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Abstract Child nutritional health has always been a research focus and an essential indicator reflecting children's health and living conditions in developing countries. This study investigates how household income and other individual and family factors influence child nutritional status. The Chinese Health and Nutrition Survey data are used to analyze changing patterns of child malnutrition status, and to compare the gap between genders, rural and urban areas etc., and the WHO new child growth standards are used in this paper as the reference for each specific age and gender. The findings in this paper include three aspects. First of all, the headcount ratio of undernourished children in both stunting and underweight has declined over years from 1991 to 2009 in China. Second, regional disparity in child nutritional status was significant, and the economic growth was a key driver to improve the nutritional conditions of the poor children. Furthermore, this paper also employs the stepwise logistic regression models to illustrate the influencing mechanisms of family income and other factors on child nutrition, and finds that household income affected child nutritional status significantly through the mechanisms of community, household, parental and individual factors. Highlights • This paper studies stunting and underweight rates of Chinese children and finds both malnutritional indicators have declined from 1991 to 2009. • This paper studies the regional and demographic differences in child nutrition and finds certain heterogeneity in malnutritional indicators. • This paper studies the relationship between family income and child nutrition and reveals significant and positive correlation between the two. • This paper finds significant impact mechanisms of individual, parental, family and community factors on child nutrition. [ABSTRACT FROM AUTHOR]

This paper compares the prevalence and age-specific changes of coresidence patterns, by means of a classification of 12 coresidence types, for the age range from 16 to 30 in the United States (US), Germany (GE), Taiwan (TW), and mainland China (CN). Panel data were used in separate nested logistic regression models to estimate transitions in coresidence for individuals in each society in the transition to adulthood. On the first level, decisions to move from different types of family-of-origin-households were modeled, depending on intergenerational solidarity and parental resources. On the second level, target household types were modeled, depending on others' trajectory events and their interaction with gender. The analysis used the National Longitudinal Study of Youth (NLSY97) from the United States, the German Family Panel (pairfam), the Taiwanese Youth Project (TYP), and the China Family Panel Studies (CFPS). Age-specific coresidence patterns were pooled and transitions probabilities were estimated for a two-year period. The systematic comparative approach makes it possible to correct misinterpretations based on analyses from single societies. Our results demonstrated that differences in coresidence patterns within the patrilineal, collectivistic societies (CN and TW), and within the bilineal, individualistic societies (US and GE) were as important as the differences between these two groups of societies. [ABSTRACT FROM AUTHOR]

INTRODUCTION Secondhand smoke exposure in many countries decreased dramatically after the implementation of smoke-free legislation in public places, but the exposure at home did not change to the same degree. The aim of this study was to describe the status and correlates of a home smoking ban in Chongqing, China. METHODS From June to August 2021, we selected two healthcare centers in the East, West, North, South and Middle regions of Chongqing. We investigated the family smoke-free situation in the selected region using a stratified random sampling method. A chi-squared test was performed to compare the totally and partially smoke-free homes, and a binary logistic regression model was used to analyze the correlates of smoke-free rules at home. RESULTS The study investigated 2121 families, among which 884 (41.7%) implemented a total ban on smoking at home. The covariates included age (OR=1.54; 95% CI: 1.18-2.01), living with children aged <14 years (OR=1.51; 95% CI: 1.20-1.90), no smokers in the family (OR=2.37; 95% CI: 1.78-3.17), awareness of the hazards of secondhand smoke (OR=1.30; 95% CI: 1.07-1.59), worrying about the impact of smoking in the presence of children on health (OR=1.92; 95% CI: 1.25-2.95), no difficulty (OR=1.34; 95% CI: 1.07-1.67) and confidence (OR=1.73; 95% CI: 1.41-2.13) in stopping others from smoking, no smoking rules in cars (OR=3.67; 95% CI: 2.58--5.22), and frequency of entertaining guests with cigarettes (OR=0.41; 95% CI: 0.28-0.59). CONCLUSIONS It is common for households in Chongqing to have smoking bans, especially those with children. If a family has members that are smokers, education researchers should pay more attention to the hazards of secondhand smoke on the health of family members, and to adopt more tobacco control measures and enhance the self-efficacy of implementing a home smoking ban. Helping smokers to quit is a vital way to decrease the hazards of cigarettes. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. Method: A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. Results: A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self‐perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Conclusions: Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences. [ABSTRACT FROM AUTHOR]

Of the Wenchuan earthquake victims, there was a special group who lost their only child, known as the Shidu parents. The purpose of this paper is to examine social support as a moderator between resilience and quality of life (QOL) in Shidu parents. A cross-sectional sample survey was conducted to collect data from 22 earthquake-stricken counties in Sichuan province. Of the Shidu parents from the Wenchuan earthquake, being of Han ethnicity, receiving a high monthly income, having a high education, having lost a younger child (18-27), and having lost a male child were all risk factors for a lower QOL ( p < 0.05). This study highlighted that different types of social support have different roles in building resilience and improving QOL. The results emphasized the importance of developing suitable social support strategies as mediators to improve resilience and the QOL in Shidu parents. [ABSTRACT FROM AUTHOR]

INTRODUCTION A number of studies have reported a high correlation between psoriasis and metabolic syndrome (MetS), and tobacco smoking is one independent risk factor accounting for the increased prevalence both for psoriasis and MetS. However, few studies have been conducted to assess the effects of tobacco smoking on co-morbidities of psoriasis and MetS. METHODS We conducted a cross-sectional study with 1014 psoriasis patients recruited from January to May 2021. Patients were recruited with a cluster survey method in Yueyang Hospital (affiliated with Shanghai University of Traditional Chinese Medicine) and Shanghai Skin Diseases Hospital (affiliated with Tongji University). Data were collected by face-to-face questionnaire interviews which included basic information, personal life habits, medical history, and clinical examinations. SPSS 24.0 was used for data analysis and a p<0.05 was considered statistically significant. RESULTS The 1014 psoriasis patients were predominantly males (65.58%), with an average age of 45.98 years (IQR: 34.00--57.00). Of these, 25.74% (261) of psoriasis had MetS and 31.85% (323) were tobacco smokers. Male psoriasis patients had higher tobacco smoking prevalence than female patients. With increasing age and BMI, the prevalence of tobacco smoking among psoriasis patients increased dramatically (p<0.01). Logistic regression indicated that psoriasis patients with tobacco smoking had 1.78 times (95% CI: 1.21--2.60) the probability to have MetS than those without tobacco smoking, even adjusting for potential confounding factors. Moreover, smoking psoriasis patients with MetS consumed more cigarettes per day, with longer smoking duration, but with an older age of smoking initiation. CONCLUSIONS The prevalence of tobacco smoking and MetS among psoriasis patients was high in Shanghai, and tobacco smoking was positively associated with the MetS among psoriasis patients. Clinicians should recommend psoriasis patients to abstain from tobacco smoking and provide tobacco cessation assistance regularly. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to identify predictors of severe white matter hyperintensity (WMH) with obesity (SWO), and to build a prediction model for screening obese people with severe WMH without Nuclear Magnetic Resonance Imaging (MRI) examination. Patients subjects and methods: From September 2020 to October 2021, 650 patients with WMH were recruited consecutively. The subjects were divided into two groups, SWO group and non-SWO group. Univariate and Logistic regression analysis were was applied to explore the potential predictors of SWO. The Youden index method was adopted to determine the best cut-off value in the establishment of the prediction model of SWO. Each parameter had two options, low and high. The score table of the prediction model and nomogram based on the logistic regression were constructed. Of the 650 subjects, 487 subjects (75%) were randomly assigned to the training group and 163 subjects (25%) to the validation group. By resampling the area under the curve (AUC) of the subject's operating characteristics and calibration curves 1,000 times, nomogram performance was verified. A decision curve analysis (DCA) was used to evaluate the nomogram's clinical usefulness. By resampling the area under the curve (AUC) of the subject's operating characteristics and calibration curves 1,000 times, nomogram performance was verified. A decision curve analysis (DCA) was used to evaluate the nomogram's clinical usefulness. Results: Logistic regression demonstrated that hypertension, uric acid (UA), complement 3 (C3) and Interleukin 8 (IL-8) were independent risk factors for SWO. Hypertension, UA, C3, IL-8, folic acid (FA), fasting C-peptide (FCP) and eosinophil could be used to predict the occurrence of SWO in the prediction models, with a good diagnostic performance, Areas Under Curves (AUC) of Total score was 0.823 (95% CI: 0.760--0.885, p < 0.001), sensitivity of 60.0%, specificity of 91.4%. In the development group, the nomogram's AUC (C statistic) was 0.829 (95% CI: 0.760--0.899), while in the validation group, it was 0.835 (95% CI: 0.696, 0.975). In both the development and validation groups, the calibration curves following 1,000 bootstraps showed a satisfactory fit between the observed and predicted probabilities. DCA showed that the nomogram had great clinical utility. Conclusion: Hypertension, UA, C3, IL-8, FA, FCP and eosinophil models had the potential to predict the incidence of SWO. When the total score of the model exceeded 9 points, the risk of SWO would increase significantly, and the nomogram enabled visualization of the patient's WMH risk. The application prospect of our models mainly lied in the convenient screening of SWO without MRI examination in order to detect SWO and control the WMH hazards early. [ABSTRACT FROM AUTHOR]

BACKGROUND Stress hyperglycemia ratio (SHR) could provide accurate information on the acute status of hyperglycemia. The relationship between SHR and acute coronary syndrome (ACS) prognosis remains unclear. This study was conducted to identity the association between SHR and in-hospital outcomes in patients with ACS. METHODS A total of 12,010 patients were eventually enrolled in the study. The relationship between SHR and in-hospital major adverse cardiovascular events (MACEs) was then modeled by restricted cubic spline (RCS) curves, and all patients were divided into three groups according to the results. The multivariate logistic regression analysis was used to determine the associations between the SHR and in-hospital outcomes, described as odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were also performed on different diseases. RESULTS The median age of this cohort was 63 (54, 71) years old, and 8942 (74.5%) were male. Group 1 was defined as SHR < 0.6 (n = 426), Group 2 was defined as SHR between 0.6 and 1 (n = 5821), and Group 3 was defined as SHR > 1 (n = 5763). Compared with Group 2, Group 1 (OR = 1.891, 95% CI: 1.028-3.479, P < 0.001) and Group 3 (OR = 1.868, 95% CI: 1.434-2.434, P < 0.001) had higher risks of suffering from in-hospital MACEs. SHR was associated with higher risks of in-hospital MACEs in the subgroups of DM [OR = 2.282, 95% CI: 1.477-3.524). CONCLUSIONS Both low and high SHR levels were independently associated with in-hospital MACEs. Young males with DM, hypertension, and decreased renal function had much higher risks of suffering from SHR-correlated MACEs. [ABSTRACT FROM AUTHOR]

Background: Despite advancements in school scoliosis screening (SSS), there are still no effective indicators to estimate the severity of spinal curvature. We aim to investigate the association between incorrect postures and curve magnitude of adolescent idiopathic scoliosis (AIS) among Chinese adolescents. Methods: In this SSS program, we examined the incorrect posture, Adam's forward bending test (FBT) results, and angle of trunk rotation (ATR) in adolescents. Those with suspected scoliosis were referred for a standing anteroposterior whole-spine radiography as outpatients. The radiographic data of 426 students with lateral Cobb angles were collected from 2016 to 2022 and the associations were studied using logistic regression (LR) models and receiver operating characteristic (ROC) curves. Results: Univariate LR revealed that female gender [odds ratio (OR) = 2.92, 95% confidence interval (CI) 1.67–5.09, P < 0.001], age 16–19y (OR = 2.83, 95%CI 1.10–7.28, P = 0.031), right shoulder height (OR = 2.15, 95%CI 1.23–3.75, P = 0.007), right scapula tilt (OR = 2.03, 95%CI 1.18–3.50, P = 0.010), right rib hump (OR = 1.88, 95%CI 1.23–2.85, P = 0.003), right thoracic rotation ≥ 5° (OR = 2.14, 95%CI 1.43–3.20, P < 0.001), and left thoracolumbar kyphosis (OR = 3.79, 95%CI 1.06–13.56, P = 0.041) were all significantly associated with the severity of the curve magnitude. Multivariate LR showed that female gender [adjusted OR (AOR) = 3.23, 95%CI 1.81–5.73, P < 0.001], those aged 16–19y (AOR = 5.08, 95%CI 1.86–13.91, P = 0.002), and with a right rib hump (AOR = 1.72, 95%CI 1.11–2.64, P = 0.015) presented with a higher risk of severe curve magnitude than men, those aged 7–12y, and without a rib hump, respectively. ROC curves further proved that sex, age, shoulder-height difference, scapula tilt, flat back, rib hump, angle of thoracic rotation were the risk predictors for curve magnitude. Conclusion: Incorrect posture and ATR, especially the right rib hump, were significantly associated with the curve magnitude of AIS. Early screening for incorrect postures and ATR could be an effective and economical strategy to predict the severity of AIS through SSS in Chinese adolescents. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the prevalence of human papillomavirus (HPV) infection and presence of licensed HPV vaccine genotypes among patients with genital warts in Foshan, China from 2015 to 2022, to provide useful references for the detection, prevention and control of genital warts in Foshan. Methods: The present study retrospectively analyzed the HPV detection rates in patients with genital warts. A total of 1,625 patients were seen at the Second People's Hospital of Foshan, Guangdong Province, China, from 2015 to 2022. Samples were collected from various lesions and genotyped for 21 genotypes of HPV by infusion hybridization. The classification principle of HPV genotypes in this study: (1) Based on the relationship between HPV and carcinogenicity; (2) Based on the number of HPV genotypes infected; (3) Based on the HPV genotypes of licensed HPV vaccines. Results: The detection rate of any HPV in patients with genital warts was 80.37% (1,306/1,625). The detection rates of HPV for low-risk infection, co-infection and high-risk infection were 49.48% (804/1,625), 24.92% (405/1,625) and 5.97% (97/1,625), respectively. Single infection was the predominant type (51.94%, 844/1625). HPV-6 and HPV-11 were the predominant types of single infection; HPV-6 and HPV-52 were the predominant types of paired combinations of multiple infection. 82.22% (1,336/1,625) of the cases had an age distribution of ≤ 24, 25--34, and 35--44. The distribution of some HPV genotypes had age specificity, annual specificity and gender specificity. The genotype detection rates of 2v, 4v and 9v showed a decreasing trend with ages (all P < 0.05). The genotype detection rates of 4v and 9v showed a decreasing trend over the 8- year period (both P < 0.05). The genotype detection rates of 4v and 9v in the male group were higher than those in the female group (both P < 0.05). The genotype detection rate of 9v was significantly higher than that of 2v and 4v in the female group (both P < 0.05). Conclusion: Our study demonstrated that low-risk infection and single infection were the main types of HPV infection in patients with genital warts, mainly among young patients. Our study provides epidemiological data for the detection, prevention and control of genital warts in China. [ABSTRACT FROM AUTHOR]

Background: To analyze the curvature characteristics of the talus trochlea in people from northern China in different sex and age groups. Methods: Computed tomography scanning data of talus from 61 specimens were collected and constructed as a three-dimensional model by Materialise's Interactive Medical Image Control System(MIMICS) software, anteromedial(AM), posteromedial(PM), anterolateral(AL), and posterolateral(PL) edge, anterior edge of medial trochlea, posterior edge of medial trochlea and anterior edge of lateral trochlea were defined according to the anatomical landmarks on trochlear surface. The curvature radii for different areas were measured using the fitting radius and measure module. Results: There were significant differences among the talus curvatures in the six areas (F = 54.905, P = 0.000), and more trends in the analytical results were as follows: PM > PL > MP > AL > MA > AM. The average PL radius from specimens aged > 38 years old was larger than that from specimens aged < = 38 years (t=-2.303, P = 0.038). The talus curvature of the AM for males was significantly larger than that for females (t = 4.25, P = 0.000), and the curvature of the AL for males was larger than that for females (t = 2.629, P = 0.010). For observers aged < = 38 years, the AM curvature of the right talus in the male group was significantly larger than that in the female group (P < 0.01). In age < = 38years group, the MA curvature of right talus in male was significantly larger than in female group(P < 0.01), fitting radius of talus for male (21.90 ± 1.97 mm) was significantly greater than female of this(19.57 ± 1.26 mm)(t = 6.894, P = 000). The average radius of the talus in the male population was larger than that in the female population. Conclusion: There was no significant relationship between age and talus curvature for males and females. The radius of curvature in the posterior area was significantly larger than that in the anterior area. We recommend that this characteristic of the talus trochlea should be considered when designing the talus component in total ankle replacement (TAR). [ABSTRACT FROM AUTHOR]

Background: Dental caries in young children is a difficult global oral health problem. In the last decade, China has put a great deal of effort into reducing the prevalence of dental caries. This study, which is part of the China Population Chronic Disease and Nutrition Surveillance 2021, aimed to investigate the prevalence of dental caries among children aged 5 in Shanghai, China, and its associated factors. Methods: A total of 1281 children aged 5 years from 6 districts in Shanghai were selected by a stratified sampling method. The survey consisted of an oral health questionnaire and an oral health examination. The questionnaire included questions on oral health knowledge, attitudes, and behaviours. The oral health examination used WHO standards. After screening, the data were input and analysed. Chi-square tests and logistic regression analyses were used to study the relevant factors affecting dental caries. Results: The prevalence of dental caries among 1281 children was 51.0%, the dmft index score was 2.46, the Significant Caries Index (SiC) score was 6.39, and the SiC10 score was 10.35. Dental caries experience was related to the frequency of sweet drink consumption, the age of starting tooth brushing, eating habits after brushing, whether the children had received an oral examination provided by the government (p < 0.05), and the mother's education level but was not related to sex, the use of fluoride toothpaste, the frequency of brushing, whether the parents assisted brushing, or the frequency of flossing (p > 0.05). Logistic regression analysis showed that the region of residence, eating after brushing and the age of starting brushing were associated with dental caries. Conclusions: Dental caries remained prevalent among 5-year-old children in Shanghai, China. Prevention strategies that target the associated factors including region of residence, eating after brushing, and the age of starting brushing should be considered. [ABSTRACT FROM AUTHOR]

Background: To identify independent factors of cognitive frailty (CF) and construct a nomogram to predict cognitive frailty risk in patients with lung cancer receiving drug therapy. Methods: In this cross‐sectional study, patients with lung cancer undergoing drug therapy from October 2022 to July 2023 were enrolled. The data collected includes general demographic characteristics, clinical data characteristics and assessment of tools for cognitive frailty and other factors. Logistic regression was harnessed to determine the influencing factors, R software was used to establish a nomogram model to predict the risk of cognitive frailty. The enhanced bootstrap method was employed for internal verification of the model. The performance of the nomogram was evaluated by using calibration curves, the area under the receiver operating characteristic curve, and decision curve analysis. Results: A total of 372 patients were recruited, with a cognitive frailty prevalence of 56.2%. Age, education background, diabetes mellitus, insomnia, sarcopenia, and nutrition status were identified as independent factors. Then, a nomogram model was constructed and patients were classified into high‐ and low‐risk groups with a cutoff value of 0.552. The internal validation results revealed good concordance, calibration and discrimination. The decision curve analysis presented prominent clinical utility. Conclusions: The prevalence of cognitive frailty was higher in lung cancer patients receiving drug therapy. The nomogram could identify the risk of cognitive frailty intuitively and simply in patients with lung cancer, so as to provide references for early screening and intervention for cognitive frailty at the early phases of drug treatment. [ABSTRACT FROM AUTHOR]

Background: Adequate preoperative evaluation of the post-intubation hemodynamic instability (PIHI) is crucial for accurate risk assessment and efficient anesthesia management. However, the incorporation of this evaluation within a predictive framework have been insufficiently addressed and executed. This study aims to developed a machine learning approach for preoperatively and precisely predicting the PIHI index values. Methods: In this retrospective study, the valid features were collected from 23,305 adult surgical patients at Peking Union Medical College Hospital between 2012 and 2020. Three hemodynamic response sequences including systolic pressure, diastolic pressure and heart rate, were utilized to design the post-intubation hemodynamic instability (PIHI) index by computing the integrated coefficient of variation (ICV) values. Different types of machine learning models were constructed to predict the ICV values, leveraging preoperative patient information and initiatory drug infusion. The models were trained and cross-validated based on balanced data using the SMOTETomek technique, and their performance was evaluated according to the mean absolute error (MAE), root mean square error (RMSE), mean absolute percentage error (MAPE) and R-squared index (R2). Results: The ICV values were proved to be consistent with the anesthetists' ratings with Spearman correlation coefficient of 0.877 (P < 0.001), affirming its capability to effectively capture the PIHI variations. The extra tree regression model outperformed the other models in predicting the ICV values with the smallest MAE (0.0512, 95% CI: 0.0511–0.0513), RMSE (0.0792, 95% CI: 0.0790–0.0794), and MAPE (0.2086, 95% CI: 0.2077–0.2095) and the largest R2 (0.9047, 95% CI: 0.9043–0.9052). It was found that the features of age and preoperative hemodynamic status were the most important features for accurately predicting the ICV values. Conclusions: Our results demonstrate the potential of the machine learning approach in predicting PIHI index values, thereby preoperatively informing anesthetists the possible anesthetic risk and enabling the implementation of individualized and precise anesthesia interventions. [ABSTRACT FROM AUTHOR]

Background and purpose: The systemic immune-inflammation index (SII), a novel inflammation index derived from the counts of circulating platelets, neutrophils and lymphocytes, has been studied in the treatment of acute cancer and ischemic stroke (AIS). However, the clinical value of the SII in postoperative delirium patients has not been further investigated. The purpose of our research was to study the incidence and preoperative risk factors for postoperative delirium (POD) and verify whether the SII could serve as a potential marker for POD in older intertrochanteric fracture patients. Finally, we created a novel nomogram for predicting POD in older patients with intertrochanteric fractures. Methods: We enrolled elderly patients with intertrochanteric fractures who underwent proximal femoral nail antirotation (PFNA) between February 2021 and April 2023. Univariate and multivariate logistic analyses were subsequently performed to confirm the risk factors and construct a nomogram model.Calibration curve and clinical decision curve analysis (DCA) were used to assess the model's fitting performance. The performance of the nomogram was evaluated for discrimination, calibration, and clinical utility. Results: A total of 293 patients were eligible for inclusion in the study, 25.6% (75/293) of whom had POD. The POD patients had higher SII values than the non-POD patients. The SII was strongly correlated with POD in older intertrochanteric fracture patients, and the optimal cutoff value was 752.6 × 109. Multivariate analysis revealed that age, diabetes, total albumin, SII > 752.6 × 109 and a CRP > 20.25 mg/L were independent risk factors for POD patients. By incorporating these 5 factors, the model achieved a concordance index of 0.745 (95% CI, 0.683–0.808) and had a well-fitted calibration curve and good clinical application value. Conclusion: The SII is a simple and valuable biomarker for POD, and the new nomogram model can be used to accurately predict the occurrence of POD. They can be utilized in clinical practice to identify those at high risk of POD in older intertrochanteric fracture patients. [ABSTRACT FROM AUTHOR]

Aim. To compare the clinical characteristics of survival and nonsurvival patients with severe acute pancreatitis (SAP) and explore the risk of mortality in SAP patients. Methods. This was a single-center retrospective study performed in a severe acute pancreatitis diagnosis and treatment center. According to the outcome, SAP patients were divided into survival group and nonsurvival group. One-way ANOVA or independent t -test was used to compare the clinical characteristics of two groups of patients. Multivariate retrospective analysis was used to identify risk factors for mortality in SAP patients. Results. A total of 486 SAP patients were included in the study, and the 90-day mortality for SAP patients was 13.58%. The common etiologies of SAP are biliary tract diseases (69.75%) and hyperlipidemia (17.28%). The most common complications caused by SAP were organ failure (55.14%), ARDS (50.62%), AKI (30.45%), sepsis (27.16%), and abdominal fluid collection (27.57%). There were differences in age, complications, and medical intervention between the nonsurvival group and the survival group. The main causes of death were infection (46.97%), abdominal bleeding (28.79%), and organ failure (9.09%). The binary logistic regression analysis showed that there were significant differences in age, AKI, sepsis, abdominal hemorrhage, organ failure, laparotomy, creatinine, and APTT between the nonsurvival group and the survival group. Conclusion. Age, AKI, sepsis, abdominal hemorrhage, and organ failure are risk factors for mortality in SAP patients. SAP patients with high creatinine and prolonged APTT upon admission require doctors to be vigilant. The main cause of death in SAP patients is pancreatitis-related organ failure and secondary infection. [ABSTRACT FROM AUTHOR]

Background: Media guidelines for suicide reporting are available in many countries. However, to what extent the mass media comply with the guidelines is unknown. Few studies are available that investigate systematically whether the mass media reflect the epidemiological reality of suicide deaths in their articles. Methods: Based on the WHO media guidelines, this study investigated the characteristics of newspaper articles of suicides in three Chinese communities, namely Hong Kong, Taiwan and Guangzhou. Epidemiological comparisons were conducted to identify the age and gender differences between the suicide victims as reported in the newspapers and the official records of suicide deaths in all three places. Results: The results found that one media characteristic complied with the WHO media guidelines (ie, only about 2% of the articles were printed on the front page), but there were a number of instances of non-compliance (ie, only 4--14% provided sources for help-seeking and 27--90% printed with photos). The epidemiological comparisons revealed an over-representation of younger suicides and an under-representation of late-life suicides in the newspapers of all three places. Furthermore, female suicides were found to be under-reported in Taiwan and Guangzhou newspapers, but not in Hong Kong papers. Conclusion: Non-compliant suicide articles are prevalent in the newspapers of these three Chinese settings. The observed media misrepresentations may potentially mislead the public and the policy makers about the actual risk for suicide in some demographic groups. [ABSTRACT FROM AUTHOR]

This paper discusses how class and gender may be read against the narration of contemporary films in urban China, specifically in Beijing. The paper acknowledges that the effects of marketisation on social life in China are extremely complex, but argues that, nonetheless, a feminist reading is appropriate and necessary at this time. The premise of the paper is therefore that China is experiencing both macro-symptoms of new class structures and divisions, and micro-examples of moral ambivalence, formations of taste, and ascriptions of gender value to certain behaviours and age groups. In government-sponsored surveys in 2005, 61 million citizens self-identified as richer than before [bi qian fu], or as middle market-class [zhongchan jieji], or as middle-class (as a rough translation of that market analysis) people. A great many more fall outside the income bracket of affluence or even of aspiration to affluence, but are nonetheless caught up in the manifestations of social value and individual worth that such trends engender. Unsurprisingly, given the connections to consumption and urban growth, contemporary media in China are fascinated with the idea of the middle class and there are endless popular debates on the definitions, behaviours and meanings of such a force in contemporary society. In film, there is also a growing awareness that narratives of everyday experience will and must reflect on the consequences of a market economy for human relationships. [ABSTRACT FROM AUTHOR]

Background: Common bile duct (CBD) stone is one of the most common diseases among elderly people. In recent decades, there are numerous studies regarding the safety and efficacy of laparoscopic common bile duct exploration (LCBDE). Elderly patients are often regarded as high-risk patients because they are more likely to present with age-specific deterioration of organ function and coexisting chronic diseases, which may reduce their tolerance of laparoscopic surgery. Although laparoscopic surgery for choledocholithiasis is now widely accepted as the treatment for CBD stone, its appropriateness for the treatment of elderly patients or those with coexisting high-risk patients has not been well established. Therefore, the objective of this paper is to analyze the safety and efficacy of LCBDE in elderly patients.Methods: Between January 2012 and November 2015, 376 patients underwent LCBDE in our center. Based on their ages, they were divided into two groups, and a retrospective study was performed. By making comparisons between younger group who were younger than 70 years (n = 253) and elderly group who were 70 years old or older (n = 123), the demographics, clinical characteristics, laboratory data, operative parameters and outcomes were analyzed.Results: Before operation, elderly patients had more coexisting chronic diseases and risk factors, such as arterial hypertension, heart diseases, pulmonary diseases and previous abdominal surgery (P < 0.05). In both groups, LCBDE was equally successful with a high clearance rate (100 % in elderly patients vs. 98.8 % in younger group, P = 0.554). Besides, the operating time, intraoperative blood loss, postoperative hospital stay, total costs and overall complication showed no significant difference between two groups (P > 0.05). There was no major bile duct injury or death in either group.Conclusion: Although elderly patients are frequently confronted with coexisting disorders, LCBDE can be considered as a safe and effective technique in choledocholithiasis treatment for elderly patients. [ABSTRACT FROM AUTHOR]

Background: Inequalities in demographic, socio-economic and health status for China labor force place them at greater health risks, and marginalized them in the utilization of healthcare services. This paper identifies the inequalities which limit the utilization of health services among China labor force, and provides a reference point for health policy. Methods: Data were collected from 23,505 participants aged 15 to 65, from the 2014 China Labor Force Dynamic Survey (a nationwide cross-sectional survey covering 29 provinces with a multi-stage cluster, and stratified, probability sampling strategy) conducted by Sun Yat-sen University. Logistic regression models were used to study the effects of demographic (age, gender, marital status, type of hukou and migration status), socio-economic (education, social class and insurance) and health status (self-perceived general health and several chronic illnesses) variables on the utilization of health services (two-week visiting and hospitalization during the past 12 months). Goodness of fit was assessed using Hosmer-Lemeshow test. Discrimination ability was assessed based on the area under the receiver operating curve (AUC). Results: Migrants with more than 1 (OR 2.80, 95% CI 1.01 ~ 7.82) or none chronic illnesses (OR 1.26, 95% CI 1.01 ~ 7.82) are more likely to be two week visiting to the clinic than non-migrants; migrants with none chronic illnesses (OR 0.61, 95% CI 0.45 ~ 0.82) are less likely to be in hospitalization during the past 12 months than non-migrants. Female, elder, hukou of non-agriculture, higher education level, higher social class, purchasing more insurance and poorer selfperceived health were predictors for more utilization of health service. More insurance benefited more two-week visiting (OR 1.12, 95% CI 1.06 ~ 1.17) and hospitalization during the past 12 months (OR 1.12, 95% CI 1.07 ~ 1.18) for individuals with none chronic illness but not ≥1 chronic illnesses. All models achieved good calibration (Hosmer-Lemeshow test's P range of 0.258-0.987) and discrimination (AUC range of 0.626-0.725). Conclusions: This study has shown that there are inequalities of demographic, socio-economic and health status in the utilization of health services for China labor force. Prudent health policy with equitable utilization of health services eliminating mentioned inequalities should be a priority in shaping China's healthcare system reform. [ABSTRACT FROM AUTHOR]

Background: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India.Methods: Using national standardised data collected from adults aged 50 years and above with DM (self-reported) in China (N = 773) and India (N = 463), multivariable logistic regression describes: 1) association between respondents' socio-demographic and health behavioural characteristics and the dependent variable, DM medication use, and 2) association between DM medication use (independent variable) and household catastrophic expenditure on medications (dependent variable) (China: N = 630; India: N = 439). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010).Results: Prevalence of DM medication use was 87% in China and 71% in India. Multivariable analysis indicates that people reporting lifestyle modification were more likely to use DM medications in China (OR = 6.22) and India (OR = 8.45). Women were more likely to use DM medications in China (OR = 1.56). Respondents in poorer wealth quintiles in China were more likely to use DM medications whereas the reverse was true in India. Almost 17% of people with DM in China experienced catastrophic healthcare expenditure on medications compared with 7% in India. Diabetes medication use was not a statistically significant predictor of catastrophic healthcare expenditure on medications in either country, although the odds were 33% higher among DM medications users in China (OR = 1.33).Conclusions: The country comparison reflects major public policy differences underpinned by divergent political and ideological frameworks. The DM epidemic poses huge public health challenges for China and India. Ensuring equitable and affordable access to medications for DM is fundamental for healthy ageing cohorts, and is consistent with the global agenda for universal healthcare coverage. [ABSTRACT FROM AUTHOR]

Dietary antioxidant indices (DAI) may be potentially associated with relative telomere length (RTL) of leucocytes. This study aimed to investigate the relationship between DAI and RTL. A cross-sectional study involving 1656 participants was conducted. A generalised linear regression model and a restricted cubic spline model were used to assess the correlation of DAI and its components with RTL. Generalised linear regression analysis revealed that DAI (β = 0·005, P = 0·002) and the intake of its constituents vitamin C (β = 0·043, P = 0·027), vitamin E (β = 0·088, P < 0·001), Se (β = 0·075, P = 0·003), and Zn (β = 0·075, P = 0·023) were significantly and positively correlated with RTL. Sex-stratified analysis showed that DAI (β = 0·006, P = 0·005) and its constituents vitamin E (β = 0·083, P = 0·012), Se (β = 0·093, P = 0·006), and Zn (β = 0·092, P = 0·034) were significantly and positively correlated with RTL among females. Meanwhile, among males, only vitamin E intake (β = 0·089, P = 0·013) was significantly and positively associated with RTL. Restricted cubic spline analysis revealed linear positive associations between DAI and its constituents' (vitamin E, Se and Zn) intake and RTL in the total population. Sex-stratified analysis revealed a linear positive correlation between DAI and its constituents' (vitamin E, Se and Zn) intake and RTL in females. Our study found a significant positive correlation between DAI and RTL, with sex differences. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the relationship between psychological resilience, thriving at work, and work performance among nurses, as well as analyse the mediating role of thriving at work in the relationship between psychological resilience and the work performance of nurses. The findings are intended to serve as a reference for nursing managers to design tailored work performance intervention programs. Method: Using convenience sampling, 308 clinical nurses were selected from a tertiary hospital in Changsha City, Hunan Province, China, from February to April 2023. The Connor–Davidson Resilience Scale (CD-RISC), the Thriving at Work Scale, and the Work Performance Scale were employed for the questionnaire survey. Pearson correlation analysis was used to explore the relationship between psychological resilience, thriving at work and work performance. The SPSS 26.0 software's 'Process' plugin was utilised for mediation effect analysis. Results: Significantly positive correlations were found between psychological resilience and thriving at work (r = 0.806, P < 0.01), thriving at work and work performance (r = 0.571, P < 0.01) as well as psychological resilience and work performance (r = 0.572, P < 0.01). Psychological resilience significantly predicted work performance positively (β = 0.558, t = 11.165, P < 0.01), and this prediction remained significant when thriving at work (the mediating variable), was introduced (β = 0.371, t = 4.772, P < 0.01). Psychological resilience significantly predicted thriving at work positively (β = 0.731, t = 20.779, P < 0.01), and thriving at work significantly predicted work performance positively (β = 0.256, t = 3.105, P < 0.05). The mediating effect size of thriving at work between psychological resilience and work performance was 33.49% (P < 0.05). Conclusion: Thriving at work plays a partial mediating role between psychological resilience and work performance. The level of work performance among clinical nurses was relatively high. Nursing managers can enhance thriving at work by fostering psychological resilience among clinical nurses, thereby further improving their work performance to ensure high-quality and efficient nursing care. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to investigate the relationship between burnout and post‐traumatic stress disorder (PTSD) among frontline nurses who went to assist the epidemic situation in Wuhan, China, during the outbreak in 2020. The study also explored the mediating role of depression and the moderating role of age in the main relationship. Background: The relationship between burnout and PTSD in nurse has rarely been investigated in the context of the COVID‐19 pandemic. Understand the relationship between these variables can provide empirical evidence for developing interventions and protocols that improve the health of nurses in future public health emergencies. Design: An online cross‐sectional survey of targeted local 327 nurses who went to assist the COVID‐19 epidemic situation in Wuhan during the initial outbreak. Methods: This study was conducted in August 2020, the burnout scale, the PTSD scale and the depression scale were used to survey participants. The moderated mediation model was used to test research hypotheses. Results: Burnout could affect the PTSD symptoms in nursing staffs and depression could mediate this relationship. Age moderated the relationship between burnout/depression and PTSD, and the effects was strong and significant among younger participants in the relationship between burnout and PTSD. Conclusions: Burnout was identified as a core risk factor of PTSD in nurses. Depression and age played significant roles in the relationship between burnout and PTSD. Relevance to Clinical Practice: PTSD, as a symptom that manifests after experiencing a stressful event, should be a key concern among frontline healthcare professionals. This study suggests that PTSD in nurses can be further reduced by reducing burnout. Attention should also be paid to the PTSD status of nurses of different age groups. Patient or Public Contribution: Patients and the public were not involved in the design and implementation of this study. Frontline nurses completed an online questionnaire for this study. [ABSTRACT FROM AUTHOR]

We investigated the association between anemia status and the risk of heart failure (HF) in patients with coronary heart disease (CHD) based on a multi-center, large-sample and retrospective cross-sectional study including 89,207 patients. Heart failure was categorized as HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and HF with mid-range ejection fraction (HFmrEF). In multi-adjusted models, compared with patients without anemia, mild anemia (odds ratio [OR] 1.71; 95% confidence interval [CI] 1.53–1.91; P <.001), moderate anemia (OR 3.68; 95% CI, 3.25–4.17; P <.001), and severe anemia (OR 8.02; 95% CI, 6.50–9.88; P <.001) were associated with the risk of HF among CHD patients. Men aged <65 years were more likely to develop HF. In subgroup analyses, the multi-adjusted ORs and 95% CI of HFpEF, HFrEF, and HFmrEF related to anemia were 3.24 (95% CI 1.43–7.33), 2.22 (95% CI 1.28–3.84), and 2.55 (95% CI 2.24–2.89), respectively. These findings suggest that anemia might be associated with increased risk of different types of HF, especially HFpEF. [ABSTRACT FROM AUTHOR]

Background: Dacryocystitis is a common disease in pediatric ophthalmology. Analysis of basic information, flora distribution, and characteristics of information on drug-resistant bacteria in children with dacryocystitis for 6 years, providing evidence for ophthalmologic infection prevention and clinical management strategies. Methods: A retrospective cohort study was conducted to evaluate the demographics of dacryocystitis in children and microbiological characteristics of secretion cultures, and to analyze the basic information, distribution of pathogenic bacteria, drug resistance, and to plot trendsand distribution pie charts according to the years. Results: This study recruited 5791 specimens. Decreased incidence of dacryocystitis from 2020 to 2022 (including the COVID-19 pandemic). The age of highest incidence of dacryocystitis is infancy, followed by the neonatal period, and the incidence decreased with age. Streptococcus pneumoniae had the highest percentage in 2017, and the overall trend was decreasing, the difference was statistically significant (p < 0.001); Streptococcus mitis showed an overall increasing trend, with the highest incidence in 2022 and the lowest in 2017, with a statistically significant difference (p < 0.001); Haemophilus influenzae was the most common gram-negative bacteria with an overall decreasing trend (p < 0.001); The incidence of Catamoeba and Stenotrophomonas varied from year to year, with statistically significant differences (p = 0.010, p = 0.033, respectively). Methicillin-resistant Staphylococcus aureus (MRSA) had the lowest incidence in 2017 and 2022 the highest incidence in 2022, with a statistically significant difference in incidence between years (p = 0.003); β-lactamase-positive was the most common type of resistance, and MRSA was the second, with statistically significant differences between years (p = 0.003, p < 0.001, respectively). Streptococcus pneumoniae is a common etiologic agent of dacryocystitis in all age groups. Conclusions: Dacryocystitis in children is significantly associated with age characteristics and infection-related pathogens, and infection prevention and control can help reduce the infection of related pathogens and the increase of new drug-resistant strains. Close monitoring of changes in pathogen distribution in ocular secretion cultures can help in early intervention and treatment of infectious dacryocystitis. [ABSTRACT FROM AUTHOR]

Background: Oral disorders are still a major global public health challenge, considering their perpetuating and chronic nature. Currently, there is no direct index to measure the quality of care on a population scale. Hence, we aim to propose a new index to measure the quality of care for oral disorders worldwide. Methods: We generated our database using the data from the Global Burden of Disease (GBD) study 2017. Among different variables such as prevalence, incidence, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine the component that bears the greatest proportion of information to generate the novel quality of care index (QCI) for oral disorders. Results: Global QCI for oral disorders gradually increased from 1990 to 2017 (from 70.5 to 74.6). No significant gender disparity was observed during this period, and the gender disparity ratio (GDR) was considered optimal in 1990 and 2017. Between 1990 and 2017, the age-standardised QCI for all oral disorders increased in all the SDI regions. The highest QCI for all oral disorders in 2017 belonged to high-middle SDI countries (=80.24), and the lowest YLDs rate was seen in the low SDI quintile. In 1990, the quality of care in European, Central Asian, and Central and South American countries was in the lowest quintiles, whereas the North American, East Asian, Middle Eastern, and some African countries had the highest quality of dental care. Maynmar (=100), Uganda (=92.5), Taiwan (=92.0), China (=92.5), and the United States (=89.2) were the five countries with the highest age-standardised QCI. Nicaragua (=41.3), Belgium (=40.2), Venezuela (=38.4), Sierra Leone (=30.5), and the Gambia (=30.3) were the five countries with the least age-standardised QCI values. Conclusion: The quality of care for all oral disorders showed an increasing trend on a global scale from 1990 to 2017. However, the QCI distribution was not homogenous among various regions. To prevent the exacerbation of imminent disparities in this regard, better attention to total tooth loss in high-income countries and prioritising primary healthcare provision in low-income countries are recommended for oral disorders. [ABSTRACT FROM AUTHOR]

China, a society long characterized by traditional Confucianism and the practice of filial piety, is undergoing dramatic socioeconomic development and erosion of traditions. In this rapidly changing context, the motives behind rural parental bequests have not been well studied. This paper draws on a survey conducted in rural Anhui province of China and uses hierarchical linear models to examine whether three kinds of support from children are associated with older parents' bequest motives. We find that while instrumental support accords with an exchange model of motivation, financial transfer is consistent with an altruistic motivation for parental bequest plans. Offspring gender is strongly associated with parental planning of bequests; family division is a strong correlate of parents' bequest plan and reflects exchange motivation. These findings have important implications for research on traditional culture and an evolving social security system. [ABSTRACT FROM AUTHOR]

INTRODUCTION Currently, 40.7% of women in China are exposed daily to secondhand smoke (SHS); however, research on SHS exposure among women in Inner Mongolia is limited. We aimed to investigate the prevalence of SHS exposure, knowledge about the harms of smoking and SHS, and the association between sociodemographic factors and SHS exposure among never-smoking women in Inner Mongolia, Northern China. METHODS This study was based on a survey of chronic disease and nutrition conducted among Chinese adults in Inner Mongolia during 2015, a cross-sectional study with multi-stage stratified cluster sampling. A total 2293 never-smoking women aged ≥18 years were included in the study. Face-to-face interviews were used to collect data of sociodemographic characteristics, SHS exposure, and related knowledge. Questionnaires were administered by trained investigators, and the reliability and validity of the questionnaires were high. We performed descriptive analysis and logistic regression. All analyses were performed by IBM SPSS Statistics version 19.0. RESULTS Of the total, 69% of young women in Inner Mongolia in 2015 reported that they were exposed to SHS, the highest rate in comparison with older and middle-aged women. A total 49.90% of young women reported being exposed to SHS every day. Respondents had insufficient knowledge regarding smoking and SHS exposure. Compared with older never-smoking women, their young counterparts had a higher risk of SHS exposure, with an odds ratio of 2.143 (95% CI: 1.647-2.787). Education level and ethnicity were also significantly associated with SHS exposure. CONCLUSIONS This study showed that the highest rates of SHS exposure were among young never-smoking women in Inner Mongolia, and women with high education levels were less likely to be exposed to SHS. Improved public health information is needed that prioritizes SHS exposure among young women in Inner Mongolia. Health education regarding SHS exposure should be widely implemented throughout communities in this region. [ABSTRACT FROM AUTHOR]

Land expropriation-induced resettlement (LEIR) is an emerging land phenomenon manifested in Chinese cities to accommodate urban transformation and outward expansion. The resettlement has forced affected rural dwellers to leave their villages and be resettled to high-density urban neighborhoods. By employing surveys with relocated villagers from two different types of LEIR neighborhoods in suburban Shanghai, this paper extends the acculturation discourse to examine villagers' life transformation in resettlement neighborhoods. Our study addresses three research questions. First, what are the general acculturation patterns manifested among resettled villagers during their life transformation in LEIR neighborhoods? Second, how do individual acculturation outcomes vary by socio-demographic attributes of resettled villagers? Third, how do villagers' acculturation outcomes influence their current residence preferences? The results indicate villagers' stronger inclination toward rural village culture than urban neighborhood culture. For the socio-demographic attributes, we find that older villagers are more likely to maintain their original culture; villagers with higher education levels better adapt to urban neighborhood culture; multi-generation living benefits intercultural learning and exchange; and pre-resettlement conditions influence villagers' acculturation. We further contend that an increase in the probability of a villager's residence preference for LEIR neighborhoods aligns with an increase in that person's adherence to urban neighborhood culture and/or a decrease in that individual's continuity of rural village culture. Comparing the results collected from the two types of resettlement neighborhoods, we posit that socio-spatial mixture and diversity facilitates villagers' urban integration. Finally, we suggest long-term institutional supports to be continuously provided to resettled villagers for building adaptive resilience. [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. Adherence to complete decongestion therapy (CDT) is of utmost importance for patients with breast cancer-related lymphedema (BCRL). However, past studies have demonstrated that adherence to CDT in BCRL patients is less than satisfactory. Our study aimed to describe the level of adherence to CDT among BCRL patients and utilize the Health Belief Model to analyse the key factors that influence adherence. Methods. We employed a convenient sampling method to select 158 patients with BCRL who were in the maintenance stage of CDT in a grade A tertiary tumour hospital in Guangzhou. A questionnaire survey was used to investigate patients' adherence to CDT, as well as their sociodemographic characteristics, medical history characteristics, disease knowledge, and health beliefs. Results. The CDT adherence score of BCRL patients was 96.46 ± 18.46 points, with an average score of 2.61 ± 0.50 points per item. The adherence rate was 65.18 ± 12.47%, indicating a moderate level of adherence. Factors that significantly influenced CDT adherence in BCRL patients included age under 45 years, having 0 or 1 child, experiencing 9 lymphedema symptoms, and having low levels of disease knowledge and health beliefs (p < 0.05). Conclusions. The level of adherence to CDT in BCRL patients is moderate and requires improvement. To enhance adherence to CDT, medical professionals should focus on patients who are younger, have fewer children, exhibit fewer symptoms of lymphedema, possess limited disease knowledge, and have weak health beliefs. [ABSTRACT FROM AUTHOR]

The present study investigated 195 Chinese adolescents' (Mage = 15.9, SD = 1.46, 56% female) everyday secret-keeping behaviors and their rationale for their behaviors as reported in a two-week daily diary. A total of 860 secrets were reported. Chinese adolescents primarily kept secrets involving personal activities, followed by academic events and events concerning interpersonal relationships and electronic use. Justifications for their secretive behaviors mainly included reports of fear of parental disapproval in all types of events, particularly in personal events. Adolescents' fear of parental disapproval was often referenced in the context of adolescents' belief that their parents differed when it came to the value of doing activities outside of academics and attitudes towards adolescents' academic successes and failures. Our findings highlighted the significance of academic events and achievement in Chinese adolescents' secret-keeping behaviors and the central role of avoiding parental punishment or criticism in their justifications across all types of events. Girls reported a greater proportion of secrets concerning personal activity and a smaller proportion concerning electronic use than boys. Developmental differences were also found in the reporting of keeping secrets in personal activity and electronic use, i.e., adolescents reported more secrets in personal activity but fewer secrets concerning electronic use when they grew older. The findings highlight the importance of balancing adolescents' needs for autonomy development and academic achievement in adolescent-parent relationships. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the epidemiological characteristics of pressure injury (PI) in older inpatients and predictive validity of the Braden scale. Design: Cross‐sectional study. Methods: Conducted in a 2600‐bed tertiary hospital in Northwestern China from January to June 2022, the study included older patients (≥60 years). The Braden scale was used for the risk assessment of PI, and the epidemiological characteristics of PI were observed. The contributing factors of PI in older inpatients were examined using univariate and multiple or multivariable logistic regression analysis. The predictive validity and optimal cut‐off value were assessed using receiver operating curve (ROC). Results: The study included 13,064 older patients, with a PI incidence of 0.20%, with the highest incidence (0.95%) in those aged ≥80. Age, BMI, Braden score and length of hospital stay were related to PI occurrence. The Braden scale showed an AUC of 0.905 for predicting PI in older inpatients, with a sensitivity of 84.6% and specificity of 86.4%. The optimal cut‐off value of 19 yielded the best predictive performance with a Yoden index of 0.710. Conclusion: PI is most likely to occur in older inpatients with older age, longer hospital stay, lower BMI and Braden score. The Braden scale demonstrated good suitability for predicting PI risk in this population, with an optimal cut‐off value of 19 showing improved predictive accuracy. Patient or Public Contribution: Throughout the investigation, patients or family members cooperated to complete all data investigation and evaluation, and nurses assisted in PI risk assessment, skin evaluation and other work. [ABSTRACT FROM AUTHOR]

urpose: This cross-sectional study aimed to depict expressive language profiles and clarify lexical–grammatical interrelationships in Mandarin-speaking preschoolers with autism spectrum disorder (ASD) during the administration of the simplified Chinese Psychoeducational Profile–Third Edition screening. Method: We collected naturalistic language samples from 81 (74 boys, seven girls) 2- to 7-year-old (Mage = 55.6 months, SD = 15.17) Mandarin-speaking children with ASD in clinician–child interactions. The child participants were divided into five age subgroups with 12-month intervals according to their chronological age. Computer-assisted part-of-speech tagging, constituency analysis, and dependency analysis addressed the developmental trajectories of early lexical and grammatical growth in each age subgroup. Results: Significant within-ASD differences were observed in content words, function words, and lexical categories. Nouns and verbs were the predominant lexical categories, while noun types overwhelmed verb types in children over 3 years old. The grammatical development of 5- to 6-year-old Mandarinspeaking children with ASD was better than that of 3- to 4-year-old children. The trends of syntactic structures, grammatical relations, and grammatical complexity in each age group were similar. Conclusions: Mandarin-speaking preschoolers with ASD produce more lexicons with increasing age. They preserve the noun bias as a universal mechanism in early lexical learning. Moreover, their developmental trajectories of grammatical growth were comparable in each age subgroup. In addition, their lexicons and grammar were synchronically developed during early language acquisition. [ABSTRACT FROM AUTHOR]

The objective of this study is to investigate the impact of exercise habits on enhancing the sleep quality of older adults. The Pittsburgh Sleep Quality Scale and other questionnaires were utilized to assess the sleep quality of older adults aged 60 years and above in the H district. The sampling method employed was stratified random sampling. To analyze the influencing factors of sleep quality, the average treatment effect was estimated, the robustness of the results was assessed and statistical methods such as Logit regression and propensity score matching were employed. The study revealed that exercise habits strongly correlated with improved sleep quality in the older adult (p < 0.05), with the average total sleep quality score being 6.22 (±3.53). It was observed that older adults who engaged in exercise habits experienced a significant 12.66% increase in the likelihood of achieving good sleep. This investigation highlights the positive association between exercise habits and enhanced sleep quality among older adults. Additionally, age, physical pain and self-rated health statuses were identified as significant factors influencing sleep quality in this population. To enhance the sleep quality of older adults, this article recommends promoting relevant exercise habits, thus contributing to their overall well-being and quality of life. [ABSTRACT FROM AUTHOR]

Aim: Analysed clinical characteristics and influencing factors for hypoglycemia in hospitalized patients with type 2 diabetes mellitus (T2DM), and providing a scientific reference for precision nursing care of hypoglycemia in hospitalized patients with T2DM. Design: A cross‐sectional study. Methods: This study involved 378 hospitalized patients diagnosed with T2DM who have suffered hypoglycemia. Through questionnaires and electronic medical records to obtain the data concerning the general information, clinical symptoms, all recorded blood glucose information, and the diabetes knowledge and self‐management level of the patients. The clinical characteristics and influencing factors for hypoglycemia were analysed on the basis of the classification of hypoglycemia published by the American Diabetes Association in 2020. Results: Among 378 patients, 207 patients (54.76%) were experiencing Grade 1 hypoglycemia and 171 patients (45.24%) were experiencing Grade 2 hypoglycemia. Hypoglycemia and Grade 2 hypoglycemia in patients with T2DM occurred predominantly within the first 3 days of hospitalization. Hypoglycemia occurred most frequently after breakfast (74 cases, 19.6%), of which Grade 1 hypoglycemia and Grade 2 hypoglycemia accounted for 50%, respectively. Multivariable logistic regression identified risk factors for Grade 2 hypoglycemia in hospitalized patients with type 2 diabetes: older age, longer duration of diabetes, low body weight, diabetic nephropathy stages 4–5, diabetic autonomic neuropathy, inadequate self‐management ability and diabetes knowledge, and lower educational background. Conclusions: Hypoglycemia in type 2 diabetes occurs in the first 3 days during the hospitalization and most often after breakfast during the full day. Identifying high‐risk individuals and providing a scientific reference for precision nursing care of hypoglycemia in hospitalized patients with T2DM. [ABSTRACT FROM AUTHOR]

Pseudotsuga sinensis, a vulnerable relict coniferous tree species, faces threats from overexploitation and habitat loss. Despite its status, the forest types, community structure, and population characteristics of this species in China have remained largely unknown. In our study, we conducted analyses of 69 vegetation plots where P. sinensis was the dominant species in southwestern China. We identified five forest types, i.e., Type 1: Pseudotsuga sinensis evergreen coniferous forest; Type 2: Pseudotsuga sinensis - Pinus yunnanensis evergreen coniferous forest; Type 3: Pseudotsuga sinensis - Cyclobalanopsis glaucoides evergreen coniferous and broad-leaved mixed forest; Type 4: Pseudotsuga sinensis - Platycarya strobilacea evergreen coniferous and deciduous broad-leaved mixed forest; Type 5: Pseudotsuga sinensis - Calocedrus macrolepis evergreen coniferous forest. These forests exhibited a multilayered vertical structure. The Simpson diversity index ranged between 0.58-0.86, while the Shannon-Wiener diversity index ranged from 1.24 to 2.3. P. sinensis trees' average growth rate of ring width decreased from 5.86 to 0.33 mm/year as increasing ages. Observed maximum age of P. sinensis was 115 years with 78 cm diameter at the breast height. Age frequency distribution of P. sinensis was multimodal. There was a great lack of individuals at 0-20 years old. Forests with moderate disturbance showed a significantly higher number of P. sinensis individuals younger than 30 years compared to areas with no, slight, or severe disturbance. P. sinensis' regeneration depends on moderate disturbance. We recommended delineating buffer zones in the protected areas at certain sites and in such zones can be allowed to sustainable firewood cutting by selectively marked species other than P. sinensis. [ABSTRACT FROM AUTHOR]

Using adjusted 2000 population census data, this paper conducts projections of China's population up to 2050. Three fertility and four mortality scenarios yield 12 sets of results. Even though fertility is below replacement, China's population will continue growing for many years. One of the notable trends is the rapid ageing of the population. By the end of 2050, one-fifth to one-third of China's population will be aged 65 and over. The demographic dividend is expected to continue in next 10 to 20 years depending on future fertility which, in turn, is determined by changes in China's one-child policy. The Chinese government should be aware of all possible situations of population change, and particularly population ageing in the first half of the century, and be well prepared for all possible challenges that may arise. [ABSTRACT FROM AUTHOR]

The research reported in this paper investigated the effects of semantic relatedness of words (closely related vs. distantly related) and morpheme type (free morpheme vs. bound morpheme) on young Chinese children's homophone awareness, an aspect of morphological awareness, in two experiments. The first experiment was a cross-sectional study including 39 children in a beginning kindergarten class, 39 children in an intermediate kindergarten class, and 36 children in a senior kindergarten class. The second experiment was a 7-month longitudinal study involving 43 first graders and 50 second graders at the beginning of the study. In both experiments, the children judged whether orally presented words shared the same morpheme or contained homophonous morphemes. The results suggest that homophone awareness emerges in Chinese children in the kindergarten years. Children's morpheme identification is facilitated by the semantic proximity of words that share a morpheme, and awareness of free morphemes is developed before that of bound morphemes. Furthermore, although semantic relatedness is the most prominent factor in kindergarten, its effect varies as a function of morpheme type in the early primary grades. Our research sheds light on the developmental course of morphological awareness and the factors that influence it. [ABSTRACT FROM PUBLISHER]

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Aim. This paper is a report of a study investigating nurse burnout and its association with occupational stressors in Shanghai, China. Background. Burnout is described as feelings of emotional exhaustion, depersonalization and reduced personal accomplishment. Measuring burnout among nurses and its association with occupational stressors are important in providing appropriate intervention to reduce stress and burnout. Method. In total, 527 nurses from 41 hospitals in Shanghai returned self-reported questionnaires in June 2008. Their burden of burnout was measured by the Chinese version of 'Maslach Burnout Inventory', and their stress by the Chinese version of 'job content questionnaire' and 'effort-reward imbalance questionnaire'. Results. Most nurses (74.76%) had a Demand/Control ratio higher than 1 and 27.13% had an Effort/Reward ratio higher than 1. The nurses showed a high level of emotional exhaustion, moderate level of depersonalization, and low level of reduced personal accomplishment. Linear regression analyses showed higher burden of stress and burnout among nurses at younger age, or on shift duty or from higher grade hospitals. Both the job content questionnaire and effort-reward imbalance questionnaire models had good predictive powers of the nurses' burnout, especially the effort-reward imbalance questionnaire model is more powerful than the other in predicting two Maslach Burnout Inventory subscales of emotional exhaustion and depersonalization. Conclusion. Nurses in Shanghai were suffering from high levels of burnout, which was strongly associated with work-related stress. Interventions in reducing occupational stress are needed to reduce the burden of burnout in Chinese nurses. [ABSTRACT FROM AUTHOR]

SummaryIntroduction1Definitions of ethnic groups and demographics of minority ethnic groups in the UK○ 1.1 Definitions of 'ethnic groups' and 'ethnicity'○ 1.2 Demographics and characteristics of minority ethnic groups in the UK– Countries of origin– Age/sex distribution and life expectancy– Geographical distribution and size of household– Religious beliefs– Education and employment patternsKey points2Overview of the health profile and dietary habits of minority ethnic groups in the UK○ 2.1 Available surveys○ 2.2 Overview of the health profiles among adults from minority ethnic groups– Overall health– Cardiovascular disease (CVD)– Coronary heart disease (CHD)– Stroke– Type 2 diabetes– Obesity○ 2.3 Possible causes of increased disease risk among minority ethnic groups○ 2.4 Smoking, drinking and physical activity habits○ 2.5 Dietary habits and nutritional status○ 2.6 Overview of the health profiles and dietary and health behaviour patterns of children from minority ethnic groups– Overall health– Diet and health behaviour patterns○ 2.7 Gaps in data availabilityKey points3Factors affecting food choice– Income and socio‐economic status– Food availability and access– Awareness of healthy eating– Religious beliefs– Food beliefs– Time and cooking skills– Generation and genderKey points4Traditional diets of minority ethnic groups○ 4.1 Overview of traditional diets of minority ethic groups– South Asians– African‐Caribbeans– Chinese○ 4.2 Dietary acculturation○ 4.3 Nutritional composition of ethnic‐style cuisineKey points5Nutritional interventions and health promotion among minority ethnic groups○ 5.1 Effective nutritional interventions○ 5.2 Health promotion interventions to prevent problems associated with fasting○ 5.3 Priorities for nutritional interventions and health promotion○ 5.4 Using behaviour change models○ 5.5 Current community initiatives○ 5.6 Catering for institutionalised individuals○ 5.7 Recommendations for future research, policy and practiceKey points6Conclusion• Acknowledgements• References Summary: According to the latest census, non‐white minority ethnic groups made up 7.9% of the UK's population in 2001. The largest of these groups were South Asians, Black African‐Caribbeans and Chinese. Studies have shown that some minority ethnic groups are more likely to experience poorer health outcomes compared with the mainstream population. These include higher rates of cardiovascular disease (CVD), type 2 diabetes and obesity. The differences in health outcomes may reflect interactions between diet and other health behaviours, genetic predisposition and developmental programming, all of which vary across different groups. As is the case for the rest of the population, the dietary habits of minority ethnic groups are affected by a wide variety of factors, but acquiring a better understanding of these can help health professionals and educationalists to recognise the needs of these groups and help them to make healthier food choices. Unfortunately, to date, there have been few tailored, well‐designed and evaluated nutritional interventions in the UK targeting minority ethnic population groups. Further needs assessment and better evaluation of nutritional interventions have been recommended to enhance the understanding of the effectiveness of different approaches amongst minority ethnic groups. This briefing paper will provide an overview of the health profile, dietary habits and other health behaviours of the three largest non‐white minority ethnic groups in the UK, explore the factors affecting their food choices, provide a summary of their traditional diets and review the evidence base to identify the factors that support successful nutrition interventions in these groups. [ABSTRACT FROM AUTHOR]

Summary: The study cohort comprised 196 females and 163 males. Lumbar spine bone mineral density (BMD) and magnetic resonance imaging (MRI) were acquired. Females had more severe disc degeneration than males. Lumbar spine lower BMD was associated with less severe disc degeneration. Lumbar disc spaces were more likely to be narrower when vertebral BMD was higher. Introduction: The purpose of this paper is to study the relationship between gender, BMD, and disc degeneration in the lumbar spine. Methods: The study cohort comprised 196 females and 163 males (age range 67-89 years) with no age difference between the two groups. Lumbar spine BMD was measured with dual X-ray densitometry, and MRI was acquired at 1.5 T. A subgroup of 48 males had additional lumbar vertebral quantitative computerized tomography densitometry. Lumbar disc degeneration was assessed using a MRI-based eight-level grading system. Results: Female subjects had more severe disc degeneration than male subjects. After removing age effect, a positive trend was observed between T-score and severity of lumbar disc degeneration. This was significant in female subjects while not significant in male subjects. Lumbar disc spaces were more likely to be narrowed when vertebral BMD was higher. These observations were more significant in the midlumbar region (L3/4 and L4/5) and less so at the thoracolumbar junction. Conclusion: Female subjects tended to have slightly more severe lumbar disc degeneration than male subjects. Lower lumbar spine BMD was associated with less severe disc degeneration. [ABSTRACT FROM AUTHOR]

INTRODUCTION The aim was to evaluate the association between secondhand smoke (SHS) exposure and abnormal cervical cytology among Chinese adult women. METHODS A one-to-one matched case-control study was conducted with outpatients of the First Hospital of Jilin University between October 2013 to September 2016. In all, 228 cytologic confirmed new cases of abnormal cervical cytology and the equivalent number of age and ethnic matched controls were interviewed about SHS exposure and related factors. RESULTS Although 78.3% of all the participants had been exposed to SHS (78.1% subjects vs 78.5% controls), there were no statistical significance of cervical cytological abnormalities and SHS exposure status (never, former, current exposure), exposure intensity in cigarettes per day (none, 1-9, 10-19, and >20), SHS exposure duration in years (none, 1-9, 10-19, and >20) and the Brinkman Index (BI) (none, 1-99, 100-399, >400) between the two groups. The univariate analysis results showed that there were statistical differences between subjects and controls in marital status, sexual frequency in past year, number of sexual partners, age at first intercourse, age at first delivery. The stratified Cox regression model only showed that the age at first sexual intercourse was associated with the cervical cytological abnormalities (0R=1.206, 95% CI: 1.104-1.319). CONCLUSIONS Studies on the association between SHS exposure and cervical lesions have been equivocal. In this study, the SHS exposure could not be detected as an independent risk factor of abnormal cervical cytology among Chinese adult women. [ABSTRACT FROM AUTHOR]

Atmospheric age reflects how long particles have been suspended in the atmosphere, which is closely associated with the evolution of air pollutants. Severe regional haze events occur frequently in China, influencing air quality, human health, and regional climate. Previous studies have explored the characteristics of mass concentrations and compositions of fine particulate matter (PM 2.5) during haze events, but the evolution of atmospheric age remains unclear. In this study, the age-resolved University of California, Davis/California Institute of Technology (UCD/CIT) model was developed and applied to simulate the concentration and age distribution of PM 2.5 during a severe regional haze episode in eastern China. The results indicated that PM 2.5 concentrations in the North China Plain (NCP) gradually accumulated due to stagnant weather conditions during the beginning stage of the haze event. Accordingly, the atmospheric age of elemental carbon (EC), primary organic aerosol (POA), sulfate (SO42-), and secondary organic aerosol (SOA) gradually increased. The subsequent PM 2.5 concentration growth was driven by the local chemical formation of nitrate (NO3-) under high relative humidity. The newly formed NO3- particles led to a decrease in the mean atmospheric age of NO3- particles. During the regional transport stage, aged particles from the NCP moved to the downwind Yangtze River Delta (YRD) region, leading to a sharp increase in PM 2.5 concentrations and the average age of EC, POA, SO42- , and SOA in YRD. In contrast, the average age of NO3- and ammonium remained unchanged or even slightly decreased due to continuous local formation in the YRD region. Different evolution of the atmospheric age among these components provides a unique perspective on the formation of PM 2.5 components during the regional haze event. The information can also be used for designing effective control strategies for different components of PM 2.5. [ABSTRACT FROM AUTHOR]

Occupational stress, cumulative fatigue, and work-related musculoskeletal disorders (WMSDs) are major concerns in the field of occupational health. Previous studies on occupational health focused on key industries, such as medical care, while there were few related studies on Information Technology (IT) industry. Our study explored the factors influencing occupational stress, cumulative fatigue, and musculoskeletal disorders in the IT industry. We collected 1363 IT workers' valid questionnaires, of which 73.1% of participants were technicians in Chongqing, 2021. The core occupational stress scale (COSS), self-diagnosis checklist for the assessment of workers' accumulated fatigue and Chinese musculoskeletal disorders questionnaire were used to measure the occupational stress, cumulative fatigue, and musculoskeletal disorders of the respondents. Logistic regressions were used to explore the correlated factors affecting these indicators. The results showed that the prevalence of occupational stress, cumulative fatigue, and musculoskeletal disorders was 50.4%, 47%, and 72.3%, respectively. Working in the current position for 3–10 years was a common increased risk for all three indicators. Insomnia was associated with an increased risk of cumulative fatigue (Odds Ratio, OR = 2.156, p < 0.001) and musculoskeletal disorders (OR = 1.878, p < 0.001). Cumulative fatigue was also associated with an increased risk of having WMSDs (OR = 3.207, p < 0.001). According to our findings, occupational factors, such as long working years, overtime work, and personal lifestyle, are highly related to the occurrence of occupational stress, cumulative fatigue, and musculoskeletal disorders for IT industry workers. More attention should be paid to women and those with long working hours in the IT industry. [ABSTRACT FROM AUTHOR]

Background: Inherited metabolic disorders (IMDs) usually occurs at young age and hence it severely threatening the health and life of young people. While so far there lacks a comprehensive study which can reveals China's nationwide landscape of IMDs. This study aimed to evaluate IMDs incidence and regional distributions in China at a national and province level to guide clinicians and policy makers. Methods: The retrospective study conducted from January 2012 to March 2021, we analyzed and characterized 372255 cases' clinical test information and diagnostic data from KingMed Diagnostics Laboratory. The samples were from 32 provincial regions of China, the urine organic acids were detected by gas chromatography-mass spectrometry (GC–MS), amino acids and acylcarnitines in dried blood spots were detected by liquid chromatography-tandem mass spectrometry (LC–MS/MS). We did a statistical analysis of the distribution of the 16 most common IMDs in amino acid disorders and organic acidemias, and then paid special attention to analyze the age and regional distributions of different IMDs. The statistical analyses and visualization analysis were performed with the programming language R (version 4.2.1). Results: There were 4911 positive cases diagnosed, which was 1.32% of the total sample during the ten-year study period. Most diseases tended to occur at ages younger than 18 year-old. The Ornithine Transcarbamylase Deficiency tended to progress on male infants who were less than 28 days old. While the peak of the positive case number of Citrin Deficiency disease (CD) was at 1–6 months. Different IMDs' had different distribution patterns in China's provinces. Methylmalonic Acidemias and Hyperphenylalaninemia had an imbalanced distribution pattern in China and its positive rate was significantly higher in North China than South China. Conversely, the positive rate of CD was significantly higher in South China than North China. Conclusions: Results of this work, such as the differences in distribution pattern of different diseases in terms of age, region, etc. provide important insights and references for clinicians, researchers and healthcare policy makers. The policy makers could optimize the better health screening programs for covering children and infants in specific ages and regions based on our findings. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim was to identify latent trajectories in physical activity (PA) and their determinants in adults with chronic obstructive pulmonary disease (COPD) based on the socio‐ecological model. Background: PA has been linked to poor long‐term outcomes in patients with COPD. However, few studies have explored their PA trajectories and their predictors. Design: Cohort study. Methods: We used data from a national cohort and included 215 participants. PA was quantified using a short PA questionnaire, and group‐based trajectory modelling was used to explore the PA trajectories. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Generalised linear mixed models were used to elucidate the associations between predictors and PA during follow‐up. A STROBE checklist was used to guide the reporting of this study. Results: Three PA trajectory patterns were identified among 215 COPD participants with an average age of 60.51 ± 8.87: stable inactive group (66.7%), sharp decline group (25.7%) and stable active group (7.5%). The logistic regression showed that age, sex, income, peak expiratory flow, upper limb capacity, depressive symptoms, the frequency of contact with children were PA predictors. Upper limb capacity weakness and depressive symptoms were found to be associated with a sharp decline in PA during follow‐up. Conclusions: This study revealed three PA trajectories among patients with COPD. In addition to strengthening the physical functions and mental health of patients, support from the family, community and society also play a crucial role in promoting PA of patients with COPD. Relevance to Clinical Practice: It is essential to identify distinct PA trajectories in patients with COPD to develop future interventions that promote PA. No Patient or Public Contribution: A national cohort study was used and no patients or the public were involved in the design and implementation of this study. [ABSTRACT FROM AUTHOR]