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Purpose: The aim of this study was to evaluate the effects of vitamin D and/or calcium supplementation on sleep quality in individuals with prediabetes. Methods: A 24-week randomized controlled trial (RCT) was conducted in a 212 Chinese population with prediabetes. Participants were randomly assigned to four groups: vitamin D + calcium group (1600 IU/day + 500 mg/day, n = 53), vitamin D group (1600 IU/day, n = 54), calcium group (500 mg/day, n = 51), and control group (placebo, n = 54). The Pittsburgh Sleep Quality Index (PSQI) was used as the primary outcome to assess sleep quality. Questionnaires and fasting blood samples were collected at baseline and post-intervention for demographic assessment and correlation index analysis. Results: After a 24-week intervention, a significant difference was observed in serum 25(OH)D concentration among the four groups (P < 0.05), and the total PSQI score in vitamin D + calcium group was lower compared to the preintervention levels. Subgroup analyses revealed improved sleep quality with calcium supplementation (P < 0.05) for specific groups, including women, individuals with a low baseline 25(OH)D level (< 30 ng/mL), and individuals in menopause. Moreover, correlation analysis revealed a negative correlation between the extent of change in sleep efficiency scores before and after the calcium intervention and the degree of change in insulin efficiency scores (r = − 0.264, P = 0.007), as well as the magnitude of change in islet beta cell function (r = − 0.304, P = 0.002). Conclusions: The combined intervention of vitamin D and calcium, as well as calcium interventions alone, exhibits substantial potential for improving sleep quality in individuals with prediabetes. Clinical trial registration: The trial was registered in August 2019 as ChiCTR190002487. [ABSTRACT FROM AUTHOR]

Background: This study aims to analyze the influencing factors of postoperative Low Anterior Resection Syndrome (LARS) in patients with middle and low rectal cancer who underwent robotic surgery. It also seeks to predict the probability of LARS through a visual, quantitative, and graphical nomogram. This approach is expected to lower the risk of postoperative LARS in these patients and improve their quality of life through effective prevention and early intervention. Patients and methods: This research involved patients with middle and low rectal cancer who underwent robotic surgery in the Department of Gastrointestinal Surgery at the First Affiliated Hospital of Nanchang University from January 2015 to October 2022. A series of intestinal dysfunction symptoms arising from postoperative rectal cancer were diagnosed and graded using LARS scoring criteria. After the initial screening of all variables related to LARS with Lasso regression, they were included in logistic regression for further univariate and multivariate analysis to identify independent risk factors for LARS. A prediction model was then constructed. Results: The study included 358 patients. The parameters identified by Lasso regression included obstruction, BMI, tumor localization, maximum tumor diameter, AJCC stage, stoma, neoadjuvant therapy (NAT), and postoperative adjuvant therapy (AT). Univariate and multivariate analyses indicated that a higher BMI, lower tumor localization, higher AJCC stage, neoadjuvant therapy, and postoperative adjuvant therapy were independent risk factors for total LARS. The AUC of the prediction nomogram was 0.834, with a sensitivity of 0.825 and specificity of 0.741. The calibration curve demonstrated excellent concordance with the nomogram, indicating the prediction curve fit the diagonal well. Conclusion: Higher BMI, lower tumor localization, higher AJCC stage, neoadjuvant therapy, and adjuvant therapy were identified as independent risk factors for total LARS. A new predictive nomogram for postoperative LARS in patients with middle and low rectal cancer undergoing robotic surgery was developed, proving to be stable and reliable. This tool will assist clinicians in managing the postoperative treatment of these patients, facilitating better clinical decision-making and maximizing patient benefits. [ABSTRACT FROM AUTHOR]

Summary: We developed a new tool to assess the severity of osteoporotic vertebral fracture using radiographs of the spine. Our technique can be used in patient care by helping to stratify patients with osteoporotic vertebral fractures into appropriate treatment pathways. It can also be used for research purposes. Purpose: The aim of our study was to propose a semi-quantitative (SQ) grading scheme for osteoporotic vertebral fracture (OVF) on anteroposterior (AP) radiographs. Methods: On AP radiographs, the vertebrae are divided into right and left halves, which are graded (A) vertical rectangle, (B) square, (C) traverse rectangle, and (D) trapezoid; whole vertebrae are graded (E) transverse band or (F) bow-tie. Type A and B were compared with normal and Genant SQ grade 1 OVF, Type C and D with grade 2 OVF, and Type E and F with grade 3 OVF. Spine AP radiographs and lateral radiographs of 50 females were assessed by AP radiographs SQ grading. After training, an experienced board-certified radiologist and a radiology trainee assessed the 50 AP radiographs. Results: The height-to-width ratio of the half vertebrae varied 1.32–1.48. On lateral radiographs, 84 vertebrae of the 50 patients had OVFs (38 grade 1, 24 grade 2, and 22 grade 3). On AP radiographs, the radiologist correctly assigned 84.2%, 91.7%, and 77.2% and the trainee correctly assigned 68.4%, 79.2%, and 81.8% of grade 1, 2, and 3 OVFs, respectively. Compared with lateral radiographs, the radiologist had a weighted Kappa of 0.944 including normal vertebrae and 0.883 not including normal vertebrae, while the corresponding Kappa values for the trainee were 0.891 and 0.830, respectively. Conclusion: We propose a new semi-quantitative grading system for vertebral fracture severity assessment on AP spine radiographs. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the risk factors influencing the development of cefoperazone-induced coagulopathy in critically ill patients and determine the threshold of serum trough concentration. Methods: A retrospective case-control study was conducted in the intensive care unit patients treated with cefoperazone, and it was approved by the Ethical Committee of Drum Tower Hospital affiliated with the Medical School of Nanjing University (NO.2023-158-01). Patients were divided into the normal group and coagulopathy group based on prothrombin time. The clinical characteristics of the two groups were compared using univariate analysis. The serum concentration threshold and influencing factors of cefoperazone-induced coagulopathy in critically ill patients were analyzed using the receiver operating characteristic curve and multivariate logistic regression analysis. Results: A total of 113 patients were included, and cefoperazone-induced coagulopathy occurred in 39 patients, with an incidence of 34.5%. These patients experienced significant prothrombin time prolongation around day 6 (median) after cefoperazone application. The serum trough concentration threshold of cefoperazone-induced coagulopathy in critically ill patients was 87.765 mg/l. Multivariate logistic regression analysis revealed that the APACHE II score (p = 0.034), prophylactic use of vitamin K1 (p < 0.001), hepatic impairment (p = 0.014), and Cmin ≥ 87.765 mg/l (p = 0.005) were associated with cefoperazone-induced coagulopathy. Conclusion: Cefoperazone-induced coagulopathy usually occurs on the 6th day of cefoperazone use in critically ill patients. The risk will increase in patients with an APACHE II score > 25, hepatic impairment, and cefoperazone Cmin ≥ 87.765 mg/l. Vitamin K1 is effective in preventing this adverse reaction. [ABSTRACT FROM AUTHOR]

Growing evidence exists about the candidate factors of childhood cognitive performance, but mainly limited to single-exposure studies. We sought to systematically and simultaneously identify and validate a wide range of potential modifiable factors for childhood cognitive performance. We used data from five waves of data from the China Family Panel Studies (CFPS-2010, 2012, 2014, 2016 and 2018). Our analytical sample was restricted to those children aged 2–5 at baseline with valid exposure information. A total of 80 modifiable factors were identified. Childhood cognitive performance was assessed using vocabulary and mathematics test at wave 5. We used an environment-wide association study (EnWAS) to screen all exposure-outcome associations independently and used the least absolute shrinkage and selection operator (LASSO) variable selection algorithm to identify factors associated with cognitive performance. Multivariable linear model was then used to evaluate causal relationships between identified factors and cognitive performance. Of the 1305 participants included in the study (mean ± SD, 3.5 ± 1.1 years age at baseline, 45.1% girls). Eight factors were retained in the LASSO regression analysis. Six factors across community characteristics (percentage of poverty in the community; percentage of children in the community), household characteristics (family size), child health and behaviors (mobile internet access), parenting behaviors and cognitive enrichment (parental involvement in child' s education), and parental wellbeing (paternal happiness) domains were significantly associated with childhood cognition. Using a three-stage approach, this study validates several actionable targets for improving childhood cognitive performance. [ABSTRACT FROM AUTHOR]

Background: Endoscopic submucosal dissection (ESD) was widely used for the removal of esophageal tumors, and post-endoscopic submucosal dissection electrocoagulation syndrome (PEECS) was one of the postoperative adverse events. The aim of this research was to develop and validate a model to predict electrocoagulation syndrome after endoscopic submucosal dissection of esophageal tumors. Materials and methods: Patients who underwent esophageal ESD in our hospital were retrospectively included. A predictive nomogram was established based on the results of multivariate logistic regression analysis, and bootstrapping resampling was used for internal validation. Besides, the clinical usefulness of the nomogram was evaluated using decision curve analysis (DCA) and clinical impact curve. Results: A total of 552 patients who underwent esophageal ESD were included in the study, and the incidence of PPECS was 12.5% (69/552). Risk factors associated with PEECS (p < 0.1) were analyzed by multivariate logistic regression analysis, and the final model included four variables, namely gender, diabetes, tumor size and operation time. The predictive nomogram was constructed based on the above four variables, and the area under the ROC curve (AUC) was 0.811 (95% CI 0.767–0.855). The calibration curve of the nomogram presented good agreement between the predicted and actual probabilities. DCA showed that the model improved patient outcomes by helping to assess the risk of PEECS in patients compared to an all-or-no treatment strategy. In addition, the clinical impact curve of the model also indicates that the nomogram has a high clinical net benefit. Conclusion: In conclusion, we have developed a predictive nomogram for PEECS after ESD for esophageal tumors with good predictive accuracy and discrimination. This predictive nomogram can be effectively used to identify high-risk patients with PEECS, which will help clinicians in clinical decision-making and early intervention. [ABSTRACT FROM AUTHOR]

Background: Many patients experience anorectal dysfunction after rectal surgery, which is known as low anterior resection syndrome (LARS). Robotic systems have many technical advantages that may be suitable for functional preservation after low rectal resection. Thus, the study aimed to explore whether robotic surgery can reduce the incidence and severity of LARS. Methods: Patients undergoing minimally invasive sphincter-sparing surgery for low rectal cancer were enrolled between January 2015 and December 2020. The patients were divided into robotic or laparoscopic groups. The LARS survey was conducted at 6, 12 and 18 months postoperatively. Major LARS scores were analysed as the primary endpoint. In order to reduce confounding factors, one-to-two propensity score matches were used. Results: In total, 342 patients were enrolled in the study. At 18 months postoperatively, the incidence of LARS was 68.7% (235/342); minor LARS was identified in 112/342 patients (32.7%), and major LARS in 123/342 (36.0%). After matching, the robotic group included 74 patients, and the laparoscopic group included 148 patients. The incidence of major LARS in the robotic group was significantly lower than that in the laparoscopic group at 6, 12, and 18 months after surgery. In multivariate logistic regression analysis, tumour location, laparoscopic surgery, intersphincteric resection, neoadjuvant therapy, and anastomotic leakage were independent risk factors for major LARS after minimally invasive sphincter-sparing surgery for low rectal cancer. Furthermore, a major LARS prediction model was constructed. Results of model evaluation showed that the nomogram had good prediction accuracy and efficiency. Conclusions: Patients with low rectal cancer may benefit from robotic surgery to reduce the incidence and severity of LARS. Our nomogram could aid surgeons in setting an individualized treatment program for low rectal cancer patients. [ABSTRACT FROM AUTHOR]

Background and study aims: Gastrointestinal stromal tumors (GIST) carry a potential risk of malignancy, and the treatment of GIST varies for different risk levels. However, there is no systematic preoperative assessment protocol to predict the malignant potential of GIST. The aim of this study was to develop a reliable and clinically applicable preoperative nomogram prediction model to predict the malignant potential of gastric GIST. Patients and methods: Patients with a pathological diagnosis of gastric GIST from January 2015 to December 2021 were screened retrospectively. Univariate and multivariate logistic analyses were used to identify independent risk factors for gastric GIST with high malignancy potential. Based on these independent risk factors, a nomogram model predicting the malignant potential of gastric GIST was developed and the model was validated in the validation group. Results: A total of 494 gastric GIST patients were included in this study and allocated to a development group (n = 345) and a validation group (n = 149). In the development group, multivariate logistic regression analysis revealed that tumor size, tumor ulceration, CT growth pattern and monocyte-to- lymphocyte ratio (MLR) were independent risk factors for gastric GIST with high malignancy potential. The AUC of the model were 0.932 (95% CI 0.890–0.974) and 0.922 (95% CI 0.868–0.977) in the development and validation groups, respectively. The best cutoff value for the development group was 0.184, and the sensitivity and specificity at this value were 0.895 and 0.875, respectively. The calibration curves indicated good agreement between predicted and actual observed outcomes, while the DCA indicated that the nomogram model had clinical application. Conclusions: Tumor size, tumor ulceration, CT growth pattern and MLR are independent risk factors for high malignancy potential gastric GIST, and a nomogram model developed based on these factors has a high ability to predict the malignant potential of gastric GIST. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of preoperative sarcopenia on the short-term and long-term outcomes in older patients with locally advanced gastric cancer (LAGC). Methods: Clinicopathological data of older patients with LAGC who underwent radical surgery were retrospectively analyzed. Sarcopenia was defined as a skeletal muscle index of less than 36.4 cm2/m2 for men and less than 28.4 cm2/m2 for women. Comparing the postoperative complications and survival between sarcopenia and non-sarcopenia groups using multicenter data. Results: A total of 406 older patients with LAGC were included in the analysis, including 145 (35.7%) with sarcopenia and 261 (64.3%) with non-sarcopenia. Multivariate logistic regression analysis showed that sarcopenia was an independent risk factor for postoperative complications with CD grade ≥ II (OR 1.616; P < 0.05). Kaplan–Meier survival curve analysis showed that the 5-year overall survival (OS) and 5-year recurrence-free survival (RFS) in the sarcopenia group were lower than those in the non-sarcopenia group (P both < 0.05). Multivariate Cox regression analyses showed that sarcopenia was an independent prognostic factor for 5-year OS and RFS (P both < 0.05). The 5-year recurrence rate in the sarcopenia group was 57.2%, which was significantly higher than that in the non-sarcopenia group (46.4%; P = 0.036). Recurrence pattern analysis showed that the incidence of distant metastases in patients with sarcopenia (42.8%) was significantly higher than non-sarcopenia (31.4%; P = 0.022). Conclusion: Sarcopenia serves as a valuable predictor of both short-term and long-term outcomes in older patients with LAGC. Therefore, the significance of assessing preoperative nutritional status and implementing thorough postoperative follow-up for older LAGC patients with sarcopenia should be emphasized. [ABSTRACT FROM AUTHOR]

Background: Patients with early gastric cancer (EGC) are at high risk of developing synchronous multiple gastric neoplasms (SMGNs) after undergoing endoscopic submucosal dissection (ESD). However, most previous studies have had small sample sizes, and few have focused on association studies. Aims: This study aimed to analyze the associations between SMGN lesion data from patients with EGC treated with ESD and their correlation coefficients. Methods: The clinical ESD data from two hospitals from January 2008 to January 2021 were retrospectively analyzed. The main lesions were defined as those with a significant depth of infiltration. The larger tumor diameter was considered the main lesion if the lesions had the same infiltration depth. Results: Of the 1013 post-ESD cases examined, 95 cases (223 lesions) had SMGN, and 25 patients had more than three lesions. For the correlation analysis, 190 lesions were included. The study revealed a similarity in pathological type between main and minor lesions (rs = 0.37) and a positive correlation in infiltration depth (rs = 0.58). The mean diameter sizes of the main and minor lesions were 20.7 ± 8.3 mm and 13.1 ± 6.4 mm, respectively, with statistically significant differences (P < 0.001). A linear correlation was observed between the diameter size and a linear regression model was constructed, producing r = 0.38 [95% confidence interval (CI) 0.19–0.54], b = 0.29 (95% CI 0.14–0.44), t = 3.94, P < 0.001]. A correlation was identified between the vertical distribution of the main and minor lesions, the horizontal distribution, and the gross endoscopic morphology (ϕc = 0.25, P = 0.02; ϕc = 0.32, P < 0.001; ϕc = 0.60, P < 0.001). Conclusions: The correlation coefficients for microscopic characteristics were higher than those for gastroscopy. There is a significant positive correlation between the main and minor lesions regarding pathological stage and depth of infiltration, respectively. The spatial distribution of the lesions and the gastroscopic morphology were similar. SMGN synchronous multiple gastric neoplasms, ESD endoscopic submucosal dissection. [ABSTRACT FROM AUTHOR]

Competitive climate and individual competitive characteristics jointly affect the mental health of adolescents. Based on person-environment fit theory, this study aimed to examine the effects of the match between trait competitiveness and competitive climate on depressive symptoms and anxiety. In this study, data were collected from 2235 Chinese adolescents in the 10th to 12th grades (48.8% girls; Mage = 16.06 years, SDage = 0.95). Self-reported depressive symptoms, general anxiety, trait competitiveness, and competitive climate were assessed. Polynomial regression analyses and response surface analyses indicated that in cases of congruence, as trait competitiveness and competitive climate increase, depressive symptoms and anxiety increase, as do their growth rate. In cases of incongruence, higher levels of depressive symptoms and anxiety are found when trait competitivenesså competitive climate compared to when competitive climateå trait competitiveness. And as trait competitiveness become increasingly higher than competitive climate, the level of depressive symptoms and anxiety were higher. This serves as a reminder for families and schools to place special emphasis on the mental health of adolescents with high levels of trait competitiveness who may exhibit high levels of depressive symptoms and anxiety. [ABSTRACT FROM AUTHOR]

Participation in evidence-based parenting programs benefits parents and children, but these programs have limited reach. This study utilized a mixed-method design to investigate the parenting concerns and parenting program needs of Chinese immigrant parents in New Zealand. Parents (n = 159) were surveyed about their perceived levels of child adjustment problems, parenting confidence, and parenting risk and protective factors. Parents' knowledge and experience with parenting programs, and their program preferences were also examined. Eight Chinese parenting practitioners were interviewed about parenting challenges, parental concerns, and barriers to program participation of Chinese immigrant parents. Survey results showed that parents who gave their child higher ratings on behavior problems reported less parental self-efficacy, and more parental adjustment, family relationship, teamwork, and parenting difficulties. Parents' knowledge and experience of available parenting programs was low. Barriers to program participation included time constraints, lack of program awareness, cultural and language barriers, and no childcare provision. Parents indicated a preference for a range of delivery options including group-based, seminar, and individually tailored programs. Program features most likely to influence attendance were content that addresses personally relevant issues and children's self-development (such as coping with failure, managing negative emotions, and increasing confidence), and convenient location of program. Practitioners indicated that managing difficult child behavior and maintaining positive parent-child relationships were key parenting challenges. These concerns were linked to cultural expectations about child obedience, academic performance, and parent/grandparent relationships. Findings highlight program preferences that could be offered to meet Chinese immigrant parenting support needs and increase program participation. Highlights: Parents and practitioners highlighted challenges, concerns, and needs of Chinese immigrant parents. Parents who gave higher child behavior problems ratings reported more parenting and family relationship difficulties. Identified parenting program, delivery, and content options that could meet Chinese immigrant parenting support needs. [ABSTRACT FROM AUTHOR]

Positive aspects of adolescent development recently have raised researchers' interests; however, studies examining reciprocal links between prosocial behavior, social preference, and subjective well-being are lacking. The present longitudinal study investigated the bidirectional relations between prosocial behavior, social preference, and subjective well-being within a theoretical framework of the developmental cascade model. A total of 1248 Chinese adolescents (M = 13.44, SD = 0.65; 47.0% girls) were surveyed across three waves with 6-month intervals. The results of analyses utilizing the random-intercept cross-lagged panel model demonstrated that prosocial behavior was positively associated with both social preference and subjective well-being, and social preference was not associated with subjective well-being at the between-person level. At the within-person level, prosocial behavior was positively reciprocally associated with social preference, while no significant relations between prosocial behavior and subjective well-being and between social preference and subjective well-being were found. The findings highlight adolescents' prosocial behavior and social preference could mutually facilitate each other over time, which can be used to guide adolescents' positive development. [ABSTRACT FROM AUTHOR]

To study the seismic vulnerabilities and performances of typical bridges, data from a field investigation of 2134 bridges on 22 highway sections hit by the Wenchuan earthquake that occurred in China on May 12, 2008, were collected and processed. From the sample data of the empirical seismic-damage observations, 1409 simply supported girder bridges, 107 continuous girder bridges, and 612 arch bridges were selected. The latest version of the Chinese seismic intensity standard was utilized to evaluate the fragility of bridge samples in different macroseismic intensity zones, and the empirical vulnerability matrix and multidimensional regression comparison model of typical bridge clusters were developed. Taking the bridge length, the coordinate azimuth of the bridge location, the number of spans, the geometric form of the pier columns, and the type of bearings and foundations as the single factors influencing vulnerability and assuming (i) the line type and bridge length, (ii) the types of pier column and foundation, and (iii) the number of spans, the type of bearings, foundations, and linearity as the coupled factors influencing vulnerability, the aforementioned typical bridges were subjected to comparative vulnerability analysis. Innovative fragility regression and probability comparison models of typical bridges were developed considering the influence of multiple factor coupling. A novel vulnerability evaluation model was proposed based on the characteristic parameters and damage grade of bridge clusters in the umbrella earthquake area, and the model was optimized and verified by using the typical bridge database of the Wenchuan earthquake. [ABSTRACT FROM AUTHOR]

Summary: This study revealed that there was no significant linear relationship between fasting C-peptide (FCP) level and bone mineral density (BMD) or fracture risk in type 2 diabetes mellitus (T2DM) patients. However, in the FCP ≤ 1.14 ng/ml group, FCP is positively correlated with whole body (WB), lumbar spine (LS), and femoral neck (FN) BMD and negatively correlated with fracture risk. Purpose: To explore the relationship between C-peptide and BMD and fracture risk in T2DM patients. Methods: 530 T2DM patients were enrolled and divided into three groups by FCP tertiles, and the clinical data were collected. BMD was measured by dual-energy X-ray absorptiometry (DXA). The 10-year probability of major osteoporotic fractures (MOFs) and hip fractures (HFs) was evaluated by adjusted fracture risk assessment tool (FRAX). Results: In the FCP ≤ 1.14 ng/ml group, FCP level was positively correlated with WB, LS, and FN BMD, while FCP was negatively correlated with fracture risk and osteoporotic fracture history. However, FCP was not correlated with BMD and fracture risk and osteoporotic fracture history in the 1.14 < FCP ≤ 1.73 ng/ml and FCP > 1.73 ng/ml groups. The study has shown that FCP was an independent factor influencing BMD and fracture risk in the FCP ≤ 1.14 ng/ml group. Conclusions: There is no significant linear relationship between FCP level and BMD or fracture risk in T2DM patients. In the FCP ≤ 1.14 ng/ml group, FCP is positively correlated with WB, LS, and FN BMD and negatively correlated with fracture risk, and FCP is an independent influencing factor of BMD and fracture risk. The findings suggest that FCP may predict the risk of osteoporosis or fracture in some T2DM patients, which has a certain clinical value. [ABSTRACT FROM AUTHOR]

The present study aims to examine and compare, in both mobile phone addicts (MPAs) and possible-MPAs, (1) the direct effect of mobile phone addiction (MPA) levels on adolescent depressive symptoms, and (2) the indirect effect of MPA levels on depressive symptoms as mediated by parent-adolescent relationships. We recruited 1766 Chinese adolescents (53.2% male; Mage= 13.30, SD = 2.00, range from 10 to 18 years) from Shenzhen Shuijing Primary School, Shenzhen Longcheng Middle School, and High School of Shenzhen Overseas Chinese Town in China. The participants completed a questionnaire survey that measured MPA levels, parent-adolescent relationships, and depressive symptoms. The results showed that (1) The direct effect of MPA on adolescent depressive symptoms was stronger than that of possible MPA; (2) the indirect effect of MPA on depressive symptoms through parent-adolescent relationships was stronger than that of possible MPA. This study expanded the interdependent relationship between Internet addiction and depression by illustrating the mediating mechanism of parent-adolescent relationships in the link between different levels of MPA and adolescent depressive symptoms, having made an important contribution to the development of family-based prevention and intervention strategies for adolescent depressive symptoms. [ABSTRACT FROM AUTHOR]

Most of the international mineral statistics are limited to production, import and export figures only. However, such statistics are not sufficient to identify possible market trends or supply risks. The political restructuring in Europe and China's rapidly increasing demand for mineral raw materials since the turn of the millennium has led to imbalances in the demand and supply of raw materials in many countries. In the present work, the importance of a more in-depth exploratory data analysis is explained. The paper also deals with the need to record raw material exploration projects. While most statistics are limited to the production figures and thus only allow a retrospect into the past only, information about the resources verified in exploration projects would also allow a glimpse into the future. Despite this need, many institutions that have compiled such statistics in the past have discontinued them meanwhile. Reduced budget and staff shortages are some of the reasons for this. For this reason, close cooperation between the few remaining organizations is urgently required. [ABSTRACT FROM AUTHOR]

Anastomotic stenosis is a serious complication after anterior resection for rectal carcinoma. In this study, we explored the factors influencing the development of anastomotic stenosis after the operation. The clinical data of 420 patients who underwent surgery between January 2013 and December 2019 in the Department of Colorectal Surgery, Changshu Hospital Affiliated to Soochow University, were analyzed. The causes of anastomotic stenosis were investigated with logistic regression. A total of 52 patients developed anastomotic stenosis (12.4%). Univariate analysis showed that gender (χ2 = 5.878, P = 0.012), protective stoma (χ2 = 4.224, P = 0.038) and distance from lower edge of tumor to anal verge (t = 3.346, P = 0.001), and anastomotic leak (χ2 = 9.432, P = 0.003) were statistically significant in the correlation of postoperative anastomotic stenosis. Logistic regression analysis showed that gender (OR = 1.662, 95%CI 1.026~2.694, P = 0.012), distance from lower edge of tumor to anal verge (OR = 0.856, 95%CI 0.822~0.892, P = 0.001), and anastomotic leak (OR = 2.455, 95%CI 1.192~3.863, P = 0.003) were independent factors of anastomotic stenosis. Male patients, the lower edge of the tumor close to the anal verge, and patients who had an anastomotic leak after surgery are more likely to develop anastomotic stenosis. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the relationship between anthropometric indices, including abdominal volume index (AVI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), conicity index (C index), body mass index (BMI), body roundness index (BRI), body adiposity index (BAI), A body shape index (ABSI) and cardiovascular risk factors, and their abilities to predict metabolic syndrome (MetS) in adults. Methods: A cross-sectional study of 76,915 participants (30,912 females and 46,003 males) aged between 14 and 100 years was conducted. AVI, WHR, WHtR, BMI, conicity index (C index), BRI, BAI, and ABSI were measured and calculated. Pearson correlation analysis and linear regression analysis were used to examine the relationship between anthropometric indicators and the components of MetS, while binary logistic regression analysis was used to assess the relationship between anthropometric indicators and overall MetS. The receiver operating characteristic curve (ROC) was used to analyze and calculate the area under the curve (AUC). Then, a 95% confidence interval (95% CI) was calculated to evaluate the ability of anthropometric indicators to predict MetS and determine the optimal cutoff value of each anthropometric indicator. The optimal cutoff value was determined by the Youden index. Results: MetS prevalence was 21.71% in males and 9.5% in females. Participants with MetS were older and had higher values of glucose, triglyceride, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), systolic blood pressure (SBP), diastolic blood pressure (DBP) than those without MetS. The high-density lipoprotein cholesterol (HDL-C) values of males and females with MetS were lower than the values found in those without MetS. Mean values of all anthropometric indicators in men and women with MetS were significantly higher than the mean values in those without MetS. After adjusting for age, alcohol consumption, and smoking, anthropometric indexes AVI, WHR, WHtR, C index, BMI, and BRI were all associated with cardiovascular risk factors (p < 0.001). Among men over the age 60 years old, an AVI cutoff of 16.0 predicted MetS with a sensitivity of 74.70% and a specificity of 84.90%. The area under the ROC curve was 0.84 (p < 0.001). Among women over the age of 60 years, an AVI cutoff of 12.8 predicted MetS with a sensitivity of 90.13% and a specificity of 63.72%. The area under the ROC curve was 0.80 (p < 0.001). Among men aged 30–60 years, an AVI cutoff of 16 predicted MetS with a sensitivity of 80.44% and a specificity of 82.36%. The area under the ROC curve was 0.85 (p < 0.001). Among women aged 30–60 years, an AVI cutoff of 12.82 predicted MetS with a sensitivity of 87.72% and a specificity of 83.47%. The area under the ROC curve was 0.90 (p < 0.001). Among men under the age of 30 years, an AVI cutoff of 16.22 predicted MetS with a sensitivity of 87.97% and a specificity of 88.65%. The area under the ROC curve was 0.92 (p < 0.001). Among women under the age of 30 years, an AVI cutoff of 12.79 predicted MetS with a sensitivity of 95.92% and a specificity of 93.79%. The area under the ROC curve was 0.97 (p < 0.001). AVI showed the strongest ability to distinguish MetS across genders and different age groups. Conclusion: AVI, WHR, WHtR, BMI, C index, and BRI were all associated with cardiovascular risk factors. The anthropometric index is a useful screening tool for MS, its components, and cardiovascular risk factors. Among all the indices examined, AVI can best distinguish MetS. [ABSTRACT FROM AUTHOR]

Helicopter Parenting (HP) refers to parenting behaviors such as overinvolvement and developmentally inappropriate support during late adolescence and emerging adulthood. To date, this construct has mainly been examined in Western cultures. This research developed and validated a multi-dimensional HP measure for mothers and late-adolescent children in Mainland China. Study 1 explored initial factor structure of HP with an online sample of Mainland Chinese mothers (N = 433; Mage = 43.63 years). Study 2 confirmed this structure with a new online sample of mothers (N = 461; Mage = 44.39 years), and assessed construct invariance between mothers of high school and college students. Study 3 confirmed this HP structure with mother-adolescent dyads (N = 248; Mothers: Mage = 44.29 years; Adolescents: Mage = 17.37 years) and assessed construct invariance and construct validity between dyad members. Across the three studies, results suggested a 16-item measure with four factors (advice/affect management, anticipatory problem solving, information-seeking, and emphasis on academic performance), which also loaded on a higher-order HP factor. The measure had good internal consistencies (αs ≥ 0.844). Fits for mother-reported high school and college student measurement invariance model, and mother-adolescent invariance model were acceptable when constraining all factor loadings. Mother and adolescent HP reports were modestly positively correlated. Within-respondent correlations in Studies 2 and 3 showed that the total HP scores were positively correlated with behavioral control and emotional support. However, mother-reported HP was negatively correlated with adolescent-reported emotional support, suggesting discrepant views about which parenting behaviors are helpful vs. overbearing. Mother- and adolescent-reported HP scores were not related to adolescent-reported psychological control or self-efficacy. This study offers a concise, multidimensional Chinese HP measure which is useful to examine Chinese mother-adolescent reporter discrepancies, as well as associations between Chinese HP and youth's psychological functioning. Highlights: This research developed a 16-item measure of HP, with four factors, that was invariant between mothers' and adolescents' reports in Mainland China. Results suggested that Chinese mothers and their adolescent children differed in views of the extent to which parenting behaviors were supportive vs. overbearing. In contrast to Western studies, HP was not associated with youth perceptions of psychological control or self-efficacy. [ABSTRACT FROM AUTHOR]

It has been found that people with disabilities remain at the margin as far as the different aspects of their lives are concerned. This paper tests the hypothesis that disability leads to lower quality of life among older adults in low and middle-income countries. The data from the Study on Global Ageing and Adult Health (SAGE) was used in this study which was conducted in Ghana, China, India, Russia, South Africa and Mexico. The disability scores have been made utilising Item Response Theory, Partial Credit Model and are centered on eight functioning and health areas. Bivariate analysis, binary logistic regression and pooled regression analysis have been used to fulfil the objectives of the paper. The findings reveal that disability acts as a hindrance in attaining a high quality of life (HQOL) amongst the older adults in the above mentioned low and middle-income countries. The older adults with disability are as much as 60% less likely to enjoy an HQOL with respect to the older adults without disability. Better socio-economic development like improved health care for disabled older adults with disability enhanced living standards for both abled and disabled, efficient pension schemes for older adults with disability and effective social service schemes would be very much essential to improve overall QOL among older adults. [ABSTRACT FROM AUTHOR]

Introduction: This population-based cross-sectional study aimed to identify the best predictor of the 10-year cardiovascular (CV) high risk among old and new anthropometric indices. Methods: We investigated 76,915 adults older than 18 years of age living in southwest China. Ten obesity indices were calculated. The 10-year cardiovascular disease (CVD) risk was estimated using the Framingham risk score. Receiver operating characteristic curve analysis was performed to assess the ability of the anthropometric index to predict the 10-year high risk of CVD events. Results: The waist-to-hip ratio (WHR) had the highest area under the curve (AUC) value (0.711; sensitivity: 62.22%, specificity: 42.73%) in men, while the body fat index (BAI) had the lowest AUC value (0.624, sensitivity: 49.07%, specificity: 54.84%). The waist-to-height ratio (WHtR) and the body roundness index (BRI) showed the highest AUC value (0.751, sensitivity: 39.24%, 39.83%, specificity: 75.68%, 68.59%) in women, while the BAI showed the lowest AUC value (0.671, sensitivity: 53.15%, specificity: 57.14%). Conclusions: The WHR was the best anthropometric measure for assessing the 10-year high risk of CVD in men, while the WHtR and BRI were the best measures for women. In men, the WHR should be < 0.88, and in women, the WHtR should be < 0.502 or the BRI should be < 3.41. [ABSTRACT FROM AUTHOR]

Hydro-morphological processes (HMPs) are some of the most destructive natural disasters. Understanding the spatiotemporal characteristics of HMPs across China is important for enabling better disaster estimation and prevention at the national scale. However, few studies have focused on the spatiotemporal HMP characterization under various geomorphic settings in China, which may shed light on their regional/national evolution. To bridge this research gap, we analysed the longest HMP time series available in China, which including 47,483 HMP records, to detect spatiotemporal patterns. Specifically, we run several tests namely, Mann–Kendall test, wavelet analysis, Monthly Frequency, and Index of Dispersion, with the objective of detecting the temporal evolution, trends, period, and clustering of HMPs in six geomorphological regions (geomorphic-regions): Eastern Plain, South Eastern Mountain (SEM), North Central Plateau, North Western Basin, South Western Mountain (SWM), and Tibetan Plateau. Our results show that in the last decades have been associated with a marked increase in HMPs and this should be accounted for, especially in those areas where we have retrieved high spatiotemporal clustering (e.g., SEM, SWM). Besides, the main periodicity of HMPs is approximately 12–25 years for most of China since the 1980s, which showed analogous patterns with precipitation anomalies. This study provides a preliminary reference for revealing the spatiotemporal characteristics of HMPs in the context of climate change; therefore, the information provided can be crucial to plan engineering applications with specific return period. [ABSTRACT FROM AUTHOR]

This study aimed to translate the Spiritual Perspectives Scale (SPS) into a Mandarin Chinese version (C-SPS) and evaluate its psychometric properties among 154 palliative care nurses from twelve community healthcare centres in Shanghai, China. Exploratory factor analysis suggested two factors (spiritually related activities and spiritual beliefs), accounting for 67.49% of the total variance. The Cronbach's α of the total C-SPS score was 0.89, and its split-half coefficient (Spearman-Brown reliability coefficient) was 0.72. The C-SPS showed consistently acceptable psychometric properties of reliability and validity. It can be used to evaluate the level of spiritual perspectives of nurses in China. [ABSTRACT FROM AUTHOR]

The climate in China is extremely abnormal in July 2020, which is largely attributed to the anomalous activities of the Western Pacific Subtropical High (WPSH). In the present study, statistical analysis and diagnostic calculation of individual terms of the complete form of vorticity equation are conducted to investigate features of meridional movement of WPSH in July 2020, and the mechanism for the anomalous meridional movement of the WPSH is also explored. Results indicate that in July 2020, the western segment of the WPSH ridge line persistently remained to the south of its climatological position, especially in the lower troposphere. Meanwhile, the eastern segment of the ridge line continuously stayed to the north of its normal position. Such a configuration leads to a large meridional span of the WPSH ridge line and is directly responsible for the super long Meiyu season in eastern China in the summer of 2020. The persistent southward shift of the WPSH ridge line in its western segment is attributed to the maintenance of strong positive vorticity anomalies to the north of the WPSH ridge line. Whereas the abnormally frequent southward invasion of cold air and the activities of troughs in the mid- and high-latitude regions are the main reasons for the maintenance of the vorticity anomalies to the north of the WPSH ridge line. In addition, the anomalously southward WPSH combined with the Indian ocean SST anomalies inhibited the development of tropical convection in the South China Sea—Philippines, which subsequently weakened the vorticity anomalies to the south of the WPSH ridge line and made the P-J teleconnection pattern exhibiting in abnormally negative phase, and resulting in anomalous cyclonic circulation and negative geopotential height developed in the middle and lower troposphere over southern Japan, which further caused the WPSH centroid locating southward and restricted the northward movement of the WPSH. [ABSTRACT FROM AUTHOR]

Though a continued increase in life expectancy is a significant public health achievement, keeping older adults active and maintaining their well-being is challenging. Active aging requires physical health, mental health, functional independence, economic stability, social participation, and spiritual identification. Among all these factors, social cohesion has significant importance, but there is a dearth of studies focusing on older adults' social cohesion. Thus, the present study focuses on the level of social cohesion among older adults and its variation among the different economic classes. This article uses data from the Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa during 2007–10. Social cohesion scores have been constructed using Item Response Theory Partial Credit Model. Also, bivariate analysis, concentration curves, concentration indices, and multivariate regressions have been used for the analysis presented in this paper. This study confirms the strong predictive power of age, wealth, education, and working status of older adults on their social cohesion across the countries. Higher social non-cohesion is found among the economically poor older adults in Mexico, Russia, India, and China. In contrast, it is just opposite in the case of older adults in South Africa. Governments should develop policies to foster a society with a high level of social inclusion, social capital, and social diversity, to achieve further advancement in social cohesion. [ABSTRACT FROM AUTHOR]

Summary: Arrhythmia, pneumonia, cardiac insufficiency, a high leukocyte count, and low albumin concentrations were associated with increased 30-day mortality in elderly hip fracture patients after surgery. It is important to improve short-term survival rates by optimizing the respiratory and cardiac function of geriatric patients before they undergo surgery. Introduction: This study aims to investigate the 30-day mortality and related risk factors for elderly patients following surgery for hip fractures. Methods: This retrospective study examined chart reviews for evaluating associations of gender, age, fracture site, biochemical indicators, pre-surgery comorbidities, number of pre-surgery comorbidities, time to surgery and anesthesia and surgery methods with postoperative 30-day mortality in elderly hip fracture surgery patients. Results: A total of 1,004 patients were included in the study and 43 (4.3%) patients died within 30 days after surgery. Univariate analysis showed that patients in the non-survival group had a higher mean age, higher leukocyte counts, lower hemoglobin and albumin levels, a higher proportion of arrhythmias, pneumoniae and cardiac insufficiency and number of presurgical comorbidities than the survival group (all P-values < 0.05). Multivariate logistic analysis further confirmed that arrhythmia (OR = 2.033, P = 0.038), pneumonia (OR = 2.246, P = 0.041), cardiac insufficiency (OR = 2.833, P = 0.029), high leukocyte count (OR = 1.139, P = 0.009), and low albumin (OR = 0.925, P = 0.041) were all significant risk factors for mortality 30 days after surgery. Conclusions: This study demonstrates that arrhythmia, pneumonia, cardiac insufficiency, a high leukocyte count, and low albumin concentrations were associated with increased 30-day mortality in elderly hip fracture patients after surgery. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyse the effects of demographic factors, clinical factors, and genetic polymorphisms of related gene loci on warfarin bleeding-related complications in the Han population. Methods: Retrospective medical record review. The study cases were patients treated at the Fujian Medical University Union Hospital from March 2016 to February 2020, and all received regular warfarin anticoagulation treatment for at least 3 months, and were provided the initial standard dose and stable dose of warfarin. Results: Data were collected from 451 qualifying patients (47% male, 53% female). The average age of patients was 53.8 ± 12.2 years, and the average body surface area was 1.6 ± 0.18 m2. There were nine major bleeding events and 141 minor bleeding events. In the univariate logistic analysis, the p-value of the four factors body weight, body surface area (BSA), amiodarone, and rs429358 was < 0.10. However, the final p-values for amiodarone and rs429358 were < 0.05 in the multifactorial logistic analysis. Conclusions: The ApoE (rs429358) gene polymorphism influences bleeding complications in Chinese Han patients treated with warfarin. The sample size of this study was relatively small; hence an international study with a larger sample size is needed in the future. [ABSTRACT FROM AUTHOR]

Background: Headache disorders are disabling, with major consequences for productivity, yet the literature is silent on the relationship between headache-attributed disability and lost productivity, often erroneously regarding the two as synonymous. We evaluated the relationship empirically, having earlier found that investment in structured headache services would be cost saving, not merely cost-effective, if reductions in headache-attributed disability led to > 20% pro rata recovery of lost productivity. Methods: We used individual participant data from Global Campaign population-based studies conducted in China, Ethiopia, India, Nepal, Pakistan and Russia, and from Eurolight in Lithuania, Luxembourg and Spain. We assessed relationships in migraine and probable medication-overuse headache (pMOH), the most disabling common headache disorders. Available symptom data included headache frequency, usual duration and usual intensity. We used frequency and duration to estimate proportion of time in ictal state (pTIS). Disability, in the sense used by the Global Burden of Disease study, was measured as the product of pTIS and disability weight for the ictal state. Impairment was measured as pTIS * intensity. Lost productivity was measured as lost days (absence or < 50% productivity) from paid work and corresponding losses from household work over the preceding 3 months. We used Spearman correlation and linear regression analyses. Results: For migraine, in a linear model, we found positive associations with lost paid worktime, significant (p < 0.05) in many countries and highly significant (p < 0.001) in some despite low values of R2 (0–0.16) due to high variance. With lost household worktime and total lost productivity (paid + household), associations were highly significant in almost all countries, although still with low R2 (0.04–0.22). Applying the regression equations for each country to the population mean migraine-attributed disability, we found pro rata recoveries of lost productivity in the range 16–56% (> 20% in all countries but Pakistan). Analysing impairment rather than disability increased variability. For pMOH, with smaller numbers, associations were generally weaker, occasionally negative and mostly not significant. Conclusion: Relief of disability through effective treatment of migraine is expected, in most countries, to recover > 20% pro rata of lost productivity, above the threshold for investment in structured headache services to be cost saving. [ABSTRACT FROM AUTHOR]

Low anterior resection syndrome (LARS) comprises a collection of symptoms affecting patients' defecation after restorative surgery for rectal cancer. The aim of this work was to study the incidence and risk factors for LARS in China. Rectal cancer patients undergoing total mesorectal excision and colorectal anastomosis between May 2012 and January 2015 were identified from a single center. The patients completed the LARS score questionnaire through telephone. The clinical and pathological factors that may influence the occurrence of LARS were analyzed using univariate and multivariate logistic regression analysis. The influence of postoperative recovery time and pelvic dimensions on the occurrence of LARS was also analyzed. This study included 337 patients, at an average age of 61.03 SD11.32. The mean LARS score of the patients was 14.08 (range 0–41). A total of 126 patients (37.4%) developed LARS after surgery, including 63 (18.7%) severe cases. Compared with the scores within the initial 6 postoperative months, the LARS scores of the patients in 6~18 months after the surgery showed significant reductions (p < 0.01). In multivariate analysis, lower locations of anastomosis, pre-surgery radiotherapy, and shorter postoperative recovery time were significant predisposing factors for LARS. A subgroup analysis revealed that patients suffering from LARS over 18 months after surgery were found to have a significantly shorter interspinous distance than those without LARS (p < 0.05). LARS could improve over time after surgery. Lower anastomotic level and pre-surgery radiotherapy are risk factors for LARS. [ABSTRACT FROM AUTHOR]

Purpose: To identify the risk factors of calcineurin inhibitor (CNI)–associated new-onset diabetes mellitus (NODM) in chronic kidney disease (CKD) treatment. Methods: We retrospectively screened patients treated with CNIs in our hospital from January 2015 to December 2018. The inclusion criteria were as follows: a clear diagnosis of CKD and patients receiving CNI treatment. We compared patients with and without CNI-associated NODM. Results: Ninety-eight of the 336 assessed patients met the inclusion criteria, 15 (15.3% [15/98]) of whom developed CNI-associated NODM. Multiple logistic regression analysis revealed that baseline glycosylated hemoglobin (OR=4.141; 1.024–16.743; p=0.046) and CNI trough concentration (1 year) (OR=1.028; 1.009–1.047, p=0.004) were independent risk factors for NODM. In contrast, glucocorticoid type (prednisone) (OR=0.075; 0.011–0.526, p=0.009) was identified as an independent protective factor for NODM. Using a receiver operating characteristic curve, a cutoff cyclosporin A trough concentration of 102.1 ng/mL was identified as a predictive factor of NODM. Univariate logistic regression showed that the incidence of diabetes was significantly higher in patients with baseline glycosylated hemoglobin in non-diabetic range but higher than 5.65% (10.2% vs. 29.2%, p=0.038). One NODM patient (6.7% [1/15]) recovered at 12.7 months after the onset of diabetes mellitus. Conclusions: We recommend that more attention be paid to patients with baseline glycosylated hemoglobin in non-diabetic range but higher than 5.65% during CKD treatment with CNIs. High trough concentrations of cyclosporin A, particularly those >102.1 ng/mL, contribute to NODM. CNI-associated NODM may be reversible in the treatment of CKD. [ABSTRACT FROM AUTHOR]

To investigate the influence of the home environment, defined as family socioeconomic status (SES) (parent education level, household income), student resource-mediated SES (access to nutritional resources and cognitively stimulating experiences), reading ability, and difficulty with homework on quality of life in children and adolescents residing in urban and suburban areas in Hangzhou City, Zhejiang Province, China. This study included 3200 Grade 3–6 students from 8 elementary schools in Hangzhou City. Assessments included questionnaires that evaluated student quality of life, family SES, resource-mediated SES (dietary behavior and the home literacy environment), reading ability, and difficulty with homework. The effects of the home environment on student quality of life were analyzed by univariate analysis, multiple linear regression analysis, and structural equation modeling. Overall, 80.6% of students had a medium or better quality of life. Young age (Grade 3 or 4), female sex, household income of 10000–15000 RMB, high breakfast consumption, daily intake of fruit, a balanced diet, and good reading habits were positively correlated with student quality of life (P < 0.05), while overuse of electronic devices was negatively correlated with quality of life (P < 0.05). Dietary behaviors, home literacy environment, and student reading ability and difficulty with homework directly affected quality of life. Family SES indirectly affected student quality of life. Children and adolescents in China should have access to good nutrition and cognitively stimulating experiences to enhance their well-being and provide them with social and academic advantages. Highlights: The influence of the home environment on quality of life in students in China was explored with structural equation modeling. Student quality of life was directly affected by diet, the literacy environment, reading ability and difficulty with homework. Student quality of life was indirectly affected by family socioeconomic status. These findings will inform the development of programs that promote improved quality of life in Chinese children. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) bring about a range of psychological distress and symptom deterioration to headache patients especially to some migraineurs. Compared to migraineurs or normal control, medication overuse headache (MOH) patients are more likely to experience a worse psychological distress and poorer outcome in non-COVID-19 time. However, in COVID-19 pandemic, whether MOH patients would have greater physical and mental symptom deterioration or worse relief of headache symptoms and medications overuse remained unclear. We aim to investigate the impact of COVID-19 on MOH patients to guide for a better management in this study. Methods: We enrolled MOH patients who were diagnosed and treated at headache clinic of West China Hospital. Information of the pre-pandemic 3 months period and COVID-19 pandemic period was collected. Univariate and multivariate logistic regression were performed to identify independent factors associated with changes in headache symptoms and drug withdrawal. Results: Seventy-eight MOH patients were enrolled into the study ultimately. In comparison to pre-pandemic period, fewer MOH patients reported decreased headache days, intensity and days with acute medications per month during the pandemic. Available access to regular prophylactic medications was significantly associated with a reduction of at least 50% in headache days and decrease in headache intensity per month with respective odds ratios of 39.19 (95% CI 3.75–409.15, P = 0.002) and 10.13 (95% CI 2.33–44.12, P = 0.002). Following abrupt withdrawal and high educational level were both significant factors in decreasing headache intensity. Male sex was significantly associated with decrease in days with acute medication per month during the pandemic (odds ratios 4.78, 95%CI 1.44–15.87, P = 0.011). Conclusions: Our findings reflect that MOH patients experienced a worse relief of headache symptoms and drug withdrawal during the pandemic. Available access to regular prophylactic medications was the significant independent factor for improvement of headache symptoms. Male sex was significantly associated with decreased days with acute medications per month. [ABSTRACT FROM AUTHOR]

Recent studies have shown that the temporary storage and manipulation of depth information (working memory for depth; WMd) is largely different from that of visual information in a 2D context (visual working memory; VWM). Although there has been abundant evidence on VWM showing that cueing a memory item during retention could bias attention to its internal representation and thus improves its memory performance (a retro-cue effect), it is unknown whether such an effect differs for WMd that is nested in a 3D context compared with that in a conventional 2D context. Here, we used a change detection task to investigate the effect of attentional selection on WMd by testing several types of retro-cue. The memory array consisted of items positioned at various stereoscopic depth planes, and a cue was presented during retention. Participants needed to make judgments on whether the depth position of target (one memory item) had changed. Our study showed reliable valid retro-cue benefits but no invalid retro-cue cost, indicating that the relational information may be registered in WMd to prevent a strategical removal of the unattended item. There was also a slight improvement in memory performance for cueing depth order compared with that for cueing other feature dimensions or 2D locations. The attentional effect on memory representation in a 3D context is different from that in a 2D context, and the divergence may suggest the distinctive nature of working memory for depth. [ABSTRACT FROM AUTHOR]

Purpose: Comprehensive understanding glioma metabolic characters is of great help for patient management. We aimed to compare amide proton transfer imaging (APTw) and magnetization transfer imaging (MT) in predicting glioma malignancy and reflecting tumor proliferation. Methods: Thirty low-grade gliomas (LGGs) and 39 high-grade gliomas (HGGs) were prospectively included, of which 58 samples Ki-67 levels were quantified. Anatomical MRI, APTw, and MT were scanned, and magnetization transfer ratio (MTR) and asymmetric magnetic transfer ratio at 3.5 ppm (MTRasym(3.5ppm)) were calculated. ROIs were semi-automatically drawn with ImageJ, from which histogram features, including 5th, 25th, 50th, mean, 70th, 90th, and 95th percentiles were extracted. The independent t test was used to test differences in LGGs and HGGs, and correlations between histogram features and tumor grades, Ki-67 were revealed by Spearman's rank or Pearson's correlation analysis. Results: The maximum correlation coefficient (R) values of APTw were 0.526 (p < 0.001) with tumor grades and 0.397 (p < 0.001) with Ki-67 at 90th percentiles, while only 5th and 25th percentiles of MT significantly correlated with tumor grades. Moreover, APTw features were significantly different in LGGs and HGGs, except 5th percentile. The most significantly different feature was 95th percentile, providing the excellent AUC of 0.808. However, the best feature in MTR was 5th percentiles with AUC of 0.703. Combing 5th and 95th of APTw achieved highest AUC Of 0.837. Conclusions: Both APTw and MT provide quantitative information for tumor metabolite imaging. However, APTw supplys more specific information in reflecting glioma biological behaviors than MT, and well differentiates glioma malignancy. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "Spatiotemporal differences in and influencing effects of per-capita carbon emissions in China based on population-related factors" published in Scientific Reports. The correction addresses the omission of the Funding section in the original version of the article. The corrected Funding section acknowledges support from various sources, including the Scientific Activities of Selected Returned Overseas Professionals in Shanxi Province, the National Statistical Science Research Project of China, the Humanities and Social Sciences Foundation of Ministry of Education, China, and the Shanxi Province Youth Talent Support Program. The original article has been corrected. [Extracted from the article]

Purpose: Silent new ischemic cerebral lesions (sNICL) detected by diffusion-weighted imaging (DWI) are common after carotid artery stenting (CAS). As part of the Revascularization of Extracranial Carotid Artery Stenosis (RECAS) study, this work aimed to determine predictors of sNICL detected by DWI following CAS. Methods: A total of 694 patients eligible for the RECAS study treated in Xuanwu Hospital, Capital Medical University, with complete imaging data were included in this retrospective study. The patients were asymptomatic after CAS, and those with stroke, transient ischemic attack (TIA), or death were excluded. The RECAS protocol specified that DWI was completed 1–7 days before the procedure and within 3 days after CAS. Several parameters were assessed for associations with sNICL occurrence after CAS in univariate analysis. Finally, multivariate analysis was performed to determine risk factors for sNICL. Results: The rate of post-procedural sNICL in CAS was 51.3% (356/694 patients with sNICL). All patients underwent stenting with embolic protection devices. Univariate analysis showed that diabetes mellitus (P = 0.008), ipsilateral calcified plaques (P = 0.036), ipsilateral ulcerated plaques (P = 0.026), pre-dilatation (P = 0.003), and open-cell stent use (P < 0.001) were significantly associated with sNICL occurrence in CAS. Multivariate analysis revealed that diabetes mellitus (P = 0.006), ipsilateral calcified plaques (P = 0.024), ipsilateral ulcerated plaques (P = 0.021), and open-cell stent use (P < 0.001) were independent risk factors for sNICL. Conclusions: Patients with diabetes, calcified or ulcerated plaques who undergo CAS with open-cell stent application, are at high risk of sNICL. Large-scale prospective randomized controlled trials are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Psychological distress is highly prevalent among migraineurs during public health emergencies. The coronavirus disease 2019 (nCOV-2019) has created mass panic in China due to its highly contagious by contact and aerosols and lack of effective treatment. However, the emotion status of migraineurs stayed unclear during the nCOV-2019 outbreak. Objective: To understand psychological distress of migraineurs by comparing with common population and identify potential high-risk factors of severe psychological distress among migraine patients. Method: We enrolled the migraineurs treated at the department of Neurology of West China Hospital and healthy controls with age- and sex-matched to migraineurs. Data on clinicodemographics and psychological distress in the month of February 2020 (during in the nCOV-2019 outbreak in China) were collected. We used the Kessler 6-item (K-6) scale to assess psychological distress. Potential risk factors of severe psychological distress were identified using univariate and multivariate logistic regression. Results: The 144 migraineurs and 150 controls were included in the study. Migraineurs showed significantly higher K-6 scores than controls (P < 0.001). Migraine attack frequency in previous 30 days and time spent paying attention to outbreak showed significant in multivariate logistic regression with respective odds ratios of 2.225 (95%CI 1.361–3.628, P = 0.001) and 1.589 (95% 1.117–2.26, P = 0.01). Conclusion: During public health outbreaks, healthcare professionals should focus not only on controlling and reducing migraine attack but also on mental health of migraineurs, especially those with high frequency migraine attack. [ABSTRACT FROM AUTHOR]

Objectives: To describe the prevalence of overweight and obesity among children under 5 years old, assess the indicators of breastfeeding practices, and explore the associations between breastfeeding practices and early childhood overweight/obesity. Methods: The survey was conducted in 20 counties in central and western China in 2016. All children under 5 years old were physically measured for anthropometric data and their breastfeeding practices were obtained through a face-to-face questionnaire interview. We performed logistic regressions to assess the associations of different breastfeeding practices with overweight/obesity. Results: The prevalence of overweight and obesity among children under 5 years old were 8.7% and 2.6%, respectively. Overall, 93.6% of children were breastfed, while only 20.7% had exclusive breastfeeding under 6 months of age and about half of the children under 5 years old were weaned at 12 months. Compared with children with a duration of breastfeeding ≥ 12 months, children who have been breastfed for < 6 months were significantly associated with a 97% increased risk of overweight/obesity (OR 1.97, 95% CI 1.34–2.88, P = 0.001). Conclusions for Practice: The present study showed that overweight and obesity among children under 5 years old in central and western China remained an important childhood health concern. The rates of most indicators of breastfeeding practices were low, which needed more public attention. Moreover, we found that a shorter duration of breastfeeding was associated with an increased risk of overweight/obesity among children in central and western China. [ABSTRACT FROM AUTHOR]

Background: Microtubule-associated protein 1 light chain 3 (LC3), an autophagic gene, has been reported as a vital marker for many diseases and cancers. However, the role of LC3 in hepatocellular carcinoma (HCC) was not still investigated. Therefore, we conducted a meta-analysis to examine the association of LC3 with its clinicopathological and prognostic in HCC. Methods: We consulted the PubMed, Cochrane Library, Web of Science, EMBASE, China National Knowledge Infrastructure and Wan Fang databases for published studies on LC3 in HCC. Newcastle–Ottawa scale was used to screen the quality of the literature. The statistical analysis was calculated by STATA 14.2. Results: Of the 1329 titles identified, 10 articles involving 949 patients in HCC were included in this meta-analysis. The results of our study show that increased LC3 expression is related to size of tumor, but not to gender, age, number of tumor, liver cirrhosis, HBsAg, TNM stage, alpha fetoprotein, vascular invasion and histological grade. Positive LC3 expression was associated with overall survival by pooled hazard ratio. Conclusions: This meta-analysis indicated that positive LC3 expression was related to size of tumor, and could predict prognosis in human hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]

The upper reaches of Minjiang (Min) River were selected to research the relationship between debris flow fan formation and topography. Combining the historical statistical data of settlement and debris flow events, there are 3 years (1994, 2004, and 2014) for which comparable data are available. With the support of remote sensing (RS) and geographic information system (GIS) technology, the distribution characteristics and evolution of valley settlements and debris flow fans in terrain conditions with varying elevation, slope, and slope aspect are analyzed. The coupled relationship between valley settlement and debris flow accumulation fan evolution is analyzed by regression analysis. The results show that the distribution characteristics of valley settlements and debris flow fans in the upper reaches of Min River show high consistency and convergence in different topographic conditions, and they have a response relationship with each other. With elevation, both settlements and debris flow fans increase linearly with each other, and, over time, the rate of change of the distribution of valley fans with debris flow accumulation increases then decreases. In regard to slope, both parameters conform to two polynomial function models, that is, the river valley settlement increases first and then decreases with the increase of debris flow accumulation fans. For the slope aspect, the number of valley settlements increases with the increase of the change rate of debris flow fans density. The study will provide some assistance for the countermeasures on valley settlements to the evolution of debris flow fans in the upper reaches of Min River. [ABSTRACT FROM AUTHOR]

Historical temperature records are often partially biased by the urban heat island (UHI) effect. However, the exact magnitude of these biases is an ongoing, controversial scientific question, especially in regions like China where urbanization has greatly increased in recent decades. Previous studies have mainly used statistical information and selected static population targets, or urban areas in a particular year, to classify urban-rural stations and estimate the influence of urbanization on observed warming trends. However, there is a lack of consideration for the dynamic processes of urbanization. The Beijing-Tianjin-Hebei (BTH), Yangtze River Delta (YRD), and Pearl River Delta (PRD) are three major urban agglomerations in China which were selected to investigate the spatiotemporal heterogeneity of urban expansion effects on observed warming trends in this study. Based on remote sensing (RS) data, urban area expansion processes were taken into consideration and the relationship between urban expansion rates and warming trends was investigated using data from 975 meteorological stations throughout China. Although urban areas constitute less than 1% of land in China, more than 90% of the meteorological stations experienced urban land use change and the average urban expansion rate was 0.33%/a. There was also a significant positive relationship between observed warming trends and urban expansion rates. Background warming, without the influence of urbanization and extra warming induced by urbanization processes, was estimated using a linear regression model based on observed warming trends and urban expansion rates. On average, urbanization led to an additional annual warming of 0.034 ± 0.005 °C/10a. This urbanization warming effect was 0.050 ± 0.007 °C/10a for minimum temperatures and 0.008 ± 0.004 °C/10a for maximum temperatures. Moreover, it appeared that urbanization induced greater warming on the minimum temperature during the cold season and maximum temperature during the warm season. [ABSTRACT FROM AUTHOR]

Little is known about the dietary patterns of Chinese Americans. Understanding their dietary patterns can provide insights for addressing cardiovascular disease (CVD) risk among Chinese American immigrants. The objective of this study was to identify dietary patterns among Chinese American immigrants living in New York City (NYC) and to describe associations with demographic and CVD risk factors. A validated Food Frequency Questionnaire assessed usual dietary intake in Chinese American immigrants living in NYC as part of the Chinese American Cardiovascular Health Assessment (CHA CHA) in 2010–2011 (n = 1973, age range 21–89 years). Principal components analysis with varimax rotation retaining three factors with eigenvalues > 1.5 identified dietary patterns. Multivariable linear regression models tested associations between CVD risk factors and dietary pattern scores. In multivariable analyses, each unit of increase in the Sweets factor was associated with 0.76 ± 0.33 (mean ± SD) mg/dL higher HDL cholesterol and a 6.2 ± 2.7% increase in HOMA-IR. In contrast, each unit increase in the Fried Noodles factor was associated with a 0.27 ± 0.11 inch greater waist circumference, − 0.89 ± 0.40 mg/dL lower HDL cholesterol, and also a 6.9 ± 2.6% increase in HOMA-IR. Each unit increase in the Vegetables factor was associated with a − 1.40 ± 0.43 mmHg and − 0.95 ± 0.27 mm Hg decrease in systolic and diastolic blood pressure, respectively. Dietary patterns are significantly associated with CVD risk factors among Chinese American immigrants in NYC. Future work will inform how dietary patterns relate to level of acculturation in order to guide the development of dietary interventions to reduce CVD risk. [ABSTRACT FROM AUTHOR]

Mine subsidence is a regional geological hazard in China. To evaluate whether a power law describes the frequency–size statistics of mine subsidence, as for earthquakes and floods, we studied the frequency–size statistics of mine subsidence at three metal mines in China (Jinchuan Nickel Mine, Sanshandao Gold Mine, and Jingerquan Nickel Mine). Data sets for these mines consisted of 1088, 345, and 101 Global Positioning System (GPS) monitoring points, covering monitoring periods of 14.5, 4, and 3.5 years, respectively. Although these mines had different geological and hydrological settings, mining methods, and stress fields, their noncumulative frequency–size distributions for subsidence and uplift events can be described using power laws. The subsidence power-law exponent for these three mines ranged from 1.20 to 1.67, 1.49 to 1.94, and 1.01 to 1.17, with mean values of 1.46, 1.76, and 1.09, respectively. The power-law scaling for each mine was valid over the range from 2 to 455 mm, 2 to 566 mm, and 2 to 277 mm, respectively; scaling was positively correlated with the power-law exponent. The frequency–size statistics for subsidence events having different time scales showed an identical power-law dependence. The power-law behavior of uplift events was similar to subsidence events. This power-law behavior, its underlying mechanisms, factors influencing the power-law exponent, and the threshold between normal and extreme subsidence events are discussed herein. We conclude that the power-law distribution of mine subsidence events reflects the scale invariance of the subsidence system. This has important practical applications for subsidence hazard assessment and subsidence event prediction. [ABSTRACT FROM AUTHOR]

Anastomotic leakage (AL) is a serious complication of colorectal surgery as it greatly increases morbidity and mortality and has been associated with augmented local recurrence and diminished survival. Many risk factors have been identified to date, but sizable studies on AL after colorectal resection are lacking. This study aimed to identify the risk factors and postoperative complications of AL after colorectal surgery in the first affiliated hospital of Sun Yat-sen University. One thousand two hundred seventy-five patients who underwent colorectal cancer surgery between January 2010 and June 2013 were retrospectively studied. Twelve preoperative, 17 operative, and 11 postoperative variables were examined by the chi-square test or Fisher's exact test for univariate analysis and were then further examined by multivariate logistic regression analysis, among which one operative and three postoperative variables were examined in 426 rectal cancer surgeries. Additionally, eight postoperative complications and short-term prognostic variables were also examined by the chi-square test or a Fisher's exact test. AL was identified in 60/1158 (5.2%) total patients, 20/732 (2.7%), and 40/426 (9.4%) of whom had colonic and rectal cancer, respectively. Univariate analysis identified preoperative variables: sex (p = 0.012), preoperative carcinoembryonic antigen (CEA) level (p < 0.001), and hemoglobin level (p = 0.089); operative variables: surgical time (p = 0.009), anastomotic methods (p = 0.003), surgical staging (p = 0.016), and operative sites (p < 0.001); and postoperative pathologic variables: distance from tumor to distal incisional margin (p < 0.001). For rectal cancer, the variables included rectal procedures (p = 0.022), rectal segments (p = 0.010), distance from the tumor to the dentate line (p = 0.011) and total mesorectal excision (TME) (p = 0.046). All of these variables were included in the multivariate analysis, which identified the surgical time (p = 0.021), preoperative CEA level ≥ 41 μg/L (p < 0.001), and double-stapled anastomosis (p = 0.007); for rectal cancer, the middle or lower rectal segment (p = 0.008, 0.005, respectively) was included as an independent predictive factor for AL. Of the eight postoperative complications or short-term prognostic variables, postoperative hospital stay, abdominal infection, urologic infection, and incisional infection were considered significant. The rate of AL after rectal cancer is much higher than that of colon cancer. Surgical time, tumor biomarkers, anastomotic methods, and rectal segments may have the potential to increase the occurrence of AL. Additionally, AL may increase patients' hospital costs, length of stay and other relevant complications. [ABSTRACT FROM AUTHOR]

This study focused on the mechanism in which family capital—human capital, financial capital, and social capital—could be mobilized in the creation of the identity capital of young people during their transition to adulthood. A total of 1153 participants in Shanghai, China, (mean age = 20.90, SD = 1.44) completed a standardized questionnaire. The study found that young people in this sample generally had a moderate level of identity capital. A higher level of family social capital was associated with a higher level of identity capital, and was the strongest predictor among all the predictor variables. Family social capital also played a significant role in mediating the effects of family human capital and financial capital on the identity capital of young people. Family human capital predicted an increased identity capital, both directly and indirectly, through its positive effects on family social capital, whereas family financial capital only showed an indirect effect on identity capital. Unexpectedly, of the three forms of family capital, only social capital was positively associated with self-efficacy. This suggested that family human capital and financial capital can be translated into self-efficacy only through the mediation of family social capital. Ultimately, the mediation model was established. Implications of these present findings for theory, practice, and policy were discussed. [ABSTRACT FROM AUTHOR]

Objectives Many obesity-related chronic diseases originate from unhealthy childhood habits. The aim of this study was to describe 9-month-old infants’ physical activity levels and patterns and to examine the correlates. Understanding these factors is necessary for improving the effectiveness of physical activity intervention programs for infants. Methods In total, 143 infant-mother dyads from Macau, SAR China, participated in this study. Physical activity (PA) was assessed by using the Actigraph GT3X+ accelerometer and the demographic variables were collected by questionnaires. Results The most important findings were that: (1) infants had more screen time during weekdays (p = .044); (2) infants and mothers were least active at 8 a.m. (both weekdays and weekends) in the morning and most active at 7 p.m. (weekdays) and 8 p.m. (weekends) in the evening; (3) infants’ PA levels significantly correlated with their mothers’ PA intensities during the weekends (r = .192, p = .036), especially the mothers’ lower intensities in the mornings and evenings; (4) maternal BMI predicted the PA levels of the 9-month-old infants’ (R2 = .06, β = 29.188, p = .009). Conclusions for Practice Physical activity promotion programs for infants should be time-specific starting from early infancy. This study was one of the first to examine 9-month-old infants’ PA levels, patterns and correlates. The results may be helpful in improving the effectiveness of future healthy lifestyle intervention programs for infants in Macau and in the region in general. [ABSTRACT FROM AUTHOR]

Popularity has been examined extensively in recent years, particularly regarding its behavioral correlates. However, much less is known about the social cognitive processes related to popularity and the strategies to attain popularity. This study examined the longitudinal association between popularity goal and popularity status by focusing on the mediation effects of perceived contributing behaviors for popularity (i.e., popularity determinants) and actual behaviors in a sample of 5th and 6th graders (N = 382; 47% girls) in China. The results revealed that participants’ popularity goal indirectly related to aggression, academic performance, and prosocial behaviors through the mediation of the corresponding popularity determinant perceptions. Furthermore, participants’ popularity goal longitudinally predicted their later popularity status changes through the mediation of perceptions of prosocial behaviors as a popularity determinant and prosocial behaviors. The findings of this study were discussed in relationship to their cultural context. [ABSTRACT FROM AUTHOR]

Introduction Despite significant global improvements in maternal health, large disparities persist. In China, rural women and women who live in western regions experience lower rates of maternal healthcare utilization and higher rates of maternal mortality than women elsewhere in the country. This paper examines maternal health care-seeking among nomadic Tibetan women in rural western China, a particularly understudied group. Methods Secondary data analysis was conducted with survey data collected in 2014 in Qinghai Province, China. Participants (rural, nomadic, adult women) provided birth histories and information on care received during antenatal, intrapartum and/or postpartum period(s). Using bivariate and multivariable logistic regression models, these outcomes were explored in relation to maternal characteristics (e.g., educational attainment and parity), use of health insurance, and time. Results Approximately half of all women had ever used antenatal care, institutional delivery, and/or skilled birth attendance. The utilization of these services has increased over time, from 10% of births prior to the year 2000, to approximately 50% since 2000. Utilization increased by year (odds ratios ranging from 1.1 to 1.3) even after controlling for covariates. Women with health insurance coverage were significantly more likely to use these services than women without insurance, although less than 20% of women reported that insurance paid for any antenatal and/or childbirth care. Discussion Utilization of maternal care is improving among this population but rates remain low in comparison to other women in rural, western China. Further targeted interventions may be needed to reach and adequately address the maternal health needs of this unique population. [ABSTRACT FROM AUTHOR]

Background: Cluster headache (CH), a rare primary headache disorder, is currently thought to be a genetic susceptibility which play a role in CH susceptibility. A large numbers of genetic association studies have confirmed that the HCRTR2 (Hypocretin Receptor 2) SNP rs2653349, and the ADH4 (Alcohol Dehydrogenase 4) SNP rs1126671 and rs1800759 polymorphisms are linked to CH. In addition, the CLOCK (Circadian Locomotor Output Cycles Kaput) gene is becoming a research hotspot for CH due to encoding a transcription factor that serves as a basic driving force for circadian rhythm in humans. The purpose of this study was to evaluate the association between CH and the HCRTR2, ADH4 and CLOCK genes in a Chinese CH case-control sample. Methods: We genotyped polymorphisms of nine single nucleotide polymorphisms (SNPs) in the HCRTR2, ADH4 and CLOCK genes to perform an association study on a Chinese Han CH case-control sample (112 patients and 192 controls),using Sequenom MALDI-TOF mass spectrometry iPLEX platform. The frequencies and distributions of genotypes and haplotypes were statistically compared between the case and control groups to identify associations with CH. The effects of SNPs on CH were further investigated by multiple logistic regression. Results: The frequency of the HCRTR2 SNP rs3800539 GA genotype was significantly higher in cases than in controls (48.2% vs.37.0%). The GA genotypes was associated with a higher CH risk (OR = 1.483, 95% CI: 0.564-3.387, p = 0.038), however, after Bonferroni correction, the association lost statistical significance. Haplotype analysis of the HCRTR2 SNPs showed that among eight haplotypes, only H1-GTGGGG was linked to a reduced CH risk (44.7% vs. 53.1%, OR = 0.689, 95% CI =0.491~0.966, p = 0.030). No significant association of ADH4, CLOCK SNPs with CH was statistically detected in the present study. Conclusions: Association between HCRTR2, ADH4,CLOCK gene polymorphisms and CH was not significant in the present study, however, haplotype analysis indicated H1-GTGGGG was linked to a reduced CH risk. [ABSTRACT FROM AUTHOR]