Notes

Growth as well as Approval of the Multidimensional Frailty Range for Specialized medical Geriatric Evaluation.
ent fat-free mass indicators.
It is found that the association between timing for introducing complementary foods during infancy and the fat mass indicators of children aged 3 to 5 years was not statistically significant, and the association between timing for introducing complementary foods and fat-free mass may be inconsistent for different fat-free mass indicators.
To develop the physical activity questionnaire for Chinese children aged 6-17 years old, in order to evaluate the children's physical activity.

After systematic review, expert review and preliminary investigation, the "6-to 17-year-old Chinese children physical activity questionnaire(CCPAQ)" was established to measure the weekly physical activity. Based on the sample size estimation and inclusion and exclusion criteria, 120 children aged 6-17 were selected from one survey site in the south and north of China. SAS 9.4 software and Mplus 8.0 software were used for factor analyses to validate the modes and types of physical activity measured by CCPAQ.

This study included 119 subjects in total. Exploratory factor analyses were used to assess the 33 modes and 7 types of physical activity time and extract four and one common factor, respectively. Confirmatory factor analysis fitted a second-order 4 factors model and first-order 7 factors model. The evaluation index of the two models were χ~2/df=1.41 and χ~2/df=1.61, respectively, showing that the models fitting were acceptable.

CCPAQ established in this study can effectively measure the physical activity of Chinese children aged 6-17 years.
CCPAQ established in this study can effectively measure the physical activity of Chinese children aged 6-17 years.
To describe the feeding status of infant and young child aged 6-23 months in China.

Data was from the China Nutrition and Health Surveillance among 0-5 Years Old Children and Lactating Women in 2013.Stratified multistage cluster sampling method was used, and 9983 children aged 6-23 months were involved. We analyzed the infant and young child feeding practices with World Health Organization(WHO) 2021 updated indicators. check details Data analyses were conducted using the complex weight based on national census from National Bureau of Statistics in 2010.We used Rao-Scott Chi-square test for statistical difference.

The proportions of children aged 6-23 months meeting minimum dietary diversity(MDD) was 34.5%(95% CI 28.8%-40.2%); it was over 50% in large cities, and only 20.4% in poor rural areas. The proportions of children aged 6-23 months meeting minimum meal frequency(MMF) was 69.2%(95% CI 64.7%-73.7%); it was about 80% in large cities, medium and small cities, and only 45.3% in poor rural areas. The proportions of children aged 6-23 months meeting minimum acceptable diet(MAD)was 23.7%(95% CI 19.2%-28.2%), it was 44.2% in large cities, and less than 10% in poor rural areas. No consistent differences were observed between boys and girls for all 3 dietary indicators(MDD, MMF and MAD), and there was significant difference in different areas and various months of age(P<0.05).

The minimum dietary diversity and minimum acceptable diet among children aged 6-23 month were not optimal in China, especially in poor rural areas.
The minimum dietary diversity and minimum acceptable diet among children aged 6-23 month were not optimal in China, especially in poor rural areas.Hepatitis C virus (HCV) genotype 3 is widely distributed, and genotype 3-infected patients achieve a lower cure rate in direct-acting antiviral (DAA) therapy and are associated with a higher risk of hepatic steatosis than patients with other genotypes. Thus, the study of the virology and pathogenesis of genotype 3 HCV is increasingly relevant. Here, we developed a full-length infectious clone and a subgenomic replicon for the genotype 3a isolate, CH3a. From an infected serum, we constructed a full-length CH3a clone, however, it was nonviable in Huh7.5.1 cells. Next, we systematically adapted several intergenotypic recombinants containing Core-NS2 and 5'UTR-NS5A from CH3a, and other sequences from a replication-competent genotype 2 a clone JFH1. Adaptive mutations were identified, of which several combinations facilitated the replication of CH3a-JFH1 recombinants; however, they failed to adapt to the full-length CH3a and the recombinants containing CH3a NS5B. Thus, we attempted to separately adapt CH3a NS5B-3'UTR by constructing an intragenotypic recombinant using 5'UTR-NS5A from an infectious genotype 3a clone, DBN3acc, from which L3004P/M in NS5B and a deletion of 11 nucleotides (Δ11nt) downstream of the polyU/UC tract of the 3'UTR were identified and demonstrated to efficiently improve virus production. Finally, we combined functional 5'UTR-NS5A and NS5B-3'UTR sequences that carried the selected mutations to generate full-length CH3a with 26 or 27 substitutions (CH3acc), and both revealed efficient replication and virus spread in transfected and infected cells, releasing HCV of 104.2 f.f.u. ml-1. CH3acc was inhibited by DAAs targeting NS3/4A, NS5A and NS5B in a dose-dependent manner. The selected mutations permitted the development of subgenomic replicon CH3a-SGRep, by which L3004P, L3004M and Δ11nt were proven, together with a single-cycle virus production assay, to facilitate virus assembly, release, and RNA replication. CH3acc clones and CH3a-SGRep replicon provide new tools for the study of HCV genotype 3.
People with spinal cord injury (SCI) experience preventable secondary health conditions (SHCs) that worsen the disability, reduce the quality of life and affect health and wellbeing. There is limited information on the prevalence of SHCs and the associated factors to inform planning and practice in South Africa (SA).

To identify the prevalence of SHCs and the associated factors in people with SCI.

We conducted a retrospective review of patients' medical records at a tertiary academic hospital and a rehabilitation hospital in Gauteng Province, SA. Data collected included demographic data, injury profile, SHCs and associated factors. Data were summarised using descriptive statistics of frequency and percentages. Fisher's exact test was used to determine the association between SHCs and sociodemographic and clinical variables. The Mann-Whitney U-test was used to determine the associated risk factors for SHCs. Multinomial regression was used to determine the predictors of the frequency of SHCs.

A total ofgs point to the need for prevention strategies to minimise the occurrence of SHCs.
Stroke is a leading cause of morbidity and mortality. Most deaths occur in low- and middle-income countries, with the incidence predicted to increase as populations undergo socioeconomic and epidemiological changes. Knowledge of contributing factors in a South African (SA) population can be used to drive healthcare initiatives to modify this burden of disease.

To analyse epidemiological data on patients with stroke presenting to an emergency department in Johannesburg, SA.

The study was a 12-month descriptive, retrospective review of medical records, undertaken at a tertiary-level hospital. Patients' records were selected based on the presumptive diagnosis of stroke. Data collected included ethnicity, age, gender, risk factors, signs and symptoms at presentation, and computed tomography (CT) brain scan findings.

Of 312 records reviewed, 160 were eligible for inclusion. The mean age of the patients included was 57.7 years, and 64 patients (40%) had CT-confirmed haemorrhagic strokes. Hypertension was thl modifiable risk factors such as hypertension and diabetes were identified. Data collection on a regional and national level is important to drive targeted healthcare initiatives.
There is a need to retain medical doctors in rural areas to ensure equitable access to healthcare for rural communities. Burnout, depression and anxiety may contribute to difficulty in retaining doctors. Some studies have found high rates of these conditions in medical doctors in general, but there is little research available on their prevalence among those working in the rural areas of South Africa (SA).

To determine the prevalence of burnout, depression and anxiety in doctors working in rural district hospitals in northern KwaZulu-Natal (KZN) Province, SA, and to explore the associated sociodemographic and rural work-related factors.

We performed a quantitative descriptive cross-sectional study in three districts in northern KZN among medical doctors working at 15 rural district hospitals during August and September 2020. The prevalences of burnout, depression and anxiety were measured using the Maslach Burnout Inventory, the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder 7-item χ2=4.08, df=1, p=0.04) were all shown to be significantly associated with doctors planning to leave the public sector in the next 2 years.

Our study found high rates of burnout, depression and anxiety in rural doctors in northern KZN, all of which were associated with the intention to leave the public sector in the next 2 years. Of particular concern was that CSMOs as a group had high burnout and anxiety rates and female gender was associated with burnout. We recommend that evidence-based solutions are urgently implemented to prevent burnout and retain rural doctors.
Our study found high rates of burnout, depression and anxiety in rural doctors in northern KZN, all of which were associated with the intention to leave the public sector in the next 2 years. Of particular concern was that CSMOs as a group had high burnout and anxiety rates and female gender was associated with burnout. We recommend that evidence-based solutions are urgently implemented to prevent burnout and retain rural doctors.
Efavirenz (EFV), a non-nucleoside reverse transcriptase inhibitor, has been a component of first-line antiretroviral therapy (ART) in the South African HIV/AIDS programme since 2004. It is extensively used in ART programmes in other low- and middle-income countries. The natural history of the previously recognised EFV drug-induced liver injury (DILI) is not known.

To define and establish a causality assessment for EFV DILI and document its natural history by detailing a patient cohort. All relevant features characterising the patterns of clinical and histological injury, the duration of clinical and biochemical recovery and the associated mortality rate were documented. Factors associated with specific histological patterns of liver injury were analysed.

Patients were prospectively included after meeting causality and inclusion criteria for EFV DILI. Clinical, demographic and liver histological features (where possible) were documented from the time of presentation and throughout follow-up. Prednisone a(<30 years; p=0.045), ART initiation in pregnancy (p=0.02), and a baseline CD4 count >350 cells/µL (p=0.018). For the nonspecific hepatitis group, pregnancy was also an associated factor (p=0.04). The mortality rate was 14%, with a median time from admission to death of 15days. The median (IQR) time to initial hospital discharge was a lengthy 33 (24 - 52) days. Biochemical recovery was prolonged, necessitating a follow-up period of more than a year at an outpatient specialist clinic, with 86% of patients initiating a protease inhibitor-based ART regimen successfully.

EFV DILI is a severe drug complication of ART with appreciable mortality and significant inpatient morbidity, requiring prolonged hospitalisation and follow-up.
EFV DILI is a severe drug complication of ART with appreciable mortality and significant inpatient morbidity, requiring prolonged hospitalisation and follow-up.
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