Polychlorinated biphenyls (PCBs) are persistent organic pollutants of global concern, yet their associations with predicted cardiovascular risk remain unclear. In this prospective Wuhan-Zhuhai cohort study, concentrations of seven serum PCBs (PCB-28, 52, 101, 118, 138, 153, and 180) were measured using GC-MS/MS. The validated China-PAR equation was used to calculate predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk, and urinary 8-iso-prostaglandin F2α (8-iso-PGF2α) served as a marker of oxidative stress. Multivariable linear and logistic regression models were fitted to evaluate PCB-related differences in continuous predicted risk and predicted high-risk status. Cross-sectionally, each one-unit increase in ln-transformed PCB-118, PCB-138, PCB-153, and ΣPCB was associated with 1.249-, 1.253-, 1.457-, and 1.829-percentage-point higher predicted 10-year ASCVD risk, respectively (all P < 0.05). The associations for PCB-118, PCB-138, and PCB-153 remained significant after FDR correction. Longitudinally, persistent high PCB-118 exposure was associated with a 0.510 percentage-point greater increase in predicted 10-year ASCVD risk (95 % confidence interval [CI]: 0.023-0.996, P < 0.05) and a higher risk of transitioning to predicted high-risk status (RR = 1.432, 95 % CI: 1.012-2.027, P < 0.05) compared with persistent low exposure, although neither association remained significant after FDR correction. Exploratory mediation analysis suggested that urinary 8-iso-PGF2α was statistically consistent with partial indirect pathways for the associations, with estimated indirect proportions ranging from 3.29 % to 11.62 %. Database-derived bioinformatics analyses highlighted TNF/NF-κB/IL-17 pathways and identified IL-6, TNF, IL-1β, and ICAM1 as candidate hub genes. Overall, several PCB measures were cross-sectionally associated with higher predicted ASCVD risk, whereas longitudinal evidence was limited and was strongest for persistent high PCB-118 exposure. Exploratory mediation and bioinformatics findings highlighted possible oxidative-stress and inflammation-related pathways that require further validation.

BACKGROUND:Unhealthy sleep behaviors are important risk factors for elevated blood pressure (BP), but evidence is limited for the combined effects of sleep behaviors on BP, especially among different ethnic groups at diverse altitudes. OBJECTIVES:We aimed to investigate the association between combined sleep behaviors and BP among multi-ethnic groups at varied altitudes in China. METHODS:The baseline survey of the Regional Ethnic Cohort Study in Northwest China enrolled more than 100,000 adults 35 to 74 years of age from multi-ethnic groups at varied altitudes in 5 provinces between 2018 and 2019. A healthy sleep score (HSS) was constructed considering 4 sleep behaviors (sleep duration, insomnia, snoring, and excessive daytime sleepiness). Multiple linear or logistic regression models were used to evaluate the associations of sleep factors with systolic BP, diastolic BP, mean arterial pressure, and hypertension. RESULTS:Among the 97,476 participants, 34,407 (35.3%) had an HSS of 4 and 6,934 (7.1%) had an HSS of 0-1. Compared with participants with an HSS of 0-1, those with an HSS of 4 had lower systolic BP (β: -4.19; 95% CI: -4.63 to -3.76), diastolic BP (β: -3.13; 95% CI: -3.40 to -2.85), and mean arterial pressure (β: -3.48; 95% CI: -3.78 to -3.18), and reduced odds of hypertension (OR: 0.68; 95% CI: 0.64-0.73). Each additional HSS was associated with 13% lower odds of hypertension (OR: 0.87; 95% CI: 0.86-0.89). The inverse associations appeared to be stronger among the Uygur ethnicity and at low residential altitude. CONCLUSIONS:Healthy sleep pattern may decrease BP among different ethnic groups at varied altitudes in Chinese adults.

Reproductive characteristics significantly shape physiological adaptations, little is known about how they relate to adiposity in women of multi-ethnic regions undergoing a rapid increase in obesity burden. This study aims to address this gap by assessing how reproductive patterns correlate with adiposity and identifying potential moderating factors among Chinese adults. In 2018–2019, 107,679 participants from the Regional Ethnic Cohort Study in China were included in this cross-sectional analysis. Restricted cubic spline and generalized linear regression models were used to assess the association of reproductive characteristics such as age at menarche and menopause, number of children, menopause status, duration of post-menopause, and reproductive years, as well as reproductive pattern with adiposity using body mass index (BMI). Reproductive pattern was characterized using a Higher-Risk Reproductive Score (HRRS), which incorporates key landmarks such as early menarche (≤ 12 years), having ≥ 3 children, and later age at menopause (≥ 51 years). Females’ mean BMI was 24.4 (standard deviation, SD 3.8) kg/m2, with the median age at menarche and menopause of 15.0 (interquartile range, IQR 2.0) and 49.0 (IQR 5.0), median number of children and reproductive years of 2.0 (IQR 1.0) and 34.0 (IQR 6.0). Age at menarche was non-linearly associated with an average drop of 0.13 kg/m2 in BMI, particularly in Uyghur ethnic and younger adults. Age at menopause and reproductive years was non-linearly related to higher BMI by 0.05 and 0.07 kg/m2 per year delay. Adiposity exhibited an inverted U-shape with number of children. The duration of post-menopause correlated with a BMI reduction of 0.08 kg/m² on average. The HRRS was associated with an increase of 0.56 kg/m2 in BMI. Among Chinese women, earlier age at menarche and later age at menopause were associated with increased adiposity. Adiposity showed an inverted U-shaped relationship with number of children, and a higher-risk reproductive pattern was linked to increased adiposity.

Background:Persistent infection with 9-valent human papillomavirus (9v-HPV) is a major risk factor for HPV-related cancers among men who have sex with men (MSM). This study aimed to develop a dynamic prediction model to assess whether longitudinal sexual-behavior-related and exposure-related indicators could predict persistent 9vHPV infection among human immunodeficiency virus type 1 (HIV-1)-negative MSM. Method:Between 2016 and 2023, HIV-negative MSM in Urumqi, China, were followed every 6 months. Baseline questionnaires and anal swabs were collected, and HPV genotyping was performed using an assay detecting 37 HPV genotypes. The primary outcome was persistent infection with 1 or more of the 9 genotypes covered by the 9-valent HPV vaccine. Persistent 9vHPV infection was defined as detection of at least one of these 9 genotypes on 2 or more consecutive visits after a negative baseline. Key indicators included same-sex partner number, anal intercourse frequency, condom use, commercial sex, club drug use, partner-seeking venues, and sexual role. A Bayesian joint model integrating longitudinal sexual-behavior-related indicators and time-to-event outcomes was developed. Predictive accuracy was assessed using the time-dependent area under the curve (AUC) with internal validation. Results:Among 704 MSM, factors including employment, commercial sex, receptive anal intercourse, and versatile roles were associated with increased persistence risk. Higher number of sexual partners (HR = 1.95) and more frequent anal intercourse (HR = 2.04) were strong predictors. The partner-based model demonstrated superior predictive accuracy (AUC = 0.727). Conclusions:The Bayesian joint model provides accurate dynamic predictions of persistent 9v-HPV infection in MSM, supporting personalized prevention strategies.

To explore the differences in the composition of the anorectal microbiota in the context of known anorectal HPV infection, providing scientific evidence for early prevention and intervention of persistent HPV infection in the MSM population. A retrospective analysis was performed based on an existing prospective cohort study conducted between 2016 and 2023, which provided rectal swab samples for microbiota sequencing. After providing consent, 58 participants with more than 8 months of follow-up were divided into two groups on the basis of their HPV infection status during their last two follow-up visits: the HPV-negative group (negative) and the persistent HPV-positive group (positive). Rectal swab samples were collected from both groups, and 16 S rRNA sequencing was performed to analyze the microbiota composition. No significant differences were observed in the α- or β-diversity of the gut microbiota between MSM with persistent HPV infection and those in the HPV-negative group. However, the relative abundance of Bacteroides fragilis was significantly higher in the persistent HPV group (p = 0.002, bh_p = 0.016). Additionally, taxa such as Victivallis, Negativibacillus, Victivallaceae, and Eggerthella were enriched in individuals with persistent infection. In contrast, Prevotella disiens, Gardnerella, and Negativicoccus sp. showed higher relative abundances in the HPV-negative group, suggesting their potential as microbial markers associated with HPV clearance. This study indicate that the gut microbiota is altered in MSM with persistent HPV infection. Although no significant differences were observed in overall α and β diversity, taxa such as Bacteroides fragilis, Victivallis, and Eggerthella were enriched in the persistent group, while Prevotella disiens and Gardnerella were more abundant in the negative group. These findings are exploratory, and future longitudinal studies with HPV genotyping and confounder control are warranted to clarify their relevance.

BACKGROUND:Chronic obstructive pulmonary disease (COPD) patients can have increased cardiovascular events risk, which might be impacted by an imbalance between fat and muscle mass. This study explores the relationships between visceral fat-to-muscle mass ratio (VMR) and cardiovascular events and mortality in COPD patients. METHODS:A prospective cohort study was performed on COPD patients from May 2018 to December 2023. Baseline information and VMR were collected. The primary outcome was major adverse cardiovascular events (MACE), including cardiovascular death, myocardial infarction, stroke, and exacerbation of congestive heart failure. Secondary outcomes were non-fatal cardiovascular events and mortality. Cox regression models, Kaplan-Meier curves, and restricted cubic splines were applied to assess the relationship between VMR and outcomes. RESULTS:Of 1045 COPD patients, 138 (13.2 %) experienced MACE, and 169 (16.2 %) experienced non-fatal cardiovascular events and mortality during an average of 62-month follow-up period. VMR was nonlinearly associated with MACE (P = 0.023), with one-standard-deviation VMR increase leading to a 50 % increase in MACE risk (hazard ratio, HR, = 1.50, 95 % confidence interval, CI = 1.17-1.93) and 20 % increase in non-fatal cardiovascular event and mortality risk (HR = 1.20, 95 % CI = 1.08-1.34). The cumulative MACE incidence rose with higher VMR categories (log-rank P < 0.0001). In the fully adjusted model, the highest VMR quartile was significantly associated with a greater MACE risk than the lowest VMR (HR = 5.18, 95 % CI = 2.75-9.75). Sensitivity analyses confirmed the robustness of these findings. Subgroup analyses indicated a more significant VMR impact in those below 60. CONCLUSIONS:Elevated VMR was associated with increased MACE among COPD patients.

Human papillomavirus (HPV) plays a significant role in cancers of the head, neck, and anogenital areas. This study aimed to estimate the burden and trends of HPV-related cancers in 44 selected countries from 1990 to 2017. Data on cancers attributable to HPV infection from 1990 to 2017 were extracted from the Cancer Incidence in Five Continents (CI5) plus database. The population-attributable fraction (PAF), age-standardised incidence rates (ASIR), and average annual percentage change (AAPC) were analyzed to identify trends. From 1990 to 2017, 3,560,554 new HPV-attributed cancer cases were recorded across 44 countries, with an ASIR of 4.6 per 100,000 population. Site-specific ASIRs were: cervical (5.8), penile (1.2), vulvar (4.0), vaginal (1.5), anal (1.9), oropharyngeal (3.1), oral (1.3), and laryngeal (1.4). While ASIRs decreased in most countries, significant increases occurred in China, Uganda, and Latvia. HPV-related cancers remain a global health challenge with marked regional variations.

BACKGROUND:Cardiovascular-kidney-metabolic (CKM) syndrome begins with obesity and glucose abnormalities, advancing to cardiovascular and kidney complications. This study investigates the relationship of advanced glycation end products (AGEs) with CKM syndrome staging and transition patterns. METHODS:This 3-year longitudinal study (2019-2022) of 1264 adults identified five CKM trajectory groups: Group 1 (stable low-risk, 6.7%, stage 0/1), Group 2 (fluctuating, 15.8%, stages 0/1-2), Group 3 (stable intermediate, 52.8%, stage 2), Group 4 (progressors, 8.9%, to stage 3/4), and Group 5 (stable high-risk, 15.8%, stage 3/4), from baseline distributions of stage 0 (1.6%), 1 (12.3%), 2 (71.0%), 3 (5.8%), and 4 (9.2%). Serum AGEs were quantified by UPLC-MS/MS. RESULTS:Higher AGEs levels showed significant associations with CKM severity, with each 1-SD increase corresponding to a 30% greater likelihood of advanced staging (95% CI:10%-54%). Quartile analysis revealed a dose-response relationship (Q2:1.66[1.15-2.41]; Q3:1.67[1.12-2.48]; Q4:1.92[1.31-2.81]). Longitudinally, the total AGEs score was significantly associated with CKM transition patterns from 2019 to 2022. The odds ratios (ORs) for Group 2, Group 3, Group 4, and Group 5 compared to Group 1 were 1.61 (1.06-2.45), 1.64 (1.11-2.41), 1.71 (1.07-2.73), and 2.03 (1.32-3.13), respectively. CONCLUSIONS:These findings suggest that serum AGEs are linked to CKM severity and progression, potentially serving as biomarkers for CKM staging and targets for intervention.

BACKGROUND:There are few studies that describe the impact of SARS-CoV-2 infection on HIV outcomes. We aimed to assess the viral adverse changes associated with SARS-CoV-2 infection in PLHIV. RESEARCH DESIGN AND METHODS:This retrospective cohort study enrolled 3327 PLHIV on ART. Baseline information was collected through questionnaires and electronic health records. PLHIV with and without SARS-CoV-2 infection (reference) were propensity score matched. The association between SARS-CoV-2 infection and HIV viral rebound was assessed by using log-binomial regression models, with relative risks estimated. RESULTS:We included 446 PLHIV without SARS-CoV-2 infection and 446 PLHIV with SARS-CoV-2 infection after matching. Compared to PLHIV without SARS-CoV-2 infection, PLHIV with SARS-CoV-2 infection had relatively higher HIV VLs (75th percentile: 105 versus 51 copies per mL; 80th percentile: 257 versus 196 copies per mL; 90th percentile: 5170 versus 2360 copies per mL). PLHIV infected with SARS-CoV-2 had a significantly increased risk of viral rebound (RR of 1.32, 95% confidence interval [CI]: 1.25, 1.40). The risk was higher among males than females but was comparable across age groups. Similar patterns were observed for secondary outcomes. CONCLUSIONS:These findings suggest that SARS-CoV-2 infection is a risk factor for viral rebound in PLHIV on ART.

Introduction This study examines dietary network in Northwest China, focusing on food group consumption and regional trends using network analysis.Methods Data from 106 424 participants in the Regional Ethnic Cohort Study were calculated using a semiquantitative food frequency questionnaire. We compared intake with the 2022 Chinese Dietary Guidelines and employed the EBICglasso method to construct dietary and staple food-related network, assessing its stability and accuracy.Results Northwest China’s staple food intake was 37.5% of total consumption, dominated by wheat. Compared with the Chinese dietary guidelines, participants’ intake of staple foods, soybeans and nuts was within the acceptable range, with insufficient intake of whole grains and beans, animal source of foods, eggs, fruits and vegetables but excessive intake of salt. Intake varied by province, sex and age. In overall participants, the strongest correlations were found between the two food groups, namely fruits and vegetables (0.33), and animal source of foods and dairy products (0.24) in dietary network. Soybeans and nuts appeared to connect to more other foods and also higher correlation with other foods and were followed by animal source of food. The staple food-related food network indicated that the intake of rice, whole grains and beans, and potatoes was positively correlated with the intake of most other foods, while intake of wheat was negatively correlated with foods of animal source of food, milk and dairy products.Conclusions Northwest China’s diet exhibits irrational patterns, highlighting the importance of assessing overall dietary patterns in nutritional evaluation.

Several studies showed higher risks of cardiovascular complications to have been observed in patients with type 2 diabetes mellitus (T2DM). Atrial fibrillation (AF) and atrial flutter have been more pronounced in patients with hyperglycemia. Sodium-glucose co-transporter 2 (SGLT2) inhibitors are now considered as second-line treatment for patients with T2DM following inadequate glycemic control with first line agents. In this analysis, we aimed to compare the risk of AF in patients with T2DM who were treated with SGLT-2 inhibitors versus DPP-4 inhibitors. Relevant publications comparing AF in patients with T2DM treated by SGLT-2 inhibitors versus DPP-4 inhibitors were searched through electronic databases. AF was the clinical endpoint in this analysis. Revman 5.4 software was used to carry out this analysis. Risk ratios (RR) with 95

Background: Pre-exposure prophylaxis (PrEP) programs have been implemented in multiple countries. Evidence from clinical trials and cohort studies has proven the safety and effectiveness of PrEP. However, minimizing drug-related adverse effects and cost should be primarily considered in PrEP. Most trials used tenofovir combined with emtricitabine as the intervention; yet, the use of tenofovir disoproxil fumarate (TDF) (ie, Tenofovir) alone has not been thoroughly evaluated. Furthermore, the medication regimen in most trials was used every day, with a few studies proposing an optimal medication regimen for PrEP. Objective: This study was designed to systematically evaluate the preventive efficacy and safety profile of TDF-based PrEP in the Chinese population. We also aimed to explore medication compliance, changes in sexual behavior, and hazard factors of HIV infection. Methods: We conducted a pragmatic randomized controlled trial (RCT) to evaluate the effectiveness and safety of TDF for HIV PrEP. Participants were randomly assigned (1:1:1) to a time-driven group (TDF 300 mg administered orally once daily), an event-driven group (TDF 300 mg administered orally 24 to 48 h before sexual activity and 2 hours after sexual activity, not exceeding 300 mg within 24 h), or an untreated control group. The primary outcomes were the effectiveness and safety of TDF during periods of PrEP use. Secondary outcomes focused on the effectiveness of TDF among participants with good compliance during PrEP use. Tertiary outcomes included the risk factors of HIV infection and behavioral changes from PrEP initiation to the last visit. For ethical reasons, all participants received condoms and health education. This study was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-13003849). Results: A total of 1914 participants underwent randomization. During the follow-up of 3513.5 person-years from June 2013 to May 2016, HIV seroconversion was observed in 30 persons (2.02 per 100 person-years) in the time-driven group (time-driven vs control group: hazard ratio [HR] 0.93, 95% CI 058-1.51; P=.78), 35 (1.73 per 100 person-years) in the event-driven group (event-driven group vs control group: HR 0.83, 95% CI 0.52-1.31; P=.42), and 37 (2.06 per 100 person-years) in the control group. Post hoc analysis showed that participants with good medication compliance reduced their HIV infection risk by 53% (P=.01) and event-driven medication with good compliance reduced the risk by 62% (P=.009). We recorded no severe adverse events during the trial. For tertiary outcomes, low medication compliance, sexual role, no condom use, and more number of sexual partners remained significantly associated with HIV risk. Conclusions: The TDF-based PrEP is ineffective without good adherence. However, when medication compliance is achieved, event-driven dosing is recommended as an optimal PrEP regimen.

BACKGROUND:Although the information on the validation status of electronic sphygmomanometer (ES) devices in use in health care institutions and households is much more clinically relevant than that of ES models available on the market, it remains insufficient. METHODS:A national survey was conducted across all administrative regions of mainland China to assess the validation status of ESs. Fifty-eight cities were selected with stratification by municipality, provincial capital, and other cities, and health care institutions and households in each city were chosen by convenience to identify ES devices in use according to the study protocol. Information on devices' model, type, was collected. The validation status of each device was ascertained through searching international online registries of its models. RESULTS:A total of 3230 ES devices (1924 from health care institutions and 1306 from households), encompassing 498 ES models, were actually selected. The weighted proportion of accuracy-validated devices was significantly higher in health care institutions (33.9% [95% CI, 31.8-36.0%]) compared with households (23.0% [95% CI, 20.8-25.4%]; P<0.001), and both exceeded the proportions for models (17.7% [95% CI, 13.7-22.6%] and 12.5% [95% CI, 9.5-16.3%], respectively). Regional economic development, device type, and years in use were associated with the proportion of accuracy-validated devices. Notably, 8.8% of devices used in secondary hospitals were wrist type. CONCLUSIONS:The accuracy validation status of ESs in China in the number of devices in use shows a more favorable situation than that in the number of models but remains low and concerning. Policies are urgently needed to promote the widespread adoption of accuracy-validated models among all users.

Background: Clearance of human papillomavirus (HPV) among adolescent men who have sex with men (MSM) is not well studied. This study aimed to evaluate the clearance of HPV DNA and antibodies among adolescent MSM. Methods: In our cohort study, we enrolled adolescent MSM in Melbourne between October 2010 and September 2013. At baseline, 3, 6, and 12 months, anal and penile swabs for HPV DNA and serum for HPV antibodies against genotypes 6, 11, 16, and 18, were collected. Definite clearance was defined as HPV DNA (same site) /antibodies for the same genotype undetected following a positive HPV DNA /antibodies test at baseline or month 3. Possible clearance was defined as HPV DNA (same site) /antibodies for the same genotype undetected at month 12 following a positive HPV DNA/antibodies test at month 6. Overall clearance was defined as either definite or possible clearance. The agreement between HPV DNA clearance and antibodies clearance was calculated. Results: A total of 183 MSM were included (median age: 19 years, interquartile [IQR]: 18 to 20). At the anus, overall clearance rate was 21.6 (95 % confidence interval[CI]: 7.9 to 47.0), 44.8 (19.3 to 88.3), 51.9 (20.9 to 106.9) and 33.7 (7.0 to 98.5) per 1000 person months (PM) for HPV 6, 11, 16 and 18. At the penis, overall clearance rate was 64.5 (13.3 to 188.5), 71.3 (14.7 to 208.2), 96.5 (31.3 to 225.3) and 333.3 (8.4 to 1857.2) per 1000 PM for HPV 6, 11, 16 and 18. For antibodies, overall clearance rate was 22.2 (9.6 to 43.7), 18.8 (3.9 to 55.0), 10.8 (0.3 to 60.1) and 19.0 (2.3 to 68.8) per 1000 PM. Agreement between anal/penile HPV DNA clearance and antibodies clearance was low: kappa = -0.18 (95 % CI: -0.28 to 0.08)/-0.13 (-0.24 to -0.02), 0.04 (-0.29 to 0.36)/0.22 (-0.32 to 0.76), -0.10 (-0.27 to 0.08)/-0.14 (-0.37 to 0.10) and -0.14 (-0.28 to 0.01)/-0.14 (-0.33 to 0.06) for HPV 6, 11, 16 and 18, respectively. Conclusion: Clearance rates of HPV DNA were low and varied by genotypes and anatomical sites among adolescent MSM. Antibodies against HPV were stable during the study period.

Background Little is known about the effects of night shifts and their interactions with genetic factors on chronic obstructive pulmonary disease (COPD). In this study, we aim to investigate relationships between long-term night shift work exposure and COPD risk, and assess modification effects of genetic predisposition. Methods A total of 277,059 subjects who were in paid employment or self-employed were included in the UK Biobank. Information on current and lifetime employment was obtained, and a weighted COPD-specific genetic risk score (GRS) was constructed. We used Cox proportional hazard models to investigate associations between night shift work and COPD risk, and their interaction with COPD-specific GRS. Results The cohort study included 277,059 participants (133,063 men [48.03%]; mean [SD] age, 52.71 [7.08] years). During a median follow-up of 12.87 years, we documented 6558 incidents of COPD. From day work, irregular night shifts to regular night shifts, there was an increased trend in COPD incidence ( P for trend < 0.001). Compared with day workers, the hazard ratio (HR) and 95% confidence interval (CI) of COPD was 1.28 (1.20, 1.37) for subjects with rarely/sometimes night shifts and 1.49 (1.35, 1.66) for those with permanent night shifts. Besides, the longer durations (especially in subjects with night shifts ≥ 10 years) and increasing monthly frequency of night shifts (in workers with > 8 nights/month) were associated with a higher COPD risk. Additionally, there was an additive interaction between night shifts and genetic susceptibility on the COPD risk. Subjects with permanent night shifts and high genetic risk had the highest risk of COPD (HR: 1.90 [95% CI: 1.63, 2.22]), with day workers with low genetic risk as a reference. Conclusions Long-term night shift exposure is associated with a higher risk of COPD. Our findings suggest that decreasing the frequency and duration of night shifts may offer a promising approach to mitigating respiratory disease incidence in night shift workers, particularly in light of individual susceptibility.

After the exit “zero-COVID” strategy in mainland China by the end of 2022, a large-scale COVID-19 outbreak seeded by Omicron variants occurred. An inhaled adenovirus type-5 vector-based (i.e., inhaled Ad5-nCoV) COVID-19 vaccine was licensed earlier in 2021. In this study, we aimed to assess the real-world effectiveness of a heterologous booster of inhaled Ad5-nCoV vaccine against Omicron infection and compared with the protection from hybrid immunity (i.e., prior breakthrough infection). In this retrospective cohort study, we identified 1087 out of a total of 1146 hospital staff from a tertiary hospital in Urumqi city, China from November 22 to December 29, 2022. Demographic characteristics, baseline health status, occupation, behavioral factors, laboratory test of serological IgG antibody, and timeline from immunization to laboratory-testing outcome were obtained. We analysed the individual-level vaccination status of inhaled Ad5-nCoV vaccine, prior SARS-CoV-2 infection status and baseline vaccination status, and other risk factors before follow-up. The protective effects of the heterologous inhaled Ad5-nCoV vaccine and hybrid immunity against Omicron BA.5 infection and hospitalization were calculated as relative rate reduction (RRR), which was estimated using multivariate Poisson regression models. A total of 1087 hospital staff (median age of 34 years, and 343 males [31.6

Abstract Background Cancer survivors face many challenges in long-term health management, including malnutrition, systemic inflammation, and sleep issues, which significantly affect their survival and quality of life. Methods A prospective cohort study was derived from the National Health and Nutrition Examination Survey from 2005–2018 harboring 1,908 cancer survivors (weighted population, 11,453,293), of whom 688 deaths (220 from cancer mortality, 468 from non-cancer mortality). The Advanced Lung Cancer Inflammation Index (ALI) was used as a measure of nutritional status and systemic inflammation in cancer patients. Weighted multivariable Cox proportional hazards regression models were utilized to explore the independent and combined effects of ALI and sleep quality on mortality outcomes. Results The participants with a high ALI were more likely to be female, aged 40 to 64 years, non-Hispanic white, and have a higher BMI. We observed that elevated ALI levels were associated with decreased risks of all-cause mortality (Hazard ratio [HR] = 0.601, 95% Confidence interval [CI] = 0.521–0.695, P < 0.001), cancer-specific mortality (HR = 0.659, 95% CI = 0.497–0.870, P = 3.34 × 10–3) and non-cancer-specific mortality (HR = 0.579, 95% CI = 0.478–0.701, P < 0.001). Similarly, better sleep quality (e.g., without sleep troubles) was associated with lower risks of all-cause mortality (HR = 0.761, 95% CI = 0.620–0.933, P = 8.79 × 10–3) and non-cancer-specific mortality (HR = 0.713, 95% CI = 0.572–0.890, P = 2.80 × 10–3). Notably, the joint analysis showed that cancer survivors with higher ALI levels and better sleep quality (e.g., standard sleep duration) had the lowest risks of all-cause (HR = 0.468, 95% CI = 0.352–0.622, P < 0.001), cancer-specific mortality (HR = 0.631, 95% CI = 0.333–0.672, P = 7.59 × 10–3) and non-cancer-specific mortality (HR = 0.440, 95% CI = 0.315–0.615, P < 0.001). Conclusions This study suggests that better nutritional and inflammatory status, combined with good sleep quality, may contribute to improved survival among cancer survivors. These results underscore the potential clinical importance of integrating nutritional and sleep quality assessments into the long-term care of cancer survivors to enhance their overall prognosis.

Background Understanding the natural history of anal high-risk human papillomavirus (hrHPV) infection is key for designing anal cancer prevention programs but has not been systematically characterized. Methods We reanalyzed data from 34 studies including 16 164 individuals in 6 risk groups defined by human immunodeficiency virus (HIV) status, sex, and male sexuality: men who have sex with men (MSM) and people with HIV (MSMWH), HIV-negative MSM, women with HIV (WWH), HIV-negative women, men who have sex with women (MSW) with HIV (MSWWH), and HIV-negative MSW. We used Markov models to estimate incidence and clearance of 13 hrHPV types and their determinants. Results Human papillomavirus (HPV) 16 had the highest incidence-clearance ratio of the hrHPV types. MSMWH had the highest hrHPV incidence (eg, 15.5% newly HPV-16 infected within 2 years), followed by HIV-negative MSM (7.5%), WWH (6.6%), HIV-negative women (2.9%), MSWWH (1.7%), and HIV-negative MSW (0.7%). Determinants of HPV-16 incidence included HIV status and number of sexual partners for MSM, women, and MSW, and anal sex behavior for MSM only. HPV-16 clearance was lower for people with HIV (PWH) and lower for prevalent than incident infection. Among MSM, increasing age was associated with lower clearance of prevalent, but not incident, HPV-16 infection. Conclusions This robust and unifying analysis of anal hrHPV natural history is essential to designing and predicting the impact of HPV vaccination and HPV-based screening programs on anal cancer prevention, particularly in MSM and PWH. Importantly, it demonstrates the higher carcinogenic potential of longstanding anal prevalent hrHPV infection than more recent incident infection.