Primary School Education Level Research Articles

Distribution of cardiovascular disease risk factors between hypertensive and normotensive adults in Garissa County, Kenya

Background: Cardiovascular diseases (CVDs) are diseases affecting the heart and the blood vessels. Globally hypertension is the leading cause of cardiovascular disease and premature death, affecting 26% of the world population with prevalence expected to rise to 29% by 2025. The main study outcome was the distribution of cardiovascular disease risk factors. Secondary outcomes were the knowledge and socio-economic factors and their impact on distribution of cardiovascular disease risk factors. Methods: This was a retrospective case control study. Information regarding the sociodemographic, cardiovascular disease risk factors, knowledge and socioeconomic factors were collected from 140 adult patients (70 hypertensives and 70 normotensives) seeking outpatient services in Garissa County, Kenya. The 95% confidence limit was used and findings whose p≤0.05 was considered statistically significant. Results: Majority of the participants were aged >65 years (28.6%), followed by 56-65 years (24.3%) with a range of 25-75 years and were mainly male (57.1%), had attained at least a primary school education level (39.3%) and employed (53.6%). The prevalence of increased cardiovascular disease risk factors (>3 CVD risk factors) was 72.1% among the study participants with the hypertensive arm having 14.9% higher prevalence. There was statistically significant association between BMI and knowledge with distribution of cardiovascular disease risk factors (p=0.01) and (p=0.05) respectively. Conclusions: The hypertensive arm had marginally higher cardiovascular disease risk factors. High BMI and low knowledge were both associated with increased cardiovascular disease risk factors. Prospective studies with larger sample size and encompassing more counties are recommendable.

Analysis of loss to follow-up status and influencing factors of children born to pregnant women with HIV infection in China in 2019

Objective: To understand the loss to follow-up of children born to pregnant women with HIV infection (HIV-exposed children) and analyze its influencing factors in China in 2019. Methods: The data were collected from the follow-up records of pregnant women with HIV infection and their children reported by the national "Management Information System for the Prevention of HIV, syphilis and Hepatitis B Mother-to-Child Transmission" in 2019. HIV-exposed children were defined as those who were not followed up after birth or who were not followed up at 18 months of age and who were not followed up at 21 months of age. The univariate and multivariate influencing factors of loss to follow-up of children born to HIV-infected pregnant women were analyzed by χ2 test and logistic regression model. SPSS 25.0 software was used for statistical analysis. Results: The number of HIV-infected pregnant women was 5 039, the number of live-born children was 5 035, the number of loss to follow-up children within 18 months of age was 283, and the loss to follow-up rate children was 5.62%(283/5 035). The results of multivariate logistic regression analysis showed that the rate of loss to follow-up of exposed children born to pregnant women who worked as farmers (animal husbandry and fishery) (aOR=0.34, 95%CI: 0.22-0.53), unmarried (aOR=0.47, 95%CI: 0.24-0.93), first marriage (aOR=0.38, 95%CI: 0.22-0.67), remarriage (aOR=0.36, 95%CI: 0.20-0.67) and cohabiting (aOR=0.47, 95%CI: 0.23-0.97), and knew they had HIV infection before this pregnancy (aOR=0.53, 95%CI: 0.40-0.70) was lower. Han nationality (aOR=1.52, 95%CI: 1.09-2.13), primary school (aOR=2.06, 95%CI: 1.10-3.89) and junior middle school (aOR=1.81, 95%CI: 1.03-3.17) educational level, non-use of antiviral drugs (aOR=6.21, 95%CI: 4.32-8.93) and delivery in township (street) level midwifery institutions (aOR=5.72, 95%CI: 1.61-20.27) had higher rates of loss to follow-up among infants born to HIV-infected pregnant women. Conclusions: HIV-exposed children still have a specific rate of loss to follow-up in China in 2019. In order to further reduce the rate of loss to follow-up, it is of great significance to improve the detection rate of HIV before pregnancy and the rate of antiviral drugs used in pregnant women with HIV infection, which is of great significance for the effective implementation of comprehensive intervention measures of prevention of mother-to-child transmission of HIV.

Online Learning with Metaverse for History Education At Primary School Education Level

Online Learning with Metaverse for History Education At Primary School Education Level

Association between intensity of physical activity and cognitive function in hypertensive patients: a case–control study

Previous studies have shown that a higher intensity of physical activity (PA) is associated with a lower risk of cognitive impairment (CI), whereas hypertension is associated with higher CI. However, there are few studies on the association between PA intensity and cognitive function in hypertensive patients. This study investigated the association between PA intensity and cognitive function in hypertensive patients. A total of 2035 hypertensive patients were included in this study, including 407 hypertensive patients with CI and 1628 hypertensive patients with normal cognitive function matched 1:4 by age and sex. The International Physical Activity Questionnaire-Long Form and the Mini-mental State Examination were used to evaluate PA intensity, total metabolic equivalents, and cognitive function in patients with hypertension. Multivariate logistic regression was used to analyze the correlation between PA intensity and CI in hypertensive patients. The Spearman correlation coefficient was used to analyze the correlation between PA intensity and the total score of each component of the MMSE and the correlation between PA total metabolic equivalents and cardiac structure in hypertensive patients. After adjusting for all confounding factors, PA intensity was negatively associated with CI in hypertensive patients (OR = 0.608, 95% CI: 0.447–0.776, P < 0.001), and this association was also observed in hypertensive patients with education level of primary school and below and junior high school and above (OR = 0.732, 95% CI: 0.539–0.995, P = 0.047; OR = 0.412, 95% CI: 0.272–0.626, P < 0.001). The intensity of PA in hypertensive patients was positively correlated with orientation (r = 0.125, P < 0.001), memory (r = 0.052, P = 0.020), attention and numeracy (r = 0.151, P < 0.001), recall ability (r = 0.110, P < 0.001), and language ability (r = 0.144, P < 0.001). PA total metabolic equivalents in hypertensive patients were negatively correlated with RVEDD and LAD (r = − 0.048, P = 0.030; r = − 0.051, P = 0.020) and uncorrelated with LVEDD (r = 0.026, P = 0.233). Higher PA intensity reduced the incidence of CI in hypertensive patients. Therefore, hypertensive patients were advised to moderate their PA according to their circumstances.

The regional disparities in liver disease comorbidity among elderly Chinese based on a health ecological model: the China Health and Retirement Longitudinal Study

PurposeThis study aimed to investigate the risk factors for liver disease comorbidity among older adults in eastern, central, and western China, and explored binary, ternary and quaternary co-morbid co-causal patterns of liver disease within a health ecological model.MethodBasic information from 9,763 older adults was analyzed using data from the China Health and Retirement Longitudinal Study (CHARLS). LASSO regression was employed to identify significant predictors in eastern, central, and western China. Patterns of liver disease comorbidity were studied using association rules, and spatial distribution was analyzed using a geographic information system. Furthermore, binary, ternary, and quaternary network diagrams were constructed to illustrate the relationships between liver disease comorbidity and co-causes.ResultsAmong the 9,763 elderly adults studied, 536 were found to have liver disease comorbidity, with binary or ternary comorbidity being the most prevalent. Provinces with a high prevalence of liver disease comorbidity were primarily concentrated in Inner Mongolia, Sichuan, and Henan. The most common comorbidity patterns identified were "liver-heart-metabolic", "liver-kidney", "liver-lung", and "liver-stomach-arthritic". In the eastern region, important combination patterns included "liver disease-metabolic disease", "liver disease-stomach disease", and "liver disease-arthritis", with the main influencing factors being sleep duration of less than 6 h, frequent drinking, female, and daily activity capability. In the central region, common combination patterns included "liver disease-heart disease", "liver disease-metabolic disease", and "liver disease-kidney disease", with the main influencing factors being an education level of primary school or below, marriage, having medical insurance, exercise, and no disabilities. In the western region, the main comorbidity patterns were "liver disease-chronic lung disease", "liver disease-stomach disease", "liver disease-heart disease", and "liver disease-arthritis", with the main influencing factors being general or poor health satisfaction, general or poor health condition, severe pain, and no disabilities.ConclusionThe comorbidities associated with liver disease exhibit specific clustering patterns at both the overall and local levels. By analyzing the comorbidity patterns of liver diseases in different regions and establishing co-morbid co-causal patterns, this study offers a new perspective and scientific basis for the prevention and treatment of liver diseases.

Cognitive behavioral stress management effectively facilitates neurologic recovery, alleviates mental distress, and elevates health status in acute ischemic stroke patients.

Cognitive behavioral stress management (CBSM) relieves physical and psychological burdens in patients with some central nervous system diseases, while its utility in acute ischemic stroke (AIS) patients is unclear. This study aimed to explore the effect of CBSM on neurologic recovery and psychosomatic health in AIS patients. Totally, 176 naive AIS patients were randomized into routine care (RC) group (n=88) and CBSM group (n=88) to receive a 3-month corresponding intervention. Modified Rankin scale (mRS) scores at the first month after discharge (M1) (P=0.008) and the third month after discharge (M3) (P=0.016) were lower in the CBSM group than in the RC group. The proportion of AIS patients with mRS score >2 at M3 was reduced in CBSM group vs RC group (P=0.045). Hospital anxiety depression scale (HADS)-anxiety score at M3 (P=0.016), HADS-depression score at M3 (P=0.005), and depression rate at M3 (P=0.021) were decreased in the CBSM group vs the RC group. EuroQol-5 dimension scores at M1 (P=0.024) and M3 (P=0.012) were decreased, while EuroQol-visual analogue scale score at M3 (P=0.026) was increased in the CBSM group vs the RC group. By subgroup analyses, CBSM had favorable outcomes in AIS patients with age ≤65 years. CBSM was beneficial to neurologic recovery and distress relief in AIS patients with an education level of middle school or above, and to health status in those with an education level of primary school or uneducated. In conclusion, CBSM benefitted neurologic recovery and psychosomatic health in AIS patients with minor neurological deficits, however, further studies should verify these results with a larger sample size and longer follow-up.

Adölesan Annelerin Sosyo-Demografik, Gebelik ve Doğum Özellikleri

Introduction: Adolescence is considered the transition period from childhood to adulthood. Pregnancy at an early age is encountered for various reasons, along with the sexuality that begins in this period. Having a child at an early age carries a high risk for both mother and baby.&#x0D; Objective: This study was conducted to determine adolescent mothers' socio-demographic, pregnancy, and birth characteristics in Bartın province.&#x0D; Method: The study was conducted as cross-sectional and descriptive. 89 adolescent women who gave birth between August and December 2008 in Bartın province constituted the population. Data were collected through a survey created by the researchers in line with the literature. SPSS 15.0 package program was used to evaluate the data. Mean and percentage were used in statistical evaluation. &#x0D; Results: It was determined that 83% of the adolescent mothers, whose average age was 18, 3 ±0.73 years, were older adolescents, 15% had primary school education or lower, 98% were housewives and worked unpaid in family businesses, and 14% did not have any social security. While 54% of the mothers live in the nuclear family before marriage, 78% live in the extended family after marriage. It was observed that 52% of the adolescent mothers got married by escaping, and 87% had adolescent marriages. It was determined that most adolescent mothers did not receive any information about family planning methods before marriage and did not use pre-pregnancy family planning methods. It was observed that 65% of the adolescent mothers had health problems during their pregnancies, 21% of the babies born had health problems postpartum, 16% of the babies were prematüre, and 8.9% had low birth weight.&#x0D; Conclusion: Adolescent mothers should receive family planning information and counseling to prevent adolescent pregnancies, an essential maternal and child health risk group. In primary care studies, it is thought that the risks to maternal and infant health will be reduced by planning appropriate reproductive health services for adolescents.

3 Validity of Visuoconstructional Assessment Methods within Healthy Elderly Greek Australians: Quantitative and Error Analysis

Objective:Visuospatial skills are frequently assessed with drawing tests. Research has suggested that the use of drawing tasks in low educated groups may lack the ability to discriminate healthy individuals from clinical populations. The aims of this study were to investigate the validity of visuoconstructional tests in a sample of older Greek Australian immigrants and compare their performances to a matched sample of patients with Alzheimer’s disease (AD).Participants and Methods:We assessed visuoconstructional performances in a sample of 90 healthy older Greek Australians, with a primary school level of education, and compared performances to a demographically matched sample of 20 Greek Australians with a diagnosis of AD on four visuoconstructional drawing tests: Greek cross, four-pointed star, intersecting pentagons, and the Necker Cube.Results:While healthy participants tended to outperform the AD group on most copy tasks, high fail rates within the healthy sample were observed for the intersecting pentagons and Necker cube (78% and 73% fail rates respectively) when using established clinical cutoff scores. High rates of curved angle, omission, distorted relation between elements, spatial disorganization and three-dimensional design errors were found across the four-pointed star, intersecting pentagons, and the Necker cube in both healthy participants and those with AD. Exploratory receiver operating characteristic curve analysis revealed that, with perhaps the exception of the Greek cross, meaningful sensitivity and specificity could not be reached for the four-pointed star, intersecting pentagons, and Necker cube.Conclusions:Cognitively healthy immigrants with low education appear to be at a disadvantage when completing visuoconstructional drawing tests, as their performance may be misinterpreted as indicating cognitive impairment. Future research is needed to identify alternative approaches to assess visuoconstructional ability in low education older cohorts.

Prevalence and associated factors of adolescent pregnancy among women attending antenatal clinic at Tumbi Regional Referral Hospital, Coast Region, Tanzania

Background: Approximately 16 million adolescent girls aged 15-19 years and 2million adolescents under the age of 15 years give birth annually. The aim of this study is to determine the prevalence and associated factors of adolescent pregnancy among women attending antenatal clinic at Tumbi Regional Referral Hospital, Coast Region, Tanzania. Material and methods: This was a descriptive cross-sectional study conducted from February 01 to April 15, 2023. A total of 118 adolescent pregnant women were enrolled in this study. Interviews were conducted with 118 sampled adolescent girls. Results: The analysis focused on 118 adolescent pregnant women. Of these, 87.3% adolescent pregnant women aged 18-19 years. 95.8% were living in Rural area. Marital status 82.2% were married. Education level primary school 50.8%, living with husband 50%. Father′s occupation, peasant 91.5%, mother′s occupation peasant 89%. Time required to reach health facility one hour or less 83.1%. Time required to reach school one hour or less 66.1%. Awareness on reproductive health 84.7%,on contraceptive 91.5%. Source of information clinics 60.2%. Types of contraceptive used injectable 59.3%. Conclusion: This study found a higher rate of adolescent pregnancy among women attending antenatal clinic in Tumbi Regional Referral Hospital. Adolescents who were more likely to adolescent pregnancy were those with limited knowledge about sexual and reproductive health living in rural from families with low economic status, their mothers had a low level of education.

Syrian Women Knowledge and Attitudes Towards Hepatitis B Prevention

Abstract Background Globally, mother-to-child transmission during childbirth is the most prevalent transmission method of hepatitis B (HBV). However, early immunization following birth is a safe and effective method of preventing this disease. This study evaluates Syrian mothers’ and pregnant females’ knowledge, attitude, and practice regarding HBV prevention and immunization. Methods This online cross-sectional study was performed in Syria between 2 October and 12 November. The inclusion criteria for this study were Syrian pregnant women who visited obstetrics and gynaecologist clinics for prenatal care, delivery, and postpartum checkups. The survey was adapted from a previous study, which contains 33 items divided into three sections. Data were analyzed using descriptive and multivariate logistic regression. Results This study enrolled 419 participants with a mean age of (28.4±5.9). More than half of the participants agreed that HBV could be transmitted from mother to her child at birth, and about two-thirds of them agreed that HBV vaccination is necessary for their infant (87.4%). Among participants with a university education degree, 35.7% revealed good knowledge, while only 12.3% of respondents with a primary school education level have good knowledge. More than half of housewife participants have shown positive attitudes (52.4%). Females with academic careers have a higher probability of good knowledge and positive attitudes than housewife women (OR = 107.09, P value&amp;lt;0.05) and (OR = 16.31, P value&amp;lt;0.05), respectively. Conclusions Syrian women have a moderate knowledge level about HBV prevention, with gaps in knowledge and attitudes among low-educated women. Performing local awareness campaigns about HBV and its vaccination for women can increase their knowledge and attitudes about this topic. Obstetric care providers should provide more information for pregnant females about HBV prevention for their children which may limit the occurrence of this phenomenon. Key messages • Syrian women have moderate knowledge of HBV prevention for their children, while lower-educated women have gaps in knowledge and attitudes. • Local awareness campaigns about HBV and its vaccination for women can improve their knowledge and attitudes.

Dynamics of Drivers of Conflict in Water-Related Resource Scarcity: Focus on Lake Turkana Basin of Kenya

Lake Turkana basin, located in Turkana County of Kenya, has become a central point for studying the dynamics of conflicts resulting from water-related resource scarcity. The study sought to identify specific drivers of water use-related resource conflicts in the basin and was anchored on the Negotiation Theory. Historically, the semi-arid and arid regions of the Kenyan borders have experienced perennial conflicts between ethnic groups in the Lake Turkana Basin that revolve around scarce water-related resources on land and in water. Using a descriptive study design, convenience sampling accessed 36 respondents through 36 questionnaires, interview schedules, three focus group discussions (FGDs), and an observation guide. The study findings demonstrate that drivers of conflicts were not just locally domesticated but also had external factors and influences, including dynamics associated with inflammatory political speeches and economic and environmental factors resulting in a harsh climate. Additionally, high illiteracy, with over 45% having only primary school level education, cultural pressures where 75% male domination was observed, ethnic tensions, historical grievances, scarce critical resources which were only concentrated in a few locations, and geopolitical interests of neighbouring countries contributed to conflicts in the region. In conclusion, drivers of conflict must be carefully understood for long-term resolutions. The study limitations included remoteness and lack of infrastructure in the basin. Further research is recommended to establish whether the key drivers could be reversed in their efforts to drive conflicts to manage perennial conflicts. Alternative Dispute Resolution (ADR) mechanisms are highly recommended for managing these perennial water resource-related conflicts.

Prevalence and antifungal susceptibility pattern of oral candidiasis among HIV-infected patients in a Mission Hospital, southeast Nigeria

Background: Oral candidiasis is an infection that follows colonization of oral cavity by Candida species mostly Candida albicans. About 90% of HIV-infected persons develop this disease during the course of HIV infection and could serve as early sign of HIV-related immunodeficiency. Treatment involves the use of antifungal drugs. The objectives of this study are to determine the prevalence of oral candidiasis and the susceptibility of isolated Candida species to available antifungal agents among selected HIV-infected patients in a mission hospital, southeast Nigeria.&#x0D; Methodology: This was a descriptive cross-sectional study of 150 consecutively selected HIV-infected patients attending the Heart-to-Heart clinic of Iyi-Enu mission hospital Ogidi, Anambra State, Nigeria, between December 2022 and February 2023. Demographic information of each participant was obtained using structured questionnaire. Five milliliters of whole blood were drawn from the antecubital vein of each participant for CD4+ estimation. Mouth specimens were collected using two sterile cotton swabs for microscopy and culture on Sabouraud Dextrose Agar, and Candida species were identified after subculture on CHROMAgar. Antifungal susceptibility testing was performed by Kirby-Bauer disk diffusion method using fluconazole, clotrimazole, ketoconazole, and nystatin disks, and results interpreted according to the guidelines of the Clinical and Laboratory Standards Institute.&#x0D; Results: A total of 98 (65.3%) HIV-infected participants were positive for oral candidiasis, with 4 species of Candida isolated; Candida albicans (62.2%), Candida glabrata (18.4%), Candida tropicalis (12.2%) and Candida krusei (7.1%). Fifty-nine (60.2%) of the 98 participants had CD4+ cell count ˂ 200, 33 (33.7%) had counts in the range of 200-399, and 6 (6.1%) had counts in the range of 400-499 cells/μL (p=0.001). The prevalence of candi- diasis was not significantly different between the female (67.0%, 65/97) and male (62.3%, 33/53) participants (p=0.6598), but the prevalence was significantly higher (p&lt;0.05) in participants age group 21-30 years (80.7%, 42/52), divorced (100%, 1/1) and married (75%, 45/60), those with primary school level education (73.7%, 42/57), civil servants (85.7%, 18/21), and those who performed mouth hygiene once daily (71.9%, 69/96). Nystatin (77.6%, 76/98) showed the highest while fluconazole and ketoconazole (68.4%, 62/98) showed the lowest in vitro antifungal activity&#x0D; Conclusion: Oral candidiasis is prevalent among HIV-infected patients in the study population, with evidence of in vitro resistance of the Candida isolates to available antifungal drugs. Proper diagnosis, susceptibility testing and treatment of infection will be helpful in managing oral candidiasis infection among HIV infected patients.

Prevalence of Psychiatric Illness Among Keratoconus Patients.

Background Keratoconus is a chronic corneal disorder characterized by progressive thinning of the cornea resulting in visual deterioration. Keratoconus patients have a higher rate of psychiatric morbidities. Therefore, this study will assess the prevalence of psychiatric illness among keratoconus patients. Methods We conducted a quantitative retrospective study in three centers across Saudi Arabia from June 2016 to February2023. We includedall patients previously diagnosed with keratoconus and any psychiatric illness. We excluded patients with other ocular diseases in addition to keratoconus. After we extracted the data, we coded and analyzed them using IBM SPSS Statistics for Windows, Version 21.0 (2012; IBM Corp., Armonk, New York, United States) and GraphPad Prism Version 8.4.2 (Dotmatics, Boston, Massachusetts, United States). Results The study included 57 keratoconus patients, with the majority being Saudi (96.5%), female (2:1), in the age group of 31-40 years (40.4%), and with a high-schoollevel of education. The majority ofpatientswere alsoobese (42.4%) andnon-smokers (82%).Mostpatients had comorbid medical disorders. Of the 57 patients,63.2% had anxietydisorders, 56.1% had depression, 10.5% had schizophrenia, and 1.8% had bipolar disorder. Patients with only a primary-school level of educationwere significantlymore likely to bediagnosed with bipolar disorder, whereas those who were single were significantly more likely to be diagnosed with schizophrenia. Corneal transplant was also significantly associated with schizophrenia. Most patients (51%) were diagnosed with a psychiatric illness before keratoconus was diagnosed. Conclusion Among the keratoconus patients, single relationship status, primary-school level of education, and comorbidities weresignificantly associatedwith schizophrenia, bipolar disorder, and anxiety disorder, respectively. In addition, corneal transplant was significantly associatedwith schizophrenia. Lastly, the occurrence of psychiatric illness beforekeratoconus diagnosis was observed in the majority of patients.

Analysis of Correlation between the Socioeconomic Environment and Level of Nutrition in the Population of Serbia: A Part of the National Survey

Being overweight is one of the leading health problems of the 21st century. In different parts of Europe, different overweight statuses are noted. The aim of this study was to explore the correlation between the socioeconomic environment and the level of nutrition in the Serbian population. This research is part of the fourth national survey of the health of the population of Serbia. It was conducted as a descriptive, cross-sectional study. For the purposes of this research, the adult population over the age of 20 was included, and 12,439 respondents were analyzed. The nutritional status was assessed by the body mass index value—BMI. In order to investigate the differences between groups, the chi-squared test was used. The risk of being overweight was evaluated by calculating the odds ratio value, using univariate and multivariate regression. The prevalence of obesity was higher in females than in males, but pre-obesity was more common among male respondents. Males in the age category 55–64 years old, married, employed, with a higher level of education and material status were more likely to be overweight. As for the females, being overweight was most common among unemployed and economically inactive respondents, widowed/divorced, aged 65–74, with a primary school educational level and low material status. The level of nutrition is significantly associated with the socioeconomic environment.

A panel study on the effect of atmospheric PM2.5 exposure on the gut microbiome in healthy elderly people aged 60-69 years old

Objective: To analyze the short-term effect of individual atmospheric PM2.5 exposure on the diversity, enterotype, and community structure of gut microbiome in healthy elderly people in Jinan, Shandong province. Methods: The present panel study recruited 76 healthy elderly people aged 60-69 years old in Dianliu Street, Lixia District, Jinan, Shandong Province, and followed them up five times from September 2018 to January 2019. The relevant information was collected by questionnaire, physical examination, precise monitoring of individual PM2.5 exposure, fecal sample collection and gut microbiome 16S rDNA sequencing. The Dirichlet multinomial mixtures (DMM) model was used to analyze the enterotype. Linear mixed effect model and generalized linear mixed effect model were used to analyze the effect of PM2.5 exposure on gut microbiome α diversity indices (Shannon, Simpson, Chao1, and ACE indices), enterotype and abundance of core species. Results: Each of the 76 subjects participated in at least two follow-up visits, resulting in a total of 352 person-visits. The age of 76 subjects was (65.0±2.8) years old with BMI (25.0±2.4) kg/m2. There were 38 males accounting for 50% of the subjects. People with an educational level of primary school or below accounted for 10.5% of the 76 subjects, and those with secondary school and junior college or above accounting for 71.1% and 18.4%. The individual PM2.5 exposure concentration of 76 subjects during the study period was (58.7±53.7) μg/m3. DMM model showed that the subjects could be divided into four enterotypes, which were mainly driven by Bacteroides, Faecalibacterium, Lachnospiraceae, Prevotellaceae, and Ruminococcaceae. Linear mixed effects model showed that different lag periods of PM2.5 exposure were significantly associated with a lower gut α diversity index (FDR<0.05 after correction). Further analysis showed that PM2.5 exposure was significantly associated with changes in the abundances of Firmicutes (Megamonas, Blautia, Streptococcus, etc.) and Bacteroidetes (Alistipes) (FDR<0.05 after correction). Conclusion: Short-term PM2.5 exposure is significantly associated with a decrease in gut microbiome diversity and changes in the abundance of several species of Firmicutes and Bacteroidetes in the elderly. It is necessary to further explore the underlying mechanisms between PM2.5 exposure and the gut microbiome, so as to provide a scientific basis for promoting the intestinal health of the elderly.

Impact of Serum Cystatin C Level on Long-Term Cognitive Impairment After Acute Ischemic Stroke and Transient Ischemic Attack.

Cognitive impairment after stroke/transient ischemic attack (TIA) has a high prevalence. Cystatin C (CysC) has been found as a novel biomarker of neurodegenerative diseases, such as dementia and Alzheimer's disease. We aimed to explore the possible correlations of serum CysC level with cognitive impairment in patients who had mild ischemic stroke and TIA after 1 year. We measured serum CysC level in 1025 participants with a minor ischemic stroke/TIA from enrolled from the Impairment of Cognition and Sleep (ICONS) study of the China National Stroke Registry-3 (CNSR-3). They were divided into four groups according to quartiles of baseline CysC levels. Patients' cognitive functions were assessed by Montreal Cognitive Assessment (MoCA)-Beijing at day 14 and at 1 year. Multiple logistic regression models were performed to evaluate the relationship between CysC and post-stroke cognitive impairment (PSCI) at 1-year follow-up. Cognitive impairment was defined as MoCA-Beijing ≤22. Most patients were in 60s (61.52±10.97 years old) with a median (interquartile range) National Institute of Health Stroke Scale(NIHSS) score of 3.00 (4.00) and greater than primary school level of education, and 743 participants (72.49%) were male. Among the 1025 participants, 331 participants (32.29%) patients suffered PSCI at 1-year follow-up. A U-shaped association was observed between CysC and 1-year PSCI [quartile (Q)1 vs Q3: adjusted odds ratio (aOR) 2.69, 95% CI 1.67-4.34, p < 0.0001; Q2 vs Q3: aOR 1.63, 95% CI 1.03-2.57, p = 0.0354; Q4 vs Q3: aOR 1.83, 95% CI 1.16-2.87, p = 0.009]. Moreover, the U-shaped trends were also found between CysC level and the subscores of attention, recall, abstraction and language in MoCA. CysC showed a U-shaped correlation with 1-year overall cognitive function. It is probable that measurement of the serum CysC level would aid in the early diagnosis of PSCI.

203-LB: Prevalence and Risk Factors of Diabetic Peripheral Neuropathy—A Population-Based Cross-Sectional Study in China

Aims: To assess the prevalence of diabetic peripheral neuropathy (DPN) and its risk factors in the type 2 diabetes mellitus (T2DM) population. Methods: This cross-sectional study enrolled patients with T2DM between July and December 2017 from 24 provinces in China. DPN and its severity were assessed by the Toronto clinical scoring system, neuropathy symptoms score and neuropathy disability score. The prevalence of DPN and its risk factors were analyzed. Results: A total of 14,908 patients with T2DM were enrolled. The prevalence of DPN was 67.6%. Among 10,084 patients with DPN, 4808 (47.7%), 3325 (33.0%), and 1951 (19.3%) had mild, moderate, and severe DPN, respectively. The prevalence of DPN was over 70% in patients aged ≥60 years, with low income (&amp;lt;5000 RMB) and education level of primary school or below. The comorbidities and complications in patients with DPN were higher than in those without DPN (P&amp;lt;0.001). Age, hypertension, duration of diabetes, diabetic retinopathy, diabetic nephropathy, glycated hemoglobin, high-density lipoprotein cholesterol, and lower estimated glomerular filtration rate were positively associated with DPN, while BMI, education level, fasting C-peptide, and uric acid were negatively associated with DPN. Conclusions: Among patients with T2DM in China, the prevalence of DPN is high, especially in the elderly, low-income, and undereducated patients. Disclosure W. Wang: None. Q. Ji: None. X. Ran: None. C. Li: None. Y. Xue: None. B. Feng: None. D. Zhu: None. Funding Chinese Diabetes Society (2019YJ017)

Incidence of chronic obstructive pulmonary disease and risk factors in the Suzhou cohort

Objective: To understand the incidence of chronic obstructive pulmonary disease (COPD) in the Suzhou cohort, and explore the risk factors for the development of COPD in Suzhou, and provide a scientific basis for COPD prevention. Methods: This study was based on the China Kadoorie Biobank project in Wuzhong District, Suzhou. After excluding individuals with airflow obstruction and self-reported chronic bronchitis, emphysema, or pulmonary heart disease at baseline, 45 484 individuals were finally included in the analysis. Cox proportional risk models were used to analyze risk factors of COPD and calculate hazard ratios and 95% confidence interval (CI) in the Suzhou cohort. The effect modifications of smoking on the association between other risk factors and COPD were evaluated. Results: Complete follow-up was available through December 31, 2017. Participants were followed up for a median of 11.12 years, and 524 individuals were diagnosed with COPD during the follow-up period; the incidence was 105.54 per 100 000 person-years. Multivariate Cox proportional risk regression models showed that age (HR=3.78, 95%CI:3.32-4.30), former smoking (HR=2.00, 95%CI:1.24-3.22), current smoking (<10 cigarettes/day, HR=2.14, 95%CI:1.36-3.35;≥10 cigarettes/day, HR=2.69, 95%CI:1.60-4.54), history of respiratory disease (HR=2.08, 95%CI:1.33-3.26), daily sleep duration ≥10 hours (HR=1.41, 95%CI:1.02-1.95) were associated with increased risk of COPD. However, education level of primary school and above (primary or junior high school, HR=0.65, 95%CI:0.52-0.81; high school and above, HR=0.54, 95%CI:0.33-0.87), consuming fresh fruit daily (HR=0.59, 95%CI:0.42-0.83) and consuming spicy food weekly (HR=0.71, 95%CI:0.53-0.94) were associated with reduced risk of COPD. Conclusions: The incidence of COPD is low in Suzhou. Older age, smoking, history of respiratory disease, and long sleep duration were risk factors for the development of COPD in the Suzhou cohort.

Analysis of tobacco dependence level and its influencing factors on Tianjin residents

Objective: To understand the prevalence and influencing factors of tobacco dependence among the population aged 15-69 in Tianjin to provide the basis for formulating targeted smoking control intervention policies and carrying out scientific smoking cessation intervention services. Methods: The data of this study comes from the 2018 Tianjin residents' health literacy monitoring survey. Probability-proportional-to-size sampling is adopted for sampling. SPSS 26.0 software was used for data cleaning and statistical analysis, and χ2 test and binary logistic regression were used to analyze the influencing factors. Results: A total of 14 641 subjects aged 15-69 were included in this study. After standardized, with a smoking rate of 25.5%, including 45.5% for men and 5.2% for women. Among the population aged 15-69, the prevalence of tobacco dependence was 10.7%; among current smokers, the prevalence rate of tobacco dependence is 40.1%, of which the prevalence rate of male tobacco dependence is 40.0%, and the prevalence rate of female tobacco dependence is 40.6%. According to multivariate logistic regression analysis, people who live in rural areas, have an education level of primary school or below, smoke every day, smoke the first cigarette ≤15 years old, smoke ≥21 cigarettes per day, and smoke for more than 20 packet years, people who report poor physical health are more likely to suffer from tobacco dependence (all P<0.05); age and smoking age did not affect the possibility of tobacco dependence (all P>0.05). Among current smokers, there was no significant difference in their willingness to quit smoking whether they had tobacco dependence (P>0.05). The proportion of people with tobacco dependence who have tried to quit smoking and failed is higher (P<0.001). Conclusions: The prevalence of tobacco dependence among smokers aged 15-69 in Tianjin is high, and the demand for quitting smoking is great. Therefore, smoking cessation publicity should be carried out for key groups, and smoking cessation intervention work in Tianjin should be continuously promoted.

Evaluation of Environmental Learning Acquisitions in the Curriculum of Primary and Middle School Courses in Line with the Revised Bloom’s Taxonomy

In this research, it was aimed to evaluate the environmental learning acquisitions in the curriculum of the primary and middle school courses in Turkey in compliance with the Revised Bloom’s Taxonomy. In line with this purpose, qualitative research approaches were used in the research. Furthermore, the primary school education level curricula published in 2018 were examined using the document analysis in the research. The primary education curriculum examined in the research was analyzed with the content analysis method. When the learning acquisitions were analyzed in compliance with the grade level, it was obvious that there was an imbalance between the grade levels in terms of environmental-related learning acquisitions. When the curricula were evaluated in compliance with the Revised Bloom's Taxonomy, it was determined that the environmental learning acquisitions were distributed unevenly in compliance with the dimensions in the taxonomy.