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• Breeding habitat can influence rice frog abundance and morphology. • Rice frog in farmland ditches exhibited highest abundance and lowest body condition. • Diverse waterbody types in agricultural landscapes benefit rice frog population. Amphibians are threatened by the intensification of agriculture throughout the world. Several studies have considered the morphology of animals to be an indicator of the health of a population, but differences in anuran morphology (especially body condition) in different breeding habitats in agricultural landscapes remain largely unknown. In this study, we investigated differences in the abundance and morphology of the rice frog (Fejervarya multistriata) in three waterbody types (ten farmland irrigation ditches, ten fruit forest drainage ditches, and ten lotus ponds) in agricultural landscapes in Shanghai, China. We sampled the snout–vent length, body mass, and body condition index for 206 individual rice frogs from the three types of waterbody. Our results showed that the abundance of rice frogs was higher in farmland irrigation ditches than in the other two habitats, whereas the snout–vent length, body mass, and body condition index of rice frogs were lower in farmland irrigation ditches than in the other two habitats. Our results suggest that breeding habitats in agricultural landscapes have different effects on rice frog abundance and morphology, and that constructing diverse waterbodies (other than farmland irrigation ditches) in the same agricultural landscape might benefit the condition of rice frogs. [ABSTRACT FROM AUTHOR]

Spread of SARS-CoV-2 led to a global pandemic, and there remains unmet medical needs in the treatment of Omicron infections. VV116, an oral antiviral agent that has potent activity against SARS-CoV-2, was compared with a placebo in this phase 3 study to investigate its efficacy and safety in patients with mild-to-moderate COVID-19. This multicentre, double-blind, phase 3, randomised controlled study enrolled adults in hospitals for infectious diseases and tertiary general hospitals in China. Eligible patients were randomly assigned in a 1:1 ratio using permuted block randomisation to receive oral VV116 (0·6 g every 12 h on day 1 and 0·3 g every 12 h on days 2–5) or oral placebo (on the same schedule as VV116) for 5 days. Randomisation stratification factors included SARS-CoV-2 vaccination status and the presence of high-risk factors for progression to severe COVID-19. Inclusion criteria were a positive SARS-CoV-2 test, an initial onset of COVID-19 symptoms 3 days or less before the first study dose, and a score of 2 or more for any target COVID-19-related symptoms in the 24 h before the first dose. Patients who had severe or critical COVID-19 or who had taken any antiviral drugs were excluded from the study. The primary endpoint was the time to clinical symptom resolution for 2 consecutive days. Efficacy analyses were performed on a modified intention-to-treat population, comprising all patients who received at least one dose of VV116 or placebo, tested positive for SARS-CoV-2 nucleic acid, and did not test positive for influenza virus before the first dose. Safety analyses were done on all participants who received at least one dose of VV116 or placebo. This study was registered with ClinicalTrials.gov , NCT05582629 , and has been completed. A total of 1369 patients were randomly assigned to treatment groups and 1347 received either VV116 (n=674) or placebo (n=673). At the interim analysis, VV116 was superior to placebo in reducing the time to sustained clinical symptom resolution among 1229 patients (hazard ratio [HR] 1·21, 95% CI 1·04–1·40; p=0·0023). At the final analysis, a substantial reduction in time to sustained clinical symptom resolution was observed for VV116 compared with placebo among 1296 patients (HR 1·17, 95% CI 1·04–1·33; p=0·0009), consistent with the interim analysis. The incidence of adverse events was similar between groups (242 [35·9%] of 674 patients vs 283 [42·1%] of 673 patients). Among patients with mild-to-moderate COVID-19, VV116 significantly reduced the time to sustained clinical symptom resolution compared with placebo, with no observed safety concerns. Shanghai Vinnerna Biosciences, Shanghai Science and Technology Commission, and the National Key Research and Development Program of China. For the Chinese translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

Background: Optimal strategies for prevention and treatment for post-stroke depression (PSD) remain unclear and a greater understanding of effect of resilience on PSD is promising. The aim was to examine the association between baseline resilience and depression at 1, 3, and 6 months after discharge, which contributes to early detection and management of PSD.Methods: A total of 217 ischemic stroke survivors were recruited in two tertiary hospitals in Shanghai, China from February 2017 to January 2018. The Chinese version of Connor-Davidson Resilience Scale (CD-RISC) was used to assess resilience at acute hospitalization. Hospital Anxiety and Depression Scale (HADS) was employed to ascertain baseline anxiety, baseline depression, and post-discharge depression. Social-demographic and disease-related information were obtained from participants' self-report and medical records. Logistic regression analysis was used to determine which factors were independently associated with PSD.Results: The prevalence of depression at baseline was 21.2% and at 1, 3, and 6 months after discharge was 34.4%, 33.2%, and 29.2%, respectively. Logistics regression analyses indicated that resilience may independently predict PSD at 1 month (OR: 0.22, 95%CI: 0.097, 0.518), 3 months (OR:0.302, 95%CI: 0.151, 0.607), and 6 months (OR: 0.03, 95%CI: 0.006, 0.153) after controlling for social-demographics, disease-related characteristics, baseline anxiety, and baseline depression.Limitations: Non-multicenter survey and mild stroke severity may affect the generalization of these findings. Moreover, response bias should be acknowledged because some participants were read questionnaires out aloud.Conclusion: Resilience is independently associated with PSD at different timepoints. Our findings reveal the important role of resilience as a protective factor against PSD. [ABSTRACT FROM AUTHOR]

Abstract: Background: Little is known about the etiology of pancreatic cancer. Epidemiological studies on tea consumption and pancreatic cancer risk have been inconclusive. The purpose of the present study was to investigate the association between green tea drinking and the risk of pancreatic cancer in urban Shanghai, China. Methods: In this population-based case–control study conducted in urban Shanghai, 908 cases of pancreatic cancer and 1067 healthy controls were recruited. Information on tea drinking, including type of tea, amount of tea consumption, temperature of tea, and the duration of regular tea drinking, were collected via interview questionnaire. Results: We examined the association of multiple tea drinking habits with the risk of pancreatic cancer. In women, regular green tea drinking was associated with 32% reduction of pancreatic cancer risk (OR 0.68, 95% CI 0.48–0.96), compared to those who did not drink tea regularly. Increased consumption and longer duration of tea drinking were both associated with reduced pancreatic cancer risk in women. Among regular tea drinkers, lower temperature of tea was associated with reduced risk of pancreatic cancer in both men and women, independent of amount or duration of tea drinking. Conclusions: Habits of green tea drinking, including regular drinking, amount of consumption, persistence of the habit, and tea temperature, may lower pancreatic cancer risk. [Copyright &y& Elsevier]

Background: Atrial fibrillation (AF) is underdiagnosed and especially undertreated in China. We aimed to investigate the prevalence of unknown and untreated AF in community residents (≥65 years old) and to determine whether an education intervention could improve oral anticoagulant (OAC) prescription. Methods and findings: We performed a single–time point screening for AF with a handheld single-lead electrocardiography (ECG) in Chinese residents (≥65 years old) in 5 community health centers in Shanghai from April to September 2017. Disease education and advice on referral to specialist clinics for OAC treatment were provided to all patients with actionable AF (newly detected or undertreated known AF) at the time of screening, and education was reinforced at 1 month. Follow-up occurred at 12 months. In total, 4,531 participants were screened (response rate 94.7%, mean age 71.6 ± 6.3 years, 44% male). Overall AF prevalence was 4.0% (known AF 3.5% [n = 161], new AF 0.5% [n = 22]). The 183 patients with AF were older (p < 0.001), taller (p = 0.02), and more likely to be male (p = 0.01), and they had a higher prevalence of cardiovascular disease than those without AF (p < 0.001). In total, 85% (155/183) of patients were recommended for OAC treatment by the established guidelines (CHA2DS2-VASc ≥ 2 for men; ≥ 3 for women). OAC prescription rate for known AF was 20% (28/138), and actionable AF constituted 2.8% of all those screened. At the 12-month follow-up in 103 patients (81% complete), despite disease education and advice on specialist referral, only 17 attended specialist clinics, and 4 were prescribed OAC. Of those not attending specialist clinics, 71 chose instead to attend community health centers or secondary hospital clinics, with none prescribed OAC, and 15 had no review. Of the 17 patients with new AF and a class 1 recommendation for OAC, only 3 attended a specialist clinic, and none were prescribed OAC. Of the 28 AF patients taking OAC at baseline, OAC was no longer taken in 4. Ischemic stroke (n = 2) or death (n = 3) occurred in 5/126 (4%), with none receiving OAC. As screening was performed at a single time point, some paroxysmal AF cases may have been missed; thus, the rate of new AF may be underestimated. Conclusions: We demonstrated a noticeable gap in AF detection and treatment in community-based elderly Chinese: actionable AF constituted a high proportion of those screened. Disease education and advice on specialist referral are insufficient to close the gap. Before more frequent or intensive screening for unknown AF could be recommended in China, greater efforts must be made to increase appropriate OAC therapy in known AF to prevent AF-related stroke. Ji-Guang Wang and colleagues highlight the gap between AF screening and treatment in Chinese residents over 65 years of age. Author summary: Why was this study done?: Atrial fibrillation (AF) is a common heart rhythm problem that often has no symptoms, so it is often underdiagnosed. People with AF can have a very high stroke risk, which is highly preventable with appropriate oral anticoagulant (OAC) medications. Neither the prevalence of unknown and untreated AF in the Chinese community nor whether patient education in the community health center has the potential to improve OAC prescription are known. What did the researchers do and find?: We screened for AF in residents aged ≥65 years in community health centers in Shanghai and provided disease education and advice on referral to specialist clinics for OAC treatment to people with newly detected or undertreated known AF. We demonstrated a noticeable gap in AF detection and treatment: 2.8% of those screened had unknown or untreated AF. At 12 months, only 17/103 people with newly detected or undertreated known AF attended specialist clinics, and only 4/17 had commenced OAC therapy. What do these findings mean?: We highlight a serious public health issue in China with underdiagnosis and undertreatment of AF in the community that requires a whole-of-system approach. To prevent AF-related stroke in China, greater efforts must be made to increase appropriate OAC therapy in people with AF. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) have recently accounted for an alarmingly increasing proportion of HIV-1 transmission in China. In order to investigate the immune status as a result of CRF01_AE infection and CXCR4 co-receptor usage in a young Shanghai-based HIV-1-infected MSM population in Shanghai, 364 HIV-1-infected MSM with average age of 22.7 years old, newly diagnosed between Jan 2009 and Jul 2013 were analyzed for CD4+T cell count, subtyping using phylogenetic analysis, and viral co-receptor tropism using Geno2pheno and webPSSM in combination. A total of 276 individuals were identified as recently infected. Subtype assignment were as follows: 176 (63.8%) CRF01_AE, 77 (27.9%) CRF07_BC, and 23 (8.3%) subtype B. Besides, 24 second-generation recombinant strains were identified. A lower CD4+T cell count at baseline survey was observed among CRF01_AE strain-infected individuals, compared to those who were infected with CRF07_BC (P<0.01). The frequency of baseline CD4+T cell count <200 was higher and the frequency of CD4 T counts >500 lower in CRF01_AE infection than CRF07_BC infection. It is worth noting that 32.4%–40.9% of CRF01_AE strain-infected individuals were predicted to carry CXCR4-tropic viruses whereas none of CRF07_BC and subtype B were found to be as CXCR4-tropic viruses (P<0.001). As could be expected CXCR4 tropism was associated with lower CD4 T counts. This study revealed that CRF01_AE strains with high frequency of CXCR4 tropism are prevailing in the young MSM population in China and could potentially cause a severe loss of CD4+T cell count and rapid disease progression. A regular surveillance of HIV-1 subtypes, CD4+T cell count and viral co-receptor usage would be greatly beneficial for effectively monitoring disease progression, improvement of antiretroviral therapy strategy and prompt intervention of transmission. [ABSTRACT FROM AUTHOR]

The H9N2 influenza virus is endemic in poultry. We report its occurrence in live-poultry markets, fair-trade markets and poultry farms in the Shanghai region between September 2006 and December 2010. An analysis of partial sequences of the HA, NA, PB1, PB2 and NP genes of eleven distinct H9N2 isolates revealed that all carried an RSSR motif at the cleavage site of HA, diagnostic of low pathogenicity in chickens. A phylogenetic analysis indicated that these isolates are derived from the lineage represented by Duck/HK/Y280/97, but they have evolved a range of reassortments. Their PB1 and NP sequences resembled those of H5N1 strains, indicating a hybrid origin involving both H9 and H5 strains. The HA and NA sequences present in all eleven isolates resembled those of the Duck/HK/Y280/97-like lineage. Infection by H9N2 is commonplace in Shanghai live-poultry markets, allowing the viruses to have evolved rapidly. [ABSTRACT FROM AUTHOR]

Purpose: We sought to determine the association of hip circumference with risk of type 2 diabetes in a relatively lean population. Methods: The relationship between hip circumference for a given waist circumference or BMI and risk of type 2 diabetes was investigated in 56,100 men and 68,273 women, aged 40 to 74, from the Shanghai Men’s Health Study and the Shanghai Women’s Health Study. Cox analyses were used. Results: Over an average of 4.0 years and 7.8 years of follow-up of the men and women, respectively, 2754 new diabetes cases (955 males; 1799 females) were documented. After adjustment for body mass index (BMI), waist circumference, and other potential confounders, the hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes in quintiles 2 to 5 compared with the first quintile of hip circumference were 0.95 (95% CI, 0.76–1.18), 0.72 (95% CI, 0.57–0.91), 0.83 (95% CI, 0.67–1.04), 0.78 (95% CI, 0.63–0.97), respectively, among men and 0.83 (95% CI, 0.72–0.96), 0.74 (95% CI, 0.64–0.86), 0.72 (95% CI, 0.62–0.84), and 0.65 (95% CI, 0.56–0.75) among women. This relationship was stronger for men and women with a BMI less than or equal to the median (23.6 kg/m2 for each gender; interaction p-value = .04 for men and .01 for women). Conclusions: A greater hip circumference for a given waist circumference and BMI is associated with a reduced risk of type 2 diabetes. [ABSTRACT FROM AUTHOR]