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Introduction Non-syndromic cleft lip with or without cleft palate is a common worldwide birth defect due to a combination of environmental and genetic factors. Genome-wide association studies reported the rs7078160 of Vax1 is closely related to non-syndromic cleft lip with or without cleft palate in European populations. The following studies showed the same results in Mongolian, Japanese, Filipino, Vietnamese populations etc. However, conflicting research had been reported in Chinese population, Objective The aim of this study was to investigate the association between the rs7078160 polymorphism and non-syndromic cleft lip with or without cleft palate in Southern Chinese patients. Methods In this study, we investigated the polymorphism distribution of rs7078160 in 100 complete patient trios (39 patients with non-syndromic cleft lip and palate; 36 patients with non-syndromic cleft lip only; 25 had non-syndromic cleft palate only; and their parents) from Southern ethnic Han Chinese. 60 healthy trios were selected as control. Polymerase chain reaction and Sanger sequencing were used to genotype rs7078160 in Vax1; both case–control and family-based associations were analyzed. Results The case–control analyses revealed the rs7078160 polymorphism was significant, associated with non-syndromic cleft lip with or without cleft palate (p = 0.04) and non-syndromic cleft lip and palate (p = 0.01), but not associated with non-syndromic cleft lip only and non-syndromic cleft palate only patients. The genotype composition of rs7078160 comprises mutated homozygous AA, heterozygous AG and wild homozygous GG. Cases with AG + AA genotypes compared with GG homozygotes showed an increased risk of non-syndromic cleft lip with or without cleft palate (p = 0.04, OR = 2.05, 95% CI: 1.01–4.16) and non-syndromic cleft lip and palate (p = 0.01, OR = 3.94, 95% CI: 1.34–11.54). In addition, we did not detect any transmission-disequilibrium in rs7078160 (p = 0.68). Conclusion This study suggests that rs7078160 polymorphism is a risk factor of non-syndromic cleft lip with or without cleft palate, and Vax1 is strongly associated with non-syndromic cleft lip with or without cleft palate in Southern Chinese Han populations.

Background Reverse shoulder arthroplasty is becoming an increasingly common surgical procedure in Hong Kong, as well as in many other countries worldwide. The aim of this study is to describe the glenoid anatomy in the Southern Chinese population. We are interested to know whether commercially available glenoid implants are suitable for this population and whether there are any steps or precautions we can take during surgery to optimize the clinical outcome for these patients. Method A total of 244 shoulders of Southern Chinese patients were analyzed using 2-dimensional computed tomography, formatted to align along the scapular axis. The anatomic parameters analyzed included the shape, axial configuration, maximum width, maximum height, version, and presence of bone defect. Results In our study, 76.6% of glenoids were pear-shaped, 23.0% were elliptical, and only 0.4% were inverted pear in shape. Of all glenoids, 95.1% of glenoids had posterior-prominent axial configuration, whereas 4.9% had neutral axial configuration. The mean maximum glenoid height for both genders was 33.8 mm, whereas the mean maximum glenoid height was 32.2 mm for women and 36.6 mm for men. The mean maximum glenoid width for both genders was 25.8 mm, whereas the mean maximum glenoid width was 24.8 mm for women and 27.3 mm for men. The differences in measurements between genders were statistically significant. Of all glenoids, 46.3% of the glenoids were retroverted, whereas 53.7% of the glenoids were anteverted. The mean version for both genders was 0.77 degrees anteversion. The mean version was 1.16 degrees anteversion for women and 0.10 degrees anteversion for men. Of the 244 glenoids, 4 had bone defects. In our study, 39.8% of patients had mean maximum glenoid widths that were less than 25 mm, which is the smallest size available for most conventional glenoid baseplates. Conclusion A significant portion of the Southern Chinese population has glenoid widths that are smaller than the smallest commercially available glenoid baseplates. Understanding the glenoid anatomy is crucial in the case of reverse shoulder arthroplasty, as it has significant implications in implant design, operative planning, and surgical outcomes.

Open residential neighbourhood (ORN) and vertical greening system (VGS) are two emerging urban design strategies in Southern Chinese cities. This paper numerically analysed the potential in thermal...

OBJECTIVES The present work describes the status and contents of The Human Bone Collection of the Faculty of Dentistry at the University of Hong Kong. MATERIALS AND METHODS The Collection originates from the 1980s and became officially established in 2017 for teaching and research purposes. Most of the Collection consists of unclaimed human remains of southern Chinese individuals exhumed from local cemeteries and donated to the Faculty in the last few decades. The demographic information was provided largely from burial records and forensic estimations. Since 2016, the Collection has undergone a process of reorganization into cranial and postcranial remains, followed by preservation procedures that included cleaning and classification. RESULTS The Collection currently consists of remains belonging to about 368 individuals (243 males, 54 females, 71 unknown), with ages ranging from 0.8 to 90 years (mean 57.4 years). It comprises cranial remains belonging to 260 individuals (169 males, 39 females, 52 unknown), and postcranial remains belonging to 248 individuals (180 males, 42 females, 26 unknown). The preservation status ranges from poor to good, with the cranial remains better preserved than the postcranial elements. For a large number of individuals, ear ossicles, soil samples, and other materials are also available. DISCUSSION The Collection is accessible to local and international institutions for teaching and research.

Sakkok area in Singkawang is notorious for its traditional Chinese ceramics industry. These ceramics are produced through a wood-firing process in a closed kiln called Dragon Kiln. Dragon Kiln is the product between culture and technology, which was brought by the Southern Chinese immigrants. The only remaining Dragon Kilns, that are still being used and fired now, are in Singapore and Sakkok, Singkawang. Singkawang city is enlisted as Indonesia’s heritage city, therefore, the city is suggested to empower its heritages. This is supported by the people of Singkawang city, in which some of them are the crafters in the Dragon Kiln area. The highlighted architectural problem in this study is “How the architectural design of Dragon Kiln will maximize its Cultural Heritage potential in order to preserve the Dragon Kiln and Traditional Chinese Ceramics Industry?” The applied method for this study is Revitalization Thinking. Revitalization Thinking is a problem solving method based on revitalizing, done in stages, to maximize the design planning. The concept that is implied is an educative, recreational, and sustainable Cultural Heritage Tourism in order to maximize the Cultural Heritage potential of Dragon Kiln through the development of tourism in preserving the Dragon Kiln and Traditional Chinese Ceramics Industry in Singkawang, Indonesia and South-east Asia.

AIM: To evaluate the predicting efficacy of severe retinopathy of prematurity (ROP) by the WINROP algorithm (http://winrop.com) in Southern China. METHODS: All preterm infants with the gestational age (GA) less than 32wk were included. Their ROP screening results and serial postnatal body weight were analysed retrospectively. Weekly body weight was entered into and measured by the WINROP system. The outcomes were analysed, and the sensitivity, specificity, positive predictive value and negative predictive value (NPV) were calculated. RESULTS: Totally 432 infants with a median GA of 30.0 (24.0-31.9)wk, and a median birth weight (BW) of 1360 (540-2700) g were included. Among these 432 infants, 50 were diagnosed as type 1 ROP but only 28 were identified by the WINROP algorithm. The sensitivity was 56% (28/50) and the NPV was 92% (252/274). However, for infants with BW 28wk in China.

Background: Different gestational age specific birthweight reference charts have been produced for different populations and ethnic groups over different time periods, mostly based on birthweight data. This study aims to update birthweight references for Hong Kong (HK) Chinese newborns to provide norms for identification of small and large for gestational age (SGA and LGA) fetuses, and to verify whether there are significant differences compared to previously published local reference charts, as well as to other southern Chinese and international data. Methods: All singleton Chinese livebirths delivered in United Christian Hospital from 2012 to 2017 were retrospectively included. The smoothed birthweight centiles at each gestation were computed. The birthweight centiles were then compared with other reference charts. Results: A total of 25,508 livebirths between 24 and 42 completed weeks of gestation were enrolled in the final analysis. The mean birthweights of our cohort were largely similar to previous studies at each gestation, but the 10th and 90th centile ranges differed significantly, so that the proportion of babies that would be classified as SGA or LGA varied widely using cut-offs from different studies. Older local studies tend to under-estimate, while the international growth charts would over-estimate the proportion of SGA babies. Conclusions: Updating fetal growth curve references based on local data is essential to establish more precise definitions of SGA and LGA babies in clinical management. The use of international growth charts in our population may not be appropriate and requires further validation.

Background To determine the optimal cut-off values and evaluate the associations of product of triacylglycerol and glucose (TyG), lipid accumulation product (LAPI), visceral adiposity index (VAI) with chronic kidney diseases (CKD) stratified by sex. Methods From January to April 2018, our team had conducted a large-scale cross-sectional survey that contained 2720 individuals on the southern coast of China. Logistic regression analysis and receiver operating characteristic (ROC) analyses were used to evaluate the optimal cut-off and value of TyG, LAPI, VAI for predicting CKD. Results A multivariate logistic regression analysis found that the TyG had the better value of prediction for the presence of CKD for the highest quartile vs the lowest quartile in both males (OR: 3.65; 95% CI, 2.04-6.52; p

Objectives To establish the norms of binocular and monocular acuity and interocular acuity differences for southern Chinese infants and compare these norms with the results for northern Chinese infants. Methods A prospective, comparative, and noninterventional study was conducted from January to August 2018. Teller Acuity Cards II were used to determine the binocular and monocular acuity of infants. The tolerance intervals and limits with a stated proportion and probability were used to evaluate the norms of binocular and monocular acuity and interocular acuity differences. An unpaired t-test was used to compare the obtained norms with the reported northern Chinese norms. Results The tolerance intervals of binocular acuity (mean acuity of 3.73, 7.35, and 12.01 cpd, respectively, at 12, 24, and 36 months), monocular acuity (mean acuity of 2.88, 6.91, and 10.75 cpd, respectively, at 12, 24, and 36 months), and interocular acuity differences (mean difference of 0.92, 2.89, and 3.99 cpd, respectively, at 12, 24, and 36 months) were obtained, exhibiting an increasing trend with age. The binocular visual acuity norms of southern Chinese infants were significantly lower than those in northern China (4.37 vs. 6.9 cpd at 8 months and 7.35 vs. 26 cpd at 24 months) (P = 0.011). Conclusions Northern and southern Chinese infants exhibited distinct acuity norms and visual development patterns. The establishment of population-specific visual acuity norms is necessary for current populations of infants from different regions.

When studying the thermal adaptation of building occupants, understanding the effects of different thermal experiences on adaptation is necessary, particularly for moderate and severe heat exposure. However, this area has seen limited research. Further, skin temperature, a common parameter for quantifying thermal sensation, may insufficiently reflect the automatic thermoregulation of the human body. This study investigates the effects of long-term heat exposure on the human body using multiple physiological and subjective indexes. Two heat exposure experiments were conducted on healthy male participants from northern and southern China. Participant responses, including skin temperature, heart rate, heart rate variability, blood volume pulse (BVP), subjective thermal comfort, thermal sensation, thermal acceptability, and normalized high and low frequency values were collected and compared. The results indicated that the subjective responses of northern and southern participants were not significantly different; however, the subjective physiological symptoms and self-reported discomfort of the latter were less than those of the former, indicating that the southern participants had superior heat tolerance. Additionally, the physiological responses of all the participants were largely similar. However, southern participants showed slightly higher normalized high frequency and BVP values, indicating that they have more active vagus nerves and better vasodilation. They also showed a wider acceptable temperature range and better acclimation to heat exposure. Notably, the mean skin temperature could not effectively predict thermal sensation during heat exposure; this was more accurately achieved using the rate of change of skin temperature. These findings suggest that long-term thermal experiences can affect building occupants’ thermal adaptability.

Although many studies have confirmed metabolic syndrome (MetS) is correlated with metal exposures, few studies have elucidated the associations of multiple metals with MetS risk. We aim to explore the relationship between serum 22 metals and MetS. We determined serum 22 metals using ICP-MS and used LASSO regression to select metals independently related with MetS to construct multiple-metals model. We further explored the dose-response relationship between positive metals and MetS by the restricted cubic spline regression. After screening by LASSO regression, serum 11 metals were selected to construct multiple-metals model in cross-sectional analysis, while 5 metals in longitudinal analysis. In the 11-metal model, only tin and zinc were associated with MetS in cross-sectional analysis (ORtin = 2.22, 95% CI:1.43, 3.45; ORzinc = 2.17, 95% CI: 1.42, 3.32; both Ptrend 0.05). Furthermore, the interaction between high tin and high zinc was also associated with increasing MetS risk (Pinteraction < 0.05). We found that serum tin and zinc were independently and interactively associated with MetS in the southern Chinese men. Our results suggested that high tin and zinc may be the risk factors of MetS.

Purpose Little is known about the recent trends of hypertension in southern China. The aim of the study was to investigate the trends of hypertension in Guangdong Province between 2012 and 2019. Methods We conducted two cross-sectional surveys in 2012 and 2019 in southern China, which included 10,970 and 27,483 participants, respectively, aged 35 to 75 years old using a method of stratified, multistage, and cluster sampling. Hypertension was defined as a mean systolic/diastolic blood pressure (SBP/DBP) ≥140/90mmHg, or a self-reported condition, or any pharmacological treatment in the last 2 weeks. In addition, according to the 2017 ACC/AHA guideline for high blood pressure, we estimated the prevalence and control rate of hypertension. Results According to the 2010 Chinese guideline, the age-standardized rate of hypertension prevalence was 34.7% in 2012 and 36.9% in 2019 with a slight increase, while the prevalence of prehypertension was stable (14.5% vs 14.3%). Over the period of our study, 45.6% and 60.7% of hypertensive patients knew their diagnosis in 2012 and 2019, and 40.8% and 51.5% were using antihypertensive medications, respectively. The control rates increased from 15.1% to 23.6%. Hypertension prevalence was 64.5% in 2012 and 63.2% in 2019, and the control rate increased from 3.0% to 4.8% during the study period under the 2017 ACC/AHA guideline. Conclusion Although the past 7 years have seen some progress in hypertension management, the rates of hypertension awareness, treatment, and control in southern Chinese remained regrettably low, and the prevalence rate was still high.

Background Hirschsprung disease (HSCR) is a rare congenital gastrointestinal disease characterized by the absence of intestinal submucosal and myometrial ganglion cells. Recently, researches indicated that miR-100 regulated the growth, differentiation and apoptosis of neurons, and affected the functions of HSCR-associated pathways. While miR-100 rs1834306 A>G polymorphism was shown to modify the susceptibility to tumors, the association between this polymorphism and HSCR susceptibility is still unknown. Methods This was a case-control study consisting of 1470 HSCR cases and 1473 controls from southern China. DNA was genotyped by TaqMan real-time PCR. Odds ratios (ORs) and 95% confidence intervals (CIs) were used as statistical indicators. Results We found that miR-100 rs1834306 G allele and GG genotype significantly increased HSCR susceptibility (GG vs AA: adjusted OR=1.31, 95% CI=1.04-1.64, P=0.020; G vs A: adjusted OR=1.12, 95% CI=1.01-1.25, P=0.041; GG vs AA/AG: adjusted OR=1.30, 95% CI=1.07-1.59, P=0.010). In the stratified analysis, miR-100 rs1834306 GG genotype carriers had higher risk to develop HSCR in all clinical subtypes when compared with those with AA/AG genotypes, and OR was rising with HSCR aggravation (SHSCR: adjusted OR=1.28, 95% CI=1.03-1.59, P=0.029; LHSCR: adjusted OR=1.48, 95% CI=1.06-2.07, P=0.020; TCA: adjusted OR=2.12, 95% CI=1.22-3.69, P=0.008). Conclusion Our findings suggested that miR-100 rs1834306 A>G polymorphism was associated with increased HSCR susceptibility in southern Chinese children. Furthermore, miR-100 rs1834306 GG genotype had a greater genetic pathopoiesis in severe HSCR.

To evaluate the impact of PM2.5 air pollution on atherogenic processes in modernizing Southern versus Northern China, we studied 1323 asymptomatic Chinese in Southern and Northern China in 1996–2007. PM2.5 exposure and metabolic syndrome (MS) were noted. Brachial flow-mediated dilation (endothelial function FMD) and carotid intima-media thickness (IMT) were measured by ultrasound. Although age and gender were similar, PM2.5 was higher in Northern China than in Southern China. The Northern Chinese were characterized by lower lipids, folate and vitamin B12, but higher age, blood pressures, MS and homocysteine (HC) (p = 0.0015). Brachial FMD was significantly lower and carotid IMT was significantly greater (0.68 ± 0.13) in Northern Chinese, compared with FMD and IMT (0.57 ± 0.13, p < 0.0001) in Southern Chinese. On multivariate regression, for the overall cohort, carotid IMT was significantly related to PM2.5, independent of location and traditional risk factors (Model R2 = 0.352, F = 27.1, p < 0.0001), while FMD was inversely related to gender, age, and northern location, but not to PM2.5. In Southern Chinese, brachial FMD was inversely correlated to PM2.5, independent of age, whereas carotid IMT was significantly related to PM2.5, independent of age and gender. In Northern Chinese, brachial FMD was inversely related to gender only, but not to PM2.5, while carotid IMT was related to traditional risk factors. Despite a higher PM2.5 pollution in Northern China, PM2.5 pollution was more significantly associated with atherogenic surrogates in Southern compared to Northern Chinese. This has potential implications for atherosclerosis prevention.

We read with interest the recent article by Chan et al (Gut, 2020; 0:1–10) analysing Fusobacterium diversity in the southern Chinese population.1 Fusobacterium nucleatum has been proven to be involved in the occurrence and progression of colorectal cancer (CRC); therefore, F. nucleatum has attracted more academic interest than other Fusobacterium species.2–5 Nevertheless, Chan et al ’s study made a critical observation: individuals in China (Hong Kong, Shenzhen and Zhejiang) with and without cancer harbour non-nucleatum types of Fusobacterium species as the dominating taxa. Similarly, Geva-Zatorsky et al reported that F. varium can exert a greater phenotypical impact in the host than F. nucleatum .6 Herein, we analysed the fusobacterial diversity in a Chinese population comprising 7009 individuals across 14 districts to provide a comprehensive understanding of Fusobacterium lineage distributions and their correlation with host parameters.7 8 Because the present dataset is based on 16S rRNA gene V4 sequencing, we first proved that these sequences can be …

Guo Zhuang Villa is a famous residence-villa in Hangzhou City, southern China. It is well known for its unique artistic style and its meticulous construction. The villa has a history of over 100 years, initially serving as the residence of Duanfu Song in 1907 Qing dynasty. In the Minguo period (Republic of China), the villa was sold to Shilin Guo. Since that time, the villa has been called “Guo Zhuang”—meaning the villa of the Guo family. Guo Zhuang not only features the elements typical of southern Chinese gardens, with their elegant re-creations of nature, but also has its own unique character, cleverly blending the garden into nature and incorporating two artificial ponds near the West Lake in Hangzhou. This article is on the basis of reading much historical document and bookmaking, researching the formation, the background and the geography of Guo Zhuang Villa, and mainly carries research on its garden location, layout spatial processing, creating artistic mood, the choice and configuration of landscape plants and so on. These are useful references to modern landscape architecture design and construction.

Background Dental age estimation can assist in the identification of victims following natural disasters and it can also help to solve birth date disputes in individuals involved in criminal activities. A reference dataset (RDS) has been developed from the dental development of 2306 subjects of southern Han Chinese origin and subsequently validated. This study aimed to test the applicability of the southern Han Chinese dental maturation RDS on three distinct East Asian population groups. Methods A total of 953 dental panoramic radiographs of subjects aged 2 to 24 years were obtained from Philippines, Thailand and Japan. The staging of dental development was conducted according to Anglo-Canadian classification system. The dental age (DA) was calculated using six methods; one un-weighted average and five weighted average (n-tds, sd-tds, se-tds, 1/sd-tds, 1/se-tds) methods based on the scores of the southern Han Chinese RDS. Statistical significance was set at p Results From six dental age calculations, all methods of DA accurately estimated the age of Japanese and few methods in Filipino subjects (n-tds, 1/sd-tds, 1/se-tds). There was consistent overestimation of age for all the methods for Thai females (p Conclusions The southern Han Chinese dental reference dataset was shown to be most accurate for Japanese, followed by Thai males and it was particularly ineffective for Filipinos and Thai females.

Background/aimsTo determine the association and interaction of genome-wide association study-reported variants for Asian populations with myopia and ocular biometric parameters in southern Chinese population.MethodsTotally, 1462 unrelated Han Chinese subjects were recruited with complete ophthalmic examinations, including 1196 myopia and 266 control subjects. A total of nine variants were selected for TaqMan genotyping. The genetic association, joint additive effect and genotype–phenotype correlation were investigated.ResultsThe 4q25 variant rs10034228 (p=0.002, OR=0.56) and MIPEP variant rs9318086 (p=0.004, OR=1.62) were found to be significantly associated with myopia as well as different severity of myopia. Moreover, 15q14 variant rs524952 (p=0.015, OR=1.49) also showed mild association with myopia and high myopia. However, there was no significant association of CTNND2, vasoactive intestinal peptide receptor 2 and syntrophin beta 1 variants with myopia. Joint additive analysis revealed that the subjects carrying 6 risk alleles of the 3 associated variants were 10-fold higher risk predisposed to high myopia. Genotype–phenotype correlation analysis revealed that high myopia subjects carrying 4q25 rs10034228 T allele showed thicker central corneal thickness, whereas high myopia subjects carrying 15q14 rs524952 A allele were associated with longer axial length and larger curvature ratio.ConclusionThis study revealed significant association of 4q25, 15q14 and MIPEP variants with myopia and different severity of myopia in southern Chinese population, joint additively enhancing 10-fold of risk predisposing to high myopia. The correlation of these associated variants with axial length and corneal parameters suggests their contribution to the refractive status in high myopia subjects.

The objective of the study was to measure the dimensions of the sella turcica in southern Chinese population. This retrospective study measured dimensions of sella turcica from lateral cephalometric radiographs obtained from the University of Hong Kong research database with a total of 582 (277 females and 305 males) 12-year-old southern Chinese children, who were randomly selected from schools in Hong Kong. Measurements were made using ImageJ (V1.45s) software for Windows with Frankfurt plane as the horizontal reference direction. Dimensions between genders were compared using Student’s t-tests. The current study found the antero-posterior length and width were 9.13 mm (SD 2.05) and 9.76 mm (SD 1.54), respectively. The sella was highest posteriorly (7.97 mm; SD 1.75 mm) and shortest anteriorly (7.56 mm; SD 1.42). Sella height anterior, sella height median and sella area were greater (p

Hirschsprung disease (HSCR) is an infrequent congenital intestinal dysplasia. The known genetic variations are unable to fully explain the pathogenesis of HSCR. The α/β‐hydratase domain 1 (ABHD1) interferes with the proliferation and migration of intestinal stem cells. Docking protein 6 (DOK6) is involved in neurodevelopment through RET signalling pathway. We examined the association of ABHD1 and DOK6 genetic variants with HSCR using 1470 controls and 1473 HSCR patients from Southern Chinese children. The results clarified that DOK6 rs12968648 G allele significantly increased HSCR susceptibility, in the allelic model (p = 0.034; OR = 1.12, 95%CI = 1.01~1.24) and the dominant model (p = 0.038; OR = 1.12, 95%CI = 1.01~1.25). Clinical stratification analysis showed that rs12968648 G allele was associated with increased risk of short‐segment HSCR (S‐HSCR), in the allelic model (p = 0.028; OR = 1.14, 95%CI = 1.01~1.28) and the additive model (p = 0.030; OR = 1.14, 95%CI = 1.01~1.28). ABHD1 rs2304678 C allele had higher risk to develop total colonic aganglionosis (TCA) in the allelic model (p = 7.04E‐03; OR = 1.67, 95%CI = 1.15~2.43) and the dominant model (p = 4.12E‐03; OR = 1.93, 95%CI = 1.23~3.04). DOK6 rs12968648 and ABHD1 rs2304678 had significant intergenic synergistic effect according to logical regression (p = 0.0081; OR = 0.76, 95%CI = 0.63~0.93) and multifactor dimensionality reduction (MDR, p = 0.0045; OR = 1.25, 95%CI = 1.07~1.46). This study verified two susceptible variations of HSCR on ABHD1 and DOK6. Their roles in HSCR should be conducted in further studies.

One nucleotide substitution in codon 189 of HLA-C*01:02:01:01 results in a novel allele, HLA-C*01:179. This article is protected by copyright. All rights reserved.

Background Nemaline myopathy 8 is a severe autosomal recessive muscle disorder characterized by fetal akinesia or hypokinesia, contractures, fractures, respiratory failure and swallowing difficulties apparent at birth. Methods An affected dizygotic twin pair from a non‐consanguineous Chinese family presented with severe asphyxia, lethargy and no response to stimuli. The dysmorphic features included prominent nasal bridge, telecanthus, excessive hip abduction, limb edema, absent palmar and sole creases, acromelia, bilateral clubfoot, appendicular hypertonia and cryptorchidism. Both infants died in the first week of life. Whole‐exome sequencing was used to identify the causative gene. Results Whole‐exome sequencing identified a recurrent missense variant c.1516A>C and a novel splice‐acceptor variant c.1153‐1G>C in KLHL40 gene in both siblings. We estimated the disease incidence in Southern Chinese population to be 2.47/100,000 based on the cumulative allele frequency of pathogenic and likely pathogenic variants in our internal database. Conclusion Our study expanded the mutation spectrum of KLHL40 and the condition could have been underdiagnosed before. We identified a recurrent missense variant c.1516A>C and provided evidence further supporting the founder effect of this variant in Southern Chinese population. Given the severity of the condition and the relative high incidence, this not‐so‐rare disorder should be included in expanded carrier screening panel for Chinese population., Two male babies with nemaline myopathy‐8 also showed appendicular hypertonia exome sequencing identified a recurrent missense variant and a novel splice‐acceptor variant in KLHL40 Four additional novel pathogenic variants of KLHL40 were identified and it is speculated that nemaline myopathy‐8 is not‐so‐rare in Chinese population.

Objective: To explore the prospective correlation between serum metals before 24 weeks’ gestation and gestational diabetes mellitus (GDM) or glucose in the late second trimester among southern Chinese pregnant women. Methods: A total of 8169 pregnant women were included in our retrospective cohort study. Logistic regression was used to investigate the relationships between metals (Manganese [Mn], copper [Cu], lead [Pb], calcium [Ca], zinc [Zn], magnesium [Mg]) and GDM. Quantile regression was performed to detect the shifts and associations with metals and three time-points glucose distribution of oral glucose tolerance test (OGTT) focused on the 10th, 50th, and 90th percentiles. Weighted quantile sum (WQS) regression was used to explore the relationship of metal mixtures and GDM as well as glucose. Results: Maternal serum concentrations of metals were assessed at mean 16.55 ± 2.92 weeks’ gestation. Women with under weight might have 25% decreased risk of GDM for every 50% increase in Cu concentration within the safe limits. A 50% increase in Mn and Zn levels was related to a 0.051 μmol/L (95% CI: 0.033–0.070) and 0.059 μmol/L (95% CI: 0.040–0.079) increase in mean fasting plasma glucose of OGTT (OGTT0), respectively. The magnitude of association with Mn was smaller at the upper tail of OGTT0 distribution, while the magnitude of correlation with Zn was greater at the upper tail. However, there was a 0.012 mmol/L (95% CI: −0.017 to −0.008), 0.028 mmol/L (95% CI: −0.049 to −0.007), and 0.036 mmol/L (95% CI: −0.057 to −0.016) decrease in mean OGTT0 levels for every 50% increase in Pb, Ca, and Mg, respectively. The negative association of Pb, Ca, and Mg was greater at the lower tail of OGTT0 distribution. No significant relationship was observed in Cu and mean OGTT0 level (−0.010 mmol/L, 95% CI: −0.021 to 0.001), however, it showed a protective effect at the upper tail (−0.034 mmol/L, 95% CI: −0.049 to −0.017). No obvious correlation was found between metals and postprandial glucose levels (OGTT1 and OGTT2 from OGTT). The WQS index was significantly related to OGTT0 (P

Objective:The current study evaluated the associations between different forms and sources of Fe and breast cancer risk in Southern Chinese women.Design:Case–control study. We collected data on the consumption of Fe from different forms and food sources by using a validated FFQ. Multivariable logistic regression and restricted cubic spline (RCS) analysis was used to reveal potential associations between Fe intake and breast cancer risk.Setting:A case-control study of women at three major hospitals in Guangzhou, China.Participants:From June 2007 to March 2019, 1591 breast cancer cases and 1622 age-matched controls were recruited.Results:In quartile analyses, Fe from plants and Fe from white meat intake were inversely associated with breast cancer risk, with OR of 0·65 (95 % CI 0·47, 0·89, Ptrend = 0·006) and 0·76 (95 % CI 0·61, 0·96, Ptrend = 0·014), respectively, comparing the highest with the lowest quartile. No associations were observed between total dietary Fe, heme or non-heme Fe, Fe from meat or red meat and breast cancer risk. RCS analysis demonstrated J-shaped associations between total dietary Fe, non-heme Fe and breast cancer, and reverse L-shaped associations between heme Fe, Fe from meat and Fe from red meat and breast cancer.Conclusion:Fe from plants and white meat were inversely associated with breast cancer risk. Significant non-linear J-shaped associations were found between total dietary Fe, non-heme Fe and breast cancer risk, and reverse L-shaped associations were found between heme Fe, Fe from meat or red meat and breast cancer risk.

Background Cone-beam computed tomography (CBCT) was employed to study the morphology and curvature of middle mesial canals (MMCs) of mandibular first molars (MFMs). Methods CBCT scanning was performed on MFMs of 1100 patients. Patients' images that met the inclusion criteria were divided into group A (t-test was used to calculate the statistical significance. P Results In 875 patients, 1750 MFM images met the inclusion criteria. Among these cases, 158 MFMs contained an MMC, yielding an incidence rate of 9.03%. The incidence rate of MMCs was 11.22% in group A and 6.61% in group B, and this difference was statistically significant (P P P > 0.05). The most common mesial root canal morphological type was type II (3-2) (53.80%). Conclusion The incidence of MMCs in MFMs declined as age increased. The canal systems of MMCs were varied and complex, mainly exhibiting an obvious mesiodistal curve. CBCT is an outstanding method to help guide root canal therapy. *Yeqing Yang and Buling Wu have contribute equally to this article.

Introduction Thalassaemia trait (TT) is potential to be missed clinically, especially normocytic thalassaemia. We aimed to establish discriminant functions (DFs) and an algorithm for detecting microcytic or normocytic TT in epidemiological screening. Methods The receiver operating characteristics (ROC) curve analysis was used to determine the diagnostic performance of the proposed formulas in differentiating TT and nonthalassaemia (non-TT). DFs combined the two blood count parameters with the highest performance, based on the area under the curve (AUC) value, into mathematical formulas, using logistic regression. The diagnostic efficacy of DFs was subsequently evaluated in 761 participants, and reliability (including adjusted agreement [AA] and Kappa values) and validity (including sensitivity, specificity, likelihood ratio and Youden's Index) were calculated. Results Among microcytic participants, the proposed DFs showed good diagnostic performance (in females: AUC = 0.892 [DF1 = 0.015 × RDW-CV/RBC - 0.096 × RDW-SD/RBC + 1.29], in males: AUC = 0.861 [DF2=-0.025 × RDW-SD/RBC - 0.035 × MCV/RBC + 1.415]). Youden's Index, AA and Kappa values for microcytic TT detection were 0.72, 0.86, and 0.72 and 0.63, 0.81 and 0.63 for females and males, respectively. In normocytic participants with RDW-CV/RBC ≤ 3.54, DF3=-0.38 × MCH-0.02 × MCHC+17.37 achieved AUC = 0.857 in females, whereas DF4 = 0.007 × MCV-0.113 × MCH+2.829 achieved AUC = 0.969 in males. The Youden's Index, AA and Kappa values for the proposed DFs for thalassaemia detection were 0.69, 0.84 and 0.67 in females, 0.76, 0.91 and 0.71 in males, respectively. Conclusion The proposed DFs performed well in the detection of TT among participants with microcytic and normocytic parameters and could be utilized in epidemiological study for TT.

INTRODUCTION: Urbanization is associated with major changes in environmental and lifestyle exposures that may influence metabolic signatures. OBJECTIVES: We investigated cross-sectional urban and rural differences in plasma metabolome analyzed by liquid chromatography/mass spectrometry platform in 500 Chinese adults aged 25–68 years from two neighboring southern Chinese provinces. METHODS: We first examined the overall metabolome differences by urban and rural residential location, using Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA) and random forest classification. We then tested the association between urbanization status and individual metabolites using a linear regression adjusting for age, sex, and province and conducted pathway analysis (Fisher’s exact test) to identify metabolic pathways differed by urbanization status. RESULTS: We observed distinct overall metabolome by urbanization status in OPLS-DA and random forest classification. Using linear regression, out of a total of 1108 unique metabolite features identified in this sample, we found 266 metabolites that differed by urbanization status (positive false discovery rate-adjusted p-value, q-value

The aim of this paper is to broaden the Eurocentric architectural history of climate control by introducing a discussion of the interrelation of architecture and thermal practices in the Southern Chinese “non-heating” zone. Based on a governmental policy that dates from the 1950s, China is divided into a heated North, where urban houses enjoy the amenities of a district heating infrastructure, and a non-heated South, which lacks this infrastructure. Most high-rise buildings in this zone are constructed without insulation, and a rapidly growing middle class heats under uninsulated conditions. Residents mitigate the winter cold through active means of climate control, primarily with electric devices that serve to warm certain parts of their bodies, or warm limited spaces in their apartments. This paper is based on a methodology that combines ethnographic building analysis, discourse analysis, architectural theory, and building science. Most of the fieldwork data−including home visits and interviews with residents and thermal experts−was collected in winter 2017-18, in the northern part of the non-heating zone of China, especially in the city of Chongqing. Our architectural view of heating in the non-heating zone perceives buildings as agents that mediate between the macro- and the micro-scale, between the North and South, and between inside and outside. Der Artikel zielt darauf ab, den eurozentrischen Blick der Architekturgeschichte der Klimatisierung zu erweitern, in dem er Überlegungen zum wechselseitigen Verhältnis von Architektur und Wärmeregulierungsstrategien in der „heizungsfreien“ Zone Südchinas vorstellt. Aufgrund einer auf die 1950er Jahre zurückgehenden Regierungspolitik ist China in zwei Zonen geteilt: den beheizten Norden, in dem die Häuser in Städten an eine Fernwärme-Infrastruktur angeschlossen sind, und den unbeheizten Süden, in dem diese Infrastruktur fehlt. Die meisten Hochhäuser in dieser Südzone sind ohne Isolierung gebaut und eine schnell wachsende Mittelschicht heizt hier unter ungedämmten Wohnbedingungen. Die Bewohner begegnen der Winterkälte mit aktiven Temperaturregulierungsmaßnahmen, vor allem mit elektrischen Geräten zum Wärmen einzelner Körperteile wärmen oder Heizen begrenzter Räume in ihren Wohnungen. Methodisch führt der Artikel ethnografische Bauforschung, Diskursforschung, Architekturtheorie und Bauphysik zusammen. Die Ergebnisse der Forschung vor Ort −zu der Hausbesuche und Interviews mit Bewohnern und Heizexperten gehörten− wurde im Winter 2017-2018 im nördlichen Teil der heizungsfreien Zone Chinas und speziell in Chongqing zusammengetragen. In unserer architektonischen Betrachtung des Heizens in der unbeheizten Zone treten Gebäude als Mittler zwischen Mikro- und Makrobereich, zwischen Nord und Süd, zwischen Innen und Außen in Erscheinung. Este artículo se opone a una visión euro centrista de cuestiones de climatización y de arquitectura interesándose a las prácticas de calefacción de la región no calentada del sur de China. En aplicación de la política gubernamental de los años 1950, la China fue dividida entre un norte calentado, dotado de infraestructuras de calefacción, y un sur no calentado. La mayoría de fincas de gran altura construidas en esta zona están desprovistas de aislamiento térmico y acogen una clase media siempre más numerosa, calentándose en malas condiciones: principalmente con la ayuda de aparatos eléctricos portátiles, o calentando solamente una parte de la vivienda. La metodología asocia análisis etnográfico y análisis de discurso, teoría arquitectural y ciencia de los edificios. La mayoría de datos están basados sobre el terreno −las visitas a domicilio y las entrevistas con los residentes y los expertos− han sido recopilados durante el invierno 2017 – 2018, en la parte sur de la zona no calentada, en particular en la ciudad de Chongqing. Este acercamiento de las problemáticas arquitecturales de calefacción considera los edificios como mediadores a mitad camino de las dimensiones micro y macroscópicas, entre el norte y el sur, entre interior y exterior. Cet article s’oppose à une vision eurocentrée des questions de climatisation et d’architecture en s’intéressant aux pratiques de chauffage dans la région « non chauffée » du sud de la Chine. En application de la politique gouvernementale des années 1950, la Chine fut divisée entre un Nord chauffé, doté d’infrastructures de chauffage, et un Sud non chauffé. La plupart des immeubles de grande hauteur construits dans cette zone sont dépourvus d’isolation et hébergent une classe moyenne toujours plus nombreuse, se chauffant dans de mauvaises conditions : principalement à l’aide d’appareils électriques portatifs, ou en ne chauffant qu’une partie du logement. La méthodologie associe analyse ethnographique et analyse du discours, théorie architecturale et science du bâtiment. La plupart des données de terrain —dont les visites à domicile et les entretiens avec les résidents et les experts— ont été recueillies au cours de l'hiver 2017-2018, dans la partie nord de la zone non chauffée, en particulier dans la ville de Chongqing. Cette approche des problématiques architecturales de chauffage envisage les bâtiments comme des médiateurs, à mi-chemin des dimensions micro et macroscopiques, entre le Nord et le Sud, entre l’intérieur et l’extérieur. Questo articolo mira ad ampliare la visione eurocentrica in materia di climatizzazione, proponendo una riflessione sulle relazioni tra architettura e pratiche di termoregolazione nella zona “non riscaldata” della Cina meridionale. Negli anni Cinquanta il governo cinese ha suddiviso il paese in due zone: un nord riscaldato, dove le abitazioni urbane godono dei comfort derivanti dalle infrastrutture di teleriscaldamento, e un sud non riscaldato, dove queste infrastrutture sono assenti. La maggior parte degli edifici multipiano della zona meridionale è costruita senza isolamento e ospita un ceto medio sempre più numeroso, che si riscalda con difficoltà. I residenti contrastano il freddo invernale ricorrendo a mezzi di climatizzazione attivi, soprattutto dispositivi elettrici che riscaldano singole parti del corpo o determinati spazi all’interno degli appartamenti. A livello metodologico, lo studio associa analisi etnografica e analisi del discorso, teoria dell’architettura e scienza delle costruzioni. Gran parte delle ricerche sul campo —tra cui le visite delle case e le interviste a residenti ed esperti— sono state condotte nell’inverno 2017-2018 nel nord della zona non riscaldata della Cina, e in particolare nella città di Chongqing. Secondo questa visione architettonica del riscaldamento, gli edifici della zona non riscaldata agiscono da mediatori tra micro e macro, tra nord e sud e tra interno ed esterno.

Background: APOE ε4 is the best-known risk factor for late-onset alzheimer’s disease (AD). Population studies have demonstrated a relatively low prevalence of APOE ε4 among Chinese population, implying additional risk factors that are Chinese-specific may exist. Apart from - alleles, genetic variation profile along the full-length APOE has rarely been investigated. Objective: In this study, we filled this gap by comprehensively determining all genetic variations in APOE and investigated their potential associations with late-onset AD and mild cognitive impairment (MCI) in southern Chinese. Methods: Two hundred and fifty-seven southern Chinese participants were recruited, of whom 69 were AD patients, 83 had MCI, and 105 were normal controls. Full-length APOE from promoter to 3′UTR regions were sequenced. Genetic variants were identified and compared among the three groups. Results: While APOE ε4 was more significantly found in AD patients, the prevalence of APOE ε4 in southern Chinese AD patients was the lowest when compared to other areas of China and nearby regions, as well as other countries worldwide. We further identified 13 rare non-singleton variants in APOE. Significantly more AD patients carried any of the rare non-singleton variants than MCI and normal subjects. Such difference was observed in the non-carriers of ε4-allele only. Among the identified rare variants, the potential functional impact was predicted for rs532314089, rs553874843, rs533904656 and rs370594287. Conclusion: Our study suggests an ethnic difference in genetic risk composition of AD in southern Chinese. Rare variants on APOE are a potential candidate for AD risk stratification biomarker in addition to APOE-ε4.

Our previous work reported activating transcription factor 1 (ATF1) is a promotive factor of nasopharyngeal carcinoma (NPC) tumorigenesis. This study is to further explore the association between the human ATF1 rs11169571 polymorphism and the risk of NPC occurrence. The association between ATF1 rs11169571 and risk of NPC occurrence was investigated in clinical samples of 560 patients and 661 controls obtained from southern China with high incidence of NPC. The genotypes were detected by PCR‐RFLP. The differential expression activity of alleles ‐T and ‐C was analyzed with CNE‐2 and C666‐1 cells by luciferase reporter assay. Our data suggested that the allelic frequency and genotypes were significantly different between patients and controls. Compared to the TT homozygote, the TC and CC genotypes have been shown to be significantly decreased in NPC patients (OR = 0.494, 95% CI = 0.387‐0.629, P

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Drawing upon a study on rural–urban migrant young men at a delivery company in a southern Chinese city, I examine how they make sense of their private life as fathers. Situated within the pervasive...

Objectives To investigate the characteristics of hairs in Female pattern hair loss (FPHL) patients and healthy females in Southern China. Materials and methods Three fundamental hair parameters in different scalp areas of 90 Southern Chinese FPHL patients and 83 healthy controls were analyzed by phototrichogram. Results Female pattern hair loss patients showed reduced hair density, hair diameter, and terminal/vellus hair ratio. The reduction correlated with the severity of Ludwig staging. Midscalp was the most affected area in FPHL, but occipital and temporal sites were also involved. In normal women, the highest hair density was observed in midscalp, followed by occipital and temporal areas. Peak hair density at midscalp sites was reached at 20s group, then declined with age. Maximum hair diameter at midscalp and occipital sites occurred in 40s group. Terminal/vellus hair ratio tended to increase with age and peak on 50-60s group. Conclusion Reduced hair density and hair diameter, and miniaturization of hair follicles are the characteristics of FPHL in Southern Chinese women. Occipital and temporal sites are also affected in FPHL. Age-associated changes might have an influence on the hair condition. The values of hair parameters obtained in this study will help to establish reference data for better evaluation of hair disorders.

Background: First degree family history of cancer is associated with developing esophageal cancer and sparse data is about the impact on poor survival among established esophageal squamous cell cancer (ESCC) patients. In this study, we investigated the prognoses of patients with ESCC with a family history. Methods: A total of 479 ESCC patients were retrospectively enrolled from a Southern Chinese institution. A positive family history was defined as having malignant cancer among parents and siblings. Kaplan-Meier plots and Cox proportional hazards regressions were applied for overall survival (OS) and progression-free survival (PFS). Results: Among 479 patients, 119 (24.8%) and 68 (14.2%) reported a first-degree family history of cancer and digestive tract cancer, respectively. Compared with patients without a family history of cancer, the adjusted hazard ratios (HR) among those with it were 1.40 (95% CI, 1.08-1.82, p=0.011) for death, 1.36 (95% CI, 1.05-1.76, p=0.018) for progression. Similar results were observed in those with a family history of digestive tract cancer (HR=1.69, 95%CI, 1.24-1.98, p=0.001 for death and HR=1.77, 95%CI, 1.30-2.37, p

Biliary atresia (BA) is the most common cause of endstage liver disease in infants with poor prognosis and high mortality. The etiology of BA is still unknown, but the genetic factors have been considered as an important player in BA. We investigated the association of two cis-regulated variants in CD14 (rs2569190) and NOTCH2 (rs835576) with BA susceptibility, using the largest case-control cohort, totaling 506 BA patients and 1,473 healthy controls in a Southern Chinese population. Significant epistatic interaction between the two variants in our samples was observed (p = 8.1E−03; OR = 2.78; 95% CI: 1.32–5.88). The expression of CD14 and NOTCH2 in the BA group was consistently lower than that in the control (CC) group (0.31 ± 0.02 versus 1.00 ± 0.14; p < 0.001), which might be related to the genetic susceptibility of the genes awaiting further validation. Keywords: CD14, Notch2, biliary atresia, epistasis

Development of human dentition has been used as a predictor for evaluating the growth and maturity of an individual. It is fairly identical in a specific population, but the effect of development on subjects with dental anomalies had not been fully explored, particularly on subjects with supernumerary teeth (ST). This study hence aims to evaluate the dental development of children with and without ST. Sample size calculation was conducted and 320 radiographs of subjects with and without supernumerary teeth (ST) were obtained from the archives of a teaching hospital. The subjects in both groups were age and sex matched. All the subjects belong to southern Chinese ethnicity aged 2 to 14 years. The left-side dentition was scored, and dental age (DA) was estimated by obtaining scores from the southern Chinese dental reference dataset. Paired t test was used to calculate the difference between chronological age and dental age (CA-DA) for boys and girls with and without ST and further based on the number and position of ST. The difference between chronological age and dental age (CA-DA) was 0.10 years for boys and 0.19 years for girls with ST whilst 0.01 and 0.05 years for boys and girls without ST (p > 0.05). The boys with bilateral ST showed significant delay in dental development of 0.23 years (p

Objectives The aim of this study is to investigate the association of HDL-C with CCAS, as well as its intracranial or extracranial location in the Southern Chinese population. Patients and methods 123 Southern Chinese patients with large-artery atherosclerotic(LAA) ischemic stroke were enrolled for the final analysis. Based on the stenosis severity defined by digital subtraction angiography, the patients were categorized into CCAS and non-CCAS groups. The degree of artery stenosis among patients of CCAS was classified into three grades. CCAS were further categorized into intracranial AS (ICAS), Extracranial AS (ECAS) and combined intra-/extra-cranial AS (IECAS). Results It was showed that patients with CCAS had a lower HDL-C level compared to NCCAS, and HDL-C levels were correlated to the degree of artery stenosis among CCAS. After adjusting for multiple potential confounders, low HDL-C level remained independently associated with CCAS(adjusted OR = 2.860). Patients with the lowest HDL-C quartile had a significantly increased risk for CCAS(adjusted OR: 5.771), referred to the highest quartile. But HDL-C levels in patients with ICAS, ECAS and IECAS were not significantly different, and there was no significant correlation between HDL-C levels and ICAS. Conclusion Our data indicate that low HDL-C level is associated with CCAS in Southern Chinese patients with LAA ischemic stroke. But the effects of HDL-C on the distribution of CCAS is required to be further explored.

Objectives. To evaluate the tooth size discrepancy and Bolton’s ratios between male and female subjects with a Class I malocclusion. Materials and Methods. The digital e-models of 100 male and 100 female 12-year-old southern Chinese children with a Class I malocclusion were selected. The mesiodistal widths from permanent first molar to the contralateral side first molar of the upper and lower dentitions were measured. Differences between the tooth size discrepancy, together with the anterior and overall Bolton’s ratios between male and female subjects, were assessed using a two-sample t-test. A paired t-test was used to determine differences between antimetric pairs of teeth within the same arch. Results. Females had statistically significant smaller teeth than males (P < 0.05) except the upper left and lower left lateral incisor and lower left and right central incisors. The mean values of anterior Bolton’s ratios for males and females were 77.04 and 77.03, respectively (P > 0.05), while the mean values of overall Bolton’s ratios of male and female are 90.48 and 90.65, respectively (P < 0.05). The clinical significant differences (Cohen’s d > 0.2) for contralateral tooth size were shown on the maxillary canines, lateral incisors, and central incisors of males; and mandibular canines and lateral incisors of females. Conclusions. Southern Chinese females presenting with Class I malocclusions have smaller mesiodistal tooth dimensions compared to males. Both males and females presented several tooth size asymmetries. There are no statistical differences in anterior and overall Bolton’s ratios between the genders.

Introduction The Joint Committee for Developing Chinese Guidelines (JCDCG) introduced the Chinese definition for metabolic syndrome (MS), which has been verified in southern Chinese people but not in northwestern Chinese people. We evaluated the MS definition proposed by the JCDCG in a northwestern Chinese population, in comparison with those of the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF). Methods This population-based cross-sectional study was a part of the China National Diabetes and Metabolic Disorders Study conducted in Shaanxi province. We included 3243 participants aged ≥ 20 years. The age-adjusted MS prevalence was assessed per the 2007 Chinese population structure. The agreement between different definitions was assessed by the kappa statistic. Results The standardized prevalence of JCDCG-MS, revised ATPIII-MS, and IDF-MS was 22.4%, 29.4%, and 24.9%, respectively. Among women, the agreement of the JCDCG definition with the revised ATPIII and the IDF definition was not good (κ = 0.599 and 0.601, respectively); 54.6% of the revised ATPIII-MS and 56% of the IDF-MS were defined as MS according to the JCDCG definition. Among men, the agreement of JCDCG definition with the revised ATPIII and IDF definitions was very good (κ = 0.863) and substantial (κ = 0.741), respectively. Conclusion The agreement of the JCDCG definition with the revised ATPIII and IDF definitions was insufficient in women. Compared with the other two definitions, the JCDCG definition underestimates MS prevalence in northwestern women. Electronic supplementary material The online version of this article (10.1007/s13300-018-0446-9) contains supplementary material, which is available to authorized users.