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BACKGROUND Physical activity (PA) may be associated with asthma management. Whether PA is associated with childhood asthma control is not well studied, and the role of body mass index (BMI) in this association remains unclarified. This study aimed to evaluate the association between PA and childhood asthma control and investigate the potential mediating and modifying role of BMI in the association. METHODS This cross-sectional study involved 303 asthmatic children aged 5-14 years. Information on PA was collected from children. Asthma control was assessed using a valid questionnaire by children and their parents. Height and weight were objectively measured and BMI was calculated and classified. Multiple linear regression, mediation, and moderation analyses were performed. RESULTS There was a positive association between PA and childhood asthma control with adjustment for variates (B = 0.144, p = .012). Mediation analysis indicated that BMI status negatively mediated the association (estimate = -0.656, 95% credit interval: -1.645, -0.006), and such indirect effect is lower than the direct effect (indirect effect/direct effect = 58.3%). No evidence of effect modification by BMI was observed (Pinteraction = 0.516). Stratified analyses showed that the significant association was only observed in children with overweight/obesity (normal weight: B = 0.863, p = .189; overweight/obese: B = 1.494, p = .044). CONCLUSIONS Increased PA is associated with improved childhood asthma control, especially for children with higher BMI. BMI exhibited a negative effect but not effect modification in this association. PA should be encouraged to improve asthma control for asthmatic children. Besides, mechanisms other than weight loss may explain the association.

Background Several cross-sectional studies have suggested an association between SUA and asthma. However, few studies have investigated this relationship longitudinally. Although SUA is an independent risk factor for chronic kidney disease and cardiovascular diseases, its contribution to incident asthma remains uncertain. Objective To determine whether a high SUA was a risk factor for adult incident asthma. Methods By using health care data from the Shandong multicenter health check-up, 76,369 participants, aged 20 to 79 years, were identified who had an SUA determination with a mean follow-up period of 3.73±2.21 years. Multivariate modeling employed Cox proportional hazards models to verify the association between SUA and incident asthma by adjusting age, BMI, smoking habits, drinking habits, and asthma-like diseases. Results A total of 51,389 individuals were included in the analysis. Cut-off values of SUA able to discriminate asthma status were identified by means of maximally selected rank statistics in the whole participants (≥376.80umol/L), women (≥314.45umol/L), and men (≥376.80umol/L). Multivariate Cox regression analyses adjusted for covariates (age, body mass index (BMI), smoking habit, drinking habit, and asthma-like disease) identified an independent association between SUA and incident asthma in the whole participants (hazard ratio (HR) 2.92, 95% confidence intervals (CI), 1.76-4.48, P=0.00) and men (HR 3.02, 95% CI 1.70-5.39, P=0.00), but not in women. Conclusion The results of the current study confirmed that high SUA was an independent risk factor for incident asthma after adjustment of potential covariates and suggested that a cut-off value related to incident asthma could be identified only in men.

Background Although metabolic syndrome is awell-known risk factor for many non-communicable diseases, its contribution to asthma remains controversial. Objective The aim of this study was to explore the associations of metabolic syndrome and its components with incident asthma in Chinese adults. Methods We conducted an open cohort study of participants who were asthma-free at baseline (n=42,304) in the Shandong multi-center health check-up longitudinal study from 2004 to 2015. Participants aged ≥20 years and had regular physical examination (once ayear) more than three times during follow-up. Results Ninety subjects (38 women and 52 men) developed incident asthma over 12 years of follow-up. Our study suggested that metabolic syndrome itself was not significantly associated with incident asthma in either women or men (P>0.050). Interestingly, we found that overweight and/or obesity was arisk factor for incident asthma among women but not men in the Cox proportional hazards model after adjusting covariates (adjusted incidence rate ratio (IRR)= 2.940, 95% confidence interval (CI): 1.467-5.894, P=0.002). The result was consistent with the Poisson regression model (hazard ratio (HR)= 2.241, 95% CI: 1.135-4.988, P=0.026). After stratifying according to overweight and/or obesity, we found that female subjects with overweight and obesity were associated with the occurrence of incident asthma (P

ObjectivesTo understand the impact of the COVID-19 epidemic on asthma control in children based on caregivers’ perspectives and experiences.DesignThis was a qualitative study deploying face-to-face, semistructured interviews. Thematic analysis was carried out to analyse the data.SettingPaediatric respiratory clinics in three tertiary hospitals.Participants16 caregivers providing unpaid asthma-related care and assistance to children under 14 years who had been diagnosed with asthma for more than 1 year and were not only treated with short-acting β2-agonists.ResultsSix main themes were identified: (1) improved asthma control; (2) decreased willingness to seek medical care driven by fear; (3) increased adherence due to enhanced awareness of asthma control; (4) coping strategies for changes caused by COVID-19; (5) a new opportunity and (6) managing new challenges in asthma control.ConclusionsThe COVID-19 outbreak and the measures in response to it have had significant impacts on asthma control among children. Children with asthma are advised to continue good asthma management, take their prescribed asthma medications as normal, wash their hands regularly and wear face masks. Regularly supported self-management and remote consultations should be provided during the COVID-19 pandemic. In addition, supporting people financially, providing continued medical support and alleviating any fear and anxiety should be considered. We anticipate that our findings will inform health promotion interventions.

Background: Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection in Intensive care units (ICUs) and is associated with the significant utilization of health-care resources. However, the incidence rates, risk factors and mortality rates of VAP are controversial.Methods: The Web of Science, EMBASE, PubMed and Cochrane Library databases through May 2020 were independently searched by two researchers to collect all relevant studies. Data including incidence rates, risk factors and mortality rates of VAP were extracted for the meta-analysis.Results: 24 studies, including 10 retrospective studies and 14 prospective studies on VAP were included in our analysis. In the meta-analysis, we found that the VAP rate was 20/1000 ventilator-days (95% confidence interval (CI) 17–22%). The data demonstrated that trauma (odds ratio (OR) 1.51; 95% CI 1.21-1.88), steroids use (OR 1.51; 95% CI 1.25-1.82), enteral feeding (OR 3.40; 95% CI 2.56-4.52), nasogastric tube placement (OR 2.96; 95% CI 1.75-5.00), tracheostomy (OR 3.65; 95% CI 1.93-6.90), reintubation (OR 6.08; 95% CI 4.62-8.00), central vascular catheter (CVC) placement (OR 3.83; 95% CI 2.55-5.77), blood transfusion(OR 1.75; 95% CI 1.16-2.64), H2 blockers use (OR 2.28; 95% CI 1.27-4.07) and Chronic obstructive pulmonary disease(COPD)(OR 1.24; 95% CI 1.07-1.44) were risk factors of VAP. When patients developed VAP, duration of ICU stay (OR 11.09; 95% CI 7.50-14.68) and duration of mechanical ventilation (MV) (OR 12.96; 95% CI 10.42-15.51) were significantly increased. What’s more, VAP was associated with an increased risk of mortality (OR 1.38; 95% CI 1.04-1.83).ConclusionsThis study may contribute to the development of improved infection control strategies for high-risk patients. Additional studies are needed in the future to clarify the incidence rates, risk factors and mortality rates of VAP.

BackgroundVentilator-associated pneumonia (VAP) is the second most common nosocomial infection in Intensive care units (ICUs) and is associated with the significant utilization of health-care resources. However，the incidence rates, risk factors and mortality rates of VAP are controversial.MethodsThe Web of Science, PubMed and Cochrane Library databases through August 2019 were independently searched by two researchers to collect all relevant studies. Data including morbidity, risk factors and mortality rates of VAP were extracted for the systematic review and meta-analysis.ResultsSixteen studies, including 4 case control studies and 12 cohort studies, on VAP were included in our analysis. In the meta-analysis, we found that the VAP rate was 22/1000 ventilator-days (95% CI 18–25%). The data demonstrated that H 2 blocker use (odds ratio (OR) 1.66; 95% CI 1.17-2.36), nasogastric tube placement (OR 2.88; 95% CI 1.03-8.04), enteral feeding (OR 3.02; 95% CI 2.18-4.20), central vascular catheter (CVC) placement (OR 3.84; 95% CI 2.55-5.78) and tracheotomy (OR 9.13; 95% CI 6.53-12.75) were risk factors of VAP. VAP was associated with an increased risk of mortality (OR 1.15; 95% CI 0.96-1.37). Four articles that were not included in the meta-analysis indicated that hyperoxemia, increased intra-abdominal pressure, and genetic polymorphism may be risk factors for VAP. ConclusionsThis study may contribute to the development of improved infection control strategies for high-risk patients. Additional studies are needed in the future to clarify the incidence rates, risk factors and mortality rates of VAP.