Numerous COVID-19-related apps were widely used during the COVID-19 pandemic. Among them, those supporting epidemiological investigations were particularly useful. This study explored the effectiveness of apps that support epidemiological investigations, factors influencing users\' intention to use them, and ways to encourage their use.
We developed and evaluated the KODARI app to demonstrate its importance in epidemiological investigations. After adapting a questionnaire based on an existing evaluation framework for COVID-19-related apps, we collected data from 276 participants through an online survey conducted between April 28 and May 25, 2023. We conducted two independent sample t-tests to determine the differences between each variable according to demographic characteristics and a multiple regression analysis to identify factors affecting intention to use.
Users were generally satisfied with the KODARI. We observed differences in sex, age, marital status, occupational characteristics, and experience with epidemiological investigation. Females rated the app\'s information accuracy higher than males. Males had a higher intention to use than females. Participants aged under 35 years rated information accuracy and transparency highly, whereas single participants rated information accuracy higher than married participants. Occupational groups with frequent interactions with others evaluated their self-determination regarding the application. The app\'s self-determination was highly valued among participants with experience in epidemiological investigations. By investigating the factors affecting the intention to use the app, we confirmed that effectiveness, self-determination, and usability significantly affected the intention to use.
This study demonstrated the effectiveness of app supporting epidemiological investigations, identified meaningful factors that influence intention to use, and confirmed the applicability of our new framework by considering the specificity of infectious disease situations such as COVID-19. This study provides a new basis for future epidemiological studies.

Negative moods in college students have caused frequent extreme behaviors. This study analyzed the current status and correlation between physical activity and negative moods in college students.
A cross-sectional study design was used in the present research. Data on college students\' physical activity and negative moods were collected using the Sports Questionnaire Star software. The questionnaires were administered to college students in five colleges and universities in Henan and Jiangsu Provinces, China, and a total of 3711 correctly completed questionnaires were returned. Data on sociological and demographic information, the International Physical Activity Questionnaire Short Form (IPAQ-SF), and the Depression Anxiety and Stress Scale (DASS) were collected. The research was conducted in December 2021.
The low-intensity physical activity rate among college students was 55.56%, while depression, anxiety, and stress symptoms were detected in 35.14%, 65.29%, and 10.99%of the college students, respectively. Depression (K = 35.58, p < 0.001) and anxiety (K = 15.56, p < 0.001) rates were significantly different among the different physical activity intensity groups. The proportion of students who perform high-intensity physical activities was lower than those who perform low- and moderate-intensity physical activities.
Low physical activity and high anxiety are evident among college students, and prolonged moderate-to-low-intensity physical activity (including static behavior) induces depression and anxiety. In the future, further studies can be conducted on improving the physical activity intensity of college students, improving the mental health monitoring and intervention systems of college students, and exploring the dose-effect relationship between physical activity and negative moods.

BACKGROUND: Tuberculosis (TB) has remained a tough problem in China. This study aims to identify the risk of tuberculosis transmission and to assess its characteristics.
METHODS: We performed a molecular epidemiological study for patients with culture-positive Mycobacterium tuberculosis (M. tuberculosis) in Shanghai, from 2009 to 2018. Demographic information was obtained from the Tuberculosis Information Management System. Whole-genome sequencing (WGS) was conducted with a threshold of 12 single-nucleotide polymorphisms (SNPs) to distinguish the genomic cluster. To analyze the characteristics of TB transmission, the contact investigation for clustered cases was performed.
RESULTS: In total, 94 (27.25%) of the 345 enrolled patients were grouped into 42 genomic clusters, indicating local transmission of M. tuberculosis strains. Compared to a health system delay <14 days, patients with a health system delay ≥14 days [adjusted odds ratios (AOR) = 2.57, 95% confidence interval (CI): 1.34-4.95] were more likely to be clustered. Patients under 65 years old (AOR = 3.11, 95% CI: 1.76-5.49), residents (AOR = 2.43, 95% CI: 1.18-4.99), and Beijing genotype strains (AOR = 3.35, 95% CI: 1.32-8.53) were associated with increased risk of clustering. Interestingly, patients with resistance to isoniazid (AOR = 2.36, 95% CI: 1.15-4.88) had a higher risk of transmission. Sixteen confirmed/probable epidemiological links were identified. Local transmission of imported cases and household transmission were prominent.
CONCLUSIONS: Health system delay is a crucial factor for TB transmission. Patients with resistance to isoniazid should be priority targets for contact investigation to reduce transmission.

Objectives: Freezing of gait (FOG) is generally considered as an independent symptom of Parkinson\'s disease (PD) with a complex pathophysiology. There is a wide range of associated clinical features of FOG reported from different studies without consistent conclusion. Thus, a multicenter, cross-sectional study was designed to investigate the prevalence and clinical features of FOG together with its unique contribution quality of life in Chinese PD patients. Methods: Eight hundred and thirty eight PD patients were consecutively recruited into this study from 12 hospital centers in six provinces in China. Clinical information, including motor and neuropsychological features as well as pharmacological details, was collected. Results: Of 827 PD patients, 245 (29.63%) reported FOG. The prevalence of FOG was strongly correlated with modified H-Y stages and symptomatic duration (p < 0.01). 84.90% freezers experienced FOG during turning and 88.98% experienced when initiating the first step. Compared with non-freezers, freezers reported longer disease duration (7.73 ± 5.44 vs. 4.69 ± 3.94, p < 0.000), higher frequent PIGD phenotype (61.22 vs. 35.91%, p < 0.000), higher scores of UPDRS III (32.85 ± 15.47 vs. 22.38 ± 12.89, p < 0.000), HAMA (10.99 ± 7.41 vs. 7.59 ± 6.47, p < 0.000), HAMD (15.29 ± 10.29 vs. 10.58 ± 8.97, p < 0.000) and lower MMSE score (25.12 ± 5.27 vs. 26.63 ± 3.97, p < 0.000), and higher daily levodopa dosage (432.65 ± 264.31 vs. 319.19 ± 229.15, p < 0.000) with less frequent initial use of dopaminergic agonist (8.57 vs. 14.78%, p < 0.05). Using binary logistic regression, the associated factors of FOG might be non-tremor dominant onset (OR = 3.817, p < 0.000), the presence of anxiety (OR = 2.048, p < 0.000) and imbalance (OR = 4.320, p = 0.012). Freezers had poorer quality of life than non-freezers and FOG impacted PDQ-8 independently. Conclusion: Nearly one third of the PD patients experienced FOG. Its frequency increased with PD progression and FOG reduced independently the quality of life. Non-tremor dominant, disease progression, and anxiety were risk factors of FOG.

China\'s vigorous anti-COVID-19 campaign has been going on for three months since January 20, which has contained the spread of the virus across China.
Epidemiological investigations found that COVID-19 fatality rates in Wuhan, rest parts of Hubei province except Wuhan (Rest of Hubei) and rest parts of Mainland China except Hubei province (Rest of China) were different. An ecological study was conducted to analyze the reasons and provide the world with China\'s anti-COVID-19 epidemic experiences.
Infected cases from Mainland China were divided into three populations: Wuhan, Rest of Hubei and Rest of China. Methods were based on The Novel Coronavirus Infected Pneumonia Diagnosis and Treatment Standards. Total confirmed cases, daily severe cases, total deaths from February 12 to April 20 were collected for statistical analysis.
50,333 total confirmed cases in Wuhan made up the most substantial part by comparison with 17,795 in Rest of Hubei and 14,630 in Rest of China, respectively. In the early stage of the COVID-19 epidemic, daily severe cases in Wuhan accounted for the majority, and as the epidemic controlled, severe cases in all three populations decreased. Total deaths in Wuhan constituted the most significant proportion, with the highest 3869 in contrast to 643 in Rest of Hubei and 120 in Rest of China. The fatality rates in Wuhan ranged from 2.82% to 7.69%, much higher than 1.80-3.61% in Rest of Hubei, and 0.49-0.88% in Rest of China. Pearson chi-square test for fatality rates in the three populations demonstrated significant differences (p < 0.01).
The ecological comparison study among the three populations have proved that social distancing, quarantine, lockdown, cutting off sources of infection and transmission routes, early detection, early isolation, early treatment are all vital to control the epidemic by reducing COVID-19 confirmed cases, severe cases and the fatality rate.

We investigated an outbreak of COVID-19 infection, which was traced back to a bathing pool at an entertainment venue, to explore the epidemiology of the outbreak, understand the transmissibility of the virus and analyse the influencing factors. Contact investigation and management were conducted to identify potential cases. Epidemiological investigation was carried out to determine the epidemiological and demographic characteristics of the outbreak. We estimated the secondary attack rate (SAR), incubation time and time-dependent reproductive number (Rt ) and explored the predisposing factors for cluster infection. The incubation time was 5.4 days and the serial interval (SI) was 4.4 days, with the rate of negative-valued SIs at 24.5%. The SAR at the bathing pool (3.3%) was relatively low due to its high temperature and humidity. The SAR was higher in the colleagues\' cluster (20.5%) than in the family cluster (11.8%). Super-spreaders had a longer isolation delay time (p = .004). The Rt of the cluster decreased from the highest value of 3.88 on January 27, 2020 to 1.22 on February 6. Our findings suggest that the predisposing factors of the outbreak included close contact with an infected person, airtight and crowded spaces, temperature and humidity in the space and untimely isolation of patients and quarantine of contacts at the early stage of transmission. Measures to reduce the risk of infection at these gatherings and subsequent tracking of close contacts were effective.

Infectious bronchitis (IB), caused by avian IB virus (IBV), is an acute and highly contagious disease of chickens. From 2016 to 2018, 56 IBV strains were isolated and identified from clinical samples obtained from various chicken farms located in central China. The S1 sequencing of these strains revealed nucleotide and amino acid identities of 70.2 to 100% and 62.6 to 100%, respectively, compared with those of reference strains. Phylogenetic analysis indicated that the genotypes of the isolates included GI-13 (4/91), GI-7 (TW-I), GI-24 (Mass), GI-19 (QX), and GI-18 (LDT3-A), with GI-19 (QX) being the predominant genotype. Meanwhile, GI-13 (4/91) was the second most dominant genotype in Henan Province, whereas it was GI-7 (TW-I) in Hunan and Hubei provinces. Recombination analysis of 3 variant strains showed that CK/CH/HeN/20160113 might be a recombination of LDT3-A- and QX-type strains and that CK/CH/HeN/20160316 might be a recombination of Italy-02-type strain and CK-CH-LJS08II. The predicted tertiary structure between CK/CH/HeN/20160113 and LDT3-A-type strain revealed that the novel 336 (L-P) and 455 (S-A) mutations changed the structure from an alpha helix to a random crimp. In addition, the 275 (Y-F) site reduced the length of the β-sheet, whereas the site 353 (A-T) extended the β-sheet. These findings suggested that GI-19 (QX) remains the predominant genotype in central China, and a locally determined complex genotype associated with variable clinical symptoms exists related to gene recombination and mutations.

UNASSIGNED: Following news of deaths in two districts of Jharkhand (West Singhbum and Garhwa) in November 2016, epidemiological investigations were contemplated to investigate any current outbreak of falciparum malaria and deaths attributed to it.
UNASSIGNED: The epidemiological investigations, verbal autopsy of suspected deaths attributed to malaria and keys interviews were conducted in the 2nd and 4th week of November 2016 in Khuntpani and Dhurki block of West Singhbum and Garhwa districts, respectively, following a strict protocol.
UNASSIGNED: The affected villages were Argundi and Korba-Pahariya and their adjacent tolas in Khuntpani and Dhurki block. Undoubtedly, there was the continuous transmission of falciparum malaria in both the regions in October and November 2016. The total cases (according to case definitions) were 1002, of them, 338 and 12 patients were positive for Plasmodium falciparum positive (Pf +ve) and Plasmodium vivax positive (Pv +ve), respectively, in the affected areas of Khuntpani block. In Dhurki block, out of the total of 631 patients fulfilling the case definition, 65 patients were PF +ve and 23 Pv +ve. Comparing to the last year, there is remarkably high number of falciparum cases. Verbal autopsy of deceased individuals showed that malaria might be one of the strongly probable diagnoses, but not conclusively.
UNASSIGNED: According to epidemiological investigation, verbal autopsy and key interviews conducted, it may be concluded that there is a definite outbreak of falciparum malaria in the area and environment is congenial for malaria and other tropical diseases.

OBJECTIVE: To describe the distribution and determinants of ocular biometric parameters and to ascertain the relative importance of these determinants in a large population of adults in rural central China.
METHODS: A population-based, cross-sectional study performed in rural central China included 1721 participants aged 40 or more years. Ocular biometrical parameters including axial length (AL), anterior chamber depth (ACD), radius of corneal curvature (K) and horizontal corneal diameter [white-to-white (WTW) distance] were measured using non-contact partial coherence interferometry [intraocular lens (IOL)-Master].
RESULTS: Ocular biometric data on 1721 participants with a average age of 57.0±8.7y were analyzed at last. The general mean AL, ACD, mean corneal curvature radius (MCR), WTW were 22.80±1.12, 2.96±0.36, 7.56±0.26 and 11.75±0.40 mm, respectively. The mean values of each parameter in 40 to 49, 50 to 59, 60 to 69, and 70 to 91 years age groups were as follows: AL, 22.77±0.87, 22.76±1.06, 22.89±1.41, 22.92±0.80 mm; ACD, 3.10±0.32, 2.98±0.34, 2.86±0.36, 2.77±0.35 mm; MCR, 7.58±0.25, 7.54±0.26, 7.55±0.26, 7.49±0.28 mm; WTW, 11.79±0.38, 11.75±0.40, 11.72±0.41, 11.67±0.41 mm. The AL, ACD, MCR and WTW were correlated with age and the AL was correlated with height and weight.
CONCLUSIONS: Our findings can serve as an important normative reference for multiple purposes and may help to improve the quality of rural eye care.