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To study the relationship of soy foods and nuts consumption during early pregnancy with the risk of gestational diabetes mellitus (GDM).This was a prospective observational study conducted in Southwest China. Dietary information was assessed through 3-day 24-h dietary recalls at 6-14 gestational weeks. For soy foods and nuts, non-consumers were used as the reference category and the consumers were categorized into tertiles. GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24-28 gestational weeks. Log-binomial models were used to assess the effects of soy foods and nuts on GDM.Of the 1495 pregnant women, 529 were diagnosed with GDM. Median (IQRs) intakes of soy foods and nuts were 2.9 (0.0, 10.3) and 5.0 (0.0, 15.0) g/d, respectively. Our study found that, compared with the non-consumers, the highest tertile of soy foods intake was associated with a decrease in risk of GDM (RR = 0.73, 95%CI: 0.54-0.99,Consumption of soy foods and nuts are independently inversely associated with the risk of GDM during early pregnancy.

ImportanceThe Sabin-strain inactivated poliovirus vaccine (IPV) may be a tool for polio outbreak response in certain situations.ObjectiveTo investigate the response to a type 2 vaccine-derived poliovirus (VDPV2) outbreak.Design, Setting, and ParticipantsThis case series was conducted in China after a VDPV2 was detected in stool specimens from a child with acute flaccid paralysis (AFP) in Sichuan Province in 2019, 3 years after the global withdrawal of live, attenuated type 2 oral poliovirus vaccine (OPV). Investigation followed National Health Commission and World Health Organization guidance and included searching hospitals for unreported AFP cases; testing stool specimens from the child, his contacts, and local children; enhanced environmental surveillance for VDPV2s in wastewater; and measuring vaccination coverage. Sabin-strain IPV campaigns were conducted in a wide geographic area.Main Outcomes and MeasuresAny VDPV2 detection after completion of the supplementary immunization activities.ResultsA 28-nucleotide-change VDPV2 was isolated from a young boy. Three VDPV2s were detected in healthy children; 2 were contacts of the original child, and none had paralysis. A search of 31 million hospital records found 10 unreported AFP cases; none were polio. No type 2 polioviruses were found in wastewater. Prior to the event, polio vaccine coverage was 65% among children younger than 5 years. Sabin-strain IPV campaigns reached more than 97% of targeted children, administering 1.4 million doses. No transmission source was identified. More than 1 year of enhanced poliovirus environmental and AFP surveillance detected no additional VDPVs.Conclusions and RelevanceThese findings suggest that the circulating VPDV2 outbreak in 2019 was associated with low vaccine coverage. An investigation discovered 3 infected but otherwise healthy children and no evidence of the virus in wastewater. Following Sabin-strain IPV–only campaigns expanding from county to prefecture, the poliovirus was not detected, and the outbreak response was considered by an expert panel and the World Health Organization to have been successful. This success suggests that the Sabin-strain IPV may be a useful tool for responding to circulating VDPV2 outbreaks when high-quality supplementary immunization activities can be conducted and carefully monitored in settings with good sanitation.

To analyze the knowledge level and related factors related to dietary recommendations for Chinese residents aged 18-64 years in 2021.A multi-stage cluster random sampling was used to select 302 survey sites across the country, there were 102 398 people surveyed, with 98 567 valid questionnaires, 49.4% male and 41.9% urban, and an average age of(38.5±12.2) years. A standardized questionnaire certified by experts and evaluated for reliability and validity was used to conduct the face-to-face survey. The questionnaire was scored out of 100 points; dietary recommendation-related knowledge was scored out of 30 points, and a score of 22.5 points or above was judged as acquiring relevant knowledge. Descriptive statistics were used to report the values of relevant knowledge level of respondents with different characteristics, and univariate and multi-variate Logistic regression models were used to analyze the factors influencing relevant knowledge level.The average score of dietary recommendation-related knowledge was(17.9±4.2), and the knowledge awareness rate was 14.7%. The five knowledge points with the lowest correct rates were the recommended intakes of soybeans and products(21.1%), added sugars(22.6%), milk(25.5%), food groups(27.6%), and cooking oils(31.4%) and the recommended intakes of fruits and salt were also less correct(56.9% and 58.5%). Multi-variate analysis revealed that the knowledge of dietary recommendations was lower among residents in rural(OR=0.945, 95%CI 0.944-0.945), central(OR=0.863, 95%CI 0.863-0.864) and western(OR=0.983, 95%CI 0.982-0.983) areas, those with chronic diseases(OR=0.784, 95%CI 0.783-0.784) and those who did not know about chronic diseases(OR=0.694, 95%CI 0.694-0.694) compared to the counterparts; female(OR=1.090, 95%CI 1.090-1.091) had a higher knowledge rate compared to male. The awareness rate of residents increased with the level of education, and the trend was statistically significant(Plt;0.001).The level of knowledge related to dietary recommendations for the adult population in China in 2021 is low, especially for the recommended intake of dairy, soybeans and products, and cooking oils, and the knowledge level of men, rural, central and western, and less educated populations is even lower.

To explore the geographical distribution of nutrition and health knowledge among 18-64 years old adults in China.A total of 102 398 residents aged 18-64 from 302 survey sites were selected by multi-stage cluster random sampling method, a total of 98 567 respondents were included in the study. Both mean and rate were calculated by complex sampling weighting.The nutrition and health knowledge score in eastern region(65.5±12.0) was higher than that in central(62.4±11.9) and western(61.4±12.9), and the score in northern region(63.9±11.8) was higher than that in southern(63.1±12.8). In the seven geographical regions, the highest score was in north(65.8±11.4), and the lowest score was in northwest(61.6±12.2). The awareness rate of nutrition and health in eastern region(22.4%) was higher than that in central(14.7%) and western(14.9%), the highest awareness rate among the seven geographic regions was in east(23.2%), followed by north(22.5%) and the lowest was in northwest(13.2%). There were also differences in nutritional health knowledge levels of residents in different regions in the five dimensions(Plt;0.001). Northwest China had the lowest awareness of food characteristics and nutrition and disease dimensions, South China had the lowest awareness of dietary recommendations and food choices dimensions, and Southwest China had the lowest awareness of food safety dimensions.The level of nutrition and health knowledge of Chinese adults have large geographical differences.

With the continuous development of the economy and agricultural modernization in the past three decades, nutritional deficiency issues in the Chinese population have been gradually improving. However, new nutritional and health challenges have emerged. Overweight and obesity, diabetes, cardiovascular diseases, and other chronic diseases have increasingly become major disease burden. In view of the problems above, the State Council released the Healthy China Initiative 2019–2030 focusing on 15 special campaigns and the Healthy Diet Campaign (HDC) as the second campaign. This article intends to interpret HDC in details including the following four aspects: background, major indices, strategies, and features. Healthy diet is the foundation of human health, and the HDC needs to be carried out together with other campaigns to achieve the overall goal of Healthy China.

Introduction Endemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated >100 million children in 2010. An increasing proportion of infections now occur among adults and there is concern that persistent susceptibility in adults is an obstacle to measles elimination in China. We performed a case-control study in six Chinese provinces between January 2012 to June 2013 to identify risk factors for measles virus infection and susceptibility among adults. Methods Persons ≥15 years old with laboratory-confirmed measles were age and neighborhood matched with three controls. Controls had blood specimens collected to determine their measles IgG serostatus. We interviewed case-patients and controls about potential risk factors for measles virus infection and susceptibility. Unadjusted and adjusted matched odds ratios and 95% confidence intervals (CIs) were calculated via conditional logistic regression. We calculated attributable fractions for infection for risk factors that could be interpreted as causal. Results 899 cases and 2498 controls were enrolled. Among controls, 165 (6.6%) were seronegative for measles IgG indicating persistent susceptibility to infection. In multivariable analysis, hospital visit and travel outside the prefecture in the prior 1–3 weeks were significant risk factors for measles virus infection. Occupation and reluctance to accept measles vaccination were significant risk factors for measles susceptibility. The calculated attributable fraction of measles cases from hospital visitation was 28.6% (95% CI: 20.6–38.8%). Conclusions Exposure to a healthcare facility was the largest risk factor for measles virus infection in adults in China. Improved adherence to hospital infection control practices could reduce risk of ongoing measles virus transmission and increase the likelihood of achieving and sustaining measles elimination in China. The use of control groups stratified by serological status identified distinct risk factors for measles virus infection and susceptibility among adults.

What is already known about this topic? After the type 2 strain of the live, attenuated poliovirus vaccine was withdrawn globally in 2016, any identification of a type 2 poliovirus is a Public Health Emergency of International Concern. A vaccine-derived type 2 poliovirus (VDPV2) was identified in Sichuan, prompting an urgent, comprehensive investigation and response. What is added by this report? Type 2 monovalent, live, attenuated oral poliovirus vaccine (mOPV2) is being used to respond to the numerous VDPV2 outbreaks seen around the world. In contrast, the response in Sichuan used Sabin strain inactivated poliovirus (sIPV) to stop circulation of the VDPV2. In the 6 months following the vaccination response, there have been no VDPV2s detected in Sichuan, despite extensive search. What are the implications for public health practices? Further search for the VDPV2 must continue in order to determine whether transmission has been stopped. The ongoing investigation and response to the Sichuan VDPV2 is providing evidence to the Global Polio Eradication Initiative on managing VDPV2 outbreaks.

To analyze the status and long-term trends in dietary vitamin intakes from 1989 to 2015 in adults aged 18 to 35 in 15 provinces(autonomous regions, municipalities) of China.Based on the data of "China Health and Nutrition Surveys" from 1989 to 2015 and "cohort study on the changes of nutritional status of Chinese residents" in 2015, covering 15 provinces(autonomous regions, municipalities) in China. Adults aged 18 to 35 were selected as study subjects. Nonparametric statistical method was used to analyze the trend of dietary vitamin intake with years. Comparing the dietary vitamin intake with the dietary reference intakes, the trend of the proportion of people at risk of insufficient dietary vitamin intake was analyzed by Cochran Armitage trend test. According to the different demographic characteristics in 2015, the vitamin intake status and the proportion of people with insufficient dietary vitamin intake were analyzed.From 1989 to 2015, the overall dietary vitamin intake of adults aged 18-35 in 15 provinces(autonomous regions, municipalities) of China showed a downward trend. The median vitamin intake of adults in 2015 were vitamin A 361. 28 μg RAE/d(based on vitamin A activity equivalent), vitamin B_1 0. 75 mg/d, vitamin B_2 0. 67 mg/d, nicotinic acid 13. 61 mg/d, vitamin C 56. 41 mg/d and vitamin E 21. 04 mg α-TE/d. In 2015, there were significant differences in dietary vitamin A, vitamin B_2, niacin and vitamin C intakes between the North and the South and the distribution of education level, in which the intakes of vitamin A, vitamin B_2, niacin and vitamin C in the South were significantly higher than those in the North; the intakes of dietary vitamin B_1 in the low education level group were significantly lower than those in the middle and high education level; the intakes of dietary vitamin B_1 in urban areas were significantly higher than those in the North. The intakes of vitamin A, vitamin B_2, niacin and vitamin E were significantly higher than those in rural areas. From 1989 to 2015, the proportion of people with insufficient intake of vitamin B_2 remained above 80%, and the proportion of adults with the risk of insufficient intake of dietary vitamin A, vitamin B_1 and vitamin C showed an increasing trend year by year. In 2015, the proportion of people at risk of insufficient intake of dietary vitamin A, vitamin B_2 and vitamin C in northern China was significantly higher than that in southern China.From 1989 to 2015, there was a risk of insufficient intake of micronutrients in adults aged 18-35 in 15 provinces(autonomous regions, municipalities) in China, and the problem of insufficient calcium intake was serious.

To analyze the trend of food intake from Chinese 15 provinces(autonomous regions, municipalities) adult aged 18 to 35.Based on the data from 10 rounds follow-up survey conducted by China Health and Nutrition Survey between 1989 and 2015, adults aged 18 to 35 were selected according to the multi-stage stratified random cluster sampling method. Dietary surveys were conducted using 24-hour dietary recall in three consecutive days, and weighing accounting method was used to investigate the consumption of condiments. Wilcoxon rank sum trend was used to test the variation trend of food intake, Cochran-Armitage trend test and Spearman rank test were used to analyze the trend of different type of food intake and the recommended intakes of dietary pagoda for Chinese residents(2016).The intake of fruits, livestock and poultry meat, aquatic products, eggs, milk and dairy products, soybeans and nuts and sugar for adults aged 18-35 in China has been increasing. Cereals and potatoes, vegetables, edible oil, cooking salt, alcohols showed a downward trend. Compared with Chinese Dietary Guidelines(2016)-summary, the number of people whose milk and dairy products lower than EAR has always exceeded 99%. The number of people whose cereals, potatoes and vegetables lower than EAR has increased from 4. 1% and 42. 3% in 1989 to 19. 2% and 67. 0% in 2015, respectively. The proportion of people whose edible oil lower than EAR and whose cooking salt higher than EAR increased, whose livestock and poultry meat higher than EAR increased from 34. 10% in 1989 to 64. 49% in 2015.There is still a high proportion of Chinese adults aged 18 to 35 who consume overmuch fat but deficiency in dietary fiber. The proportion of whose consumed cereals, potatoes, vegetables and dairy products lower than EAR and exceed EAR of meat and cooking salt shows an increasing trend. The problem of unreasonable dietary structure is still serious.

Background Measles is among the most highly infectious human diseases. By virtue of increasingly effective childhood vaccination, together with targeted supplemental immunization activities (SIAs), health authorities in the People’s Republic of China have reduced measles’ reproduction number from about 18 to 2.3. Despite substantial residual susceptibility among young adults, more in some locales than others, sustained routine childhood immunization likely would eliminate measles eventually. To support global eradication efforts, as well as expedite morbidity and mortality reductions in China, we evaluated alternative SIAs via mechanistic mathematical modelling. Methods Our model Chinese population is stratified by immune status (susceptible to measles infection; infected, but not yet infectious; infectious; and recovered or immunized), age (0, 1–4, 5–9, …, 65+ years) and location (31 provinces). Contacts between sub-populations are either empirical or a mixture of preferential and proportionate with respect to age and decline exponentially with distance between locations at age-dependent rates. We estimated initial conditions and most parameters from recent cross-sectional serological surveys, disease surveillance and demographic observations. Then we calculated the reproduction numbers and gradient of the effective number with respect to age- and location-specific immunization rates. We corroborated these analytical results by simulating adolescent and young adult SIAs using a version of our model in which the age-specific contact rates vary seasonally. Results Whereas the gradient indicates that vaccinating young adults generally is the optimal strategy, simulations indicate that a catch-up campaign among susceptible adolescent schoolchildren would accelerate elimination, with timing dependent on uptake. Conclusions These results are largely due to indirect effects (i.e. fewer infections than immunized people might otherwise cause), which meta-population models with realistic mixing are uniquely capable of reproducing accurately.

To explore the effect of iron supplement intake on gestational diabetes mellitus(GDM) in early and middle pregnancy.From February to April 2017, a prospective study was conducted among 807 early pregnant women in a prenatal clinic of a maternal and child medical institution in Chengdu City through purposive sampling. Data on maternal demographic characteristics was collected through questionnaire in early pregnancy. In early and middle pregnancy, the information of iron supplement intake were collected with questionnaire, 3-day 24 hour dietary recall method was used to assess maternal diet. According to the WHO recommendation, 60 mg/d iron supplementation during pregnancy was used as the dividing point,lt;60 mg/d iron supplementation was used as the low level group, and ≥60 mg/d iron supplementation was used as the high level group. At the 24 th to 28 th pregnant week, the oral glucose tolerance test(OGTT) was conducted, and GDM was diagnosed according to the Guidelines for the Diagnosis and Treatment of Pregnancy Diabetes in China(2014). Multivariate unconditional Logistic regression model was used to analyze the effect of iron supplement intake on gestational diabetes mellitus(GDM) in early and middle pregnancy.A total of 739 valid samples were followed up, the age was(28. 22±3. 75) years old. In early and middle pregnancy, the rate of taking iron supplementation was 5. 0% and 67. 9%, 3. 8% and 47. 1% of them iron supplement intake was more than 60 mg/d. After adjustmenting for body mass index, age, dietary iron, etc. Multivariate unconditional Logistic regression analysis showed that there was a positive correlation between the average intake of iron supplement and the occurrence of GDM in women during the second trimester of pregnancy(OR=1. 059, 95%CI 1. 016-1. 104). Compared with the lower iron supplement intake(lt;60 mg/d) women in midpregnancy, the risk of GDM was 1. 406 times(95%CI 1. 019-1. 939)in the higher iron supplement intake(≥60 mg/d) women. No correlation was found between iron intake in early pregnancy and the occurrence of GDM.Iron supplement intake during pregnancy may increase the risk of GDM. Appropriate intake of iron supplement for pregnant women is worth discussing.

To investigate the effects of anxiety and depression on gestational diabetes mellitus(GDM) in early pregnancy.A prospective study was conducted in 2017 to select 1426 single-child healthy pregnant women of 8-14 weeks from the Sichuan Provincial Hospital for Women and Children through a deliberate sampling method. The age was(28. 6±4. 0) years old. Basic information such as age, pre-pregnancy weight, parity, and gravidity of pregnant women was collected through questionnaire survey. The anxiety self-rating scale(SAS) and depression self-rating scale(SDS) were used to collect information of anxiety and depression in pregnant women, and their anxiety and depressive symptoms were evaluated according to the result of Chinese norm. At 24 to 28 weeks of gestation, the oral glucose tolerance test(OGTT) was conducted. GDM was diagnosed according to the Guidelines for the Diagnosis and Treatment of Pregnancy Diabetes in China(2014). Multivariate unconditional Logistic regression was adopted to analyze the effects of anxiety and depression on GDM in pregnant women.The incidence of GDM in early pregnancy anxiety group and depression group was 41. 8% and 33. 6%, respectively. The incidence of anxiety, depression, and anxiety combined with depression were 7. 7%, 10. 5% and 4. 8%, respectively. The incidence of anxiety and depression in the group of pregnant women younger than 30 years old(9. 0% and 11. 7%) was higher than that in the group of pregnant women older than 30 years old(5. 3% and 8. 1%). The prevalence of anxiety and depression in the group of nulliparous women(8. 8% and 11. 9%) was higher than that in the group of multiparous women(5. 4% and 6. 4%). The difference was statistically significant(Plt;0. 05). After adjusting the confounding factors such as age, pre-pregnancy body mass index, family history of diabetes, gravidity, parity, energy intake, conception, education, occupation, smoking and drinking, the result showed that the risk of GDM in anxious pregnant women was increased, compared with that in non-anxious pregnant women in early pregnancy(OR=1. 556, 95% CI 1. 014-2. 387). However, the association between early pregnancy depression and the occurrence of GDM was not found(Pgt;0. 05). Compared with the non-anxiety group in the early pregnancy, the risk of GDM in the anxiety group was increased both in pregnant women under 30 years old(OR=1. 654, 95% CI 1. 004-2. 726) and nulliparous women(OR=1. 633, 95% CI 1. 013-2. 634). No correlation between anxiety and risk of GDM was observed in pregnant women over 30 years old and multiparous women(Pgt;0. 05).Anxiety in early pregnancy increases the risk of GDM. Pregnant women under 30 years old and and nulliparous women are at high risk of anxiety.

The friction stir welding (FSW) parameters were designed in this study by orthogonal experimental method. The microstructure, mechanical properties and corrosion behavior of corresponding FSW joints of 5083 aluminium alloy (AA5083) were also investigated. Scanning Kelvin probe force microscopy (SKPFM) was employed to study local potential differences on the FSW joint. Results showed that the welding parameters greatly influenced the FSW joint properties of the AA5083. The ratio of rotation speed to welding speed (n/v) mainly affected the mechanical properties of the joint. The tensile strength for the joint was reduced when welded with too large or too small n/v. The hardness of all FSW joints was characterized with similar ‘W-shaped,’ and minimum hardness value appeared on advancing side of the heat affected zone. Different heat input and agitation intensity caused heterogeneous microstructure for the AA5083 FSW joint, which led to differences in passivation properties of weld nugget zone, thermo-mechanically affected zone and heat-affected zone. Susceptibility of the AA5083 FSW joint to pitting corrosion was attributed to the difference of relative potential between the intermetallic phase and Al matrix.

What is already known about this topic? After the type 2 strain of the live, attenuated poliovirus vaccine was withdrawn globally in 2016, any identification of a type 2 poliovirus is a Public Health Emergency of International Concern. A vaccine-derived type 2 poliovirus (VDPV2) was identified in Sichuan, prompting an urgent, comprehensive investigation and response. What is added by this report? Type 2 monovalent, live, attenuated oral poliovirus vaccine (mOPV2) is being used to respond to the numerous VDPV2 outbreaks seen around the world. In contrast, the response in Sichuan used Sabin strain inactivated poliovirus (sIPV) to stop circulation of the VDPV2. In the 6 months following the vaccination response, there have been no VDPV2s detected in Sichuan, despite extensive search. What are the implications for public health practices? Further search for the VDPV2 must continue in order to determine whether transmission has been stopped. The ongoing investigation and response to the Sichuan VDPV2 is providing evidence to the Global Polio Eradication Initiative on managing VDPV2 outbreaks.

China has used 3 different mumps-containing vaccines (MuCV) since 1990: monovalent mumps vaccine, measles-mumps (MM) vaccine, and measles-mumps-rubella (MMR) vaccine, and one dose MuCV (using MMR at 18 months) has been included in the EPI since 2007. MuCV effectiveness has been of concern following large-scale mumps outbreaks. In 2015, an outbreak of mumps occurred in a primary school, which allow us assess vaccine effectiveness of different MuCVs.All children in the school were studied as a retrospective cohort. Vaccination histories and case information were obtained from vaccination records and clinic/hospital logs. Parental questionnaires were used to confirm students' illnesses and calculate attack rate (AR). VE was assessed using the formula, VE = (AR in unvaccinated students- AR in the vaccinated students) / (AR in unvaccinated students). VEs of different type of MuCV were compared.In total, 283 students were identified as clinical mumps among the 2370 students, and 1908 students were included for MuCV VE assessment. 213 (including 21 [8.9%] patients) were 2-dose MuCV recipients (AR: 9.9%), 1165 (including 123 [51.9%] patients) were 1-dose recipients (AR: 10.6%), and 530 (including 93 [39.2%] patients) were unvaccinated (AR: 17.5%). VE was 44% for 2 doses and 40% for one dose. For one-MuCV-dose students, estimated mumps VE was 63% for vaccinated within 3 years (between vaccination and this outbreak); 50% for vaccinated within 3 to 5 years; and 34% for vaccinated more than 5 years. Comparing VE by vaccine type and 5-year interval since vaccination, VE for MMR was 60%, which was consistently higher than VE for monovalent mumps vaccine (22%) and MM (2%).This outbreak was associated with low and declining 1-dose MuCV effectiveness. China's immunization program should evaluate the potential of a 2-dose MMR schedule to adequately control mumps.

Introduction Endemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated more than 100 million children in 2010. We performed a case–control study in six Chinese provinces during January 2012 through June 2013 to identify risk factors for measles infection among children aged 0–7 months. Methods Children with laboratory-confirmed measles were neighborhood matched with three controls. We interviewed parents of case and control infants on potential risk factors for measles. Adjusted matched odds ratios (mOR) and 95% confidence intervals (CIs) were calculated by multivariable conditional logistic modeling. We calculated attributable fractions for risk factors that could be interpreted as causal. Results Eight hundred thirty cases and 2303 controls were enrolled. In multivariable analysis, male sex (mOR 1.6 [1.3, 2.0]), age 5–7 months (mOR 3.9 [3.0, 5.1]), migration between counties (mOR 2.3 [1.6, 3.4]), outpatient hospital visits (mOR 9.4 [6.6, 13.3]) and inpatient hospitalization (mOR 107.1 [48.8, 235.1]) were significant risk factors. The calculated attributable fractions for hospital visits was 43.1% (95% CI: 40.1, 47.5%) adjusted for age, sex and migration. Conclusions Hospital visitation was the largest risk factor for measles infection in infants. Improved hospital infection control practices would accelerate measles elimination in China.

The weather conditions of fog and haze make the images taken at night blurred, which seriously affects the image and video quality such as video surveillance. The existing daytime dehazing methods are not suitable for night hazy scenes, night-specific dehazing methods need to be developed. In this paper, by analyzing the nature of night hazy scenes with Retinex theory, we propose a bilateral filtering approach to estimate the locally variant atmospheric illumination, which can accurately obtain the local atmospheric light as well as preserve edges. To solve the problem that the dark channel of haze-free image in the light source area is not zero, an adaptive dark channel prior (ADCP) is proposed to estimate the transmission map. Based on the difference of image value between light source area and non-light source area, the transmission can be estimated adaptively to achieve better dehazing effect. The experimental results show that the subjective visual effect of the proposed algorithm outperform the dark channel-based method. The proposed method can effectively remove haze in the night, improve the image contrast and visibility, especially for the light areas.

“MoH issued an action plan for a nationwide measles vaccine SIA!” This news made Dr. Xiaofeng Liang, China CDC NIP director, very excited, but then he felt the burden on his shoulders increase. Given that China is the world’s largest country, having a population of 1.3 billion people, it was not so easy to make a decision to conduct a nationwide SIA.

BACKGROUND: China reduced hepatitis B virus (HBV) infection by 90% among children under 5 years old with safe and effective hepatitis B vaccines (HepB). In December 2013 this success was threatened by widespread media reports of infant deaths following HepB administration. Seventeen deaths and one case of anaphylactic shock following HBV vaccination had been reported. METHODS: We conducted a telephone survey to measure parental confidence in HepB in eleven provinces at four points in time; reviewed maternal HBV status and use of HepB for newborns in birth hospitals in eight provinces before and after the event; and monitored coverage with hepatitis B vaccine and other programme vaccines in ten provinces. RESULTS: HepB from the implicated company was suspended during the investigation which showed that the deaths were not caused by HepB vaccination. Before the event 85% respondents regarded domestic vaccines as safe decreasing to 26.7% during the event. During the height of the crisis 30% of parents reported being hesitant to vaccinate and 18.4% reported they would refuse HepB. Use of HepB in the monitored provinces decreased by 18.6% from 53 653 doses the week before the event to 43 688 doses during the week that Biokangtai HepB was suspended. Use of HepB within the first day of life decreased by 10% among infants born to HBsAg-negative mothers and by 6% among infants born to HBsAg-positive mothers. Vaccine refusal and HepB birth dose rates returned to baseline within 2 months; confidence increased but remained below baseline. CONCLUSIONS: The HBV vaccine event resulted in the suspension of a safe vaccine which was associated with a decline of parental confidence and refusal of vaccination. Suspension of a vaccine can lead to loss of confidence that is difficult to recover. Timely and credible investigation accompanied by proactive outreach to stakeholders and the media may help mitigate negative impact of future coincidental adverse events following immunization. (c) The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Introduction Endemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated more than 100 million children in 2010. In 2011, almost half of the 9943 measles cases in China occurred in children eligible for measles vaccination. We conducted a case-control study during 2012–2013 to identify risk factors for measles infection in children aged 8 months–14 years. Methods Children with laboratory-confirmed measles were age- and neighborhood-matched with three controls. We interviewed parents of case and control infants on potential risk factors for measles. We calculated adjusted matched odds ratios and 95% confidence intervals of risk factors. We calculated attributable fractions for risk factors that could be interpreted as causal and vaccine efficacy (VE) for the measles containing vaccine (MCV) used in the Chinese immunization program. Results In all, 969 case-patients and 2845 controls were enrolled. In multivariable analysis, lack of measles vaccination both overall (mOR 22.7 [16.6, 31.1] and when stratified by region (east region, mOR 74.2 [27.3, 202]; central/western regions mOR 17.4 [12.5, 24.3]), hospital exposure (mOR 63.0, 95% CI [32.8, 121]), and migration among counties (overall mOR 3.0 [2.3, 3.9]) were significant risk factors. The calculated VE was 91.9–96.1% for a single dose of MCV and 96.6–99.5% for 2 doses. Conclusions Lack of vaccination was the leading risk factor for measles infection, especially in children born since the 2010 supplementary immunization activity. Reducing missed vaccination opportunities, improving immunization access for migrant children, and strengthening school/kindergarten vaccine checks are needed to strengthen the routine immunization program and maintain progress toward measles elimination in China.

Background Rubella-containing vaccine (RCV) became available in China in 1993 and was introduced nationwide into the Expanded Immunization Program (EPI) in 2008. We evaluated implementation and impact of RCV from 2 years prior to nationwide introduction through the 10 years after nationwide introduction. Methods We analyzed RCV lot-release (doses distributed) data, 1- and 2-dose RCV coverage, and rubella data from China’s nationwide disease surveillance system to describe the current status and changes in rubella epidemiology between 2005 and 2017. Results While the vaccine was included into the routine immunization program in 2008, its full implementation required 4 years due to sporadic vaccine supply constraints. RCV1 and RCV2 coverage increased from 51.5% and 39.0% in 2008 to >95% during 2012 through 2016. From 2005 to 2017, the annual incidences (per million) of rubella ranged from 91.09 in 2008 down to 1.16 in 2017; reductions occurred in all age groups. The proportion of cases among individuals ≥20 years old increased from 0.97% in 2005 to 31.2% in 2017. In the better-developed eastern China, most cases were among adults; in central and western China, most cases were among children or adolescents. Conclusions The marked decrease rubella was a result of inclusion of RCVs into EPI targeting children less than 2 years of age and achieving high level of 2-dose coverage. Rubella was reduced in absolute terms, and its epidemiology was changed to older cases with substantial inter-province variation. Ensuring full vaccination of school children and identifying strategies to reach adults with measles and rubella combined vaccines will be important to hasten elimination of rubella and prevent CRS outbreaks.

In July 2013, the National Immunization Program of China was notified by the US Centers for Disease Control and Prevention that measles was detected in 3 newly adopted, special needs children with cerebral palsy (CP) from China. We report an investigation of measles transmission in China that led to infection of these children. Interviews were conducted with welfare institute staff and panel physicians; health records of the potentially exposed population were reviewed; and immunization coverage was assessed among institute residents. Five residents with CP, all unvaccinated against measles, among who were the 3 adoptees, were linked epidemiologically into 3 generations of measles transmission antecedent to the US outbreak. In a random sample of residents, first dose of measles containing vaccine (MCV1) and MCV2 coverage was 16 of 17 (94%) and 7 of 11 (64%) among children with CP, and 100% (32 of 32) and 96% (21 of 22) among children without CP. Vaccinators reported reluctance to vaccinate children with CP because the China pharmacopeia lists encephalopathy as a contraindication to vaccination. Panel physicians reported to investigators no necessity of vaccination for adoptees to the United States if US parents sign an affidavit exempting the child from vaccination. We recommend that the China pharmacopeia vaccine contraindications be reviewed and updated, the United States should reconsider allowing vaccination exemptions for internationally adopted children unless there are true medical contraindications to vaccination, and US pediatricians should counsel adopting parents to ensure that their child is up-to-date on recommended vaccinations before coming to the United States.

Background The goal of polio eradication is to complete elimination and containment of all wild, vaccine-related and Sabin polioviruses. Vaccine-derived poliovirus (VDPV) surveillance in China from 2001–2013 is summarized in this report, which has important implications for the global polio eradication initiative. Methods Acute flaccid paralysis (AFP) cases and their contacts with VDPVs isolated from fecal specimens were identified in our AFP surveillance system or by field investigation. Epidemiological and laboratory information for these children were analyzed and the reasons for the VDPV outbreak was explored. Results VDPVs were isolated from a total of 49 children in more than two-thirds of Chinese provinces from 2001–2013, including 15 VDPV cases, 15 non-polio AFP cases and 19 contacts of AFP cases or healthy subjects. A total of 3 circulating VDPVs (cVDPVs) outbreaks were reported in China, resulting in 6 cVDPVs cases who had not been vaccinated with oral attenuated poliomyelitis vaccine. Among the 4 immunodeficiency-associated VDPVs (iVDPVs) cases, the longest duration of virus excretion was about 20 months. In addition, one imported VDPV case from Myanmar was detected in Yunnan Province. Conclusions Until all wild, vaccine-related and Sabin polioviruses are eradicated in the world, high quality routine immunization and sensitive AFP surveillance should be maintained, focusing efforts on underserved populations in high risk areas.

Chloroplast biogenesis has been well documented in higher plants, yet the complex methods used to regulate chloroplast activity under fluctuating environmental conditions are not well understood. In rice (Oryza sativa), the CYTOKININ-RESPONSIVE GATA TRANSCRIPTION FACTOR1 (Cga1) shows increased expression following light, nitrogen, and cytokinin treatments, while darkness and gibberellin reduce expression. Strong overexpression of Cga1 produces dark green, semidwarf plants with reduced tillering, whereas RNA interference knockdown results in reduced chlorophyll and increased tillering. Coexpression, microarray, and real-time expression analyses demonstrate a correlation between Cga1 expression and the expression of important nucleus-encoded, chloroplast-localized genes. Constitutive Cga1 overexpression increases both chloroplast biogenesis and starch production but also results in delayed senescence and reduced grain filling. Growing the transgenic lines under different nitrogen regimes indicates potential agricultural applications for Cga1, including manipulation of biomass, chlorophyll/chloroplast content, and harvest index. These results indicate a conserved mechanism by which Cga1 regulates chloroplast development in higher plants.

IntroductionFollowing implementation of China's 2006–2012 Action Plan for measles elimination, which led to a nadir of measles in 2012, a resurgence started in 2013 that continued into 2014. Measles typically is a disease that mainly affects children. We investigated a community outbreak in 2014 with measles virus transmission among adults without children serving as virus reservoirs. Our investigation highlights adult susceptibility to measles.MethodsWe conducted a retrospective active case search, and analyzed confirmed case data to describe person, place, and time characteristics of the outbreak. All individuals with measles with onset during the first 2 months of the outbreak were interviewed face-to-face to determine source(s) of infection and transmission route (from whom and to whom).ResultsAmong the 280 cases, 220 (77.6%) were among ≥20-year-old adults, 24 (8.6%) were among 8–23 month olds, 22 (7.9%) were among

In 2006, China set a goal of measles elimination by 2012. To describe progress toward this goal, we reviewed relevant policies and strategies and analyzed national data for 2000-2009. In response to implementation of these strategies, including increased routine measles vaccination coverage and province-specific supplementary immunization activities (SIAs), reported measles incidence decreased to a historically low level of 39.5 cases per million in 2009. A synchronized nationwide SIA was scheduled in 2010 to further decrease susceptibility to measles. However, reaching and maintaining measles elimination will require strong political commitment and efforts for strengthening surveillance, increasing 2-dose vaccine coverage to >95%, stricter enforcement of the requirement to check immunization status at school entry, and careful attention to measles susceptibility in those aged ≥15 years.