Studies regarding blood pressure of Nepal have demonstrated a contrasting prevalence. We aimed at providing a generalized estimate of the prevalence of hypertension and prehypertension in urban, suburban, and rural areas of Nepal. This systematic review followed PRISMA guidelines. A thorough search of PubMed, EMBASE, and Web of Science was performed, and studies satisfying the eligibility criteria were reviewed. Pooled prevalence was calculated by random-effects model, and the sources of heterogeneity were explored with meta-regression and subgroup analysis. Twenty-three studies with 99,792 subjects were identified, and the estimated rate of hypertension and prehypertension were found to be 27.3% (95% CI: 23.8–30.9) and 35.4% (30.3–40.8). The prevalence of hypertension was 28.4% (22.4–34.7), 25.5% (21.4–29.8), and 24.4% (17.9–31.6) among urban, suburban, and rural populations, respectively. Moreover, rates of hypertension were found to be substantially higher in male (31.6%, 27.3–36.1) compared to female (20.0%, 14.2–26.6), and significantly higher among the middle-aged (≥40 years; 36.8%, 29.4–44.5) than among younger adults (< 40 years; 13.2%, 9.2–17.7). Further, prehypertension prevalence was found to be highest in rural areas (40.4%, 25.4–56.4) followed by urban areas (29.3%, 20.8–38.5) and lowest in suburban areas (25.5%, 18.9–32.7). Our study identified an alarming situation of hypertension among Nepalese males and middle-aged, and a situation of concern with prehypertension in rural areas affecting almost 40 % of the population.

Despite a decline in the prevalence of hepatitis B in China, the disease burden remains high. Large populations unaware of infection risk often fail to meet the ideal treatment window, resulting in poor prognosis. The purpose of this study was to develop and evaluate models identifying high-risk populations who should be tested for hepatitis B surface antigen. Data came from a large community-based health screening, including 97,173 individuals, with an average age of 54.94. A total of 33 indicators were collected as model predictors, including demographic characteristics, routine blood indicators, and liver function. Borderline-Synthetic minority oversampling technique (SMOTE) was conducted to preprocess the data and then four predictive models, namely, the extreme gradient boosting (XGBoost), random forest (RF), decision tree (DT), and logistic regression (LR) algorithms, were developed. The positive rate of hepatitis B surface antigen (HBsAg) was 8.27%. The area under the receiver operating characteristic curves for XGBoost, RF, DT, and LR models were 0.779, 0.752, 0.619, and 0.742, respectively. The Borderline-SMOTE XGBoost combined model outperformed the other models, which correctly predicted 13,637/19,435 cases (sensitivity 70.8%, specificity 70.1%), and the variable importance plot of XGBoost model indicated that age was of high importance. The prediction model can be used to accurately identify populations at high risk of hepatitis B infection that should adopt timely appropriate medical treatment measures.

Guangdong Province in the Pearl River Delta of Southeast China is among the areas in the country with the highest rates of avian flu cases. In order to control the outbreak of human-infected H7N9 cases, Guangdong launched a new policy on the central slaughtering of live poultry in 2015. This study aims to evaluate attitudes of consumers and live-poultry workers toward the policy. The live-poultry workers consisted of two sub-groups: live-poultry traders and poultry farm workers. Consumers and live-poultry workers from Guangdong were enrolled by stratified multi-stage random sampling. Online and field surveys were conducted to investigate participants’ attitudes on policy implementation. Questionnaires were developed to quantify participant demographics, to collect information about attitudes toward the policy, and to identify influential factors of policy acceptability. Proportional odds logistics regression was used in the univariate and multivariate analyses. A total of 1449 consumers, 181 live-poultry traders, and 114 poultry farm workers completed the study. Policy acceptability percentages among consumers, live-poultry traders, and poultry farm workers were 57.1, 37.9, and 62.6%, respectively. Logistics regression shows that consumers tended not to support the policy if they were males, if they were concerned with the food safety of chilled products, and if they preferred purchasing live poultry. Live-poultry traders tended not to support if they were subsidized by the government, if they were males, if they experienced a drop in trading volume, and if they were unclear whether avian flu was a preventable disease. Finally, poultry farm workers tended not to support if they experienced a drop in trading volume, if they operated a poultry farm on a small to medium scale, and if they experienced inconvenience in their work due to the policy. The study reveals a substantial refusal or slowness to accept the policy. Failure to accept the policy results from varying reasons. Among consumers, concern about food safety and dietary preference are two major causes of disapproval. Policy acceptability among live-poultry workers diverges within the two sub-groups. While a large percentage of poultry farm workers accept the policy, the drop in trading and an insufficient subsidy hamper acceptance by live-poultry traders. We recommend that policy-makers promote health education and alleviate the policy impact on trading with a reformed subsidy policy to increase acceptability. These findings are crucial for the prevention of human-infected H7N9 cases in Guangdong.

Objectives: To determine the performance of pretreatment structural and arterial spin labelling (ASL) MRI in predicting p53 mutation in patients with high-grade gliomas (HGGs).Methods: Pre-treatment structural and ASL MRI were performed in 57 patients with histologically confirmed HGGs and information of p53 status. Whole-lesion histogram analysis of cerebral blood flow (CBF) images of the enhancing tumour and the peritumoral oedema in the HGGs were performed. Visually AcceSAble Rembrandt Images features were used as qualitative analysis. The differences of ASL histogram parameters and Visually AcceSAble Rembrandt Images features between HGGs with or without p53 mutation were analyzed with post hoc correction for multiple comparisons. LASSO regression was performed to select the optimal features that could predict p53 mutation, followed by receiver operating characteristic analysis to determine the predictive efficacy.Results: A total of 33 HGGs with p53 mutation and 24 without p53 mutation were included. HGGs with mutant p53 showed lower CBF_percentile5and CBF_uniformityof the enhancing tumour (p < 0.05) and higher prevalence of the qualitative MRI feature of enhancing tumour crossing midline (ETCM) (p < 0.05) as compared with HGGs with wild-type p53. LASSO regression showed that the CBF_uniformityof the enhancing tumour and ETCM were predictive features for p53 mutation. CBF_uniformityshowed an acceptable performance in predicting p53 mutation (area under the curve = 0.721), when combined with the feature of ETCM, its predictive efficacy was significantly improved (area under the curve = 0.814, p = 0.012).Conclusion: An integrated pre-treatment structural and ASL MRI can help to predict p53 mutation in HGGs.