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This paper aims to investigate the impact of the GreenLeaders designation on hotel performance under the joint theoretical framework of environmental corporate social responsibility and social identity theory. We focus on 1,198 individual hotel properties from five major cities in Texas between 2010 and 2019. A two-way fixed-effects model is applied to model monthly revenue per available room (RevPAR) and TripAdvisor ratings for each hotel. Results show that GreenLeaders certification leads to a 6.00% increase in hotels' monthly RevPAR and a 4.25% increase in hotels' monthly average TripAdvisor rating. This impact grew over time during the research period. The findings also unveil a set of moderating variables, such as hotel class and chain affiliation. More specifically, the effect of GreenLeaders certification is larger for upscale and independent hotels. The major results are also confirmed through a robustness analysis using propensity-score-based weighting and placebo tests. Lastly, implications are provided for hoteliers and investors. [ABSTRACT FROM AUTHOR]

This paper investigates the impact of the COVID-19 pandemic and its associated policy effects on global tourism performance. Using daily data from 117 countries between January 23, 2020 and June 5, 2021, we applied a fixed-effects panel data model to investigate the impact and its moderators. Results show that COVID-19 cases had a significantly negative effect on tourism revenue and pricing. Specifically, a 10% increase in COVID-19 cases led to a 0.490%, 0.103%, and 0.388% decline in RevPAR, ADR, and occupancy change, respectively. Furthermore, degree of dependence on tourism, and economic support policies moderated this effect. Consequences related to revenue and demand were more remarkable for luxury tourism products than economic ones. Geographical and temporal heterogeneity were also noteworthy, and the impact of pandemic severity on revenue and demand was highly notable in certain periods, such as April and May 2020 and January to mid-March 2021. Lastly, implications are provided. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate the independent and combined effects of progesterone and suppressor of cytokine signaling (SOCS)-3 DNA methylation on type 2 diabetes mellitus (T2DM) among men and postmenopausal women in rural China. Methods: A case–control study with 914 participants (329 T2DM, 585 controls) was conducted. Serum progesterone was detected with liquid chromatography-tandem mass spectrometry. DNA methylation of SOCS3 was determined by MethylTarget™. Linear regression was applied to evaluate the associations of progesterone and SOCS3 methylation with marks of glucose metabolism. Logistic regression was employed to investigate the independent and combined effects of progesterone and SOCS3 methylation with T2DM in men and postmenopausal women. Results: After multiple adjustment, progesterone was positively associated with T2DM in both men (odds ratio (OR) (95% confidence interval (CI)): 2.77 (1.79, 4.29)) and postmenopausal women (OR (95% CI): 1.85 (1.26, 2.72)). Methylation level of Chr17:76,356,190 or Chr17:76,356,199 (SOCS3) was negatively associated with T2DM in both men (OR (95% CI): 0.58 (0.39, 0.86) or 0.27 (0.14, 0.51)) and postmenopausal women (OR (95% CI): 0.43 (0.29, 0.65) or 0.53 (0.28, 0.99)). Subjects with high progesterone and low Chr17:76,356,190 or Chr17:76,356,199 methylation were more susceptible to have a higher prevalence of T2DM (men: OR (95% CI): 5.20 (2.49, 10.85) or 5.62 (2.74, 11.54); postmenopausal women: OR (95% CI): 3.66 (1.85, 7.26) or 3.27 (1.66, 6.45)). Conclusions: The independent and combined effects of progesterone and SOCS3 methylation on T2DM were found among men and postmenopausal women, suggesting that ensuring low levels of progesterone and high methylation of SOCS3 could reduce the prevalence of T2DM. Trial registration The Chinese Clinical Trial registration: The Henan Rural Cohort Study, ChiCTR-OOC-15006699. Registered 06 July 2015, http://www.chictr.org.cn/showproj.aspx?proj=11375 [ABSTRACT FROM AUTHOR]

Background: The increasing menace of the COVID-19 epidemic led to an atmosphere of anxiety around the world, however the evidence among Chinese students aged 12 to 18 years has been limited.Methods: A total of 373216 junior and senior high school students were recruited using a cluster sampling method in Zhengzhou, Xinxiang, Xinyang city of Henan Province, China, during February 4-12, 2020. Presence of anxiety symptoms was determined by Generalized Anxiety Disorder tool (GAD-7). Multiple logistic regression was performed to estimate the potential risk factors.Results: Among the participants, junior and senior high school students were found to have anxiety symptoms, producing an overall prevalence of 9.89%. The prevalence was lower in female than in male (9.66% vs. 10.11%) and the prevalence was higher for junior high school students than senior high school students (13.89% vs. 12.93%). The prevalence of anxiety symptoms was highest among rural students and lowest among urban students (11.33% vs. 8.77%). The cognitive level was negatively associated with the prevalence of anxiety symptoms. After adjusting for potential confounders, age, gender, residential location, worried level, fear level and behavior status were found to be associated with anxiety symptoms.Limitations: Prevalence may be skewed by assessing anxiety symptoms using self-reported scales rather than clinical interviews.Conclusions: This large-scale study assesses the prevalence of anxiety symptoms and its potential influencing factors in junior and senior high school students. These findings suggest that governments need to pay more attention to the mental health of young people in combating COVID-19. [ABSTRACT FROM AUTHOR]

We propose a conceptual framework to investigate factors influencing the supply of Airbnb units in US urban communities. Based on a sample of Airbnb supply data from 1068 zip codes in 28 major US cities, we apply a mixed-effects negative binomial model to uncover supply determinants. The results confirm the significance of five supply determinant categories, namely, hotel market demand and supply, housing market demand and supply, and short-term rental regulation. We also highlight the respective impacts of supply determinants on three different Airbnb units: entire houses, private rooms, and shared rooms. Moreover, we examine the unique effects of different types of regulation policies. In general, regulations related to tailored legal framework and hostile enforcement significantly decrease Airbnb unit supply. [ABSTRACT FROM AUTHOR]

Objective: Glucose metabolism is impacted by circadian disruption. Dinner-bedtime interval (DBI) was an accessible indicator to reflect the alignment between dinner time and circadian clock. We aimed to investigate the association of DBI with type 2 diabetes mellitus (T2DM). Methods: 7676 adult subjects from the Henan Rural Cohort were included. Their demographic information including dinner time and bedtime was collected. Fasting venous blood samples were collected for biochemical determinations. Generalized linear regression model was used to analyze the factors influencing DBI. Furthermore, logistic regression incorporated with restricted cubic spline model was applied to evaluate the association between DBI and T2DM. Results: The results of multiple linear regression model showed that age (β: -0.018, 95% CI: -0.021, -0.015) was negatively correlated with DBI. Female (β: 0.311, 95% CI: 0.229, 0.393), junior high school education (β: 0.246, 95% CI: 0.187, 0.306), high school education or above (β: 0.346, 95% CI: 0.259, 0.433), average monthly income with 1000–1999 CNY(0.102, 95% CI: 0.032, 0.171), average monthly income ≥ 2000 CNY (β: 0.164, 95% CI: 0.076, 0.251), moderate physical activity (β: 0.134, 95% CI: 0.071, 0.197), current smokers (β: 0.214, 95% CI: 0.118, 0.309), current drinkers (β: 0.099, 95% CI: 0.008, 0.190) were positively correlated with DBI. Furthermore, DBI was significantly associated with T2DM (adjusted OR: 0.910, 95%CI: 0.845–0.979, P = 0.012). DBI longer than 3 h was associated with decreased risk of T2DM (adjusted OR: 0.773, 95%CI: 0.648–0.921, P = 0.004). Conclusions: DBI larger than 3 h is beneficial to T2DM prevention. Further investigation is required to verify the association. [ABSTRACT FROM AUTHOR]

In the past, most research focused on the children living near a typical contaminated area but ignored the health risks of children living in the fourth or fifth tier cities without typical contaminated sources. These cities are now facing a series of problems, such as serious environmental pollution, undeveloped health system and so on. Furthermore, the development of modern logistics for food delivery has altered lifestyles that directly impact diets and eating patterns. In this study, multiple exposure pathways and health risks of children to heavy metal(loid)s were studied based on questionnaire-based surveys and field sampling of soil, dust, fine particulates, drinking water and food. We found that Pb, Cd and Mn levels in environmental samples were very high indicating a serious pollution problem. Inhalation exposure via aerosol particles was the most important pathway and was greater than exposure by food ingestion. The hazard index for Mn via aerosol particles was >1 even at the 5th percentile and Mn levels in urine was 10 times higher than those of people living in typical contaminated areas. The total incremental lifetime cancer risk (ILCR) for all metal(loid)s was also higher than the threshold at the 95th percentile. This study highlights health risks to children living in fourth tier cities and the importance of air pollution control to protect heavy metal exposure for children. • Multiple exposure pathways and health risks of children are analyzed. • Inhalation exposure via aerosol particles has become the main exposure pathway. • Metals in food were low, which were only one-tenth of previously reported values. • The local Mn pollution most likely contributes to high environmental exposure. • High health risks happen to the local children living in fourth-tier cities. [ABSTRACT FROM AUTHOR]

In this article, we unveil determinants of guest satisfaction with urban hotel locations and disclose what types of locations are preferred by guests. Using data from 8,185 online reviews of 220 Los Angeles hotels checked in during a 1-year period, we apply a mixed-effect ordered logit model to investigate factors determining location evaluation scores. We classify all location-related factors into three categories: accessibility to points of interest, transport convenience, and surrounding environment. Our results suggest that a property’s accessibility to attractions, airports, universities and public transportation, as well as green spaces, bodies of water, and local businesses are significant determinants. Free parking and airport shuttle bus service could mitigate disadvantages related to inferior airport accessibility. Moreover, we underscore different hotel location satisfaction effects across travelers’ experiences and types of travel described in the online reviews. Lastly, different types of travelers demonstrate heterogeneous location preferences related to different tourist attractions. [ABSTRACT FROM AUTHOR]

Set within the human capital framework, the focus of this exploratory study is to investigate how individual and industry attributes affect the earnings of salaried restaurant managers in the United States. Previous compensation studies in the restaurant industry have almost exclusively focused on executive compensation and its relationship to a firm's financial variables. Given the size of the industry, it is important to investigate compensation practices at various levels of its leadership. The findings show that relevant work experience, gender, education, race, and property size are significant attributes effecting restaurant managers’ compensation. Practical implications are provided. [ABSTRACT FROM PUBLISHER]

Aim: Before Chinese primary school students were generally vaccinated against the COVID-19 vaccine, this study evaluated the willingness of this population and its influencing factors before vaccination, and evaluate its association between attitudes toward the vaccine and depressive symptoms.Methods: A cross-sectional study involved 386,924 primary school students using a cluster sampling method during May 21-27, 2021. The Chinese version of the Children Depression Inventory (CDI) was used to assess depressive symptoms. Multiple logistic regression analysis models were used to estimate the relationship between attitudes toward COVID-19 vaccines and depressive symptoms.Results: Among the participants, the prevalence of depressive symptoms was higher in higher grades. The prevalence was higher in fifth and sixth grade students than third and fourth grade students and first and second grades (10.22% vs. 6.07% vs. 3.04%). In addition, 20.79% of students do not know whether the vaccine can protect him from the COVID-19 infection, and 40.60% of students do not know whether the vaccine is safe. Of note, in terms of attitudes toward COVID-19 vaccines, students with more positive attitudes have a lower risk of depressive symptoms (adjusted odds ratio (aOR) = 0.151; 95% confidence interval (CI): 0.140-0.164).Conclusion: Based on these findings, it is necessary for the government and schools to promote vaccine safety and reliability information in a timely manner to increase vaccination uptake. [ABSTRACT FROM AUTHOR]

Self-efficacy influences students’ activities, effort and persistence, and it can help predict their motivation and academic performance. This study attempts to investigate the relationship between self-efficacy, preferred learning methods, and academic performance under different learning methods in a unique hospitality course setting. The results indicate that hospitality management students prefer a “learn by doing” approach instead of computer-based learning and lecturing. This study concludes that self-efficacy affects the academic performance in both lecturing and practical learning in hospitality education. However, students’ preference in terms of learning methods does not influence their academic performance. Emphasizing “learn by doing” in the hospitality higher education curriculum is recommended in addition to recruiting faculty members with extensive industry experience. Conversely, it is recommended that faculty find the means to increase students’ self-efficacy when adopting different teaching approaches. [ABSTRACT FROM AUTHOR]

Exposure to endocrine disruptors in utero appears to alter epigenetics in the male germ-line and subsequently promote adult-onset disease in subsequent generations. Fetal exposure to bisphenol A (BPA), a highly prevalent endocrine disruptor in environment, has been shown to alter epigenetic modification and result in glucose intolerance in adulthood. However, whether fetal exposure to BPA can induce epigenetic modification and phenotypic changes in their subsequent offspring are still unclear. The present study was designed to investigate whether exposure to BPA in early life induced glucose intolerance in the offspring through male germ line, and the underlying epigenetic molecular basis. F0 pregnant SD rats were received corn oil or 40 μg/kg/day of BPA during gestation and lactation. F1 male rats were maintained to generate F2 offspring by mating with untreated female rats. Both the F1 rats after weaning and the F2 offspring were not received any other treatments. Our results showed that male F2 offspring in the BPA group exhibited glucose intolerance and β-cell dysfunction. Decreased expression of Igf2 and associated hypermethylation of Igf2 were observed in islets of male F2 offspring. In addition, similar effects were observed in female F2 animals, but the effects were more pronounced in males. Moreover, abnormal expression and methylation of Igf2 was observed in sperm of adult F1 male rats, indicating that epigenetic modification in germ cells can be partly progressed to the next generation. Overall, our study suggests that BPA exposure during early life can result in generational transmission of glucose intolerance and β-cell dysfunction in the offspring through male germ line, which is associated with hypermethylation of Igf2 in islets. The changes of epigenetics in germ cells may contribute to this generational transmission. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between mask wearing practice and the risk of anxiety symptoms during the COVID-19 epidemic among Chinese students aged 12-18 years old.Methods: Totally, 386,432 junior and senior high school students were recruited using a cluster sampling method across three cities of Henan Province in China during February 4-12, 2020. Mask wearing practice was defined according to its type and the behavior exhibited in relation to wearing a mask. Presence of anxiety symptoms was determined by Generalized Anxiety Disorder tool (GAD-7). Multiple logistic regression was performed to estimate the association between mask wearing and anxiety symptoms.Results: Among the participants, compared with students who completely adhered to the all the mask wearing practice, students who did not adhere to all the mask wearing practice had 1.97 times more likely to suffer from anxiety symptoms (adjusted odds ratio (aOR) = 1.97; 95% confidence interval (CI): 1.74-2.22). Furthermore, compared with students who did not know the proper type of mask, students who knew the proper type of mask had a lower risk of anxiety symptoms (aOR = 0.78; 95%CI: 0.76-0.80). Students who adhered to proper behavior of mask wearing was associated with 34% decreased odds for anxiety symptoms (aOR = 0.68; 95%CI: 0.62-0.74).Conclusions: To conclude, proper mask wearing may be an important attribute that play a significant role in reducing the risk of anxiety symptoms among junior and senior school student. However, since this study is a cross-sectional study, prospective studies are needed to further verify. [ABSTRACT FROM AUTHOR]

Hotel image has been found to be highly correlated with customer selection of hotels. The consumer's online reviews greatly impact hotel image and, in turn, customer choice of hotels. In addition, the consumers become increasingly demanding and discriminating given the superfluous development of hotels in the past decades. It becomes unprecedentedly important to monitor and assess online customer reviews so as to identify what image generates customers' positive attitudes and behaviors toward hotels. This study utilized online customer reviews to examine the image of hotels of all scales and delineate the attributes that mostly decide the customer choice of hotels and loyalty behaviors. Content analysis of textual reviews and regression analyses of customer online ratings revealed that hotel room condition, location, and staff are the most important attributes in generating the customer revisit intention and the referrals of the hotels. [ABSTRACT FROM PUBLISHER]

• This was a large sample study of 538,500 individuals to investigate the prevalence of anxiety in students. • The prevalence of anxiety symptoms among chinese primary school students was higher at 13.4%. • After adjusting for potential confounders, school location, knowledge and protective practices of COVID-19 were found to be associated with anxiety symptoms. • Good knowledge of COVID-19 was associated with a lower prevalence rate, which was higher in rural areas, but there was little difference between levels of protection practice. This study was conducted on elementary school students in Henan Province, China, from February 4th to 11th, 2020, during the coronavirus disease 2019 (COVID-19) epidemic. The purpose of the study was to examine the prevalence of anxiety among students and identify the related risk factors contributing to anxiety. Demographic information and psychological status were assessed by using self-reported measures. The generalized anxiety disorder tool (GAD-7) and a multiple logistic regression model were used to assess anxiety and identify potential influencing factors. Cross-sectional data indicated that the overall anxiety prevalence was 13.4%. The prevalence of anxiety symptoms was highest among rural primary school students and lowest among city students. Three groups of students in different regions were surveyed, and the prevalence of anxiety symptoms was significantly higher among students with poor knowledge of COVID-19 than among students with good knowledge of COVID-19. After adjusting for potential confounding factors, it was found that location, knowledge, and practice were related to anxiety. This study showed that the prevalence of anxiety symptoms was higher among Chinese primary school students. The influencing factors found in this study may help relevant staff improve the mental health of children during the epidemic. [ABSTRACT FROM AUTHOR]

This study empirically investigates the relationship between firm-wise financial factors and firm performance in the restaurant industry from 2000 to 2004 using panel data regression. A fixed effects model was determined to be the appropriate approach for the investigation. The model identifies debt leverage and activity as significant financial factors affecting restaurant firm performance. On the other hand, the intercept of the model was found to play an equally important role in a restaurant firm's market performance, implying that firm-wise nonfinancial factors should be examined in future research. [ABSTRACT FROM AUTHOR]

• There is a positive correlation between isofenphos, isocarbophos levels with T2DM. • Isofenphos and isocarbophos significantly increased the risk of T2DM. • The association may be mediated by WBC and NE. To investigate the associations between isocarbophos and isofenphos with impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM), and to assess the mediation roles of inflammation cells. There were 2701 participants in the case-control study, including 896 patients with T2DM, 900 patients with IFG, 905 subjects with NGT. Plasma isocarbophos and isofenphos concentrations were measured using gas chromatography and triple quadrupole tandem mass spectrometry. Generalized linear models were used to calculate the relationships between plasma isofenphos and isocarbophos levels with inflammatory factor levels and T2DM. Inflammatory cell was used as mediators to estimate the mediating effects on the above associations. Isocarbophos and isofenphos were positively related with T2DM after adjusting for other factors. The odds ratio (95% confidence interval) (OR (95%CI)) for T2DM was 1.041 (1.015, 1.068) and for IFG was 1.066 (1.009, 1.127) per unit rise in ln-isocarbophos. The prevalence of T2DM increased by 6.4% for every 1 unit more of ln-isofenphos (OR (95% CI): 1.064 (1.041, 1.087)). Additionally, a 100% rise in ln-isocarbophos was linked to 3.3% higher ln-HOMA2IR and a 0.029 mmol/L higher glycosylated hemoglobin (HbA1c) (95% CI: 0.007, 0.051). While a 100% rise in ln-isofenphos was linked to increase in ln-HOMA2 and ln-HOMA2IR of 5.8% and 3.4%, respectively. Furthermore, white blood cell (WBC) and neutrophilic (NE) were found to be mediators in the relationship between isocarbophos and T2DM, and the corresponding proportions were 17.12% and 17.67%, respectively. Isofenphos and isocarbophos are associated with IFG and T2DM in the rural Chinese population, WBC and NE have a significant role in this relationship. [Display omitted] [ABSTRACT FROM AUTHOR]

Excessive daytime sleepiness is associated with many adverse consequences, including cardiovascular diseases and mortality. Although exposure to air pollution has been suggested in connection with excessive daytime sleepiness, evidence in China is scarce. The study aimed to explore the association between long-term exposure to air pollution and excessive daytime sleepiness in rural China. A lot of 27935 participants (60% females) from the Henan Rural Cohort Study were included in this analysis. A satellite-based spatiotemporal model estimated a 3-year average air pollution exposure to NO 2 (nitrogen dioxide), PM 1 (particulate matter with aerodynamic diameters not more than 1 μm) and PM 2.5 (particulate matter with aerodynamic diameters not more than 2.5 μm) at the home address of participants before the baseline survey. Logistic regression was used to evaluate the odds ratio and 95% confidence interval between long-term air pollution and excessive daytime sleepiness. The average concentrations of NO 2 , PM 1 and PM 2.5 during three years preceding baseline survey were 38.22 μg/m³, 56.29 μg/m³ and 72.30 μg/m³. Exposure to NO 2 , PM 1 and PM 2.5 were all associated with excessive daytime sleepiness. Each 1 μg/m³ increment of NO 2 , PM 1 and PM 2.5 were related to a 20% (OR: 1.20, 95% CI: 1.13–1.27), 10% (OR: 1.10, 95% CI: 1.05–1.16) and 17% (OR: 1.17, 95% CI: 1.10–1.23) increase of the prevalence of excessive daytime sleepiness. The study demonstrated that long-term exposure to NO 2 , PM 1 and PM 2.5 were all associated with excessive daytime sleepiness. The impact of air pollution should be considered when treating individuals with excessive daytime sleepiness. • The survey studied the effect of air pollution on daytime sleepiness in rural China. • Exposure to ambient NO 2 , PM 1 and PM 2.5 were all associated with daytime sleepiness. • NO 2 showed higher effect on daytime sleepiness than PM 1 and PM 2.5 • Women and those of moderate exercise have higher odds ratios for daytime sleepiness. [ABSTRACT FROM AUTHOR]

Background: Few studies are available on the relationship of androstenedione with inflammation and obesity and the effect of androstenedione and inflammation on the association between testosterone and obesity. This study intended to examine the mediation effect of inflammatory markers on the association of testosterone with obesity and the moderation effect of androstenedione on the association of testosterone with inflammation and obesity in Chinese rural men. Materials and methods: This cross‐sectional research enrolled 2536 male rural inhabitants from the Henan Rural Cohort study. The serum concentrations of testosterone and androstenedione were determined by liquid chromatography–tandem mass spectrometry. Linear and logistic regression were used to examine the relationships between testosterone, inflammatory markers, and obesity. Mediation and moderation analyses were carried out to evaluate the potential effects of inflammatory markers on the relationship between testosterone and obesity, as well as androstenedione on the relationships of testosterone with inflammation and obesity. Results: After adjusting for confounding factors, the results showed that testosterone and androstenedione were negatively related to obesity, and inflammatory markers were positively associated with obesity. Besides, testosterone and androstenedione were negatively associated with inflammatory markers. Mediation analysis showed that white blood cell, neutrophil, monocyte, and high‐sensitivity C‐reactive protein had mediating effects on the association between testosterone and obesity. The most vital mediator was high‐sensitivity C‐reactive protein, and its proportion of the effect was 11.02% (defined by waist circumference), 11.15% (defined by waist‐to‐hip ratio), 12.92% (defined by waist‐to‐height ratio), and full mediating effect (defined by body mass index). Moreover, androstenedione played negative moderation effects on the associations of testosterone with inflammation and obesity. Conclusion: Inflammatory markers and androstenedione were first found to have modifying effects on the association of testosterone with obesity. Higher levels of testosterone and androstenedione could reduce the inflammation level and risk of obesity, indicating their potential roles in the prevention and treatment of chronic diseases. [ABSTRACT FROM AUTHOR]

Purpose: Type 2 diabetes is a complex disease determined by variable genes and environmental factors. The study was designed to investigate the effect of interactions of four polymorphisms of suppressor of cytokine signaling 3 (SOCS3) with fruit and vegetable (F&V) intake on type 2 diabetes in a rural population of China. Methods: A total of 4411 participants from the rural areas of Henan, China were included in the study. Multivariate logistic regression and restricted cubic splines were used to estimate the associations between polymorphisms and risk allele score of SOCS3 and type 2 diabetes in different groups. Haplotype analysis was conducted to examine the effects of linkage inheritance at these four loci on type 2 diabetes. Results: Three of the four polymorphisms showed significant associations with type 2 diabetes in the less F&V intake group after adjusting the covariates, the odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were 1.24 (1.08–1.41) for rs4969168, 1.16 (1.02–1.32) for rs9892622, and 1.21 (1.06–1.39) for rs9914220. No significant association was detected in the more F&V intake group. The obvious dose–response relationship between the risk allele score and type 2 diabetes was also noted only in the less F&V intake group. Conclusions: Variants of SOCS3 gene were associated with type 2 diabetes and the associations could be modified by the F&V intake. [ABSTRACT FROM AUTHOR]

Objective: To assess the independent and combined effects of night sleep duration and sleep quality on depressive symptoms.Methods: A total of 28,202 participants (11,236 males and 16,966 females) aged 18-79 years from the Henan Rural Cohort were included in this study. Night sleep duration and sleep quality were defined by the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and restricted cubic splines were applied to evaluate the association of night sleep duration and sleep quality with depressive symptoms.Results: A U-shaped dose-response relationship between night sleep duration and depressive symptoms along with a J-shaped relationship between sleep quality and depressive symptoms were observed. Compared with reference group (7-<8 h), shorter sleep duration (<6 h) and longer sleep duration (≥10 h) were associated with increased risk of depressive symptoms in males (short sleep: Odds Ratio (OR) = 1.84, 95% confidence interval (CI), 1.34-2.52; long sleep: OR = 1.56, 95% CI, 1.01-2.42) and females (short sleep: OR = 2.19, 95% CI, 1.77-2.70; long sleep: OR = 1.51, 95% CI, 1.10-2.10). Compared with good sleepers, poor sleepers had 4.23-fold (95% CI:3.54-5.06) and 3.87-fold (95% CI: 3.41-4.40) increased odds of depressive symptoms in males and females. Furthermore, participants with longer night sleep duration (≥10 h) and poorer sleep quality had the strongest effect on depressive symptoms (males: OR = 6.64, 95% CI, 3.21-13.74; females: OR = 7.76, 95% CI, 5.00-12.02).Conclusions: Extreme night sleep duration and poor sleep quality were independently and combinedly related to elevated depressive symptoms, suggesting that keeping optimal night sleep duration and good sleep quality maybe benefit for maintaining mental health.Trial Registration: Chinese Clinical Trial Register. Registration number: ChiCTR-OOC-15006699. [ABSTRACT FROM AUTHOR]

The study aimed to explore the relationship between visceral fat index (VFI) and dyslipidemia and evaluate the efficiency of VFI as a marker for identifying dyslipidemia in Chinese rural adults. The cross-sectional study recruited 35,832 aged 18-79 years eligible participants from The Henan Rural Cohort Study. VFI was measured by bioelectrical impendence methods and classified into sex-specific quartiles. Fasting blood samples were collected. Logistic regression models with VFI as a categorical variable and restricted cubic spline regression models with VFI as a continuous variable were performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Receiver-operating characteristic (ROC) curve was conducted to evaluate the identifying performance of VFI. The age-standardized prevalence of dyslipidemia was 29.80% and 26.01% in male and female, respectively. Increasing VFI quartiles were significantly positively related to the risk of dyslipidemia and its components (Pfor trend < 0.01). The adjusted ORs (95% CIs) for per 1-SD increase in VFI were 2.11 (2.02-2.20) and 1.52 (1.47-1.56) in male and female, respectively, and dose-response relationships were observed in both genders (Pfor nonlinearity < 0.01). In addition, area under the curves (AUCs) in male (0.697) was larger than in female (0.655) (P < 0.05). VFI was significantly positively related to the risk of dyslipidemia and its components, and the risk was shown to be more prominent in male. Meanwhile, dose-response relationships were observed in both genders. Furthermore, VFI might be a relatively effective marker for identifying dyslipidemia in male, but not in female. [ABSTRACT FROM AUTHOR]

In this study 3307 samples of 24 vegetables and fruits from 18 regions of Henan Province, China, were collected in 2021 with the aim of assessing the levels of pesticide residues and analysing the differences between different sources in Henan Province. Thirteen kinds of pesticides were analysed by gas chromatography-mass spectrometry (GC-MS) and detection rates were compared by the chi-square test. In all samples, except ginger, pimento, edible fungi and yam, pesticide residues were detected. The detection rates of difenoconazole, acetamiprid, carbendazim, procymidone, emamectin benzoate, lambda-cyhalothrin, cypermethrin and dimethomorph in supermarkets and traditional farmers' markets were different. The difenoconazole group and the dimethomorph group were both statistically different (P < 0.05). This study showed common vegetables and fruits to contain pesticide residues in Henan Province and provided a scientific basis for their evaluation. Different sources take different regulatory measures to control pesticide residues to ensure food safety. [ABSTRACT FROM AUTHOR]

Background We explored the association between serum uric acid (SUA) and metabolic syndrome (MetS) in Chinese rural adults. Methods A total of 16,577 subjects (6354 men and 10,223 women) were from the RuralDiab study. SUA concentration was measured by the enzymatic colorimetric method. A meta-analysis including 12 eligible studies focused on SUA and MetS was preformed to confirm the findings of the cross-sectional study. Results After adjustment for age, educational level, and other covariates, the odds ratio (ORs) for MetS increased smoothly with the increasing SUA concentration in both sexes ( P for no-linear trend > 0.05). The adjusted ORs of MetS comparing the fourth and firstly quartiles were 3.11 [95% CI: 2.58–3.74] in men and 3.64 [95% CI: 3.22–4.11] in women ( P trend  < 0.001). In continuous analysis, each 1 mg/dl increment in SUA concentration was significantly associated with a 41% increased risk of MetS in men and 62% in women. The meta-analysis validated the positive association between SUA and MetS (pooled OR: Men, 1.80 [95% CI: 1.57–2.07]; Women, 2.46 [95% CI: 1.95–3.12]). Conclusion SUA concentration was positively with the prevalence of MetS in Chinese rural population, and more studies are needed to explore the mechanisms of the relationship. What is already known on this topic? Previous studies have explored the association between serum uric acid and metabolic syndrome, but evidence on the strength and consistency of the association remains uncertain and limited, especially in rural population. In addition, the epidemiological research and meta-analysis on the association have not been reported. What does this study add? The results of this study showed that serum uric acid was significantly associated with metabolic syndrome and its components in Chinese rural population. Furthermore, the findings demonstrated that the significant associations varied across sex. In addition, the results of epidemiological research were similar with the meta-analysis, which demonstrates the credible of the results of the epidemiology research. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the independent and combined dose-response association of napping and night sleep duration with type 2 diabetes mellitus (T2DM) among different genders in the rural Chinese population.Methods: For this research, a total of 19,257 participants were enrolled in the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study. Napping and night sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). Restricted cubic splines and logistic regression were used to estimate the relationship between napping and night sleep duration with T2DM.Results: A linear dose-response relationship between napping duration and T2DM as well as a U-shaped relationship between night sleep duration and T2DM were found. Compared with those who reported no napping, participants who had a napping duration of ≥91 min were associated with a 19% increase in prevalence of T2DM. Adjusted odds ratios (ORs) (95% confidence intervals (CIs)) for T2DM were 1.48 (1.03, 2.14) and 1.50 (1.22, 1.85) for shorter (≤5 h) and longer (>9 h) night sleep duration compared with the referential group. Additionally, the combination of longer napping duration (≥91 min) and night sleep duration (>9 h) increased 104% (95% CI: 45%, 128%) prevalence for T2DM. These associations were not found in males but were evident in females.Conclusions: Longer napping duration and extreme night sleep duration increased the prevalence of T2DM. Meanwhile, longer napping and night sleep duration might be jointly associated with a higher prevalence of T2DM. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the recent prevalence and the distributions of morphological subtypes of anaemia in the rural population. Design: Anaemia was defined according to the WHO and the Chinese criteria, and the morphological subtypes of anaemia were classified based on the erythrocyte parameters. The age-standardised prevalence was calculated according to the data of the Population Census 2010 in China. Setting: A cross-sectional study in Henan Province. Participants: 33 585 subjects aged 18–79 years old. Results: The standardised prevalence of anaemia across the WHO and the Chinese definitions was 13·63 % and 5·45 %, respectively. Regardless of which criteria was used, the standardised prevalence of anaemia was higher among women than among men and that increased with age in men, while markedly decreased after menopause in women. There were shifts in morphological patterns of anaemia using the WHO and the Chinese criteria that the standardised prevalence of microcytic anaemia was 3·74 % and 2·97 %, normocytic anaemia was 9·20 % and 2·34 %, and macrocytic anaemia was 0·75 % and 0·14 %, respectively. Besides, there were differences in the influencing factors of anaemia according to different criteria or gender. However, age, education level and renal damage were consistently significantly associated with anaemia in all participants. Conclusions: Anaemia may still be a serious health problem in rural China. It is necessary to reformulate prevention and management strategies to reduce the disease burden of anaemia. [ABSTRACT FROM AUTHOR]

Background: Limited studies have focused on the risk assessment of stroke in rural regions. Moreover, the application of artificial intelligence in stroke risk scoring system is still insufficient. This study aims to develop a simplified and visualized risk score with good performance and convenience for rural stroke risk assessment, which is combined with a machine learning (ML) algorithm. Methods: Participants of the Henan Rural Cohort were enrolled in this study. The total participants (n = 38,322) were randomly split into a train set and a test set in the ratio of 7:3. An ML algorithm was used to select variables and the logistic regression was then applied to construct the scoring system. The C-statistic and the Brier score (BS) were used to evaluate the discrimination and calibration. The Framingham stroke risk profile (FSRP) and the self-reported stroke risk function (SRSRF) were chosen to be compared. Results: The Rural Stroke Risk Score (RSRS) was produced in this study, including age, drinking status, triglyceride, type 2 diabetes mellitus, hypertension, waist circumference, and family history of stroke. On validation, the C-statistic was 0.757 (95% CI 0.749–0.765) and the BS was 0.058 in the test set. In addition, the discrimination of RSRS was 6.02% and 7.34% higher than that of the FSRP and SRSRF, respectively. Conclusions: A well-performed scoring system for assessing stroke risk in rural residents was developed in this study. This risk score would facilitate stroke screening and the prevention of cardiovascular disease in economically underdeveloped areas. [ABSTRACT FROM AUTHOR]

It is worth paying attention to the level of worry and fear of students during the normalization of the epidemic. We conducted the cross‐sectional study that included 182,991 high school students using an online survey to assess worry and fear levels and its influencing factors in three cities in Henan Province, China, from May 21 to May 27, 2021. Worry and fear levels were measured using a five‐item Likert‐type scale. Multinomial logistic regression was used to analyze the risk factors. Approximately 65.42% of students reported being high worry about the coronavirus disease 2019 (COVID‐19) epidemic, and about 41.44% of students reported being high fear about the COVID‐19 epidemic. In addition, compared with female, male had lower odds of suffering from a high worry, and compared with senior high school students, junior high school students were more likely to suffer from a high worry. Students lived in rural had highest odds increased likelihood of high worry. Similar results in fear levels. During the normalization period of the COVID‐19 epidemic, many students have high levels of worry and fear. This study has implications for potential influencers of worry and fear levels in follow‐up work. Practitioner Points: Approximately 65.42% of students reported being high worry about the coronavirus disease 2019 (COVID‐19) epidemic, and about 41.44% of students reported being high fear about the COVID‐19 epidemic.Students lived in rural had highest odds increased likelihood of high level of worry and fear.Compared with senior high school students, junior high school students were more likely to suffer from a high worry. [ABSTRACT FROM AUTHOR]

Sex hormones have been shown to be negatively associated with hypertension, but the relationship between serum progesterone levels and hypertension has not been adequately studied. Therefore, we aimed to evaluate the association between progesterone and hypertension among Chinese rural adults. A total of 6222 participants were recruited, which included 2577 men and 3645 women. The concentration of serum progesterone was detected by liquid chromatography-mass spectrometer system (LC-MS/MS). Logistic regression and linear regression were used to assess the associations between progesterone levels and hypertension and blood pressure related indicators, respectively. Constrained splines were used to fit the dose-response relationships of progesterone with hypertension and blood pressure related indicators. Moreover, the interactive effects of several lifestyle factors and progesterone were identified by a generalized linear model. After fully adjusting the variables, progesterone levels were inversely associated with hypertension in men [odds ratio (OR): 0.851, 95% confidence interval (CI): 0.752, 0.964]. Among men, a 2.738 ng/ml increase in progesterone was associated with a 0.557 mmHg decrease in diastolic blood pressure (DBP) (95% CI: –1.007, –0.107) and a 0.541 mmHg decrease in mean arterial pressure (MAP) (95% CI: –1.049, –0.034), respectively. Similar results were observed in postmenopausal women. Interactive effect analysis showed that only a significant interaction was observed between progesterone and educational attainment on hypertension in premenopausal women (p=0.024). Elevated levels of serum progesterone were associated with hypertension in men. Except for premenopausal women, a negative association of progesterone with blood pressure related indicators was observed. [ABSTRACT FROM AUTHOR]

Background: This study aimed to estimate healthy life expectancy (HLE) regarding anxiety, depression and their comorbidity among rural older adults.Methods: A total of 12,851 subjects (5790 men and 7061 women) enrolled from the Henan Rural Cohort Study were used to evaluate healthy status expectancy (HSE), and 10,096 (4475 men and 5621 women) of them were used to estimate health-adjusted life expectancy (HALE). The life expectancy was calculated using period life table, and HSE and HALE indicators were calculated via the Sullivan method.Results: For participants aged 60, the depression-free life expectancy (DFLE), anxiety-free life expectancy (AFLE), and depression- and anxiety-free life expectancy (DAFLE) were 23.0993, 23.3314, and 22.7206 years, respectively. The quality-adjusted life expectancy (QALE) of those with neither anxiety nor depression, with anxiety, with depression, and with comorbidity was 22.0727, 20.8751, 18.1484, and 17.0823 years, respectively. The ratio of DFLE (AFLE) to LE increased with age among both genders, while the DAFLE/LE showed a decreasing trend. Regardless of HSE or HALE indicators, women tended to have higher HLE, while HLE/LE was lower than men. Furthermore, all HLE indicators associated with anxiety were the largest in both genders compared to indicators regarding depression.Limitations: The HLE may be overestimated ignoring institutional population in the study.Conclusion: Anxiety and depression played essential roles in the quality of life among rural older adults, especially depression. Comorbidity would intensify the adverse effect in rural areas, especially for older men. More attention should be paid to the psychological problems among rural older population. [ABSTRACT FROM AUTHOR]

Objective: Food-away-from-home (FAFH) is one of the leading dietary patterns in Chinese families. However, the relationship between FAFH and dyslipidemia remains unclear, especially in the rural adult population. This study explored the relationship of FAFH frequency with serum lipid levels and dyslipidemia in rural Chinese adults. Methods: A total of 12,002 men and 17,477 women aged 18–79 were included from the Henan rural cohort. Serum lipid levels were measured by enzyme colorimetry. Information on FAFH frequency was collected using a validated questionnaire. The associations of FAFH frequency and serum lipid levels were assessed through multiple linear regression modeling. Logistic regression was performed to explore the linkages of the FAFH frequency to dyslipidemia and its four parameter types. Mediation analysis examined whether body mass index (BMI) acted as a mediator between the FAFH frequency and dyslipidemia. Results: After adjusting for potential confounders, the adjusted odds ratio (OR) and 95% confidence interval (CI) of the groups with 8–11 FAFH times/week for dyslipidemia were 1.991 (1.569, 2.526) in men compared with 0-frequency subgroup. Participants who consumed 8–11 FAFH times/week had a higher risk of high total cholesterol (TC), high triglycerides (TG), high LDL-cholesterol (LDL-C), and low HDL-cholesterol (HDL-C) with the OR and 95% CI of 1.928 (1.247, 2.980), 1.723 (1.321, 2.247), 1.875 (1.215, 2.893), and 1.513 (1.168, 1.959), respectively. In addition, the interaction effect between FAFH and gender was significantly associated with dyslipidemia and lipid levels (P < 0.001). BMI played a fully mediating effect between FAFH frequency and dyslipidemia in men, and the Sobel test showed the significance of the mediating effect (z = 4.2158, P < 0.001). Conclusion: In rural Chinese adults, FAFH was significantly associated with a higher risk of dyslipidemia, which indicated the importance of FAFH reduction and dietary intervention in patients with dyslipidemia and cardiovascular disease, especially in clinical practice. Trial Registration: The Henan Rural Cohort Study has been registered on the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15,006,699). [ABSTRACT FROM AUTHOR]

Background and Purpose: Limited research focused on the association between household air pollution (HAP) and health-related quality of life (HRQoL). This study aimed to investigate the association of HAP with HRQoL and the effect modification of physical activity.Method: A total of 16,761 eligible participants were derived from the Henan Rural Cohort Study. Based on structured questionnaires, HAP was assessed by fuel type, cooking duration and kitchen ventilation; HRQoL was measured with utility index and VAS score from the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L); physical activity was assessed by the International Physical Activity Questionnaire. Generalized linear models and tobit regression models were utilized to explore the relationship of HAP with HRQoL. Further sensitivity analyses were conducted using structural equation models.Results: Compared with those who cooked with clean fuels, short-duration, or good kitchen ventilation, participants who cooked with solid fuels, long-duration, and poor ventilation had lower utility index and VAS score (All P < 0.001). The decrease in utility index for solid fuel users vs. clean fuel users were 0.06 [95%confidence interval (CI) 003, 0.08], 0.03 (95%CI 0.01, 0.04) and 0.02 (95%CI 0.01, 0.04) in low, moderate and high physical activity group, respectively, which decreased with physical activity levels (Pfor interaction < 0.05). Similar results were observed in associations of kitchen ventilation with utility index and VAS score.Conclusion: HAP negatively associated with HRQoL in rural population, and potential intervention aimed at maintaining adequate physical activity.Trail Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375 . [ABSTRACT FROM AUTHOR]

Increasing evidence suggested that the expression and inter-regulation of long noncoding RNA (lncRNA), microRNA (miRNA), and messenger RNA (mRNA) were related to the development of diabetes. Based on bioinformatics analysis, this study aimed to comprehensively analyze the dysregulated RNA molecules related to new-onset type 2 diabetes mellitus (T2DM). Twenty-four patients with new-onset T2DM were included as cases, and sex- and age-matched participants were included as controls. The differentially expressed lncRNAs, miRNAs, and mRNAs between the two groups were screened by RNA sequencing. LncRNA-miRNA-mRNA network and enrichment analysis were used to reveal the RNA molecules that were potentially associated with T2DM and their early changes. A total of 123 lncRNAs, 49 miRNAs, and 312 mRNAs were differentially expressed in the new-onset T2DM (fold change ≥ 1.5 and p value < 0.05). Functional analysis revealed that differentially expressed RNAs were likely to play essential roles in diabetes-related pathways. In addition, the protein–protein interaction (PPI) network screened multiple hub mRNAs, and lncRNA-miRNA-mRNA networks showed that a single miRNA could be related to multiple lncRNAs, and then they coregulated more mRNAs. SLC25A4, PLCB1, AGTR2, PRKN, and SCD5 were shown to be important mRNAs in T2DM, and miR-199b-5p, miR-202-5p, miR-548o-3p as well as miR-1255b-5p could be involved in their regulation. In conclusion, several new and previously identified dysregulated lncRNAs, miRNAs, and mRNAs were found to be vital biomarkers in T2DM. Their alterations and interactions could modulate the pathophysiology of T2DM. Those findings may provide new insights into the molecular mechanisms underlying the development of T2DM. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the relationships of separate and mixed exposure of neonicotinoids on cardiometabolic risk at baseline and follow-up and its change over 3 years, and further explore whether inflammatory markers levels and platelet traits (PLT) mediate these relationships. In this prospective cohort study from the Henan Rural Cohort Study, 2315 participants were involved at baseline, and 1841 participants completed cardiometabolic risk predictors determinations during the 3-year follow-up. Each neonicotinoid pesticide was normalized to imidacloprid (IMI eq) using the relative potency factor approach. Quantile-based g-computation (Qgcomp) regression was used to evaluate the effect of the mixtures of neonicotinoids mediation analysis was employed to explore whether inflammatory markers levels and platelet traits mediated these relationships. A two-sample mendelian randomization (MR) study was further used to causal association. Qgcomp regression revealed a statistically positive relationship between neonicotinoids mixture exposure and cardiometabolic risk score at baseline and follow-up over 3 years. Both neutrophils/monocytes and PLT were mediators in the relationship between IMI eq and cardiometabolic risk score at baseline and follow-up over 3 years. The causal risk effect of pesticide exposure were 2.50 (0.05, 4.95) and 5.24 (1.28, 9.19) for cardiometabolic risk indicators including insulin resistance and triglyceride, respectively. Nevertheless, there was no correlation discovered between pesticide exposure and other markers of cardiometabolic risk. Neonicotinoid insecticides exposure was connected to an increased cardiometabolic risk, especially in individuals with T2DM. Furthermore, inflammatory markers and PLT seem to be two vital mediators of these associations. Additionally, genetic evidence on pesticide exposure and cardiometabolic risk still needs to be validated by multiregional and multiethnic GWAS studies. [Display omitted] • Neonicotinoids exposure was connected to an increased cardiometabolic risk. • Relations of neonicotinoids mixture exposure with cardiometabolic risk were linear. • High neonicotinoids exposure in type 2 diabetes mellitus amplifies cardiometabolic risk. • Inflammation markers and platelet count seemed to be two vital mediators of this association. [ABSTRACT FROM AUTHOR]

Background: Long‐term exposure to ambient ozone links to aging biomarkers and increased risk for atherosclerotic cardiovascular diseases (ASCVD). However, the roles of aging biomarkers in the association of long‐term exposure to ambient ozone with ASCVD are unclear. Methods: A total of 5298 participants completed the questionnaire and physical examination and provided biological specimens. Aging biomarkers (telomere length [TL] and mitochondrial copy number [mtDNA‐CN]) were measured by using a real‐time polymerase chain reaction method. The concentration of ambient ozone was assessed using a random forest model. Associations of ambient ozone or aging biomarkers with 10‐year ASCVD risk were analyzed using logistic regression models. The roles of aging biomarkers in the association of ambient ozone exposure with 10‐year ASCVD risk were explored by mediation analysis. Results: The adjusted odds ratios and 95% confidence interval of high 10‐year ASCVD risk were 1.16 (1.08, 1.25), 0.71 (0.60, 0.85), and 0.78 (0.64, 0.96) in association with each 1‐unit increment in ambient ozone (1 μg/m3) concentration, relative TL, and mtDNA‐CN, respectively. The mediated proportion of the association between ambient ozone exposure and high 10‐year ASCVD risk by TL or mtDNA‐CN was 21.13% or 7.75%, respectively. The total proportion of association between ambient ozone exposure and high 10‐year ASCVD risk mediated by TL plus mtDNA‐CN was 21.02%. Conclusions: Long‐term exposure to ambient ozone was associated with increased 10‐year ASCVD risk, and the association was partially mediated by aging biomarkers (shortened TL and decreased mtDNA‐CN). This study indicated that ambient ozone pollution–related ASCVD risk might be partially explained by the telomere–mitochondrial axis of aging. [ABSTRACT FROM AUTHOR]

Background and Aims. The effects of cortisol on cardiovascular diseases (CVD) and CVD risk are unknown, especially in patients with type 2 diabetes mellitus (T2DM). Furthermore, it is unclear whether 25 (OH)D can alter the associations of cortisol with CVD and CVD risk factors. Thus, the present study was to investigate the associations of serum cortisol with CVD and CVD risk factors and whether 25 (OH)D altered these associations among patients with T2DM. Materials and methods. A total of 762 patients diagnosed with T2DM were recruited. The levels of serum cortisol and 25 (OH)D were measured with a liquid chromatography-tandem mass spectrometry. Logistic regression and linear regression were used to assess the association of cortisol with CVD and multiple cardiovascular risk factors. Modification analyses were performed to identify whether 25 (OH)D altered the above associations. Results. A 1 SD increase in cortisol was associated with a higher prevalence of stroke (odds ratio (OR): 1.25, 95% confidence interval (CI): 1.05, 1.50). Elevated cortisol was associated with related cardiovascular risk factors, including deceased ß cell function, high-density lipoprotein-cholesterol (HDL-C), and fasting insulin, as well as increased triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c). In addition, modification analyses suggested that the associations of cortisol with ß cell function, fasting insulin, FPG, and HbA1c were modified by 25 (OH)D. Conclusions. Serum cortisol was associated with the prevalence of stroke and cardiovascular risk factors, and the associations of cortisol with cardiovascular risk factors were moderated by 25 (OH)D, suggesting that T2DM patients with exposure to lower 25 (OH)D levels and higher cortisol levels were more susceptible to have higher cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Although solid fuel use for cooking is linked to an increased risk for depression, there is limited evidence on the effects of cooking duration and kitchen ventilation on these associations in rural areas. Among 29 903 participants from the Henan Rural Cohort, the independent and combined associations of cooking fuel type, cooking duration, and kitchen ventilation with depressive and anxiety symptoms were examined by logistic regression models and restricted cubic spline. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of solid fuel use for depressive and anxiety symptoms were 1.237 (1.041, 1.469) and 1.384 (1.153, 1.662), respectively. Increased cooking duration was associated with an increased prevalence of depressive symptoms (aOR: 1.098, 95% CI: 1.033, 1.166) and anxiety symptoms (aOR: 1.074, 95% CI: 1.009, 1.144). Solid fuel use and long‐duration cooking associated with increased prevalence of depressive and anxiety symptoms were only observed in individuals without kitchen ventilation. Kitchen ventilation may attenuate the positive associations of solid fuel use and long‐duration cooking with the prevalence of depressive and anxiety symptoms, which suggested popularizing clean fuel and promoting kitchen ventilation may be effective strategies to improve mental health related to household air pollution sourced from solid fuel use and long‐duration cooking. [ABSTRACT FROM AUTHOR]

Purpose: A significant shift in meal pattern with frequent eating out was closely associated with multiple chronic outcomes, but with limited evidence on hyperuricemia. We aimed to explore the associations between eating out and serum uric acid (SUA) as well as hyperuricemia. Methods: A total of 29,597 participants were recruited from the Henan Rural Cohort Study. A validated food frequency questionnaire (FFQ) was used to collect dietary data, including the frequency of eating out. Linear regression models were used to examine the association of eating-out frequency with SUA and BMI. Logistic regression and restricted cubic spline were performed to assess the association and dose–response relationship between eating-out frequency and hyperuricemia. The mediation effect of BMI between eating out and the risk of hyperuricemia was evaluated. Results: Eating out was significantly associated with higher SUA levels in the total population and males (P < 0.001). Multivariate-adjusted odds ratios (ORs) with 95% confidence interval (CIs) of hyperuricemia were 1.26 (1.09, 1.46) for the total population and 1.18 (1.00, 1.40) for males (≥ 7 times/week vs 0 time/week). A non-linear positive dose–response relationship between eating-out frequency and hyperuricemia was observed. Furthermore, BMI played a partial mediating role in the relationship between eating out frequency and hyperuricemia, which explained 30.7% in the total population and 44.8% in males. Conclusion: Our findings indicated that eating out was associated with increased SUA levels and elevated hyperuricemia risk in rural China, especially in males. Moreover, the relationship was partly mediated by BMI. Clinical trials: ChiCTR-OOC-15006699 (2015-07-06). [ABSTRACT FROM AUTHOR]

Background: Physical activity and vitamin D receptor (VDR) have been associated with type 2 diabetes mellitus (T2DM). However, the associations of VDR methylation with T2DM and physical activity remained unknown. We aimed to investigate whether VDR methylation was a link between physical activity and T2DM. Methods: A 1:1 matching case‐control study was designed based on the Henan Rural Cohort Study, including 272 pairs of T2DM patients and nonpatients. Physical activity level was assessed using the International Physical Activity Questionnaire. The high‐resolution melt method was applied to determine the methylation level of the promoter region of VDR. The association between physical activity and T2DM was analyzed with a conditional logistic regression model. The effect modification of VDR methylation levels on the association between physical activity and T2DM was conducted. A multivariate correlation analysis model was applied to investigate correlations of VDR methylation with insulin sensitivity. Results: Physical activity level was associated with T2DM risk (crude model: odds ratio [OR] 0.611; 95% CI, 0.416‐0.897; adjusted model: OR 0.619; 95% CI, 0.418‐0.917). In effect modification analysis, the effects of physical activity on T2DM were stronger for low VDR methylation levels than for high (P =.025). Moreover, VDR methylation levels were associated with insulin (r = −0.089, P =.039) as well as homeostatic model assessment of insulin resistance (r = −0.098, P =.022). Conclusions: The methylation status of the VDR promoter is associated with the secretion and sensitivity of insulin. VDR methylation attenuates the association between physical activity and T2DM, indicating that proactively physical activity may reduce the risk of T2DM, especially in people with low VDR methylation level. [ABSTRACT FROM AUTHOR]

Novel halogenated flame retardants (HFRs) have attracted much attention due to their environmental hazard and adverse effects on human health. In this study, a sensitive and simultaneous method for the determination of six novel HFRs was developed, including tetrabromobisphenol A (TBBPA), tetrachlorobisphenolA, TBBPA bis(2-hydroxyethyl ether), TBBPA bis(allyl ether), TBBPA bis(2,3-dibromopropyl ether) and 2,4,6-tris(2,4,6-tribromophenoxy)-1,3,5-triazine. ZIF-8 modified nitrogen-doped reduced graphene oxide (ZIF-8@N-rGO) was synthesized and coated onto a syringe filter to prepare a thin film microextraction (TFME) device. The adsorption capacities of ZIF-8@N-rGO for novel HFRs ranged from 50.98 to 112.84 mg g−1, exhibiting good extraction efficiency through a combination of π-π, hydrophobic, and hydrogen bonding interactions. The TFME device was coupled to a high-performance liquid chromatography-ultraviolet detection system to simultaneously determine target HFRs in crayfish-aquaculture water systems. Under the optimal extraction parameters, the linearities ranged from 0.1 to 100 ng mL−1. The method detection limits ranged from 0.030 to 0.14 ng mL−1 and relative recoveries ranged from 88.6 to 106.2%. We found that novel HFRs were detected in water and crayfish samples and were primarily distributed in the viscera and head shell of the crayfish. The bioconcentration factors ranged from 0.25 to 19.20 L kg−1, indicating non-bioaccumulation in the crayfish. This study provides valuable technology and information for potential health risks of exposure to novel HFRs from consuming crayfish. [Display omitted] • ZIF-8@N-rGO was synthesized as the coating material of a TFME device. • ZIF-8@N-rGO exhibited good adsorption capacities (50.98–112.84 mg g−1) and enrichment factors (324–368) for novel HFRs. • A TFME-HPLC-UV method was developed for the determination of novel HFRs in crayfish-aquaculture water systems. • The MDLs ranged from 0.030 to 0.14 ng mL−1 for novel HFRs. • The tissue distribution and bioaccumulation of novel HRFs in crayfish were investigated. [ABSTRACT FROM AUTHOR]

This study investigates the nature of critical success factors (CSFs) in China's budget hotel operations and development from the perspectives of various stakeholders, including customers, industry professionals, government authorities, and hotel investors. Understanding the differences in CSFs becomes extremely important to the success of the budget hotel segment in China. Results indicated that while all five dimensions of CSFs (i.e., physical product, service quality, price, promotion, and location) were deemed important by the industry professional, government authority, and hotel investor, the sequence of importance differed substantially among these groups. By contrast, customers were primarily concerned with service quality issues, indicating service quality was still the core customer expectation in China's budget hotel market. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate whether dietary patterns were associated with the risk of type 2 diabetes mellitus (T2DM) or pre-diabetes in adults of rural area in Henan. Design: Cross-sectional study. Principal component analysis was used to identify dietary patterns, while multivariate logistic regression analysis and restricted cubic spline regression models were used to analyse the association between dietary patterns and both pre-diabetes and T2DM. Setting: Rural area of Henan province, China. Participants: A total of 38 779 adults aged 18–79 years were recruited from the Henan rural cohort study as the subjects. Results: The prevalence of pre-diabetes and T2DM in rural Henan was 6·8 % and 9·4 %, respectively. A total of three dietary patterns were assessed in the present study. Dietary pattern I with a high intake of red meat and white meat; dietary pattern II with a high intake of grains, nuts, milk and eggs and dietary pattern III with a high intake of vegetables, staple food and fruits. The highest quintile (Q5) of pattern III could reduce 32·7 % risk of pre-diabetes. The Q5 of pattern II showed a 15·5 % decreased risk of T2DM, in a U-shaped dose–response manner; meanwhile, the Q5 of pattern III was significantly associated with reduced risks of T2DM (OR: 0·582, 95 % CI (0·497, 0·682)). Conclusions: Pattern III is beneficial for reducing risk of pre-diabetes or T2DM. Though a higher consumption of 'grains-nuts-egg' may associate with a reduced risk of T2DM, excessive intakes should be avoided. This study may provide a reference for the prevention of diabetes on dietary precautions. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Studies have found that a plant‐based diet was associated with a lower risk of type 2 diabetes, but evidence is scarce on such associations in China. The aim of this study was to investigate whether a plant‐based diet is related to a lower risk of type 2 diabetes among Chinese adults. Materials and Methods: A total of 37,985 participants were enrolled from the Henan Rural Cohort Study. An overall plant‐based diet index (PDI) was created by assigning positive and reverse scores to 12 commonly consumed food groups. Multivariate logistic regression models and restricted cubic spline analysis were performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI). Results: After multivariable adjustment, the risk of type 2 diabetes was inversely associated with the PDI (extreme‐quartile OR = 0.88, 95% CI: 0.79–0.98; P = 0.027), the risk associated with a 1 standard deviation (SD) increase in PDI was 4% lower (95% CI, 0.93–1.00; P trend = 0.043) for type 2 diabetes. Moreover, the odds of type 2 diabetes was decreased with an increment of PDI after fitting restricted cubic splines (Ptrend < 0.01). Conclusions: Among Chinese populations, diets higher in plant foods and lower in animal foods were associated with a reduced risk of type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: Previous studies reported that testosterone and DNA methylation of suppressor of cytokine signaling‐3 (SOCS3) were associated with type 2 diabetes (T2D). Testosterone affects SOCS3 gene expression. Therefore, we aimed to investigate how the SOCS3 methylation mediates the relationship between testosterone and T2D among Chinese rural adults. Methods: A case‐control study comprised 365 T2D patients and 651 controls was conducted. Liquid chromatography‐tandem mass spectrometry and MethylTarget were used to determine the levels of serum testosterone and DNA methylation of SOCS3 gene, respectively. The odds ratio (OR) of testosterone or SOCS3 methylation for T2D was calculated using logistic regression models, and β value of testosterone for SOCS3 methylation was evaluated by linear regression models. Furthermore, through mediation analysis the mediating effect of SOCS3 methylation on the association of testosterone with T2D was estimated. Results: After adjusting for multiple variables, the protective effect of testosterone on T2D was found in men (OR = 0.61, 95% confidence interval [CI]: 0.47‐0.80), and the methylation of Chr17:76356190 or Chr17:76356199 was negatively related to T2D in both men and women. Moreover, testosterone was positively associated with Chr17:76356190 methylation in men and Chr17:76356199 methylation in women (both P <.05). The mediation analysis showed that the Chr17:76356190 methylation partly mediated effect of testosterone on T2D in men was approximately 8.2%. Conclusions: High levels of serum testosterone in men and Chr17:76356190 and Chr17:76356199 (SOCS3) methylation were related to a lower prevalent T2D. In addition, Chr17:76356190 methylation partially mediated the effect of testosterone on T2D in Chinese rural men. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the effects of serum testosterone, obesity and their interaction on blood pressure (BP) parameters and hypertension among Chinese rural adults. A total of 6199 adults were recruited from the Henan Rural Cohort Study. Serum testosterone was measured by liquid chromatography-tandem mass spectrometry. Logistic regression and linear regression were used to evaluate the association between testosterone, hypertension and BP parameters (including systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP)). A generalized linear model was performed to identify the interactive effects of testosterone and obesity on hypertension. High levels of serum testosterone were associated with a lower prevalence of hypertension in males (odds ratio (OR): 0.69, 95% confidence interval (CI): 0.53, 0.89). After stratification by obesity, observed associations were only found in non-obese males. Each one-unit increase in ln-testosterone was associated with a 1.23 mmHg decrease in SBP, 0.97 mmHg decrease in DBP, and 1.05 mmHg decrease in MAP among males. Moreover, interactive effects between testosterone and obesity on hypertension and BP parameters were found, indicating that protective effects of serum testosterone on hypertension and BP parameters were counteracted and accompanied by increased values of obesity-related indicators in males, and additional testosterone increased BP parameters and prevalence of hypertension at high levels of waist-to-hip ratio and waist-to-height ratio in females. Elevated levels of serum testosterone were associated with decreased BP parameters and prevalent hypertension in males, and obesity modifying effects of serum testosterone on BP parameters and hypertension. [Display omitted] • Serum testosterone was negatively associated with hypertension in males. • Obesity modified the effects of testosterone onhypertension in males and females. [ABSTRACT FROM AUTHOR]