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36% were in the active phase, and 2.19% were in the community phase. Based on our experience, launching mass screening programs is crucial for early case detection, isolation, and pattern recognition for immediate public interventions.Objective To clarify the correlation between temperature and the COVID-19 pandemic in Hubei. Methods We collected daily newly confirmed COVID-19 cases and daily temperature for six cities in Hubei Province, assessed their correlations, and established regression models. Results For temperatures ranging from -3.9 to 16.5°C, daily newly confirmed cases were positively correlated with the maximum temperature ~0-4 days prior or the minimum temperature ~11-14 days prior to the diagnosis in almost all selected cities. An increase in the maximum temperature 4 days prior by 1°C was associated with an increase in the daily newly confirmed cases (~129) in Wuhan. The influence of temperature on the daily newly confirmed cases in Wuhan was much more significant than in other cities. Conclusion Government departments in areas where temperatures range between -3.9 and 16.5°C and rise gradually must take more active measures to address the COVID-19 pandemic.One of the most critical arenas for conflicts between parents and their children relates to food. Although parent-child conflicts about food are a real occurrence, this form of parent-child interaction has been rarely examined. Given the special role of parents in shaping children's diet, we especially focus on the impact of parental measures. This study investigates how parental communication strategies (i.e., active vs. restrictive) and feeding practices (i.e., overt control vs. covert control) affect the emergence of parent-child conflicts about food over time. Based on previous research, we assessed overt control through parents' use of food as a reward and restriction of their children's access to specific food types. We explored the impact of our predictors on both conflicts about unhealthy and healthy food with a two-wave panel study including parents and their children (N = 541; children aged between 5 and 11) in Austria between fall 2018 and spring 2019. Results of two multiple linear regressions indicated that predominantly parents' use of unhealthy food as a reward is connected to both healthy and unhealthy food conflicts. Furthermore, inconsistent parental educational styles increased the respective conflict potential. Active food-related mediation and covert control did not relate to food-related conflicts about unhealthy and healthy food. Parents' increased use of overtly controlling and restrictive feeding practices might not be only counterproductive for children's diet but also for food-related parent-child interactions. Instead, a "health discourse" (i.e., active food-related mediation) might prevent food-related conflicts and foster a healthy growth in the future.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.Lyme borreliosis (LB) is a growing epidemiological threat in many areas of the world, including North America and Europe. Due to the lack of effective protection against this disease, it seems important to ensure a timely diagnosis for effective treatment and the prevention of serious health consequences. The aim of this study was to assess the costs of diagnosis and treatment of Lyme disease in Poland. The costs incurred for the medical payer were analyzed. The cost of hospitalization due to LB for one patient in 2018 was estimated to be ~582.39 EUR, which constituted 53.10% of the average monthly salary of that year. In the analyzed period (2008-2018), the number of people treated by medical services due to Lyme disease increased, both in hospitalization and ambulatory specialist care. learn more Although, the costs of hospitalization were the highest of the two, we noticed a change ratio between hospitalization and ambulatory specialist care in favor of the latter.Background Early childhood dental care (ECDC) is a significant public health opportunity since dental caries is largely preventable and a prime target for reducing healthcare expenditures. This study aims to discover underlying patterns in ECDC utilization among Ohio Medicaid-insured children, which have significant implications for public health prevention, innovative service delivery models, and targeted cost-saving interventions. Methods Using 9 years of longitudinal Medicaid data of 24,223 publicly insured child members of an accountable care organization (ACO), Partners for Kids in Ohio, we applied unsupervised machine learning to cluster patients based on their cumulative dental cost curves in early childhood (24-60 months). Clinical validity, analytical validity, and reproducibility were assessed. Results The clustering revealed five novel subpopulations (1) early-onset of decay by age (0.5% of the population, as early as 28 months), (2) middle-onset of decay (3.0%, as early as 35 months), (3) late-onslows for the development of cost-effective interventions that target high-risk patients. Furthermore, an integrated medical-dental care delivery model promises to reduce costs further while improving patient outcomes.There has been increased focus on clinically managing multi-morbidity in the older population, but it can be challenging to find appropriate paradigm that addresses the socio-economic burden and risk for polypharmacy. The Commission on Social Determinants of Health (CSDH) has examined the need for institutional change and the parallel need to address the social causes of poor health. This study explored three potential interventions namely, meaningful information from electronic health records (EHR), social prescribing, and redistributive welfare policies from a person-centered perspective using the CARE (connecting, assessing, responding, and empowering) approach. Economic instruments that immediately redistribute state welfare and reduce income disparity such as direct taxation and conditional cash transfers could be adopted to enable older people with long-term conditions have access to healthcare services. Decreased socioeconomic inequality and unorthodox prescriptive interventions that reduce polypharmacy could mitigate barriers to effectively manage the complexities of multi-morbidity.The aim of this study is to investigate the knowledge, attitude, and practice (KAP) on Coronavirus Disease 2019 (COVID-19) care among nursing staff and analyze its influencing factors. The survey was conducted on February 18, 2020, among 7,716 voluntary participants from 143 medical institutions in Zhejiang, China. The findings indicated that KAP of nursing staff scored well. However, the accuracy of psychological nursing knowledge was much lower, 14.3% only. Nursing staff working in isolation wards have higher knowledge (OR = 1.776, 95% CI 1.491-2.116), attitude (OR = 1.542, 95% CI 1.298-1.832), and practice (OR = 1.902, 95% CI 1.590-2.274) scores than those in general wards. In terms of KAP, nursing staff with working experience ≤ 10 years scored lower than those with working experience ≥ 20 years, with OR values of 0.490 (95% CI 0.412-0.583), 0.654 (95% CI 0.551-0.775), and 0.747 (95% CI 0.629-0.886), respectively. It is necessary to take measures to enhance the training on COVID-19, especially for KAP of junior nurses in general wards.Macrophage activation syndrome (MAS) is a rare, potentially life-threatening, condition triggered by infections or flares in rheumatologic and neoplastic diseases. The mainstay of treatment includes high dose corticosteroids, intravenous immunoglobulins and immunosuppressive drugs although, more recently, a more targeted approach, based on the use of selective cytokines inhibitors, has been reported. We present the case of a two-year-old boy with 1-month history of high degree fever associated with limping gait, cervical lymphadenopathy and skin rash. Laboratory tests showed elevation of inflammatory markers and ferritin. By exclusion criteria, systemic onset Juvenile Idiopathic Arthritis (sJIA) was diagnosed and steroid therapy started. A couple of weeks later, fever relapsed and laboratory tests were consistent with MAS. He was promptly treated with high doses intravenous methylprednisolone pulses and oral cyclosporin A. One day later, he developed an acute myocarditis and a systemic capillary leak syndrome needing intensive care. Intravenous Immunoglobulin and subcutaneous IL-1-antagonists Anakinra were added. On day 4, after an episode of cardiac arrest, venous-arterial extracorporeal membrane oxygenation (VA-ECMO) was started. Considering the severe refractory clinical picture, we tried high dose intravenous Anakinra (HDIV-ANA, 2 mg/Kg q6h). This treatment brought immediate benefit serial echocardiography showed progressive resolution of myocarditis, VA-ECMO was gradually decreased and definitively weaned off in 6 days and MAS laboratory markers improved. Our case underscores the importance of an early aggressive treatment in refractory life-threatening sJIA-related MAS and adds evidence on safety and efficacy of HDIV-ANA particularly in acute myocarditis needing VA-ECMO support.Introduction Prematurity, a well-established risk factor for various intestinal diseases in newborns, results in increased morbidity and mortality. However, the intestinal inflammatory status of preterm (PT) infants has been poorly characterized. Here we have broadly described the intestinal and systemic inflammatory status of PT children. Materials and Methods Meconium and plasma from 39 PT and 32 full term (T) newborns were studied. Fecal calprotectin, polymorphonuclear leukocyte elastase (PMN-E), TNF, IL-17A, IL-8, IP-10, MCP-1, MIP-1, IL-1β, IL-1α, and E-selectin and the enzymatic activities of myeloperoxidase (MPO) and alkaline phosphatase (AP) in meconium were measured. Plasma levels of AP, hepatocyte growth factor, nerve growth factor (NGF), proinflammatory cytokines, leptin, adiponectin, PAI-1, and resistin were also determined. Correlations with gestational age (GA) and birth weight (BW) were studied. Results Neutrophil derived PMN-E, MPO and calprotectin were increased in the meconium of PT compared to T newborns, while AP was decreased.