Qiaoyan Liu

Background: An increasing number of original studies suggest that exposure to shift work could be associated with the risk of overweight and obesity, but the results remain conflicted and inconclusive. This study aimed to quantitatively synthesize available epidemiological evidence on the association between shift work and the risk of overweight and obesity by a meta-analysis. Methods: The authors searched PubMed, Embase and the reference lists of all included studies up to April 2017, with a verification search in December 2017. Inclusion criteria were original studies that reported odds ratios, relative risks or hazard ratios (ORs, RRs or HRs, respectively) of at least one outcome of overweight or obesity. Summary risk estimates were calculated by random-effect models. Results: Twenty-six studies (7 cohort studies, 18 cross-sectional studies and 1 case-control study) involving 311 334 participants were identified. Among these studies, the cut-off points of overweight and obesity varied greatly, so the heterogeneity was substantial; however, the results were stable. Shift work was found to be positively associated with the risk of overweight [RR: 1.25; 95% confidence interval (95% CI): 1.08-1.44] and obesity (RR: 1.17; 95% CI: 1.12-1.22). Conclusions: Individuals involved in shift work are more likely to become overweight or obese. Appropriate preventive interventions in the organization of shift schedules according to ergonomic criteria would allow shift workers to avoid potential health impairment.

Objective Multiple clinical similarities exist between IgG4-related sclerosing cholangitis (IgG4-SC) and primary sclerosing cholangitis (PSC), and while gut dysbiosis has been extensively studied in PSC, the role of the gut microbiota in IgG4-SC remains unknown. Herein, we aimed to evaluate alterations of the gut microbiome and metabolome in IgG4-SC and PSC. Design We performed 16S rRNA gene amplicon sequencing of faecal samples from 135 subjects with IgG4-SC (n=34), PSC (n=37) and healthy controls (n=64). A subset of the samples (31 IgG4-SC, 37 PSC and 45 controls) also underwent untargeted metabolomic profiling. Results Compared with controls, reduced alpha-diversity and shifted microbial community were observed in IgG4-SC and PSC. These changes were accompanied by differences in stool metabolomes. Importantly, despite some common variations in the microbiota composition and metabolic activity, integrative analyses identified distinct host–microbe associations in IgG4-SC and PSC. The disease-associated genera and metabolites tended to associate with the transaminases in IgG4-SC. Notable depletion of Blautia and elevated succinic acid may underlie hepatic inflammation in IgG4-SC. In comparison, potential links between the microbial or metabolic signatures and cholestatic parameters were detected in PSC. Particularly, concordant decrease of Eubacterium and microbiota-derived metabolites, including secondary bile acids, implicated novel host–microbial metabolic pathways involving cholestasis of PSC. Interestingly, the predictive models based on metabolites were more effective in discriminating disease status than those based on microbes. Conclusions Our data reveal that IgG4-SC and PSC possess divergent host–microbe interplays that may be involved in disease pathogenesis. These data emphasise the uniqueness of IgG4-SC.

BACKGROUND: Lesotho has one of the highest rates of tuberculosis (TB) incidence and TB-HIV co-infection in the world. Our study aimed to assess the knowledge, attitude and associated factors towards TB in the general population of Lesotho. METHODS: A cross-sectional analysis from the Lesotho Demographic and Health Survey (LDHS) 2014 was carried out among 9247 respondents. We used the chi-square test as well as univariate and multivariate logistic regression analyses to assess the associations of socio-demographic variables with respondent knowledge of and attitude towards TB. RESULTS: The overall knowledge of TB in the general population of Lesotho was adequate (59.9%). There was a significant difference between female and male respondents regarding knowledge about TB (67.0% vs. 41.8%). Almost 95% of respondents had "heard of an illness called tuberculosis", and 80.5% knew that TB can be cured. Only 11.5% knew the correct cause of TB (TB is caused by Mycobacterium tuberculosis). Female respondents were relatively aware of TB, knew about the correct cause and mode for transmission of TB and knew that TB is a curable disease compared to male respondents. A higher proportion of respondents (72.8%) had a positive attitude towards TB. Multivariate logistic regression analysis showed that sex (adjusted odds ratio [AOR] = 2.45, 95% CI: 2.10-2.86; p < 0.001), age (AOR) =1.76, 95% CI: 1.29-2.41; p < 0.001), educational level (AOR = 6.26, 95% CI: 3.90-10.06; p < 0.001), formerly married or cohabitated (AOR = 1.42, 95% CI: 1.10-1.85; p = 0.008), mass media exposure (AOR = 1.33, 95% CI: 1.08-1.64; p = 0.008) and occupation (AOR = 1.20, 95% CI: 1.00-1.44; p = 0.049) were strongly associated with respondent knowledge of TB. Sex (AOR = 1.19, 95% CI: 1.01-1.41; p = 0.034), educational level (AOR = 1.661, 95% CI: 06-2.60; p = 0.028), mass media exposure (AOR = 1.31, 95% CI: 1.06-1.62; p = 0.012) and occupation (AOR = 1.26, 95% CI: 1.04-1.52; p = 0.016) were strongly associated with respondent attitude towards TB. CONCLUSION: Strategies to improve the knowledge of Lesotho's people about TB should focus on males, young residents, those who are illiterate, those who are unmarried and farmers. Special attention should be given to males, young residents, rural residents, those who are illiterate and farmers to improve their attitude towards TB in Lesotho.

BACKGROUND: The concept of healthy aging has become a global health strategy in response to the population aging. In China, old-aged migrants are facing serious health care challenges due to the obstacles in the utilization of health services, social integration and ignored public policies. We aimed to examine the old-aged migrants' utilization of the essential public health services and its underlying factors on account of change of residence, and social support. METHODS: tests and binary multilevel model were conducted to analyze the difference and the underlying factors of the utilization of essential health services among old-aged migrants. RESULTS: Approximately 66.2% of old-aged migrants did not receive free physician examination services from health institutions in the past year, and 34.6% of old-aged migrants with chronic disease have been followed up by doctors. There were significant differences in the utilization of essential public health services among old-aged migrants across different individuals and families. It showed that exercise time, migrating range, migrating reason, physical health condition, chronic disease, local friends, health insurance, household expenditure, and income were significantly associated with the elderly migrants' utilization of essential public health services. CONCLUSIONS: The utilization of essential public health services among old-aged migrants was insufficient in comparison with the general population. The government should launch targeted policies such as production and work-related injuries for the floating population. The supply side should promote the equalization of essential public health services for migrants. Social organizations and community should undertake the responsibility in social support for old-aged migrants.