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Background: According to the World Population Outlook (2019), people over 65, usually accompanied by various chronic diseases, will make up 16% of the population in 2050. Therefore, the health problems of middle-aged and elderly people are becoming the focus of current global attention. Some scholars have found that the health of middle-aged and elderly people is related to the childhood socio-economic environment. Methods: Using the China Health and Retirement Longitudinal Study (CHARLS) data, this paper innovatively constructed four measurement dimensions of health (namely, self-rated health, physical health, emotional health, and mental health). Moreover, logistic regression was used to explore the impact of childhood socio-economic environment (such as parent's education level, work experience, etc.) on the health status of middle-aged and elderly people. Results: Compared with a poor childhood social-economic environment, a good childhood socio-economic environment is more advantageous to the self-rated health of middle-aged and elderly people, especially a childhood socio-economic environment close to the medium level; the psychological health of middle-aged and elderly people who have experienced an adverse childhood socio-economic environment was better than those who did not; the childhood socio-economic environment has no apparent impact on the cognitive situation of middle-aged and elderly people. Conclusions: Some policy implications can be drawn. For example, the government should vigorously introduce policies to help migrant workers' children receive education in cities and provide special education guarantees for migrant workers' children. Societies and families should also pay more attention to the childhood socio-economic environment. [ABSTRACT FROM AUTHOR]

Aim: To analyze the level of knowledge, attitudes, practices, and risk perception regarding COVID-19 among Chinese residents 1.5 years after the pandemic. Subject and methods: A cross-sectional study was carried out with both online and paper questionnaires. We included a variety of covariates that were characteristic-related factors such as age, gender, education level, and retirement status, as well as those closely associated with risk perception regarding COVID-19. Results: Participants (n = 3588), 53.49 ± 18.88 years old, from two provinces of China, of which 44.7% were male and 52.03% had a high school or greater level of education, answered the questions. More than 90% of participants had adequate background knowledge about COVID-19 and agreed or even strongly agreed with many attitude items related to the government's role in diagnosis, treatment, and dealing with COVID-19 infections. About three fifths of the participants reported fear of contracting COVID-19, but only a minority (18.63%) felt they were more susceptible than others. Respondents aged 45 years or younger were more likely to fear contracting the virus than those older than 45 years (adjusted OR = 1.464, 95% CI 1.196 to 1.794, P = 0.0002). High education level (adjusted OR = 1.503, 95% CI 1.187 to 1.904, P = 0.0007) and non-retired status (adjusted OR = 1.679, 95% CI 1.354 to 2.083, P < 0.0001) were associated with a higher perception of susceptibility to infection than others. Moreover, respondents who were not retired had a significantly reduced practice score (adjusted OR = 1.554, 95% CI 1.261 to 1.916, P < 0.0001). Age, retirement status, and education level were also associated with knowledge, attitude, and practice level. Conclusion: Our findings suggest that the public generally has trust in the COVID-19 vaccine and the government with regard to COVID-19 in China. We recommend that high-risk groups of communities, such as elders and patients with chronic diseases, be given greater consideration in the outbreaks. Health education campaigns combined with workplace preventive intervention should be aimed at improving COVID-19 knowledge and beliefs in order to encourage more optimistic attitudes and to maintain safe practices. [ABSTRACT FROM AUTHOR]

Background: Limited data regarding the effects of school-based obesity prevention programs focusing on the changes in obesity-related knowledge and behaviors in China are available. The objective of this paper was to evaluate the effects of a school-based comprehensive lifestyle intervention among Chinese kids against obesity (CLICK-Obesity) in primary schools in Nanjing. Methods: We designed a cluster randomized controlled trial in eight randomly selected urban primary schools among 4th graders between May 2011 to April 2012 in Jianye, an urban district of Nanjing. Each school was randomly assigned to either the intervention or control group (four schools in each group). Mixed regression models and generalized estimating equations (GEE) were used to adjust for individual-level covariates under cluster randomization. Results: In this study, 1178 students (96.2%; 665 boys and 513 girls, 544 in control and 634 in intervention) participated in the baseline survey with mean age 10.2 ± 0.5 years. At the end of one-year intervention, 1125 students (91.8%; 628 boys and 497 girls, 513 in control and 612 in intervention) were reassessed. Notably, we found that the intervention group improved the knowledge and awareness of obesity-related risk factors, presented a lower increase of consumption of red/white meat (with a mean difference of −180.9 g/week, 95% CI: −350.6 to −11.2, p = 0.040), a larger increase in the time spent playing ball (with a mean difference of 24.2 min/week, 95% CI: −5.3 to 53.7, p = 0.090), and a significant reduction in screen time (with a mean difference of −71.0 min/week, 95% CI: −125.3 to −16.6, p = 0.020) compared to the control group after cluster (school) adjustment. Conclusion: The school-based integrated intervention was successful to modify unhealthy lifestyle behaviors and had a potential effect on childhood obesity prevention in urban China. However, the long-term effects and cost-effectiveness need to be evaluated in through further study. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that arteriosclerosis and sarcopenia (decreased muscle mass) share some of their many causes. However, after controlling for confounding factors, it is unclear whether the presence of arteriosclerosis correlates with sarcopenia. Objectives: The aim of this paper is to explore whether sarcopenia is associated with arteriosclerosis. Design: A multicenter cross-sectional community-based study. Materials and methods: A total of 2511 elderly subjects from six Chinese community health service centers in Anhui province were surveyed through an e-health promotion system to collect basic data and measurements of brachial-ankle pulse wave (baPWV), body composition, and handgrip strength (HGS). Pearson's correlation and binary logistic regression analyses were performed to identify associations between sarcopenia and high baPWV. Results: The prevalence rates of sarcopenia were 12.9% in men and 15.3% in women according to the 2019 standard of Asian Working Group for Sarcopenia. Among subjects with high baPWV, the proportion of sarcopenia was higher compared to those with normal baPWV (men: 17.7% vs. 3.7%; women: 20.4% vs. 4.9%, both p<0.001). Binary logistic regression analysis revealed that sarcopenia was associated with high baPWV (p<0.0001, odds ratio=1.619) after adjusting for confounding factors. HGS slightly and negatively correlated with baPWV (−0.19 in men and −0.18 in women). Conclusions: The intertwined pathophysiological mechanisms shared by arteriosclerosis and sarcopenia are potential targets for future interventions to reduce morbimortality in subjects with both disorders. Upcoming prospective studies and clinical trials are expected to advance these findings. [ABSTRACT FROM AUTHOR]

Background: Numerous single nutrients have been suggested to be linked with leukocyte telomere length (LTL). However, data on nutrient patterns (NPs), particularly in Chinese population, are scarce. This study aimed to examine the relationship between nutrient-based dietary patterns and LTL, and the potential role of metabolic factors. Methods: Dietary data was obtained via 24-hour food recalls, and principal component analysis (PCA) was used to identify NPs. LTL was assessed using a real-time PCR assay. Multiple linear regression was conducted to determine the association between NPs and LTL. The potential role of metabolism among them was analyzed using mediation models. Results: A total of 779 individuals from northern China were included in this cross-sectional analysis. Five main nutrient patterns were identified. Adjusted linear regression showed that the "high sodium" pattern was inversely associated with LTL (B=-0.481(-0.549, -0.413), P < 0.05). The "high vitamin E-fat" pattern exhibited a positive correlation (B = 0.099(0.029, 0.170), P < 0.05), whereas the "high vitamin A-vitamin B2" pattern was negatively correlated with LTL (B=-0.120(-0.183, -0.057), P < 0.05), respectively. No significant associations were observed for the remaining nutrient patterns. The mediation model demonstrated that diastolic blood pressure and waist circumference could individually and collectively mediate the negative impact of the "high sodium" pattern on LTL (BDBP=-0.0173(-0.0333, -0.0041), BWC=-0.0075(-0.0186, -0.0004), Bjoint=-0.0033 (-0.0072, -0.0006), all P < 0.05). Moreover, glycosylated hemoglobin and non-high-density lipoprotein cholesterol mediate the relationship between the "high vitamin E-fat" pattern and LTL (BHbA1c=0.0170(0.0010,0.0347), Bnon-HDL-C= 0.0335 (0.0067, 0.0626), all P < 0.05), respectively. Conclusions: The "high sodium" and "high vitamin E-fat" nutrient patterns demonstrated negative and positive associations with LTL and metabolic indicators may play complex mediating roles in these relationships. [ABSTRACT FROM AUTHOR]

Background: Many individuals consider nocturia a significant nuisance, leading to a reduced health-related quality of life (HRQOL). However, there has been a lack of psychometrically sound patient-reported outcome measures to assess the impact of nocturia on patients in Chinese contexts. This study aimed to translate, culturally adapt, and validate the International Consultation on Incontinence Questionnaire Nocturia Quality of Life Module (ICIQ-NQOL) for use among primary care patients in Hong Kong, China. Additionally, it sought to investigate the mechanisms that link nocturia and sleep quality with HRQOL by employing moderated mediation analysis. Methods: The traditional Chinese version of the ICIQ-NQOL was developed through iterative translations, cognitive debriefing interviews, and panel reviews. The psychometric evaluation included assessments of factor structure, convergent validity, concurrent validity, known-group validity, internal consistency, test-retest reliability and responsiveness. Study instruments included the ICIQ-NQOL, International Prostate Symptom Score (IPSS), Pittsburgh Sleep Quality Index (PSQI), and a modified Incontinence Impact Questionnaire-Short Form (IIQ-7). Results: A total of 419 primary care patients were recruited from general outpatient clinics, among whom 228 experiencing an average of two or more nocturia episodes per night over the past four weeks. Confirmatory factor analysis supported the two-factor structure of the ICIQ-NQOL. Concurrent validity was confirmed by moderate correlations between the IIQ-7 total score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.43 to 0.49, all p < 0.001). The ICIQ-NQOL also had moderate correlations with the IPSS total symptom score (r ranging from 0.40 to 0.48, all p < 0.001). Convergent validity was supported by moderate correlations between the global PSQI score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.42 to 0.52, all p < 0.001). Known-group comparisons showed that the ICIQ-NQOL could differentiate between patients with and without nocturia in terms of sleep/energy domain score (p < 0.001), bother/concern domain score (p < 0.001), and total score (p < 0.001), each demonstrating a moderate Cohen's d effect size. Item-total correlations corrected for overlap exceeded 0.4, and Cronbach's alpha coefficients were greater than 0.7. Test-retest reliability was confirmed with intraclass correlation coefficients exceeding 0.7 among patients reporting no change in their nocturia symptoms at a 2-week follow-up. Regarding responsiveness, the Cohen's d effect sizes for differences in domain and total scores between the baseline and 2-week follow-up assessments were greater than 0.3 among patients showing improvement in nocturia. Our moderated mediation analysis indicated that sleep quality significantly moderated the impact of nocturia on HRQOL, with a notably stronger indirect effect among females compared to males. Conclusions: The ICIQ-NQOL is a reliable and valid instrument for assessing the HRQOL in primary care patients suffering from nocturia. The findings advocate for gender-specific approaches in the management and treatment of nocturia to optimize HRQOL. [ABSTRACT FROM AUTHOR]

Traditional static neural networks often fail to describe dynamic flood processes, while recurrent neural networks can reflect this dynamic feature of flooding. In this paper, a real-time framework for probabilistic flood forecasting using an Elman neural network is presented. Based on this framework, flood forecasting models with different lead times are developed and trained by a real-time recurrent learning algorithm for forecasting the inflow of the Xianghongdian reservoir of the Huai River in East China. The performances of these models are evaluated. The forecasting model having a 3 h lead time meets the precision requirements and is chosen as the deterministic flood forecasting model. Compared with the multilayer perceptron having a 3 h lead time, the relative error of flood volume is 5.28% less, and the coefficient of efficiency is 0.105 greater. We further analyze the error characteristics of the selected model and derive the discharge probability density function based on the heterogeneity of error distributions. The forecasted discharge intervals with different confidence levels, the expected values, and the median values are obtained. The results show that the average relative errors of flood volume and peak discharge obtained by the median value forecasting are −1.66% and 5.69% respectively, and the coefficient of efficiency is 0.784. The performance of the median value forecasting was slightly better than that of the deterministic forecasting, and considerably better than that of the expected value forecasting. This study demonstrates that the proposed model has high practicability and can provide decision support for flood control. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies regarding the association between carrot intake and prostate cancer risk have reported inconsistent results. We conducted a meta-analysis to summarize evidence on this association and to quantify the potential dose-response relationship. Method: A systematic literature search of papers published in August 2013 was conducted using PubMed, EMBASE, Scopus, Web of Science, the Cochrane register, and the Chinese National Knowledge Infrastructure databases, and the references of the retrieved articles were screened. The summary risk estimates with 95 % confidence intervals (CIs) for the highest versus the lowest intake of carrots were calculated. A dose-response meta-analysis was also conducted for the studies reporting categorical risk estimates for a series of exposure levels. Results: We found a significantly decreased risk of prostate cancer associated with the intake of carrots (odds ratio 0.82, 95 % CI 0.70-0.97). In addition, the dose-response meta-analysis indicated that for each serving per week, or 10 g per day increment of carrot intake, the risk estimate of prostate cancer was 0.95 (0.90-0.99) or 0.96 (0.94-0.99). There was no evidence of significant publication bias based on Begg's funnel plot ( P = 1.000) or Egger's test ( P = 0.804). Conclusion: Carrot intake might be inversely associated with prostate cancer risk. Because of the limited number of cohort studies and substantial heterogeneity observed between studies in this meta-analysis, further well-designed prospective studies are warranted to confirm the findings from our study. [ABSTRACT FROM AUTHOR]

Background: Health literacy is one of the important determinants of healthy aging, yet few studies have focused on the association between health literacy and falls. Aims: This study aims to explore the relationship between health literacy and falls, with a focus on sex differences among older people in China. Methods: This cross-sectional study enrolled 2,144 older people aged ≥ 60 years from Shandong Province, China in 2021. We used general health literacy screening scale to assess health literacy, and collected the incidence of falls in the past year. Logistic regression models were employed to analyze the relationship between health literacy and falls. We investigated the sex differences by subgroup analyses. Results: The prevalence of adequate health literacy and falls was 21.7% (95% CI: 20.0–23.5%) and 25.4% (95% CI: 23.6–27.3%), respectively. In a fully-adjusted model, adequate health literacy was associated with a lower prevalence of falls in older adults (OR = 0.71, 95%CI: 0.52–0.96). Subgroup analysis revealed sex differences in this relationship (Pfor interaction <0.05). Specifically, the female group showed no significant relationship between health literacy and falls (OR = 0.92, 95% CI: 0.59–1.44); however, the male group demonstrated a robust and significant relationship (OR = 0.58, 95% CI: 0.37–0.90). Conclusions: Older people with adequate health literacy have lower prevalence of falls, which appears to differ by sex. This relationship was significant among men but not among women. These findings emphasize the need for policymakers and healthcare providers to consider sex differences when designing and implementing programs aimed at improving health literacy and preventing falls in the older population. Improving health literacy among older women could be a strategic component in bridging sex inequality in falls. [ABSTRACT FROM AUTHOR]

Background: High-dose cytarabine (HDAC) is commonly used for consolidation therapy in young acute myeloid leukemia (AML) patients, but the dosage of cytarabine is still controversial in the clinic due to its obvious post-chemotherapy adverse effects. The aim of this study was to contrast the efficacy in different dose groups of cytarabine after consolidation therapy in Chinese AML patients. Methods: AML patients treated with cytarabine consolidation at Qilu Hospital, Shandong University from January 2010 to September 2022 were retrospectively analyzed, from which 346 AML patients with relatively complete follow-up data were selected for this study. We compared the patients' overall survival (OS) rate, relapse-free survival (RFS) rate, and hematologic adverse events in terms of their general characteristics, cytarabine consolidation therapy dose, consolidation course, 2022 European Leukemia Net (ELN) risk stratification, and transplantation. Results: In AML patients under 60 years of age, the 5-year RFS rate with high-dose cytarabine consolidation therapy was superior to that of small-dose cytarabine (P = 0.024), while the 5-year RFS rate was comparable in the high-dose and intermediate-dose groups, and there was no obvious difference among the three groups in the 5-year OS rate (P > 0.05). OS and RFS of those given more than 3 courses of cytarabine consolidation therapy were better than those in the 1–2 courses group (P = 0.060, P = 0.040). OS and RFS were better in patients with cumulative dose of cytarabine ≥ 36g than in patients with cumulative dose < 36g (P < 0.05), but cumulative dose ≥ 54g was comparable in OS and RFS with ≥ 36–< 54g group (P > 0.05). There was no significant difference in hematologic adverse effects among the three treatment groups. In the latest ELN risk stratification favorable-risk group, the cumulative dose of cytarabine ≥ 36g had a better 5-year RFS rate than the < 36g group (P = 0.038), and in the intermediate-risk group the 5-year OS rate and RFS rate were better in the ≥ 36g group than the < 36g group (P = 0.012, 0.025). In addition, the prognosis of transplanted patients was better than that of non-transplanted patients, whereas in non-transplanted patients, consolidation therapy with ≥ 36g cytarabine can effectively improve outcomes. Multivariate analysis indicated that age, fibrinogen (FIB) and the cumulative dose of cytarabine of ≥ 36–< 54g were predictors of OS, while age, white blood cell (WBC) and HDAC were predictors of RFS. Conclusion: The results of the study showed that consolidation therapy with cytarabine up to a cumulative dose of ≥ 36–< 54g in AML patients who did not undergo transplantation significantly improved patient prognosis. In the latest ELN risk stratification, cumulative doses of cytarabine ≥ 36g had a better prognosis in favorable and intermediate-risk patients. [ABSTRACT FROM AUTHOR]

Ensuring diagnostic performance of artificial intelligence (AI) before introduction into clinical practice is essential. Growing numbers of studies using AI for digital pathology have been reported over recent years. The aim of this work is to examine the diagnostic accuracy of AI in digital pathology images for any disease. This systematic review and meta-analysis included diagnostic accuracy studies using any type of AI applied to whole slide images (WSIs) for any disease. The reference standard was diagnosis by histopathological assessment and/or immunohistochemistry. Searches were conducted in PubMed, EMBASE and CENTRAL in June 2022. Risk of bias and concerns of applicability were assessed using the QUADAS-2 tool. Data extraction was conducted by two investigators and meta-analysis was performed using a bivariate random effects model, with additional subgroup analyses also performed. Of 2976 identified studies, 100 were included in the review and 48 in the meta-analysis. Studies were from a range of countries, including over 152,000 whole slide images (WSIs), representing many diseases. These studies reported a mean sensitivity of 96.3% (CI 94.1–97.7) and mean specificity of 93.3% (CI 90.5–95.4). There was heterogeneity in study design and 99% of studies identified for inclusion had at least one area at high or unclear risk of bias or applicability concerns. Details on selection of cases, division of model development and validation data and raw performance data were frequently ambiguous or missing. AI is reported as having high diagnostic accuracy in the reported areas but requires more rigorous evaluation of its performance. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to identify and assess evidence related to the efficacy of mind-body interventions on irritable bowel syndrome (IBS) in the Chinese population. Method: Drawn from Chinese databases, nine RCTs and three Q-E studies were included in the systematic review. The methodological quality of RCTs was evaluated based on the following criteria: adequate sequence generation, allocation concealment, blinding, completeness of outcome data, selective reporting, and other potential biases. For continuous variables, the effect size (ES) was determined by calculating the standardized mean difference between groups. For dichotomous variables, the ES was determined by calculating the risk ratio (RR) between groups. Given the heterogeneity between the trials and the small number of studies included, both random effects and fixed effects models were used. The inverse variance method was used for pooling. Statistical analyses were performed using Review Manager version 5.0. Results: The total number of papers identified was 710: 462 from English language databases and 248 from Chinese language databases. Twelve studies met our eligibility criteria. Among the studies selected, three were Q-E studies the rest RCTs. Two studies described the randomization process. None of the studies reported allocation concealment nor blinding. Seven studies reported no dropouts. One of the studies mentioned the total amount of dropouts; though the reason for dropping out was not referenced. The other four studies did not clearly report dropouts. With the exception of three studies, there was inadequate information to determine biased reporting for the majority; the level of risk for bias in these studies is unclear. Finally, six meta-analyses were performed. One was conducted with four randomized controlled trials (RCTs) that used cure rate as outcome measures to evaluate gastrointestinal (GI) symptoms, which suggested that mind-body interventions were effective in improving GI symptoms (random effects model: RR = 1.08; 95 % CI 1.01 to 1.17; fixed effects model: RR = 1.07; 95 % CI 1.01 to 1.12). The remaining five were conducted in three RCTs, which suggested that mind-body interventions were effective in improving several aspects of quality of life, including interference with activity (random effects and fixed effects models: SMD = 0.64; 95 % CI 0.41 to 0.86), body image (random effects model: SMD = 0.36; 95 % CI 0.06 to 0.67; fixed effects model: SMD = 0.33; 95 % CI 0.11 to 0.55), health worry (random effects and fixed effects models: SMD = 0.67; 95 % CI 0.44 to 0.90), food avoidance (random effects and fixed effects models: SMD = 0.45; 95 % CI 0.23 to 0.68), and social reaction (random effects model: SMD = 0.79; 95 % CI 0.47 to 1.12; fixed effects model: SMD = 0.78; 95 % CI 0.55 to 1.01), as measured by Irritable Bowel Syndrome Quality of Life Questionnaire ( IBS-QOL). Conclusion: Mind-body interventions may have the potential to improve GI symptoms in Chinese patients with IBS. The improvement of GI symptoms was also accompanied with the improvement of various outcomes, including depression, anxiety, and quality of life, just to mention a few. However, the published studies generally had significant methodological limitations. Future clinical trials with rigorous research design are needed in this field. More studies focusing on the mind-body interventions originated in China, such as tai chi and qi gong should be encouraged. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore the relationships between single-nucleotide polymorphisms (SNPs) of crucial molecules in the cGAS-STING signalling pathway and the susceptibility to, induction chemotherapy response of, and prognosis of acute myeloid leukaemia (AML) in Chinese patients. Methods: Thirteen SNPs of crucial molecules in the cGAS-STING signalling pathway were genotyped in 262 AML patients using the Sequenom MassARRAY system. The associations of SNPs with susceptibility, and induction chemotherapy response were analysed using the chi-square test or Fisher's exact test and univariate binary logistic regression, the connection of SNPs with prognosis of AML was analysed using the log-rank test, and Kaplan–Meier curves were applied for survival estimation. Results: In our study, gene polymorphisms of cGAS-STING signalling pathway molecules could be vitally associated with AML. In the recessive model, the cGAS rs311678 gene polymorphism could be closely related to AML susceptibility (CC vs. TT + TC, odds ratio (OR) = 0.480, 95% confidence interval (CI) = 0.260–0.889, p = 0.020). Moreover, IKKA rs3808917 might be associated with the WBC count, cGAS rs311678 could be associated with the bone marrow (BM) blast percentage, and NF-κB rs1056890 under codominant and recessive models could be connected with the HGB level. Patients who were STING rs7380272 TT/CT carriers was likely to have higher insensitivity to induction chemotherapy than CC carriers (TT + CT vs. CC, OR = 2.917, 95% CI = 1.073–7.929, p = 0.036). Survival analysis indicated that the IKKB rs3747811 TT genotype might be associated with decreased overall survival (OS) (p < 0.05). Conclusions: SNPs of molecules in the cGAS-STING signalling pathway could be significantly associated with AML. The cGAS rs311678 gene polymorphism could be associated with AML susceptibility, the STING rs7380272 variant might be related to induction chemotherapy response, and IKKB rs3747811 tended to be associated with AML overall survival. Moreover, IKKA rs3808917 could be associated with the WBC count, cGAS rs311678 could be associated with the BM blast percentage, and NF-κB rs1056890 might be related to the HGB level. [ABSTRACT FROM AUTHOR]

Background: The effect of a self-regulatory intervention with its focus on planning sunscreen use is evaluated in comparison to a standard educational condition. Purpose: This paper studied whether planning mediates between the experimental conditions and the behavioral outcome. Further, it is examined who benefits more: already motivated or unmotivated individuals. Method: College students ( N = 253) were randomly assigned to two groups: a self-regulatory and a standard-care condition. Sunscreen use, intention to use sunscreen, and planning were assessed at two points in time, 1 month apart. Results: The self-regulatory intervention improved planning to use sunscreen but not the behavior directly. Planning emerged as the mediator between conditions and later sunscreen use, controlling for baseline behavior. Moreover, participants who were less motivated benefited more from the intervention. Conclusions: Although it is generally assumed that planning interventions are best designed for already motivated persons, the present findings suggest that less prepared individuals might have more to gain from a brief self-regulatory intervention. [ABSTRACT FROM AUTHOR]

Background: Atherosclerosis is a primary risk factor for cardiovascular disease, but its pathogenesis is unclear. Previous studies reported that the prospero homeobox 1 (PROX1) gene is associated with lipid disorders and insulin resistance. However, few studies have been concerned about the relationship between PROX1 gene and atherosclerosis in Chinese individuals. Material and methods: A total of 2177 individuals with data on body indicators, pulse wave velocity, and genotype were included in this study. We estimated the cardiometabolic index (CMI) of the participants and analyzed the association between the rs340974 single nucleotide polymorphism (SNP) and CMI as well as pulse wave velocity (PWV). The interaction effects between the rs340974 SNP and metabolic factors for the early atherosclerosis index were also analyzed. Results: The rs340874 SNP CC genotype exhibits increased metabolism factors, such as carotid femoral PWV, body mass index (BMI), and CMI, compared with those in other groups. The prevalence ratios of hypertension in different genotype groups were significantly different. However, after adjusting for some metabolic factors, the difference disappeared. The associations between the rs340874 SNP and CMI as well as carotid femoral PWV were confirmed by multiple linear regression. The interaction effect indicates that sex and BMI modified the relation of the rs340874 SNP and CMI or carotid femoral PWV, which are indexes of early atherosclerosis. Conclusions: The PROX1 gene rs340874 SNP CC genotype is associated with CMI and cfPWV, and sex and obesity can modify this relationship in Chinese populations. [ABSTRACT FROM AUTHOR]

Background: Migraine is a common disabling neurological disorder with severe physical and psychological damage, but there is a lack of convenient and effective non-invasive early prediction methods. This study aimed to develop a new series of non-invasive prediction models for migraine with external validation. Methods: A total of 188 and 94 subjects were included in the training and validation sets, respectively. A standardized professional questionnaire was used to collect the subjects' 9-item traditional Chinese medicine constitution (TCMC) scores, Pittsburgh Sleep Quality Index (PSQI) score, Zung's Self-rating Anxiety Scale and Self-rating Depression Scale scores. Logistic regression was used to analyze the risk predictors of migraine, and a series of prediction models for migraine were developed. Receiver operating characteristic (ROC) curve and calibration curve were used to assess the discrimination and calibration of the models. The predictive performance of the models were further validated using external datasets and subgroup analyses were conducted. Results: PSQI score and Qi-depression score were significantly and positively associated with the risk of migraine, with the area of the ROC curves (AUCs) predicting migraine of 0.83 (95% CI:0.77–0.89) and 0.76 (95% CI:0.68–0.84), respectively. Eight non-invasive predictive models for migraine containing one to eight variables were developed using logistic regression, with AUCs ranging from 0.83 (95% CI: 0.77–0.89) to 0.92 (95% CI: 0.89–0.96) for the training set and from 0.76 (95% CI: 0.66–0.85) to 0.83 (95% CI: 0.75–0.91) for the validation set. Subgroup analyses showed that the AUCs of the eight prediction models for predicting migraine in the training and validation sets of different gender and age subgroups ranged from 0.80 (95% CI: 0.63–0.97) to 0.95 (95% CI: 0.91–1.00) and 0.73 (95% CI: 0.64–0.84) to 0.93 (95% CI: 0.82–1.00), respectively. Conclusions: This study developed and validated a series of convenient and novel non-invasive prediction models for migraine, which have good predictive ability for migraine in Chinese adults of different genders and ages. It is of great significance for the early prevention, screening, and diagnosis of migraine. [ABSTRACT FROM AUTHOR]

Background: The relationship between preoperative frailty and pulmonary complications after cardiac surgery in elderly patients is unclear. This study was designed to evaluate the relationship between frailty and postoperative pulmonary complications (PPCs) in elderly patients undergoing cardiac surgery and to provide a basis for their prevention and treatment. Aims: This study aimed to investigate the predictive value of preoperative frailty on pulmonary complications after cardiac surgery in elderly patients. Methods: Frailty was assessed using the CAF. The diagnosis of PPCs was based on the criteria defined by Hulzebos et al., and patients were classified into a PPCs group and a non-PPCs group. Factors with clinical significance and P < 0.05 in univariate regression analysis were included in multivariate logistic regression analysis to determine the relationship between preoperative frailty and PPCs. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare the predictive effects of the CAF, EuroSCORE II, and ASA + age on the occurrence of PPCs. Results: A total of 205 patients were enrolled in this study, 31.7% of whom developed PPCs. Univariate logistic regression analysis showed that frailty, ASA grade, EuroSCORE II, hemoglobin concentration, FVC, time of operation, and postoperative AKI were associated with the development of PPCs. However, after adjustments for all possible confounding factors, multivariate logistic regression results showed that frailty, prolonged operation time, and postoperative AKI were risk factors for PPCs, and the risk of postoperative PPCs in frail patients was approximately 4.37 times that in nonfrail patients (OR = 4.37, 95%CI: 1.6–11.94, P < 0.05). The predictive efficacy of the traditional perioperative risk assessment tools EuroSCORE II and ASA + age was lower than that of CAF. Conclusions: Frailty before surgery, prolonged operation time, and postoperative AKI were independent risk factors for pulmonary complications after heart surgery in elderly individuals, and CAF was more effective than the traditional risk predictors EuroSCORE II and ASA + age. [ABSTRACT FROM AUTHOR]

Background: Jumping exercise is frequently regarded as an optimum strategy for increasing pubertal bone growth, but its role in promoting or preserving adult bone mineral density (BMD) is still undefined. Objectives: This meta-analysis aimed to evaluate the evidence for the influence of jumping exercise on BMD in premenopausal women and to define the effectiveness of high-impact exercise in improving or maintaining female bone health. Methods: We searched MEDLINE, PubMed, EMBASE, SPORTDiscus, Google Scholar and BIOSIS up to 1 September 2013 for jumping exercise influence on BMD in premenopausal women. The search terms used were 'jumping', 'skipping', 'brief exercise', 'high impact', 'bone density', 'BMD', 'femoral neck', 'lumbar spine', and 'trochanter', and the search was limited to females. Six papers met the search criteria. Results: Six studies on BMD in the femoral neck ( Q = 2.63, p = 0.854, I = 0.0 %), trochanter ( Q = 2.10, p = 0.10, I = 0.0 %) and lumbar spine ( Q = 1.17, p = 0.979, I = 0.0 %) were highly homogenous in determining skeletal responses to jumping exercise. Jumping exercise significantly increased BMD in the femoral neck {weighted mean difference (WMD) [fixed effect] = 0.017 g/cm, 95 % confidence interval (CI) 0.014-0.20, p < 0.001} and trochanter (WMD [fixed effect] = 0.021, 95 % CI 0.018-0.024, p < 0.001). However, the lumbar spine seemed to benefit less from such high-impact exercise ( p = 0.181). Visual inspection of the plots implicated some degree of asymmetry, indicating a slightly positive treatment effect at the femoral neck and trochanter sites. Conclusions: Based on meta-analysis of existing studies, the sensitivity of skeletal response to jumping exercise in premenopausal women is significant and site-specific, with significant benefit from high-impact exercise noted, especially at the hip. [ABSTRACT FROM AUTHOR]

Background: The prevalence of childhood obesity is increasing rapidly in China. However, research on its modifiable environmental determinants to inform preventive interventions is limited. Purpose: This paper reports a cross-sectional study that aimed to identify family and neighborhood environmental correlates of overweight and related health behavior among Chinese primary school-aged children in urban areas. Methods: Routinely collected height and weight data of third year students (8-10 years) from four primary schools in socioeconomically distinct districts of two southern cities of China was obtained. Using the WHO 2007 reference values, children were categorized into overweight/obese or non-overweight. Parents of the same children completed a questionnaire, comprising mainly validated questions, about family and perceived neighborhood environments, parental physical activity habits, and the child's dietary and physical activity patterns. Multiple logistic regression analysis was performed to examine the association between these environmental factors and childhood overweight or whether or not the child engages in at least 1 h daily moderate to vigorous physical activity. Multiple linear regression analysis was undertaken to examine the association between environmental factors and the frequency of consumption of unhealthy snacks, fruit, and vegetables in children. Results: Data on 497 children were available. Children who were mainly cared for by their grandparents were over twice as likely to be overweight/obese (adjusted OR 2.03; 95 % CI 1.19-3.47) and to have higher consumption of unhealthy snacks and sugar-added drinks (B = 2.13, 95 % CI 0.87-3.40), compared with children who were mainly cared for by their parents or other adult. Children who lived with at least two grandparents in the household were at higher risk for being overweight/obese than children who lived without any grandparent (adjusted OR 1.72; 95 % CI 1.00-2.94). No evidence was found for associations between perceived neighborhood environmental characteristics and child's weight status and obesogenic behaviors in this study. Conclusions: Children's family environment, particularly the living-in grandparents, should be targeted in future preventive interventions among China's southern urban populations. [ABSTRACT FROM AUTHOR]

Background: Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China. Purpose: This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students. Methods: Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables. Results: There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores. Conclusions: Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to explore the contribution of genotype-guided selection of P2Y12 inhibitors on prognosis in Chinese patients with acute coronary syndromes (ACS) or chronic coronary syndromes (CCS) undergoing percutaneous coronary intervention (PCI). Methods: Totally, 2063 patients were included. They were divided into empiric treatment group (n = 1025) and individualized treatment group (n = 1038) depending on whether taken CYP2C19 genetic testing. The incidences of clinical endpoint events were compared in two groups at 1-year follow-up. The effective endpoint events were major adverse cardiovascular events (MACEs), including all-cause mortality, in-stent restenosis, nonfatal myocardial infarction, nonfatal stroke and severe recurrent ischemia. Meanwhile, the safe endpoint was bleeding events defined by the Bleeding Academic Research Consortium (BARC) criteria. Results: Finally, 66.83% patients were diagnosed with ACS and 33.17% patients were diagnosed with CCS in empiric group. 68.11% patients were diagnosed with ACS and 31.89% patients were diagnosed with CCS in individualized group. At 1-year follow-up, individualized group showed lower MACEs rate than empiric group (19.61% vs. 10.69%, HR: 1.915; 95% CI: 1.534 to 2.392; P < 0.0001, log-rank test; adjusted HR: 1.983; 95% CI: 1.573 to 2.501; P = 0.000, cox proportional hazards regression models), while bleeding events were significantly less common in empiric group than in individualized group (7.32% vs. 10.40%, HR: 0.693; 95% CI: 0.519 to 0.926; P = 0.0132, log-rank test; adjusted HR: 0.695; 95% CI: 0.518 to 0.933; P = 0.016, cox proportional hazards regression models). It was mainly manifested in BARC class 1 bleeding, which did not warrant the interruption of antiplatelet therapy (ITA). Further, subgroup analyses illustrated that no significant difference existed in cumulative MACEs-free survival rate between all treatment arms of individualized group (P = 0.6579 by log-rank test), and CYP2C19 intermediate metabolizer (IM) genetype appeared to be significantly associated with bleeding events for patients treated with ticagrelor (clopidogrel vs. ticagrelor: 6.80% vs. 14.88%; adjusted HR:0.440; 95% CI: 0.246 to 0.787; adjusted P = 0.006). Conclusions: Genotype-guided selection of P2Y12 inhibitor made a very positive contribution on the prognosis in Chinese ACS/CCS patients undergoing PCI. Instead of intensifying antiplatelet strategies, conventional-dose clopidogrel could be recommended as P2Y12 inhibitor after weighing MACEs and bleeding events in CYP2C19 IM patients. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to predict the probability of postoperative pulmonary infection in elderly patients with hip fractures by developing and validating a precise model. Methods: The clinical data of 1008 elderly hip fracture patients undergoing surgical treatment in Shanghai Tenth Peoples' Hospital were retrospectively selected. A univariate analysis and multivariate regression were used to analyze the independent risk factors for postoperative pulmonary infection in elderly patients with hip fractures. A risk prediction model was established, and a nomogram was drawn. The area under the ROC curve and Hosmer‒Lemeshow test were used to evaluate the predictive effect of the model. Results: The multivariate regression analysis indicated that age > 73, time from fracture to surgery (d) > 4 days, smoking, ASA ≥ III level, COPD, hypoproteinemia, red cell distribution width > 14.8%, mechanical ventilation time > 180 min, and stay in the ICU were independent risk factors for postoperative pulmonary infection in elderly patients. The AUCs of the model were 0.891 and 0.881, 0.843, respectively, in the two verification groups. For the Hosmer‒Lemeshow test, the P values were 0.726 in the modeling group and 0.497 and 0.231 in the verification group (P > 0.05). Conclusion: Overall, this study uncovered different independent risk factors for postoperative pulmonary infection in patients with hip fractures. The nomogram can effectively predict the occurrence of postoperative pulmonary infection. [ABSTRACT FROM AUTHOR]

Background: Trauma patients are at high risk of Venous thromboembolism (VTE), but compared to well-established deep venous thrombosis (DVT), data specifically evaluating post-traumatic pulmonary embolism (PE) are scarce. The aim of this study is to assess whether PE represents a distinct clinical entity with injury pattern, risk factors, and prophylaxis strategy different from DVT, among severe poly-trauma patients. Patients and methods: We retrospectively enrolled patients admitted to our level I trauma center from January 2011 to December 2021 who were diagnosed with severe multiple traumatic injuries and identified thromboembolic events among them. We regarded four groups as None (without thromboembolic events), DVT only, PE only, and PE with DVT. Demographics, injury characteristics, clinical outcomes, and treatments were collected and analyzed in individual groups. Patients were also classified according to the occurring time of PE, and indicative symptoms and radiological findings were compared between early PE (≤ 3 days) and late PE (> 3 days). Logistic regression analyses were conducted to explore independent risk factors for different VTE patterns. Results: Among 3498 selected severe multiple traumatic patients, there were 398 episodes of DVT only, 19 of PE only, and 63 of PE with DVT. Injury variables associated with PE only included shock on admission and severe chest trauma. Severe pelvic fracture and mechanical ventilator days (MVD) ≥ 3 were the independent risk factors for PE with DVT. There were no significant differences in the indicative symptoms and location of pulmonary thrombi between the early and late PE groups. Obesity and severe lower extremity injury might have an impact on the incidence of early PE, while patients with a severe head injury and higher ISS are particularly at risk for developing late PE. Conclusion: Occurring early, lacking association with DVT, and possessing distinct risk factors warrant PE in severe poly-trauma patients special attention, especially for its prophylaxis strategy. [ABSTRACT FROM AUTHOR]

Background : Coronavirus disease 2019 (COVID-19) has impacted many people's meaning in life and health behaviors. This study aimed to verify the relationship among meaning in life (MIL), epidemic risk perception, health locus of control (HLC), and preventive health behaviors among older adults after the COVID-19 outbreak was declared a pandemic. Method: In this longitudinal study, 164 participants aged 55 years and above completed the following measures at time 1 (February 19, 2021) and one month later at time 2 (March 19, 2021): Meaning in Life in the Epidemic Questionnaire, Epidemic Risk Perception Questionnaire, Multidimensional Health Locus of Control Scale, and Health Behaviors Before and After the Epidemic Survey. Hayes' SPSS Process Macro was used to analyze the mediating effect of epidemic risk perception (model 4) and the moderating role of powerful others HLC in the mediation model (model 14). Results: The results showed that after controlling for gender, age, education level, and health behaviors at the baseline, risk perception had a significant mediating effect on the relationship between MIL and preventive health behaviors (β =.02, SE =.01, 95% CI [.00,.04]). In addition, powerful others HLC had a moderating effect on the second half of the mediating effect (β =.02, p =.02, 95% CI [.00,.03]). Specifically, compared to the older adults with low powerful others HLC, the risk perception of older adults with high powerful others HLC increased preventive health behaviors. Conclusion: Practitioners should adequately cultivate older adults' risk awareness and reinforce the importance of advice from doctors and professionals, thereby effectively enhancing the preventive health behaviors of older adults in China during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Backgrounds: Household solid fuel have been associated with changes of handgrip strength, and exposure to ambient air pollution might be one risk factor of sarcopenia. However, the prospective association between household solid fuel use and sarcopenia remains limited. Methods: A total of 11,924 participants (5,723 men (48%) and 6,201 women (52%) with the average age was 59.17 ± 9.57 years) from the China Health and Retirement Longitudinal Study 2011 were included in cross-sectional analyses. 7,507 participants at baseline were included in longitudinal analyses and were followed up in 2015. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Results: In cross-sectional analyses, the participants who used solid fuel for cooking and heating had higher prevalence of sarcopenia than those who used clean fuel. During the follow-up, 302 (4.02%) participants experienced sarcopenia. In the longitudinal analysis, after multivariable adjustment of age, sex and other risk factors, individuals who used solid fuel for cooking had an elevated risk of new-onset sarcopenia, with corresponding odds ratio of 1.32 (95% confidence interval, 1.03–1.71). Consistently, individuals reported solid fuels use for heating were associated with 20% (odds ratio=1.20, 95% confidence interval: 1.01–1.56) increased risk of sarcopenia. In addition, a self-reported switch from clean to solid fuel for cooking appeared to have an increased sarcopenia risk (odds ratio=1.20, 95% confidence interval: 1.02–1.43). Conclusion: Using household solid fuel for cooking and heating was associated with increased risk of sarcopenia prevalence and incidence. [ABSTRACT FROM AUTHOR]

Background: Although studies have identified a high prevalence of migraine among employees in the banking sector, the symptoms of migraine, related disability and occupational risk factors are not well understood. Aims: To determine migraine prevalence, symptoms and disability among bank employees in Guizhou province in China and to examine occupational risk factors associated with migraine positivity and symptoms. Methods: In a cross-sectional survey, two-stage probability sampling was used to select bank employees in Guizhou province, China. From May to October 2022, uniformly trained interviewers conducted face-to-face interviews using the HARDSHIP questionnaire. Logistic regression was used to examine factors associated with migraine positivity and symptoms. Results: Of 1,985 contactable eligible subjects, 1,929 (male 45.4%, female 54.6%) completed the survey. The one-year prevalence of migraine was 27.2% (95% CI 25.2–29.2%). Of migraine-positive individuals, 11.2% had a monthly frequency ≥ 15 days, 11.8% had an attack duration > 72 h, and 14.9% had severe pain intensity. The median of days lost from work, housework and social activities due to migraine during a three-month period was 4, 3 and 2 days, respectively, with more than half (52.8%) patients reporting Grade III or IV disability. In multivariable analyses, positions in data analysis (OR = 1.8 [95% CI 1.2–2.8], p < 0.01) and information technology (OR = 3.8 [95% CI 1.7–8.3], p < 0.01) were occupational risk factors for migraine positivity. It was also found that professional positions were predictive of migraine attacks ≥ 15 days per month, administrative positions were predictive of duration > 72 h and severe pain intensity of migraine attacks, and working in remote branches was predictive of duration > 72 h. Conclusions: Migraine is prevalent among employees in the banking sector in Guizhou province in China, with a large proportion of sufferers carrying a high burden of symptoms and disability. The practical implication of this study is that the risk factors identified here could be translated to the focus of workplace monitoring and interventions to manage and prevent migraine. [ABSTRACT FROM AUTHOR]

Purpose: Prenatal exposure to famine has been linked to increased diabetes risk in adulthood. However, one fundamental issue to be addressed is that the reported famine-diabetes relation may be confounded by the age differences between the exposed and non-exposed groups. We aimed to determine the association between prenatal exposure to the Chinese famine of 1959–1962 and risk of diabetes by applying age well-controlled strategies. Methods: Among 20,535 individuals born in 1955–1966 who participated in the China Health and Nutrition Survey from 1997 to 2015, we constructed age-matched exposed vs. non-exposed groups to investigate the role of prenatal exposure to the Chinese famine of 1959–1962 in relation to diabetes. We also built a hierarchical age-period-cohort (HAPC) model to specifically examine the relation of famine to diabetes risk independent of age. Results: Compared to the age-balanced men in the non-exposed group, the exposed men born in 1961 had a 154% increased risk of diabetes [odds ratio (OR) 2.54 (95% CI 1.07–6.03), P = 0.04). In the HAPC analysis, the predicted probabilities of diabetes peaked in the 1961-birth cohort of men [3.4% (95% CI 2.4%–5.0%)], as compared to the average probability of diabetes (reference) of 1.8% for men overall. Neither analytical strategy revealed any strong relation between famine exposure and diabetes risk in women. Conclusion: Among the pre-defined Chinese famine period of 1959–1962, early-life exposure to famine was associated with increased diabetes risk in men but not in women, and these relations were independent of age. [ABSTRACT FROM AUTHOR]

Purpose: Fruit intake is beneficial to several chronic diseases, but controversial in diabetes. We aimed to investigate prospectively the associations of whole fresh fruit intake with risk of incident type 2 diabetes (T2D) in subjects with different glucose regulation capacities. Methods: The present study included 79,922 non-diabetic participants aged ≥ 40 years from an ongoing nationwide prospective cohort in China. Baseline fruit intake information was collected by a validated food frequency questionnaire. Plasma HbA1c, fasting and 2 h post-loading glucose levels were measured at both baseline and follow-up examinations. Cox proportional hazards models were used to calculate hazard ratio (HR) and 95% confidence intervals (CI) for incident diabetes among participants with normal glucose tolerance (NGT) and prediabetes, after adjusted for multiple confounders. Restricted cubic spline analysis was applied for dose–response relation. Results: During a median 3.8-year follow-up, 5886 (7.36%) participants developed diabetes. Overall, we identified a linear and dose-dependent inverse association between dietary whole fresh fruit intake and risk of incident T2D. Each 100 g/d higher fruit intake was associated with 2.8% lower risk of diabetes (HR 0.972, 95%CI [0.949–0.996], P = 0.0217), majorly benefiting NGT subjects with 15.2% lower risk (HR 0.848, 95%CI [0.766–0.940], P = 0.0017), while not significant in prediabetes (HR 0.981, 95%CI 0.957–4.005, P = 0.1268). Similarly, the inverse association was present in normoglycemia individuals with a 48.6% lower risk of diabetes when consuming fruits > 7 times/week comparing to those < 1 time/week (HR 0.514, 95% CI [0.368–0.948]), but not in prediabetes (HR 0.883, 95% CI [0.762–1.023]). Conclusion: These findings suggest that higher frequency and amount of fresh fruit intake may protect against incident T2D, especially in NGT, but not in prediabetes, highlighting the dietary recommendation of higher fresh fruit consumption to prevent T2D in normoglycemia population. [ABSTRACT FROM AUTHOR]

Objectives: Excessive accumulation of adipose tissue may accelerate brain aging, but the underlying mechanisms are poorly understood. Several adiposity indices were proposed to assess obesity, while their linkage with brain health in older adults remained unclear. Here we aimed to examine the associations of adiposity indices with global and regional cerebral blood flow (CBF) in older adults, while considering insulin resistance. Design: This was a cross-sectional population-based study that included older adults derived from the baseline participants in the ongoing Multimodal Interventions to Delay Dementia and Disability in rural China (MIND-China) study. Setting And Participants: The study included 103 Chinese rural-dwelling older adults (age≥60 years; 69.9% women) who underwent brain magnetic resonance imaging scans. Methods: We estimated eight adiposity indices based on anthropometric measures. We automatically quantified global and regional CBF using the arterial spin labeling scans. Insulin resistance was assessed using the triglyceride-glucose index and then dichotomized into high and low levels according to the median. Data were analyzed using general linear model and voxel-wise analysis. Results: Of the eight examined adiposity indices, only higher waist-to-height ratio (WHtR) and body roundness index (BRI) were associated with reduced global CBF (multivariable-adjusted β-coefficients and 95%CI: −1.76; −3.25, −0.27 and −1.77; −3.25, −0.30, respectively) and hypoperfusion in bilateral middle temporal gyri, angular gyri and superior temporal gyri, left middle cingulum and precuneus (P<0.05). There were statistical interactions of WHtR and BRI with levels of insulin resistance on CBF, such that the significant associations of higher WHtR and BRI with lower global and regional CBF existed only in people with high insulin resistance (P<0.05). Conclusion: Higher WHtR and BRI are associated with cerebral hypoperfusion in older adults, especially in people with high insulin resistance. This may highlight the pathological role of visceral fat in vascular brain aging. [ABSTRACT FROM AUTHOR]

Objective: To investigate comorbidities among hospitalized patients with dementia. Method: Data were extracted from the discharge records in our hospital. Comorbidities based on ICD-10 were selected from the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI). The distributions of these comorbidities were described in dementia inpatients and age- and sex-matched nondementia controls, as well as in inpatients with Alzheimer's disease and vascular dementia. A logistic regression model was applied to identify dementia-specific morbid conditions. Results: A total of 3355 patients with dementia were included, with a majority of 1503 (44.8%) having Alzheimer's disease, 395 (11.8%) with vascular dementia, and 441 (13.1%) with mixed dementia. The mean number of comorbidities was 3.8 in dementia patients (vs. 2.9 in controls). The most prevalent comorbidities in inpatients with dementia compared with those without dementia were cerebral vascular disease (73.0% vs. 35.9%), hypertension (62.8% vs. 56.2%), and peripheral vascular disease (53.7% vs. 31.2%). Comorbidities associated with dementia included epilepsy (OR 4.8, 95% CI 3.5–6.8), cerebral vascular disease (OR 4.1, 95% CI 3.7–4.5), depression (OR 4.0, 95% CI 3.2–5.0), uncomplicated diabetes (OR 1.5, 95% CI 1.4–1.7), peripheral vascular disease (OR 1.8, 95% CI 1.6–2.0), rheumatoid arthritis collagen vascular disease (OR 1.7, 95% CI 1.3–2.3), and anemia (OR 1.2, 95% CI 1.04–1.3). Some comorbidities suggested a protective effect against dementia. They were hypertension (OR 0.8, 95% CI 0.7–0.9), COPD (OR 0.6, 95% CI 0.5–0.6), and solid tumor without metastasis (OR 0.4, 95% CI 0.3–0.4). Vascular dementia has more cardiovascular and cerebrovascular comorbidities than Alzheimer's disease. Conclusion: Patients with dementia coexisted with more comorbidities than those without dementia. Comorbidities (esp. cardio-cerebral vascular risks) in patients with vascular dementia were more than those in patients with AD. Specifically, vascular and circulatory diseases, epilepsy, diabetes and depression increased the risk of dementia. [ABSTRACT FROM AUTHOR]

Background: Epidemiological studies have reported that among participants with impaired cognitive, overweight and mild obesity are associated with substantially improved survival, this finding has been termed the "obesity paradox" and has led to uncertainty about secondary prevention. Aims: To explore whether the association of BMI with mortality differed in different MMSE score, and whether the obesity paradox in patient with cognitive impairment (CI) is real. Methods: The study used data from CLHLS, a representative prospective population-based cohort study in China, which included 8348 participants aged ≥ 60 years between 2011 and 2018. The independent association between BMI and mortality in differed MMSE score by calculating hazard ratios (HRs) in multivariate Cox regression analysis. Results: During a median (IQR) follow-up of 41.18 months, a total of 4216 participants died. In the total population, underweight increased the risk of all-cause mortality (HRs, 1.33; 95% CI 1.23–1.44), compared with normal weight, and overweight was associated with a decreased risk of all-cause mortality (HR 0.83; 95% CI 0.74–0.93). However, compared to normal weight, only underweight was associated with increased mortality risk among participants with MMSE scores of 0–23, 24–26, 27–29, and 30, and the fully-adjusted HRs (95% CIs) for mortality were 1.30 (1.18, 1.43), 1.31 (1.07, 1.59), 1.55 (1.34, 1.80) and 1.66 (1.26, 2.20), respectively. The obesity paradox was not found in individuals with CI. Sensitivity analyses carried out had hardly any impact on this result. Conclusion: We found no evidence of an obesity paradox in patients with CI, compared with patients of normal weight. But underweight individuals may have increased mortality risk whether in the population with CI or not. And overweight/obese people with CI should continue to aim for normal weight. [ABSTRACT FROM AUTHOR]

Purpose: Dietary behavior is an important part of lifestyle interventions for obesity and its cardiovascular comorbidities. However, little is known about associations between dietary patterns and obesity phenotypes in Southwest China, a region with unique dietary patterns and significant heterogeneity in obesity. Methods: Data from the baseline survey of the China Multi-Ethnic Cohort in Southwest China were analyzed (n = 64,448). Dietary intakes during the past year were measured with the semi-quantitative Food Frequency Questionnaire (s-FFQ). Principal component factor analysis (PCFA) was used to identify dietary patterns. Multinomial logistic regressions were used to examine the associations between dietary patterns and obesity phenotypes and stratified analyses were performed to assess whether the associations differed across demographic variables. Results: Three dietary patterns were identified and then named according to their apparent regional gathering characteristics: the Sichuan Basin dietary pattern (characterized by high intakes of various foods), the Yunnan-Guizhou Plateau dietary pattern (characterized by agricultural lifestyles), and the Qinghai-Tibet Plateau dietary pattern (characterized by animal husbandry lifestyles), respectively. Higher adherence to the Sichuan Basin dietary pattern was positively associated with metabolically healthy overweight/obesity (MHO, OR 1.13, 95% CI 1.05–1.21) but negatively associated with metabolically unhealthy normal weight (MUNW, OR 0.78, 95% CI 0.65–0.95). Higher adherence to the other two dietary patterns was positively associated with MHO and metabolically unhealthy overweight/obesity (MUO). Besides, differences in socioeconomic status also affected the relationship between dietary patterns and obesity phenotypes. Conclusions: Adherence to the more diverse Sichuan basin dietary pattern performed a mixed picture, while the other two may increase the risk of obesity phenotypes, which indicates nutritional interventions are urgently needed. [ABSTRACT FROM AUTHOR]

Purpose: Food insecurity and multimoribidity (i.e., ≥ 2 chronic conditions) may be linked bidirectionally, but there are no studies on this topic from LMICs. Therefore, the aim of the present study was to examine the association between food insecurity and physical multimorbidity in a large representative sample of older adults from six LMICs. Methods: Cross-sectional, community-based data on adults aged ≥ 50 years from the World Health Organization's Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa were analyzed. A total of 11 chronic physical conditions were assessed. Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted to assess the associations. Results: Data on 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 47.9% males] were analyzed. After adjustment for potential confounders, in the overall sample, compared to being food secure, moderate and severe food insecurity were associated with 1.29 (95% CI 1.06–1.56) and 1.56 (95% CI 1.13–2.16) times higher odds for multimorbidity, respectively Conclusion: Food insecurity was associated with greater odds for multimorbidity in older adults from LMICs. Addressing food insecurity in the general population may reduce risk for multimorbidity, while screening for food insecurity and addressing it among those with multimorbidity may lead to better clinical outcomes, pending future longitudinal research [ABSTRACT FROM AUTHOR]

Objectives: Summarize the existing evidence regarding the prevalence and risk factors of frailty in stroke patients. Design: A meta-analysis and systematic review. Participants: Stroke patients in hospitals or communities. Methods: We undertook a systematic review and meta-analysis using articles available in 8 databases, including PubMed, The Cochrane Library, Web of Science, Embase, Chinese Biomedical Database (CBM), China National Knowledge Infrastructure Database (CNKI), Wanfang Database, and Weipu Database (VIP) from January 1990 to April 2022. Studies were quality rated using the Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality tool. Results: A total of 24 studies involving 30,423 participants were identified. The prevalence of frailty and pre-frailty in stroke patients was 27% (95%CI: 0.23–0.31) and 47.9% (95%CI: 0.43–0.53). Female gender (OR = 1.76, 95%CI: 1.63–1.91), advanced age (MD = 6.73, 95%CI: 3.55–9.91), diabetes (OR = 1.34, 95%CI: 1.06–1.69), hyperlipidemia (OR = 1.46, 95%CI: 1.04–2.04), atrial fibrillation (OR = 1.36, 95%CI: 1.01–1.82), National Institutes of Stroke Scale (NIHSS) admission scores (MD = 2.27, 95%CI: 1.72–2.81) were risk factors of frailty in stroke patients. Conclusions: Frailty was more prevalent in stroke patients. Female gender, advanced age, diabetes, hyperlipidemia, atrial fibrillation, and National Institutes of Stroke Scale (NIHSS) admission scores were identified as risk factors for frailty in stroke patients. In the future, medical staff should pay attention to the early screening of frailty in high-risk groups and provide information on its prevention. [ABSTRACT FROM AUTHOR]

Summary: We hypothesized that air pollution could cause oxidative damage and inflammation in the human body, which was linked to bone loss. Our result showed that long-term exposure to air pollution might decrease bone mineral density (BMD) T-score and increase the prevalence of osteoporosis in Hubei province. Introduction: Osteoporosis is becoming an increasingly serious public health problem with the advent of global aging. Long-term exposure to air pollution has been linked to multitudinous adverse health outcomes, but evidence is still relatively limited and inconsistent for BMD T-score and osteoporosis. This study aimed at exploring the associations between long-term exposure to air pollution and BMD T-score and osteoporosis. Methods: The Hubei part of the China Osteoporosis Prevalence Study was extracted. Data on air pollutants were collected by the national air quality real-time release platform of China Environmental Monitoring Station. Linear mixed models and multilevel logistic regression analyses were performed to assess the associations between air pollution and BMD T-score and osteoporosis, respectively. Subgroup analyses were conducted to identify vulnerable populations. Results: A total of 1845 participants were included in this cross-section study. Per 10 ug/m3 increase in PM2.5 and SO2 were associated with 0.20 (95% CI: 0.04, 0.36) and 0.31 (95% CI: 0.11, 0.51) decrease in BMD T-score of the neck of femur, respectively. Per 10 ug/m3 increase in CO was linked with 0.03 (95% CI: 0.02, 0.05) decrease in BMD T-score of the total hip. Per 1 ug/m3 increase in PM2.5 was associated with 5% increase in the prevalence of osteoporosis in all participants. In general, the higher concentrations of PM2.5 with the more adverse effect on osteoporosis (P for trend = 0.01). The impact of PM2.5 on osteoporosis in males was higher than that in females [1.29, 95% CI (1.11, 1.50) vs 1.01, 95% CI (0.95, 1.07)]. Per 1 ug/m3 increase in PM10 corresponded with 4% elevation in the risks of osteoporosis in rural population. The ORs (95% CI) for the association of osteoporosis and NO2 in ever/current smoking and drinking population were 1.07 (1.01, 1.13) and 1.05 (1.00, 1.09), respectively. SO2 had a statistically significant positive effect on people with comorbidity [OR = 1.10, (95% CI: 1.00 to 1.21)], while none in people without comorbidity [OR = 0.96, (95% CI: 0.88 to 1.05)]. Conclusion: Our study provided evidence that long-term exposure to PM2.5 was linked with the decreased BMD T-score and increased risk of osteoporosis among all participants. The adverse impacts of PM2.5, PM10, and NO2 were larger in males than in females. People having comorbidity, living in rural areas, and current/ever smoking or drinking were more vulnerable to air pollution. Public health departments should consider air pollution to formulate better preventive measures for osteoporosis. [ABSTRACT FROM AUTHOR]

Background: Increased fish consumption reduces the risk of dementia. However, it is unknown whether fish consumption reduced all-cause mortality in people with dementia. The purpose of the study is to investigate the association of fish consumption with all-cause mortality in older people with dementia versus those without dementia. Methods: Using a standard method of the Geriatric Mental State, we interviewed 4165 participants aged ≥ 60 years who were randomly recruited from five provinces in China during 2007–2009 to collect the baseline data of socio-demography, disease risk factors, histories of disease, and details of dietary intakes, and diagnosed dementia (n = 406). They were followed up for vital status until 2012. Results: The cohort follow-up documented 329 deaths; 61 were in participants with dementia (55.3 per 1000 person-years) and 224 were those without dementia (22.3). In all participants, the risk of all-cause mortality was reduced with fish intake at " ≥ twice a week" (multivariate-adjusted hazard ratio 0.58, 95% CI 0.34–0.96) and at "once a week or less" (0.79, 0.53–1.18) compared to "never eat" over the past two years. In participants without baseline dementia, the corresponding HRs for all-cause mortality were 0.57 (0.33–0.98) and 0.85 (0.55–1.31), while in participants with dementia were 1.36 (0.28–6.60) and 1.05 (0.30–3.66), respectively. Conclusion: This study reveals that consumption of fish in older age reduced all-cause mortality in older people without dementia, but not in people with dementia. Fish intake should be increased in older people in general, prior to the development of dementia in the hope of preventing dementia and prolonging life. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of preventive and control measures for congenital syphilis (CS) implemented since 2012 in Guangdong Province, China, and assess the epidemic trend in the near future. Methods: The interrupted time series analysis was conducted to compare changes in slope and level of CS notification rate from 2005 to 2020 in Guangdong Province and its three regions with different economic developmental levels. The ARIMA model was established to predict the new CS case number of Guangdong Province in 2021. Results: A total of 12,687 CS cases were reported from 2005 to 2020. The CS notification rate of the province had been increasing until 2012 (128.55 cases per 100,000 live births) and then been decreasing constantly, hitting the lowest point in 2020 (5.76 cases per 100,000 live births). The severe epidemic cluster shifted from the developed region to underdeveloped ones over time. The effectiveness of the measures was proved by the significant change in the slope of the notification rate which was found in both of the provinces (− 18.18, 95% CI − 25.63 to − 10.75) and two less-developed regions (− 10.49, 95% CI − 13.13 to − 7.86 and − 32.89, 95% CI − 41.67 to − 24.10, respectively). In the developed region where the notification rate had already been decreasing in the pre-implementation period, implementing these measures also aided in hastening the rate of descent. The CS case number in 2021 was predicted to be 48, indicating a low-level epidemic. Conclusions: The preventive and control measures have assisted Guangdong Province to control CS effectively, of which the supportive ones ensured a successful implementation. For resource-limited countries where CS is still endemic, especially guaranteeing the support in financial subsidy, professional training, supervision and so on might trigger the effectiveness of other measures and eventually make significant and sustainable progress. [ABSTRACT FROM AUTHOR]

The reverse transcription-quantitative polymerase chain reaction (RT-qPCR) approach has been widely used to detect the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, instead of using it alone, clinicians often prefer to diagnose the coronavirus disease 2019 (COVID-19) by utilizing a combination of clinical signs and symptoms, laboratory test, imaging measurement (e.g., chest computed tomography scan), and multivariable clinical prediction models, including the electronic nose. Here, we report on the development and use of a low cost, noninvasive method to rapidly sniff out COVID-19 based on a portable electronic nose (GeNose C19) integrating an array of metal oxide semiconductor gas sensors, optimized feature extraction, and machine learning models. This approach was evaluated in profiling tests involving a total of 615 breath samples composed of 333 positive and 282 negative samples. The samples were obtained from 43 positive and 40 negative COVID-19 patients, respectively, and confirmed with RT-qPCR at two hospitals located in the Special Region of Yogyakarta, Indonesia. Four different machine learning algorithms (i.e., linear discriminant analysis, support vector machine, stacked multilayer perceptron, and deep neural network) were utilized to identify the top-performing pattern recognition methods and to obtain a high system detection accuracy (88–95%), sensitivity (86–94%), and specificity (88–95%) levels from the testing datasets. Our results suggest that GeNose C19 can be considered a highly potential breathalyzer for fast COVID-19 screening. [ABSTRACT FROM AUTHOR]

Illegal wildlife trade enforcement is a cornerstone conservation strategy worldwide, yet we have a limited understanding on its social impacts. Using Chinese online wildlife seizure news (2003–2018), we evaluated the interactions among enforcement operations, news frequency, and social engagement (i.e., whistle-blowing) frequency. Our results showed that intensive enforcement operations, which commenced after 2012, have social impacts by increasing the frequency of all seizure news significantly by 28% [95% Confidence Interval (CI): 5%, 51%] and those via whistle-blowing by 24% [95% CI: 2%, 45%], when compared to counterfactual models where possible confounding factors were accounted for. Furthermore, we revealed the potential interaction between enforcement seizure news with and without social engagement, and the consequential social feedback process. Of the species identified from 'whistle-blowing' news, up to 28% are considered as high conservation priorities. Overall, we expanded our understanding of the enforcement impacts to social dimensions, which could contribute to improving the cost-effectiveness of such conservation efforts. [ABSTRACT FROM AUTHOR]

Background: Copper is associated with mild cognitive impairment (MCI). However, there is a lack of relevant population studies with large sample sizes. Aims: This study used baseline data from a cohort study to determine the distribution characteristics of MCI in the elderly and to estimate the association between whole blood copper concentrations and MCI. Methods: MCI status was screened by the Mini-Mental State Examination (MMSE) scale and Activities of Daily Living (ADL) scale. The concentration of copper in whole blood was determined by Inductively Coupled Plasma Mass Spectrometer (ICP-MS). Results: A total of 1057 subjects with an average age of 71.82 ± 6.45 years were included in this study. There were 215 patients with MCI, and the prevalence of MCI was 20.34%. After adjusting for general demographic variables, logistic regression analysis showed that the risk of MCI in the elderly with high copper level was 1.354 times higher than that in the elderly with low copper level (OR 1.354, 95% CI 1.047–1.983, P = 0.034). Conclusion: In this study, it was found that the prevalence of MCI was different in gender, age, education level and other aspects, and a higher copper level in the elderly was significantly related to the occurrence of MCI. The association was stronger in older adults and men. [ABSTRACT FROM AUTHOR]

Background and aims: Stroke is currently the leading cause of death in China; however, the past decade has produced no new epidemiological studies of stroke. Therefore, the current study aimed to compare the prevalence and risk factors of stroke between 2010 and 2019. Methods: A comparative study was used to analyze the prevalence of risk factors for stroke in a population aged 65 years or older between 2010 and 2019. Demographic characteristics, risk factors, medical history, and other clinical characteristics were collected for all participants via door-to-door interviews and inpatient hospital records. Results: The standardized prevalence of stroke was 7.9% in 2010 and 14.2% in 2019 (p < 0.001). The prevalence of stroke was significantly higher in men than in women (p < 0.05) for all age groups. The risk factors of stroke were being male, hypertension, and diabetes mellitus in both 2010 and 2019. When comparing the risk factors between 2010 and 2019, these risk factors were statistically significantly more strongly associated with stroke in 2019 than in 2010. Conclusion: The current study suggests that the prevalence of stroke increased nearly by twofold in a population aged 65 years or older within the past 10 years. Hypertension, diabetes mellitus, and being male were the primary risk factors. In addition, these factors were more significantly associated with stroke in 2019 compared to 2010. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and safety of 'Three-Typed Syndrome Differentiation' (TTSD) in treating type 2 diabetes mellitus patients. Methods: A systematic review and meta-analysis was done based on the clinical diabetes treatment literature of the 'TTSD'. Overseas databases like the PubMed/MEDLINE, EMBASE, Cochrane Library and Cochrane Central Register of Controlled Clinical Trials, and China databases like China Biology Medicine Disc (CBM), Chinese national Knowledge Infrastructure (CNKI), Wanfang database, and VIP database, without limitation on language, were included with the time limitation from Jan 1982 to Dec 2012 by retrieval of relative original clinical research articles. Results: Nineteen articles where contains 1,840 diabetes patients were obtained, in which no adverse reactions were reported. Of these, 14 literatures involved the effect of fasting blood glucose (FBG), 10 involved that of postprandial 2-h blood glucose (P2hBG), and 19 involved the overall efficacy based on the national Chinese medicine (CM) diagnosis and treatment standard of diabetes. All the meta-analysis results prefer to the 'TTSD' groups (CM+Western medicine Based on TTSD). The results show that, beside the efficacy of Western medicine, the concentrations of FBG and P2hBG in 'TTSD' groups continue to drop with statistical significance. For 'TTSD' groups, the FBG subsequently dropped 1.03 mmol/L, 95%CI [1.24,0.82] P <0.00001), the P2hBG subsequently dropped 1.09 mmol/L, 95% CI [1.61, 0.57] ( P <0.0001), and the overall efficacies benefit 3.46 times those of Western medicine alone, 95% CI [2.67,4.48] ( P <0.00001). Conclusions: The CM by the diagnosis and treatment of type 2 diabetes based on TTSD might be safe and effective, and could better improve both blood glucose and the overall status of patients, including symptoms. [ABSTRACT FROM AUTHOR]

Purpose: Ultra-processed foods make up more than 50% of daily energy consumed in Western countries and are rapidly increasing in China. However, little is known about the association between ultra-processed food intake and muscle strength, a predictor for physical disability in senior years. We aimed to investigate the association of ultra-processed food intake with longitudinal changes in grip strength among middle-aged and older Chinese adults. Methods: This prospective cohort study included a total of 5409 adults aged 40 years and over (61.3% men). Ultra-processed food intake was obtained by means of a validated food frequency questionnaire and classified according to the NOVA classification system. Grip strength was measured annually using a handheld digital dynamometer. Multivariable linear regression models were used to examine the association between ultra-processed food intake and annualized change in grip strength and weight-adjusted grip strength. Results: In the fully adjusted models, annualized changes in grip strength and weight-adjusted grip strength per 10% increment in the proportion of ultra-processed foods in the diet were − 0.3708 kg (95% confidence interval − 0.5687, − 0.1730; P < 0.001) and − 0.0057 kg/kg (95% confidence interval − 0.0086, − 0.0029; P < 0.0001), respectively. In analyses stratified by age, sex, body mass index, physical activity, hypertension, hyperlipidemia, diabetes, and healthy diet score, such associations were largely consistent in most subgroups (all P for interaction > 0.05). Conclusions: Our data indicate that higher ultra-processed food intake was associated with faster grip strength decline in middle-aged and older Chinese adults. [ABSTRACT FROM AUTHOR]

To evaluate androgen receptor and AR gene expression impact of gastric cancer (GC). Meta-analysis of microarray data obtained from the Gene Expression Omnibus (GEO) database, TCGA (The Cancer Genome Atlas) database, and data by systematic search of PubMed, China National Knowledge Internet and Web of Science. This meta-analysis included 30 studies involving 4487 patients. From our results, we can know that the positive rate of AR expression in gastric cancer is 40%. The expression of AR was significantly higher in men (SWD = 1.00, 95% CI 0.03 ~ 1.96, P = 0.042). The higher AR expression was linked with poor over survival (OS) (HR = 1.30, 95% CI 1.13 ~ 1.49, P < 0.0001). AR gene may be an important factor affecting the poor prognosis of GC patients of different genders. [ABSTRACT FROM AUTHOR]

Objective: Women frequently report breastfeeding problems in the early postpartum period. Women who have self-endorsed beliefs that breastfeeding benefits their babies and themselves are more likely to continue breastfeeding despite breastfeeding barriers. Maternal self-endorsed beliefs is a key component of maternal self-regulated motivation. The present study examined the association between maternal self-regulated motivation, breastfeeding duration and exclusivity in Chinese women. Methods: This was a prospective cohort study, of which we recruited participants in postnatal maternity units of publicly funded hospitals in Hong Kong. Postpartum women were asked to fill in the validated breastfeeding self-regulation questionnaire (BSRQ) before hospital discharge and their breastfeeding status was assessed by telephone follow-ups at 6 and 12 weeks postpartum. Multiple logistic regression was used to study the relationship between breastfeeding self-regulated motivation and the duration of breastfeeding at follow-up. Results: At 6 and 12 weeks postpartum, women who breastfed exclusively scored significantly higher in self-regulated motivation than those who formula-fed. The self-regulated motivation was associated with higher odds of exclusive breastfeeding at 6 weeks and any breastfeeding at 12 weeks postpartum. Conclusions for Practice: The study found that self-regulated motivation was positively related to breastfeeding duration. Maternal self-regulated motivation toward breastfeeding could be enhanced by the availability of social support and breastfeeding-friendly facilities, resulting in longer breastfeeding duration. [ABSTRACT FROM AUTHOR]

In this egocentric network study, we explored Chinese collectivism in relation to social network characteristics and sex work-related stigma among mid-age female sex workers (FSWs). Respondent-driven sampling was used to recruit 1245 mid-age FSWs from three cities in China. We found that a one standard deviation (SD) increase in FSWs' collectivism was associated with a 0.18 SD decrease in social support (95% CI − 0.32, − 0.04), a 0.20 SD decrease in network effective size (i.e., the diversity of a social network; 95% CI − 0.30, − 0.10), and a 0.21 SD decrease in network betweenness (i.e., the "bridging potential" of egos within their networks; 95% CI − 0.33, − 0.09). Among participants who perceived more sex work stigma, the association between collectivism and FSWs' network betweenness was attenuated. In a collective culture emphasizing group values and honor, belonging to a less interconnected social network may give FSWs a structural advantage to cope with stigma and secure social support. [ABSTRACT FROM AUTHOR]

Background: The results of animal studies suggest there is a significant role for dietary fat in the development of colorectal cancer (CRC). However, inconsistent results have been reported by epidemiological studies. Aim of study: To evaluate the association between total dietary fat and risk of colorectal cancer development using a meta-analysis based on prospective cohort studies. Methods: Published literature was retrieved from Medline, Embase and CNKI (China Knowledge Resource Integrated Database) databases updated to 1st May, 2009. Overall, thirteen prospective cohort studies with 3,635 cases and 459,910 participants were included. Results: The combined relative risk (RR) [95% confidence interval (95%CI)] for the risk of CRC was 0.99 (0.89,1.09) when the highest level of total dietary fat was versus (vs.) the lowest level. Stratified analyses according to gender, ethnicity, country and age showed that the highest level of total dietary fat did not increase the risk of CRC [RR (95%CI): 0.89 (0.77,1.03) for males; 1.09 (0.94,1.26) for females; 1.08 (0.94,1.25) for Caucasians; 0.90 (0.77,1.04) for Asians; 1.13 (0.94,1.36) for Americans; 0.92 (0.81,1.04) for individuals older than 40]. Besides those, the highest level of total fat diet also did not increase the risk of neither colon cancer [RR (95%CI): 0.96 (0.82,1.13)] nor rectal cancer [RR (95%CI):1.07 (0.63,1.82)]. Furthermore, neither animal fat nor plant fat were associated with the risk of CRC [RR (95%CI): 1.05 (0.91-1.22) for animal fat and 0.96 (0.82-1.11) for plant fat]. Conclusions: This meta-analysis suggests that dietary fat may not be associated with the increased risk of CRC. More well-designed studies with larger population performed among Asians are needed to further evaluate the associations. In addition, probable bias caused by measurement error should be noticed in this meta-analysis, and measurement error needs to be adjusted in the future studies. [ABSTRACT FROM AUTHOR]

Toxoplasma gondii is an important intracellular parasitic protozoan with a variety of hosts, including chickens, which poses a potential threat to public health. However, little is known regarding overall T. gondii infection in chickens in China. Herein, the prevalence and risk factors associated with T. gondii infection in chickens in China were investigated using a meta-analysis. Forty studies regarding the prevalence of T. gondii in chickens in China from 1993 to 2021 were identified using five databases (PubMed, Science Direct, CNKI, Wang Fang, and VIP). Quantitative and potential sources were analyzed through subgroup analysis and meta-regression in R v3.5.2. The overall prevalence of T. gondii in chickens in China was 13.4% (95% confidence interval (CI): 10.9–16.0). In the region subgroup, the lowest prevalence was presented in Northwestern China (6.0%, 95% CI: 3.2–9.5; P < 0.001). Seasonally, T. gondii prevalence was the highest in spring (17.9%, 95% CI: 7.7–30.9; P = 0.007). Among detection methods, the prevalence in the ELISA subgroup was the highest (22.8%, 95% CI: 17.1–29.1; P < 0.001). According to the farming mode, the prevalence of T. gondii in free-range chickens (19.5%, 95% CI: 15.4–23.9) was significantly higher than that in chickens raised by intensive farming (7.4%, 95% CI: 5.1–10.2; P < 0.001). We also estimated the relationships between region, sampling year, chicken age, chicken application, gender, sample classification, study quality, and T. gondii prevalence in chickens in China. Our study showed that region, season, and farming model played important roles in T. gondii infection of chickens. Integrated control measures should be undertaken to reduce the losses caused by T. gondii infection to the chicken industry. [ABSTRACT FROM AUTHOR]

Bidirectional naming is an important ability which enables children to acquire listener and speaker behaviors through exposure to relevant word-object associations. Many children with autism spectrum disorder (ASD) or developmental delays do not demonstrate this ability and require systematic instruction. The purpose of the present study was to evaluate the efficacy of computer-assisted multiple exemplar instruction to facilitate bidirectional naming. Three 5-year-old Chinese boys with ASD participated in a multiple probe across three participants design. The results indicated that all three children's naming performance increased from pretest to posttest, supporting the potential practicality of the instructional system for use in applied settings. [ABSTRACT FROM AUTHOR]

Aim: The association between visual impairment and mild cognitive impairment (MCI) has not been investigated to date. Thus, we assessed this association among older adults from six low- and middle-income countries (LMICs) (China, India, Ghana, Mexico, Russia, and South Africa) using nationally representative datasets. Methods: Cross-sectional, community-based data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment (at distance and near) was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better-seeing eye. The definition of MCI was based on the National Institute on Aging-Alzheimer's Association criteria. Multivariable logistic regression was conducted. Results: Data on 32,715 individuals aged ≥ 50 years [mean (SD) age 62.1 (15.6) years; 51.2% females] were analyzed. Compared to those without far or near vision impairment, those with near vision impairment but not far vision impairment (OR = 1.33; 95% CI = 1.16–1.52), and those with both far and near vision impairment (OR = 1.70; 95% CI = 1.27–2.29) had significantly higher odds for MCI. Only having far vision impairment was not significantly associated with MCI. Conclusions: Visual impairment is associated with increased odds for MCI among older adults in LMICs with the exception of far vision impairment only. Future longitudinal and intervention studies should examine causality and whether improvements in visual acuity, or early intervention, can reduce risk for MCI and ultimately, dementia. [ABSTRACT FROM AUTHOR]