肺炎支原体感染流行病学及耐药状况的研究进展

肺炎支原体是呼吸道感染病原之一,是引起儿童获得性肺炎常见的病原体。学龄期前和学龄期的儿童是易感人群,感染后多见社区获得性肺炎。但是由于地理位置、气候和性别的差异,在同一季节不同地区的儿童肺炎支原体感染的流行特征也存在差异。近年来重症及难治性肺炎支原体肺炎相关报道逐渐增多,耐药菌株的出现造成了治疗的困难。肺炎支原体感染除了引起呼吸道疾病外,还会引发神经系统和消化系统疾病等并发症。本文就肺炎支原体的病原生物学特征、流行病学特征、耐药状况等作一综述。     

Prevalence rates of helmet use among motorcycle riders in a developed region in China

This study aimed to determine the prevalence rates of helmet use, and of correct helmet use (chinstrap firmly fastened) among motorcycle riders and their passengers in Zhongshan, Guangdong Province, China. A cross-sectional survey involving direct observation of motorcycle riders was conducted at 20 randomly selected intersections. A total of 13,410 motorcycles were observed during a 10-day period in February 2009. The overall prevalence of helmet use was 72.6% (95% CI: 71.8–73.3%) among drivers and 34.1% (95% CI: 32.7–35.5%) among pillion passengers. The prevalence of correct use was 43.2% (95% CI: 42.4–44.0%) and 20.9% (95% CI: 19.8–22.1%) for drivers and passengers respectively. The helmet wearing rate on city streets was almost 95%, however city riders were more likely than rural riders to wear non-motorcycle helmets while riding. In multivariate analyses, factors associated with increased helmet use included riding on city streets, male gender, being a driver, carrying less passengers and riding a registered motorcycle. The results indicated enforcement and education activities need to be strengthened with respect to both helmet use and helmet quality, especially in rural areas, in order to improve wearing rates.     

Short and long sleep duration and risk of drowsy driving and the role of subjective sleep insufficiency

Experimental sleep restriction increases sleepiness and impairs driving performance. However, it is unclear whether short sleep duration in the general population is associated with drowsy driving. The goal of the present study was to evaluate whether individuals in the general population who obtained sleep of 6 h or less are more likely to report drowsy driving, and evaluate the role of perceived sleep sufficiency. Data exploring whether subgroups of short sleepers (those who report the most or least unmet sleep need) show different risk profiles for drowsy driving are limited. From the 2009 Behavioral Risk Factor Surveillance System (N = 31,522), we obtained the following self-reported data: (1) sleep duration (≤5, 6, 7, 8, 9, or ≥10 h/night); (2) number of days/week of perceived insufficient sleep; (3) among drivers, yes/no response to: “During the past 30 days, have you ever nodded off or fallen asleep, even just for a brief moment, while driving?” (4) demographics, physical/mental health. Using 7 h/night as reference, logistic regression analyses evaluated whether self-reported sleep duration was associated with drowsy driving. Overall, 3.6% reported drowsy driving. Self-identified short-sleepers reported drowsy driving more often, and long sleepers, less often. Among those who perceived sleep as always insufficient, drowsy driving was reported more often when sleep duration was ≤5 h, 6 h, or ≥10 h. Among those who perceived sleep as always sufficient, drowsy driving was reported more often among ≤5 h and 6 h sleepers. Overall, drowsy driving was common, particularly in self-identified short-sleepers as a whole, as well as subgroups based on sleep insufficiency.     

Alcohol-related traffic accidents with fatal outcomes in the city of Sao Paulo

Aims

The aims of the present study were to characterize fatal traffic accident victims in a major urban center in Brazil and their association with alcohol consumption.

Methods

Cross-sectional study of 907 fatal traffic accident victims in Sao Paulo, in 2005.

Results

Adult males between the ages of 25 and 54 represented the majority of cases with positive blood alcohol concentrations (BAC). Overall, males had a higher proportion of BAC and mean BAC than females. Pedestrians, particularly those with no detectable BAC, were typically older than other victims. Most accidents (total and BAC-positive) happened on weekends between midnight and 6 a.m. Considering all victims, 39.4% were positive (BAC over 0.1 g/l). When only drivers (automobile, motorcycle and bicycle) were evaluated, 42.3% had BAC over the legal limit (0.6 g/l).

Conclusions

Alcohol is associated with nearly half of all traffic accident deaths in the city of Sao Paulo, especially for days and times associated with parties and bars (weekends between 12 a.m. and 6 a.m.).     

Modifiable lifestyle risk factors for dry eye disease

PurposeTo examine the association between modifiable lifestyle factors and dry eye disease.MethodsThree hundred and twenty-two community residents (186 females, 136 males; mean ± SD age, 41 ± 22 years) with no major systemic or ophthalmic conditions (other than dry eye disease) were recruited in a cross-sectional study. A lifestyle factor questionnaire was administered, and dry eye symptomology, ocular surface characteristics, and tear film quality were evaluated for each participant within a single clinical session, in accordance with the global consensus recommendations of the TFOS DEWS II reports.ResultsA total of 111 (34 %) participants fulfilled the TFOS DEWS II diagnostic criteria for dry eye disease. Multivariate regression analysis demonstrated that advancing age, female sex, East Asian ethnicity, and increased digital screen exposure time were positive risk factors for dry eye disease (all p < 0.05), while increased caffeine consumption was a protective factor (p = 0.04).ConclusionsIncreased digital screen exposure time and reduced caffeine consumption were modifiable lifestyle factors associated with higher odds of dry eye disease. These findings might contribute to informing the design of future prospective research investigating the efficacy of preventative intervention and risk factor modification strategies.     

Systemic,environmental and lifestyle risk factors for dry eye disease in a mediterranean caucasian population

ObjectivesTo assess systemic, environmental and lifestyle risk factors for dry eye disease (DED) in a Mediterranean Caucasian population.MethodsA cross-sectional study was performed on 120 Caucasian participants aged between 18 and 89 years (47.0 ± 22.8 years). Medical history, information regarding environmental conditions and lifestyle, Ocular Surface Disease Index, Dry Eye Questionnaire-5, non-Invasive (Oculus Keratograph 5 M) breakup time, tear film osmolarity and ocular surface staining parameters were assessed in a single clinical session to allow DED diagnosis based on the guidelines of the Tear Film and Ocular Surface Society Dry Eye Workshop II Diagnostic Methodology Report. A multivariate logistic regression model was constructed including those variables with a p-value less than 0.15 in the univariate analysis.ResultsA prevalence of 57.7 % for DED was found. No age differences were found between those with and without DED (U = 1886.5, p = 0.243). Nevertheless, the DED group had more females (X² = 7.033, p = 0.008). The univariate logistic regression identified as potential risk factors for DED the following: female sex, sleep hours per day, menopause, anxiety, systemic rheumatologic disease, use of anxiolytics, daily medication, ocular surgery, poor diet quality, more ultra-processed food in diet, not drinking caffeine and hours of exposure to air conditioning per day. Multivariate logistic regression revealed that hours of sleep per day, menopause and use of anxiolytics were independently associated with DED (p ≤ 0.026 for all).ConclusionsDED is associated with systemic, environmental and lifestyle risk factors. These findings are useful to identify potentially modifiable risk factors, in addition to conventional treatments for DED.     

Structural identifiability and observability of compartmental models of the COVID-19 pandemic

The recent coronavirus disease (COVID-19) outbreak has dramatically increased the public awareness and appreciation of the utility of dynamic models. At the same time, the dissemination of contradictory model predictions has highlighted their limitations. If some parameters and/or state variables of a model cannot be determined from output measurements, its ability to yield correct insights – as well as the possibility of controlling the system – may be compromised. Epidemic dynamics are commonly analysed using compartmental models, and many variations of such models have been used for analysing and predicting the evolution of the COVID-19 pandemic. In this paper we survey the different models proposed in the literature, assembling a list of 36 model structures and assessing their ability to provide reliable information. We address the problem using the control theoretic concepts of structural identifiability and observability. Since some parameters can vary during the course of an epidemic, we consider both the constant and time-varying parameter assumptions. We analyse the structural identifiability and observability of all of the models, considering all plausible choices of outputs and time-varying parameters, which leads us to analyse 255 different model versions. We classify the models according to their structural identifiability and observability under the different assumptions and discuss the implications of the results. We also illustrate with an example several alternative ways of remedying the lack of observability of a model. Our analyses provide guidelines for choosing the most informative model for each purpose, taking into account the available knowledge and measurements.     

Sodium nitrite: the "cure" for nitric oxide insufficiency

This process of "curing" food is a long practice that dates back thousands of years long before refrigeration or food safety regulations. Today food safety and mass manufacturing are dependent upon safe and effective means to cure and preserve foods including meats. Nitrite remains the most effective curing agent to prevent food spoilage and bacterial contamination. Despite decades of rigorous research on its safety and efficacy as a curing agent, it is still regarded by many as a toxic undesirable food additive. However, research within the biomedical science community has revealed enormous therapeutic benefits of nitrite that is currently being developed as novel therapies for conditions associated with nitric oxide (NO) insufficiency. Much of the same biochemistry that has been understood for decades in the meat industry has been rediscovered in human physiology. This review will highlight the fundamental biochemistry of nitrite in human physiology and highlight the risk benefit evaluation surrounding nitrite in food and meat products. Foods or diets enriched with nitrite can have profound positive health benefits.     

Older drivers and rapid deceleration events: Salisbury Eye Evaluation Driving Study

Drivers who rapidly change speed while driving may be more at risk for a crash. We sought to determine the relationship of demographic, vision, and cognitive variables with episodes of rapid decelerations during five days of normal driving in a cohort of older drivers. In the Salisbury Eye Evaluation Driving Study, 1425 older drivers aged 67–87 were recruited from the Maryland Motor Vehicle Administration's rolls for licensees in Salisbury, Maryland. Participants had several measures of vision tested: visual acuity, contrast sensitivity, visual fields, and the attentional visual field. Participants were also tested for various domains of cognitive function including executive function, attention, psychomotor speed, and visual search. A custom created driving monitoring system (DMS) was used to capture rapid deceleration events (RDEs), defined as at least 350 milli-g deceleration, during a five day period of monitoring. The rate of RDE per mile driven was modeled using a negative binomial regression model with an offset of the logarithm of the number of miles driven. We found that 30% of older drivers had one or more RDE during a five day period, and of those, about 1/3 had four or more. The rate of RDE per mile driven was highest for those drivers driving <59 miles during the 5-day period of monitoring. However, older drivers with RDE's were more likely to have better scores in cognitive tests of psychomotor speed and visual search, and have faster brake reaction time. Further, greater average speed and maximum speed per driving segment was protective against RDE events. In conclusion, contrary to our hypothesis, older drivers who perform rapid decelerations tend to be more “fit”, with better measures of vision and cognition compared to those who do not have events of rapid deceleration.