586 completed responses (response rate 28.5%), the intention to vaccinate daughter against HPV was high (83.3%). Higher maternal education and perceived benefit and barriers were associated with greater intention to vaccinate. Among mothers who did not intend to vaccinate their daughters, the three most common reasons were daughter being too young to receive HPV vaccination (40.6%), fear of side effects (31.9%) and vaccine price is too high (16.0%). The largest proportion (41.4%) preferred their daughter to be vaccinated with the 9-valent HPV vaccine (9vHPV). Greater preference for 9vHPVwas strongly associated with higher maternal education level and annual household income. The majority of mothers expressed a preference for imported HPV vaccine (56.3%). Our result indicates that lower intentions to vaccinate daughters against HPV among less educated and lower-income mothers may lead to significant social inequalities in HPV vaccine uptake in the country.
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http://dx.doi.org/10.1080/21645515.2020.1756152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872083PMC
January 2021

Risk Factors of Esophageal Squamous Cell Cancer Specific for Different Macroscopic Types.

Nutr Cancer 2020 11;72(8):1336-1344. Epub 2020 Mar 11.

Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China.

To further explore risk factors of esophageal squamous cell cancer specific for different macroscopic types. A total of 423 patients and 423 age (±3 years) and gender matched controls were recruited. Multinomial logistic regression and multivariable logistic regression analysis were used to evaluate the risk factors of ESCC specific for different macroscopic types. In this study, we found that drinking hot tea (OR = 1.98, 95% CI:1.14-3.43) and higher intake of hard food (OR = 1.64, 95% CI:1.05-2.58) positively associated with ulcerative type of ESCC, but not with medullary type or other types. Although alcohol drinking and lower intake of fresh vegetable appeared to be more harmful to the ulcerative-type ESCC, the discrepant risks were not significantly different in ulcerative type and medullary type. Moreover, tobacco smoking, intake of hot food, spicy food, fresh fruit, scallion and garlic were related to ESCC risk, whereas no significant difference in magnitude of their associations with respect to macroscopic type was observed. Furthermore, significant multiplicative interaction between tobacco smoking and alcohol drinking was found in ulcerative-type and medullary-type ESCC. Drinking hot tea and higher intake of hard food were associated with increased risk of ulcerative type of ESCC. However, the mechanism for this difference needs to be further studied.
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http://dx.doi.org/10.1080/01635581.2020.1733623DOI Listing
March 2020

HPV vaccination intent and willingness to pay for 2-,4-, and 9-valent HPV vaccines: A study of adult women aged 27-45 years in China.

Vaccine 2020 03 29;38(14):3021-3030. Epub 2020 Feb 29.

Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. Electronic address:

Objective: This study aims to investigate acceptance and willingness to pay for HPV vaccination among adult women in China.

Methods: An online survey was sent to mothers aged 27-45 years of primary school pupils in the Fujian province, China. Participants completed questions about HPV related knowledge and health beliefs, intention to take the HPV vaccine and the willingness to pay for bivalent vaccine (2vHPV), quadrivalent vaccine (4vHPV), and 9-valent HPV vaccine (9vHPV).

Results: Of a total of 2339 complete responses, 58.3% reported intent to obtain HPV vaccine. Mothers who were younger in age, residing in urban, working in managerial or professional occupations, who knew someone with cervical cancer and who were able to make independent decisions about the HPV vaccine (vs. joint decision with spouse) were more likely to express intent to have HPV vaccination. Perceived barriers, cues to action and self-efficacy were three of the constructs in the health belief model that significantly influenced HPV vaccination intent. A higher proportion of participants expressed willingness to pay for 2vHPV (81.2%) and 4vHPV (75.9%), as compared to 9vHPV (67.7%).

Conclusion: Adults women expressed moderate intention to receive the HPV vaccine. Intervention to address barriers to uptake of the HPV vaccine among adult women in China is warranted.
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http://dx.doi.org/10.1016/j.vaccine.2020.02.042DOI Listing
March 2020

Time intervals and routes to diagnosis for lung cancer in 10 jurisdictions: cross-sectional study findings from the International Cancer Benchmarking Partnership (ICBP).

BMJ Open 2019 11 27;9(11):e025895. Epub 2019 Nov 27.

Centre for Population Health Sciences, Edinburgh University, Edinburgh, UK.

Objective: Differences in time intervals to diagnosis and treatment between jurisdictions may contribute to previously reported differences in stage at diagnosis and survival. The International Cancer Benchmarking Partnership Module 4 reports the first international comparison of routes to diagnosis and time intervals from symptom onset until treatment start for patients with lung cancer.

Design: Newly diagnosed patients with lung cancer, their primary care physicians (PCPs) and cancer treatment specialists (CTSs) were surveyed in Victoria (Australia), Manitoba and Ontario (Canada), Northern Ireland, England, Scotland and Wales (UK), Denmark, Norway and Sweden. Using Wales as the reference jurisdiction, the 50th, 75th and 90th percentiles for intervals were compared using quantile regression adjusted for age, gender and comorbidity.

Participants: Consecutive newly diagnosed patients with lung cancer, aged ≥40 years, diagnosed between October 2012 and March 2015 were identified through cancer registries. Of 10 203 eligible symptomatic patients contacted, 2631 (27.5%) responded and 2143 (21.0%) were included in the analysis. Data were also available from 1211 (56.6%) of their PCPs and 643 (37.0%) of their CTS.

Primary And Secondary Outcome Measures: Interval lengths (days; primary), routes to diagnosis and symptoms (secondary).

Results: With the exception of Denmark (-49 days), in all other jurisdictions, the median adjusted total interval from symptom onset to treatment, for respondents diagnosed in 2012-2015, was similar to that of Wales (116 days). Denmark had shorter median adjusted primary care interval (-11 days) than Wales (20 days); Sweden had shorter (-20) and Manitoba longer (+40) median adjusted diagnostic intervals compared with Wales (45 days). Denmark (-13), Manitoba (-11), England (-9) and Northern Ireland (-4) had shorter median adjusted treatment intervals than Wales (43 days). The differences were greater for the 10% of patients who waited the longest. Based on overall trends, jurisdictions could be grouped into those with trends of reduced, longer and similar intervals to Wales. The proportion of patients diagnosed following presentation to the PCP ranged from 35% to 75%.

Conclusion: There are differences between jurisdictions in interval to treatment, which are magnified in patients with lung cancer who wait the longest. The data could help jurisdictions develop more focused lung cancer policy and targeted clinical initiatives. Future analysis will explore if these differences in intervals impact on stage or survival.
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http://dx.doi.org/10.1136/bmjopen-2018-025895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886977PMC
November 2019

Factors influencing intention to obtain the HPV vaccine and acceptability of 2-, 4- and 9-valent HPV vaccines: A study of undergraduate female health sciences students in Fujian, China.

Vaccine 2019 10 20;37(44):6714-6723. Epub 2019 Sep 20.

Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. Electronic address:

Background: Little research has been conducted on the intention to obtain HPV vaccine now that the vaccine is approved for use in China. Acceptance of the three HPV vaccines, which differ in valency and price, has never been investigated.

Methods: An online cross-sectional survey assessing female undergraduate students' intention to obtain the HPV vaccine and their acceptability of 2-, 4- and 9-valent HPV vaccines (2vHPV, 4vHPV, and 9vHPV, respectively).

Results: Of a total of 997 complete responses, 55.2% reported intent to obtain the HPV vaccine. Some of the significant factors exerting influence on intent to obtain HPV vaccination were high knowledge score (OR = 1.469, 95% CI:1.087-1.987), perceived high risk of HPV infection (OR = 1.466, 95%CI:1.017-2.114), perception of no serious side effects (OR = 1.562, 95%CI:1.150-2.121), and mass media exposure to HPV vaccination information (OR = 2.196, 95%CI: 1.625-2.966). Socioeconomic status indicators did not significantly influence intent to obtain the HPV vaccine. A higher proportion of respondents were willing to pay for 2vHPV (78.6%) and 4vHPV (68.0%) compared with 9vHPV (49.3%). Socioeconomic status indicators were the strongest correlates of acceptability for all the three vaccines. Exposure to mass media reporting about HPV vaccination is the factor which exerts the most influence on acceptance of 9vHPV after socioeconomic status indicators.

Conclusions: It is important to improve knowledge and health beliefs, and to establish a mass media marketing strategy to promote HPV vaccination in order to enhance HPV vaccine uptake. Undergraduate female students should be provided with detailed information about the different valency vaccine choices to help them make informed decisions about immunization.
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http://dx.doi.org/10.1016/j.vaccine.2019.09.026DOI Listing
October 2019

Prevalence of Cardiovascular Disease Among the Cancer Mortality Population Between 1969 and 2008 in the United States.

Popul Health Manag 2019 12 18;22(6):556-557. Epub 2019 Jul 18.

School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

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http://dx.doi.org/10.1089/pop.2019.0064DOI Listing
December 2019

Sociodemographic and Lifestyle Factors in Relation to Gastric Cancer in a High-Risk Region of China: A Matched Case-Control Study.

Nutr Cancer 2020 15;72(3):421-430. Epub 2019 Jul 15.

Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, China.

To explore the role of sociodemographic and lifestyle factors in the development of gastric cancer in a high-risk region of China. In a case-control study, all newly diagnosed patients with gastric cancer were compared with healthy controls matched (1:1) by sex, age (±3 years), and place of residence during 2013-2017. A total of 622 gastric cancer and 622 healthy controls were included. Larger household size (>4 family members) appeared to decrease gastric cancer risk for -negative ones (odd ratio = 0.43, 95% CI = 0.26-0.70). Similarly, longer refrigerator ownership was associated with a 67% decreased risk in -negative group (95% CI = 0.15-0.77). Participants with a family history of gastric cancer had nearly fivefold higher risk (odd ratio = 4.88, 95% CI = 2.49-9.55). Smoking attributed to 83% increased risk (odd ratio = 1.83, 95% CI = 1.19-2.80). Tea consumption dramatically decreased risk in whole study population (odd ratio = 0.28, 95% CI = 0.17-0.45). In summary, family history, smoking, -related chronic atrophic gastritis, and infection were positively associated with gastric cancer. Whereas, tea consumption and refrigerator use negatively associated with gastric cancer and could be promoted to reduce gastric cancer rate in high-risk populations, especially in the developing regions.
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http://dx.doi.org/10.1080/01635581.2019.1638425DOI Listing
December 2020

Risk Factors of Gastric Cancer in High-Risk Region of China: A Population-Based Case-control Study

Asian Pac J Cancer Prev 2019 Mar 26;20(3):775-781. Epub 2019 Mar 26.

Fujian Xianyou Hospital, Putian, China.

Background: The reason for the high incidence of gastric cancer (GC) in Xianyou County of China was largely unknown. We aimed to explore the potential sociodemographic risk factors and their associations to GC. Methods: A population-based case-control study was conducted during March 2013 and April 2016 in Xianyou County. All newly diagnosed patients of GC were recruited as cases, while controls were selected by matching for cases’ sex, age (± 3 years) and the place of residence. Results: A total of 523 GC cases and 523 matched healthy controls were included in the final analysis with mean age of 66.27±8.81 years for cases and 66.31±8.83 years for controls, respectively. Participants with low socioeconomic status were observed with higher GC risk compared to those in high socioeconomic status (adjusted OR=2.10, 95% CI: 1.13-3.89). Compared to those regularly drink green tea, patients did not have this dietary habit had nearly 3-fold increased GC risk (adjusted OR=2.91, 95% CI: 1.38-6.13). Other dietary habit, including consumption of hard food, omission of breakfast, consumption of pickled vegetables 30 years ago, overeating were all associated with increased risk of GC. Interaction effect were found. Patients in low socioeconomic status and skipped breakfast had 10-fold higher risk of GC compared to reference group in high socioeconomic status and eat breakfast regularly (OR=10.71, 95% CI: 5.19-22.10). Furthermore, patients in low socioeconomic status and consumed pickled vegetable 30 years ago had 6-fold higher risk of GC compared to those in high socioeconomic status but did not intake pickled vegetables 30 years ago (OR=6.11, 95% CI: 3.87-9.66). Conclusion: High incidence of GC risk in Xianyou County might be partly attributed to various sociodemographic factors. Specific prevention effort could be target on population in low socioeconomic status combined with habit of breakfast omission or intake of pickled vegetables.
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http://dx.doi.org/10.31557/APJCP.2019.20.3.775DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825772PMC
March 2019

Impact of variation in cancer registration practice on observed international cancer survival differences between International Cancer Benchmarking Partnership (ICBP) jurisdictions.

Cancer Epidemiol 2019 02 9;58:184-192. Epub 2019 Jan 9.

National Disease Registration, Public Health England, England, UK. Electronic address:

Background: International cancer survival comparisons use cancer registration data to report cancer survival, which informs the development of cancer policy and practice. Studies like the International Cancer Benchmarking Partnership (ICBP) have a duty to understand how registration differences impact on survival prior to drawing conclusions.

Methods: Key informants reported differences in registration practice for capturing incidence date, death certificate case handling and registration of multiple primary tumours. Sensitivity analyses estimated their impact on one-year survival using baseline and supplementary cancer registration data from England and Sweden.

Results: Variations in registration practice accounted for up to a 7.3 percentage point difference between unadjusted (estimates from previous ICBP survival data) and adjusted (estimates recalculated accounting for registration differences) one-year survival, depending on tumour site and jurisdiction. One-year survival estimates for four jurisdictions were affected by adjustment: New South Wales, Norway, Ontario, Sweden. Sweden and Ontario's survival reduced after adjustment, yet they remained the jurisdictions with the highest survival for breast and ovarian cancer respectively. Sweden had the highest unadjusted lung cancer survival of 43.6% which was adjusted to 39.0% leaving Victoria and Manitoba with the highest estimate at 42.7%. For colorectal cancer, Victoria's highest survival of 85.1% remained unchanged after adjustment.

Conclusion: Population-based cancer survival comparisons can be subject to registration biases that may impact the reported 'survival gap' between populations. Efforts should be made to apply consistent registration practices internationally. In the meantime, survival comparison studies should provide acknowledgement of or adjustment for the registration biases that may affect their conclusions.
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http://dx.doi.org/10.1016/j.canep.2018.10.019DOI Listing
February 2019

Diagnostic routes and time intervals for patients with colorectal cancer in 10 international jurisdictions; findings from a cross-sectional study from the International Cancer Benchmarking Partnership (ICBP).

BMJ Open 2018 11 27;8(11):e023870. Epub 2018 Nov 27.

Research Unit for General Practice, Aarhus University, Aarhus, Denmark.

Objective: International differences in colorectal cancer (CRC) survival and stage at diagnosis have been reported previously. They may be linked to differences in time intervals and routes to diagnosis. The International Cancer Benchmarking Partnership Module 4 (ICBP M4) reports the first international comparison of routes to diagnosis for patients with CRC and the time intervals from symptom onset until the start of treatment. Data came from patients in 10 jurisdictions across six countries (Canada, the UK, Norway, Sweden, Denmark and Australia).

Design: Patients with CRC were identified via cancer registries. Data on symptomatic and screened patients were collected; questionnaire data from patients' primary care physicians and specialists, as well as information from treatment records or databases, supplemented patient data from the questionnaires. Routes to diagnosis and the key time intervals were described, as were between-jurisdiction differences in time intervals, using quantile regression.

Participants: A total of 14 664 eligible patients with CRC diagnosed between 2013 and 2015 were identified, of which 2866 were included in the analyses.

Primary And Secondary Outcome Measures: Interval lengths in days (primary), reported patient symptoms (secondary).

Results: The main route to diagnosis for patients was symptomatic presentation and the most commonly reported symptom was 'bleeding/blood in stool'. The median intervals between jurisdictions ranged from: 21 to 49 days (patient); 0 to 12 days (primary care); 27 to 76 days (diagnostic); and 77 to 168 days (total, from first symptom to treatment start). Including screen-detected cases did not significantly alter the overall results.

Conclusion: ICBP M4 demonstrates important differences in time intervals between 10 jurisdictions internationally. The differences may justify efforts to reduce intervals in some jurisdictions.
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http://dx.doi.org/10.1136/bmjopen-2018-023870DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278806PMC
November 2018

Correction to a posterior versus anterior debridement in combination with bone graft and internal fixation for lumbar and thoracic tuberculosis.

J Orthop Surg Res 2018 May 1;13(1):103. Epub 2018 May 1.

Department of Spinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian, China.

In the original publication of this article (1) was an incorrect funding number published. The correct version can be found below.
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http://dx.doi.org/10.1186/s13018-018-0790-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928578PMC
May 2018

Combining Fourier phase encoding and broadband inversion toward J-edited spectra.

J Magn Reson 2018 Jun 20;291:1-7. Epub 2018 Mar 20.

Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, State Key Laboratory of Physical Chemistry of Solid Surfaces, Xiamen University, Xiamen 361005, China.

Nuclear magnetic resonance (NMR) spectra are often utilized for gathering accurate information relevant to molecular structures and composition assignments. In this study, we develop a homonuclear encoding approach based on imparting a discrete phase modulation of the targeted cross peaks, and combine it with a pure shift experiments (PSYCHE) based J-modulated scheme, providing simple 2D J-edited spectra for accurate measurement of scalar coupling networks. Chemical shifts and J coupling constants of protons coupled to the specific protons are demonstrated along the F and F dimensions, respectively. Polychromatic pulses by Fourier phase encoding were performed to simultaneously detect several coupling networks. Proton-proton scalar couplings are chosen by a polychromatic pulse and a PSYCHE element. Axis peaks and unwanted couplings are complete eradicated by incorporating a selective COSY block as a preparation period. The theoretical principles and the signal processing procedure are laid out, and experimental observations are rationalized on the basis of theoretical analyses.
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http://dx.doi.org/10.1016/j.jmr.2018.02.021DOI Listing
June 2018

DcR3, a new biomarker for sepsis, correlates with infection severity and procalcitonin.

Oncotarget 2018 Feb 28;9(13):10934-10944. Epub 2017 Dec 28.

Fujian Key Laboratory of Individualized Active Immunotherapy, Fuzhou 350005, China.

Early diagnosis of sepsis is critical for successful treatment. The clinical value of DcR3 in early diagnosis of sepsis was determined in a dynamic follow-up study. Alterations in plasma levels of DcR3, PCT, CRP, and IL-6 were measured by ELISA and compared among patients with sepsis ( = 134), SIRS ( = 60) and normal adults ( = 50). Correlations and dynamic patterns among the biomarkers, APACHE II scores, clinical outcomes, and pathogens were also examined. Plasma DcR3 was significantly increased in sepsis compared to SIRS and normal adults (median 3.87 1.28 and 0.17 ng/ml). The elevated DcR3 could be detected in 97.60% sepsis patients 1-2 days prior to the result of blood culture reported. For diagnosis of sepsis, the sensitivity was 97.69% and specificity 98.04%; and for differential diagnosis of sepsis from SIRS, the sensitivity was 90.77% and specificity 98.40%. DcR3 level was positively correlated with severity of sepsis ( = 0.82). In 41 patients who died of sepsis, DcR3 elevated as early as 1-2 days before blood culture and peaked on day 3 after blood culture performed. In 90% of sepsis patients, the dynamic alteration pattern of DcR3 was identical to that of PCT, while pattern of 10% patients differed in which clinical data was consistent with DcR3. In 13% sepsis patients, while PCT remained normal, DcR3 levels were at a high level. DcR3 levels had no difference among various pathogens infected. DcR3, a new biomarker, will aid in early diagnosis of sepsis and monitoring its outcome, especially when sepsis patients were PCT negative.
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http://dx.doi.org/10.18632/oncotarget.23736DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834251PMC
February 2018

Investigation of the international comparability of population-based routine hospital data set derived comorbidity scores for patients with lung cancer.

Thorax 2018 04 27;73(4):339-349. Epub 2017 Oct 27.

National Cancer Registration and Analysis Service, Skipton House, Public Health England, London, UK.

Introduction: The International Cancer Benchmarking Partnership (ICBP) identified significant international differences in lung cancer survival. Differing levels of comorbid disease across ICBP countries has been suggested as a potential explanation of this variation but, to date, no studies have quantified its impact. This study investigated whether comparable, robust comorbidity scores can be derived from the different routine population-based cancer data sets available in the ICBP jurisdictions and, if so, use them to quantify international variation in comorbidity and determine its influence on outcome.

Methods: Linked population-based lung cancer registry and hospital discharge data sets were acquired from nine ICBP jurisdictions in Australia, Canada, Norway and the UK providing a study population of 233 981 individuals. For each person in this cohort Charlson, Elixhauser and inpatient bed day Comorbidity Scores were derived relating to the 4-36 months prior to their lung cancer diagnosis. The scores were then compared to assess their validity and feasibility of use in international survival comparisons.

Results: It was feasible to generate the three comorbidity scores for each jurisdiction, which were found to have good content, face and concurrent validity. Predictive validity was limited and there was evidence that the reliability was questionable.

Conclusion: The results presented here indicate that interjurisdictional comparability of recorded comorbidity was limited due to probable differences in coding and hospital admission practices in each area. Before the contribution of comorbidity on international differences in cancer survival can be investigated an internationally harmonised comorbidity index is required.
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http://dx.doi.org/10.1136/thoraxjnl-2017-210362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870453PMC
April 2018

A posterior versus anterior debridement in combination with bone graft and internal fixation for lumbar and thoracic tuberculosis.

J Orthop Surg Res 2017 Oct 16;12(1):150. Epub 2017 Oct 16.

Department of Spinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China.

Background: Surgery treatment is usually required for spinal tuberculosis. The aim of this study was to compare the clinical efficacy and outcomes of anterior and posterior surgical approach in combination with debridement, bone grafting, and internal fixation.

Methods: All patients with thoracic and lumbar tuberculosis who underwent either the anterior or posterior surgery in combination with debridement, bone grafting, and internal fixation from August 2009 to August 2016 were reviewed retrospectively.

Results: A total of 186 patients were recruited in the analyses, 37 of whom received the anterior approach and 149 treated with the posterior approach. In the entire study population, there was no statistically significant difference between the groups in terms of kyphosis Cobb's angle, VAS pain score, neurological status, operation duration, perioperative blood loss, and hospitalization days (p > 0.05). Good clinical outcomes were achieved in both treatment groups. In lumbar vertebra-affected patients, the average preoperative kyphosis Cobb's angle was 8.7 ± 16.6° and - 5.6 ± 16.0° for the anterior and posterior groups, respectively, which were corrected to - 3.3 ± 13.2° and - 10.1 ± 13.8° after surgery. For thoracic vertebra-affected patients, the corrected kyphosis Cobb's angle was 8.1 ± 9.7° and 10.3 ± 6.5°, respectively. After surgery, 32.4% of patients in the anterior group and 48.3% of patients in the posterior group claimed no pain (p = 0.24), while 83.8 and 85.9% recovered to Frankel grade E, respectively (p = 0.85).

Conclusions: The posterior debridement joint bone graft and internal fixation is an alternative procedure to treat lumbar and thoracic tuberculosis compared to the traditional anterior approach with similar clinical efficacy in terms of pain control, Cobb's angle, and neurological function. The posterior approach is sufficient for lesion debridement.
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http://dx.doi.org/10.1186/s13018-017-0650-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644256PMC
October 2017

A discrete Fourier-encoded, diagonal-free experiment to simplify homonuclear 2D NMR correlations.

J Chem Phys 2017 Jul;147(3):034201

Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, State Key Laboratory of Physical Chemistry of Solid Surfaces, Xiamen University, Xiamen 361005, China.

Nuclear magnetic resonance (NMR) spectroscopy has long served as an irreplaceable, versatile tool in physics, chemistry, biology, and materials sciences, owing to its ability to study molecular structure and dynamics in detail. In particular, the connectivity of chemical sites within molecules, and thereby molecular structure, becomes visible by multi-dimensional NMR. Homonuclear correlation experiments are a powerful tool for identifying coupled spins. Generally, diagonal peaks in these correlation spectra display the strongest intensities and do not offer any new information beyond the standard one-dimensional spectrum, whereas weaker, symmetrically placed cross peaks contain most of the coupling information. The cross peaks near the diagonal are often affected by the tails of strong diagonal peaks or even obscured entirely by the diagonal. In this paper, we demonstrate a homonuclear encoding approach based on imparting a discrete phase modulation of the targeted cross peaks and combine it with a site-selective sculpting scheme, capable of simplifying the patterns arising in these 2D correlation spectra. The theoretical principles of the new methods are laid out, and experimental observations are rationalized on the basis of theoretical analyses. The ensuing techniques provide a new way to retrieve 2D coupling information within homonuclear spin systems, with enhanced sensitivity, speed, and clarity.
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http://dx.doi.org/10.1063/1.4990541DOI Listing
July 2017