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Since the outbreak and spread of COVID-19 all over the world, many countries, including China, are taking measures for epidemic prevention and control, and some measures require citizens to provide personal privacy information. In the era of big data, it is worth paying attention to how people view the collection of personal privacy data under the special background that China collects personal information to better fight against the COVID-19 epidemic. In particular, it is of great significance and value to explore the privacy concept of Chinese higher education groups, the most important participants in the era of big data in China. This study focuses on the privacy concept of Chinese higher education groups under the background of COVID-19 epidemic, and higher education groups from 19 provinces, 4 municipalities and 4 autonomous regions are selected as research samples. Through questionnaire survey and statistical analysis, individual privacy sensitivity, individual privacy deliver willingness, individual privacy security and other issues of Chinese higher education groups under the COVID-19 epidemic situation are discussed. And this study tries to explore the influencing factors behind it. It is found that Chinese higher education groups generally have high privacy sensitivity and high perception of privacy risk. However, in the special period of fighting against the COVID-19 epidemic, Chinese higher education groups generally have a high willingness to deliver private information and a high privacy security. In addition, education level, discipline background and parents' education level are important factors affecting the privacy concept of Chinese higher education groups.

This article examines Chinese student teachers' perceived university support for community service at the start of the semester in relation to three levels of purpose: expectations to feel self-transcendent emotions while doing service work, the strength of their sense of purpose and endorsement of specific purposes focused on social benefits. American questionnaires translated into Chinese were completed online by 284 students in a teachers' university in northeast China. Compared to student teachers who perceived a lack of university support, those who perceived strong support more weakly expected to feel negative self-transcendent emotions during community work, reported higher searching for purpose level and attached greater importance to both social and creative purposes aimed to help others.

This article discusses the concept of "One Health," which recognizes the interconnectedness between humans, animals, and the environment. It focuses on the issue of reverse zoonosis, which refers to the transmission of pathogens from humans to animals. The study specifically examines the occurrence of SARS-CoV-2 reverse zoonosis among cats in China. The research found a 1.5% positivity rate for SARS-CoV-2 among infected cats, with the Omicron variant being detected. The study highlights the need for targeted surveillance and precautionary measures to mitigate the impact of SARS-CoV-2 reinfections in cats and emphasizes the importance of a holistic One Health approach. [Extracted from the article]

The objective of this study was to estimate the association of depressive and anxiety symptoms with the risk of cardiovascular disease (CVD) in middle-aged and older Chinese women and to further evaluate whether the association was influenced by sociodemographic factors. This cross-sectional study included 9544 women aged 40 to 70 years from the eastern, central, and western regions of China in 2018. Logistic regression models were utilized to examine odds ratios (ORs) and their 95% confidence intervals (CIs) for depressive and anxiety symptoms with CVD risk. Depressive (OR = 1.89) and anxiety symptoms (OR = 1.55) were independently associated with an increased risk of CVD after adjusting for potential confounders. Stratified analyses found that depressive symptoms were only significantly associated with higher risk of CVD in women aged over 50 years and with lower levels of education and household income, whereas anxiety symptoms were only significantly associated with an elevated risk of CVD in women aged 60 to 70 years, and living in rural areas, and with lower levels of education and household income. Our findings emphasize the improvement of recognizing and managing depressive and anxiety symptoms to reduce the risk of CVD in middle-aged and older women, particularly in older women of low socioeconomic status. [ABSTRACT FROM AUTHOR]

Canine parvovirus 2 (CPV-2) is a highly contagious virus in dogs that typically causes hemorrhagic enteritis and a high mortality rate in unvaccinated puppies. The genetic variability and antigenic diversity of CPV-2 hinder its effective prevention of infection by vaccination. To investigate the epidemiology and genetic characteristics of CPV-2 in China, rectal swabs from affected dogs were collected from different animal clinics in Kunshan from 2022 to 2023. Preliminary detection and capsid gene sequencing of CPV-2 were performed using previously described primers and protocols. The overall detection rate for CPV-2 was 16.5% (33/200). A significant association was found between the CPV-2-positivity and clinical signs, age, breed and vaccination status. Sequence analysis revealed the presence of CPV-2c genotypes in all positive samples, which were genetically similar to other Asian CPV-2c strains. Notably, four key mutations (A5G, F267Y, Y324I and Q370R) were detected in all isolates, and one novel mutation (I447M) was detected in three CPV-2 isolates. These mutations in the CPV-2 strains could impact vaccine efficacy and the effectiveness of the virus immune evasion. Surprisingly, no recombination events were observed between the identified CPV-2c strains and reference strains from China. Our data revealed that amino acid residues 324, 426 and 440 of VP2 may under strong selection pressure. This pattern of genetic variation in the CPV-2 lineage warrants continuous laboratory-based surveillance programs in other parts of China to better understand the pattern of seasonal distribution and association between emerging genotypes and the intensity of disease severity. [ABSTRACT FROM AUTHOR]

This article discusses the potential for reverse zoonotic transmission of human seasonal influenza A virus (H1N1, H3N2) among cats in China. The close contact between cats and humans increases the risk of pathogen spillover and the emergence of new pathogenic strains. The study collected nasal swab samples from diseased cats in China and found evidence of human seasonal influenza A virus in 2.8% of the samples. The findings highlight the potential risk of cats catching influenza from their owners and emphasize the need for further research and preventive measures to minimize reverse zoonotic transmission. [Extracted from the article]

Objective: The relationships between childhood weight self-misperception and obesity-related factors particularly health markers have not been extensively discussed. This study aims to examine the associations between weight self-misperception and obesity-related knowledge, attitudes, lifestyles and cardio-metabolic markers among Chinese paediatric population. Design: Cross-sectional study. Setting: Data sourced from a national survey in Chinese seven provinces in 2013. Participants: Children and adolescents aged 5–19 years. Results: Of the total 14 079 participants, there were 14·5 % and 2·2 % participants over-estimated and under-perceived their weight, respectively. Multi-variable logistic regression was applied to calculate OR and 95 % CI (95 % Cl) of obesity-related behaviours and cardio-metabolic markers by actual and perceived weight status. Individuals who perceived themselves as overweight/obese were more likely to have prolonged screen time, insufficient dairy intake and over sugar-sweetened beverages consumption (all P < 0·05), regardless of their weight. Furthermore, actual overweight/obese individuals had higher odds of abnormal cardio-metabolic markers, but a smaller magnitude of association was found among weight under-estimators. Among non-overweight/obese individuals, weight over-estimation was positively associated with abdominal obesity (OR: 10·49, 95 % CI: 7·45, 14·76), elevated blood pressure (OR: 1·30, 95 % CI: 1·12, 1·51) and dyslipidemia (OR: 1·43, 95 % CI: 1·29, 1·58). Conclusions: Weight over-perception was more prevalent than under-estimation, particularly in girls. Weight over-estimators tended to master better knowledge but behave more unhealthily; both weight over-perception and actual overweight/obesity status were associated with poorer cardio-metabolic markers. Future obesity intervention programmes should additionally pay attention to the population with inaccurate estimation of weight who were easily overlooked. [ABSTRACT FROM AUTHOR]

Summary: Objective: Birth weight (BW) and sibling's status are two important indicators of early intrauterine environment and subsequent living environment, but no evidence has emerged on their joint associations on metabolic obesity phenotype. To determine the joint associations between BW and single‐child status with childhood metabolic obesity phenotype was our purpose. Methods: A cross‐sectional assessment of children and adolescents aged 7–18 years was performed in Chinese seven provinces in 2013. We obtained anthropometric, blood pressure and biochemical measurements, and distributed questionnaires covering demographic, neonatal and lifestyle characteristics. The metabolic obesity phenotype was defined by 2018 consensus‐based criteria. Logistic regression and restricted cubic spline models were applied to evaluate the associations of BW and metabolic obesity phenotype, and estimate the multiplicative interactions and the combined associations of BW and single‐child status with metabolic obesity phenotype. Results: Of enrolled 12 346 children and adolescents, the prevalence of metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) was 1.96% and 3.03%. There were 8.95% and 4.03% children with high BW or low BW, and 67.55% did not have siblings. High BW was positively associated with MHO (OR = 1.94, 95%CI = 1.28–2.94). Single‐child also had increased odds of MHO and MUO (p < 0.05), and it had joint associations with high BW showing 0.85‐ to 2.58‐fold higher odds of MUO and MHO. Conclusions: High BW and single‐child status have joint positive associations with the subsequent odds of MHO and MUO, which should be jointly prevented through earlier screening and subsequent preventive strategies. [ABSTRACT FROM AUTHOR]

The present study aimed to explore the association between healthy lifestyle pattern and childhood early onset of puberty. Based on a cohort study in Xiamen of China, a total of 1294 children was followed for three and a half years. Children's lifestyles, including dietary behaviour, physical activity, sleep duration, smoking and drinking behaviour and sedentary behaviour, were collected by questionnaires. Healthy lifestyle pattern was determined mainly according to the recommendations by the Dietary Guidelines for Chinese school-age children and Canadian Guidelines for children and youth. The pubertal development was assessed by clinical examination according to Tanner stages. The association between pre-pubertal lifestyle and early onset of puberty was estimated using linear regression and log-binomial regression. We found that children who adhered to a healthy lifestyle had a 0·36-year delay of the age of puberty onset (coef = 0·36, 95 % CI (0·08, 0·65)) and 53 % lower risk of early onset of puberty (risk ratio = 0·47, 95 % CI (0·27, 0·80)), compared with those who had a poor lifestyle. However, the beneficial effect of favourable lifestyles on the early onset of puberty was found only in boys with normal weight. Boys who adhered to active physical activity and low sedentary behaviour had a relatively delayed age of puberty onset (coef = 0·49, 95 % CI (0·26, 0·72)). This is the first time to find that healthy lifestyle pattern was associated with a substantially lower risk of early onset of puberty, especially in boys with normal weight. Advocating an integrated healthy lifestyle is essential for the development of children. [ABSTRACT FROM AUTHOR]

Pesticides are widely used to maintain tea yields. For achieving satisfactory effects on pests, multiple pesticides in a low application dose have been the trend at present. In this study, we investigated the dissipation and dietary risk assessment of thiacloprid and tolfenpyrad. A method for the determination of thiacloprid and tolfenpyrad was developed. The recoveries ranged from 73% to 105% with standard deviations between 0.7% and 8.3%. Limits of quantification were 0.01 mg/kg for both pesticides. Field trials were conducted in China in 2021. The half-lives were in ranges of 3.22 to 8.45 days for thiacloprid and 2.91 to 10.50 days for tolfenpyrad. The terminal residues were in the range of 0.04–2.55 mg/kg for thiacloprid and <0.01–4.00 mg/kg for tolfenpyrad, respectively. Finally, a dietary risk assessment was conducted representing the acceptable risk of the two pesticides, which of ratios were all less than 100%. The safe pre-harvest interval of 14 days was suggested. This study can serve as a guide for the rational application of thiacloprid and tolfenpyrad in tea, which also ensures the safety of human health. [ABSTRACT FROM AUTHOR]

Evidence on the effects of exposure to ambient gaseous pollutants on children's vision was consistently scarce. We aimed to explore the effect of ambient gaseous pollutant exposure on the incidence of visual impairment (VI) in children. From 2005 to 2018, a total of 340,313 children without VI participated in a longitudinal and two-center dynamic cohort. The logMAR acuity was used to assess visual function. The space–time extremely randomized trees model was used to estimate SO2 and CO exposures levels. The association between SO2 and CO and VI risks among children was assessed using a proportional hazards model with a restricted cubic spline. Subgroup analyses stratified by gender and grades were used to investigate the differences in an association of SO2 and CO exposures with childhood VI. A total of 158381 (46.54%) children experienced an new incident VI. A ten-unit (10 μg/m3) increase in SO2 exposure concentrations was significantly associated with a 1.70 times higher risk of childhood VI. In addition, a 0.1-unit (0.1 mg/m3) increase in CO exposure was significantly associated with a 1.22 times higher risk of childhood VI. The positive association between ambient gaseous pollutants (including SO2 and CO exposures) and childhood VI risks remained even after adjusting for other environmental variables. An increase in the incidence of VI in children was positively linked to SO2 and CO exposure. Such evidence might aid governments in developing strategies to interfere with children's eyesight by decreasing air pollution and changing school curricula. [ABSTRACT FROM AUTHOR]

Mapping of groundwater distribution potential over space, built by synergizing environmental variables and machine learning models, was of great significance for regional water resources management. A total of 245 wells were identified based on field survey in the Chihe River basin in Anhui province, out of which 172 wells locations were randomly used for training the machine models and the other 73 wells for validation process of machine models. Thirteen environmental variables including elevation, slope, slope aspect, plan curvature, profile curvature, topographic wetness index (TWI), drainage density, distance to rivers, distance to faults, lithology, soil type, land use, and normalized difference vegetation index (NDVI) were used to build the spatial database of this research. Three GIS-based machine learning models were used for mapping the groundwater distribution potential: logistic regression (LR), deep neural networks (DNN) and random forest (RF). Then, the applicability of those models was evaluated by the evaluation index of mean absolute error (MAE), root mean square error (RMSE) and correlation coefficient (R). The final results indicated that the potential of regional groundwater distribution is concentrated in moderate to high potential areas. Among them, the moderate to the high potential distribution area in the LR model accounted for 81.14% of the total area, 90.36% and 87.55% in the DNN model and the RF model, respectively. In addition, three machine learning models can be implemented for prediction of groundwater distribution based on the three evaluation indexes, among which the LR model performs more prominently. The good prediction capabilities of machine learning technologies can provide a reliable scientific basis for spatial prediction of groundwater distribution and management of water resources. [ABSTRACT FROM AUTHOR]

Using manually collected data of Chinese listed companies, this study investigates the effect of CEOs' supply chain experience on corporate innovation. We find that such experience is positively associated with corporate innovation inputs, outputs, and innovative efficiency. The main findings withstand checks for endogeneity, self-selection bias, and robustness tests. Additionally, CEOs' supply chain experience improves corporate innovation performance through providing information more efficiently, reducing the financial constraints faced by firms, and improving the effectiveness of corporate governance. Further analyses indicate that the effect this experience on innovation varies in different environments. Overall, our results suggest that CEOs' supply chain experience, as an essential component of social ties, contributes to corporate innovation. [ABSTRACT FROM AUTHOR]

In the operation and management of the company, major customers may affect a supplier firm's level of governance. The goal of our study is investigating whether a major customer acts as an important role in corporate governance in emerging markets and exposing the mechanism that how major customers affect corporate decision-making. There is a growing body of literature involving studies about the effect of customer concentration on firm performance of western countries. Few studies have recognized to what degree does customer concentration satisfy the sustainable development of supplier firm. Using a sample of Chinese listed firms, we found a nonlinear relationship between customer concentration and risk-taking, corporate policies and firm performance. Evidence shows that the effect of customer concentration in China resembles an inverted U-shaped curve and major customers are crucial in financial and investment policies. Our results help to provide a broader perspective on the role of major customers, giving a deep explanation about the role of customer concentration in corporate governance. [ABSTRACT FROM AUTHOR]

As an important driving force for China's economic transformation and upgrading, the problems of financing difficulties and expensive financing for SMEs have become increasingly prominent. The main objective of this paper was to analyze the impact of financial intermediary departments' risk preference on corporate finance. Under the revised DSGE framework, this paper discusses the impact and stability analysis of commercial banks' risk preferences on SMEs' financing. The results show that positive interest rate shocks inhibit commercial banks' credit to SMEs, and with the increasing weight of commercial banks' risk preference for default rate, the trend of credit repression will be intensified. [ABSTRACT FROM AUTHOR]

Background: The prevalence of MS among children and adolescents continues to rise, which has become an escalating serious health issue worldwide. It had been reported that maternal current lifestyle had a strong independent correlation with offspring health. However, it is not clear whether comprehensive lifestyle of mother has an impact on the MS risk in offspring and the role of offspring's lifestyle in it. Methods and Results: We included 4,837 mother-child pairs from a multi-centered cross-sectional study conducted in China. The information of maternal lifestyle was obtained by self-reported questionnaire, and metabolic syndrome (MS) in offspring was determined by anthropometric measurements and blood tests. Logistic regression models were employed to evaluate the association between maternal lifestyle and risk of MS in offspring. We found maternal healthy lifestyle was independently associated with lower risk of offspring MS, and the risk of MS in offspring decreased with the increased number of maternal ideal lifestyle factors. Although adolescents' lifestyle did not fully explain the relationship between maternal lifestyle and risk of offspring MS, compared with those had less ideal lifestyle factors in both mothers and offspring, the risk of offspring MS was lower in those had more ideal lifestyle factors in both mothers and adolescents. Conclusions: Healthy lifestyle in mothers was associated with a lower risk of MS in offspring, which was independent of offspring's lifestyle. These findings support mother-based lifestyle intervention could be an effective strategy to reduce the MS risk in adolescents. [ABSTRACT FROM AUTHOR]

There are 9 major coal-accumulating periods during geological history in China, including the Early Carboniferous, Late Carboniferous-Early Permian, Middle Permian, Late Permian, Late Triassic, Early-Middle Jurassic, Early Cretaceous, Paleogene and Neogene. The coal formed in these periods were developed in different coal-accumulating areas (CAA) including the North China, South China, Northwest China, Northeast China, the Qinghai–Tibet area, and China offshore area. In this paper, we investigated depositional environments, sequence stratigraphy, lithofacies paleogeography and coal accumulation pattern of five major coal-accumulating periods including the Late Carboniferous to Middle Permian of the North China CAA, the Late Permian of the South China CAA, the Late Triassic of the South China CAA, the Early-Middle Jurassic of the North and Northwest China CAA, and the Early Cretaceous in the Northeast China CAA. According to distribution of the coal-bearing strata and the regional tectonic outlines, we have identified distribution range of the coal-forming basins, sedimentary facies types and coal-accumulating models. The sequence stratigraphic frameworks of the major coal-accumulating periods were established based on recognition of a variety of sequence boundaries. The distribution of thick coals and migration patterns of the coal-accumulating centers in the sequence stratigraphic framework were analyzed. The lithofacies paleogeography maps based on third-order sequences were reconstructed and the distribution of coal accumulation centers and coal-rich belts were predicted. [ABSTRACT FROM AUTHOR]

The Early Cretaceous is an important coal accumulation period in China. Abundant coal resources were formed in the southeastern margin of Songliao Basin. Sequence stratigraphy and coal accumulation of the Early Cretaceous in the southeastern margin of Songliao Basin have been studied on the basis of extensive outcrop and borehole data. Based on regional unconformity, basal erosional surfaces of incised valley fills, and abrupt depositional facies-reversal surface, six sequence boundaries have been identified, which subdivide the Early Cretaceous coal-bearing series into 5 third-order sequences. Sequence I corresponds to Huoshiling Formation, sequences II and III correspond to member I and member II of Shahezi Formation. Sequences IV and V correspond to member I and member II of Yingcheng Formation. Sequence I developed at the initial subsiding stage, sequence II and III developed during the stable subsiding stage, while sequence IV and V developed during the basin shrinkage stage. The major coal seams were developed in the sequence II and III, which ensured the relative balance between the increase rate of the accommodation space and the rate of peat accumulation for a longer period, thus forming a thick coal seam. [ABSTRACT FROM AUTHOR]

Public health has been associated with environmental pollution and regulations. With the increasing awareness of environmental protection, the real effects of environmental regulations and mechanisms on public health remain uncertain. We develop a theoretical model of individual utility and investigate how environmental regulations affect public health from a social welfare perspective. By using the panel data from the China Household Finance Survey (CHFS) in 2011, 2013, 2015, 2017, and 2019, we find that environmental regulations positively influence public health. This positive effect is attributable to a boost in employment and an improvement in individual happiness. Furthermore, the heterogeneity analysis reveals that environmental regulations are more likely to affect groups with low education, middle-aged, living in eastern China and rural areas. These results provide a comprehensive understanding of the heterogeneous effects of environmental regulation on health and offer a new perspective for policy-makers to balance social welfare with environmentally sustainable development. [ABSTRACT FROM AUTHOR]

Early onset of puberty could have significant impacts on childhood health, but the extent to which it was affected by phthalate esters (PAEs) and sex hormone disruption was not understood. The aim of this study is to investigate the associations between exposure to PAEs and sex hormone disruption and early onset of puberty in children. A longitudinal cohort study was conducted in China from May 2017 to Oct 2020, involving 740 children during consecutive visits. The onset of puberty was evaluated using Tanner definition, and early puberty was defined as an onset age less than the first 25 %, with cut-offs of 10.33 and 8.97 years for boys and girls, respectively. Serum testosterone (TT), estradiol (E 2) and urinary PAE metabolites were measured during three visits. Generalized linear models were used to explore the associations between PAE and sex hormones with the age of puberty onset, while log-binomial regressions were applied to assess the associations of persistent exposure to PAEs and sex hormones with early pubertal onset. Approximately 86.0 % of boys and 90.2 % of girls completed puberty onset from pre-puberty, and more than 95 % of participants had PAE concentrations higher than the limit of detection. Boys showed higher exposure to PAE pollutants and higher TT levels. Persistent exposure to PAEs was positively associated with early pubertal onset in girls (ARR = 1.97, 95 %CI = 1.12, 3.46). Moreover, persistent exposure to PAEs and E 2 had synergistic associations with early pubertal onset in both boys (ARR = 4.77, 95 %CI = 1.06, 21.54) and girls (ARR = 7.07, 95 %CI = 1.51, 33.10). However, PAEs and TT had antagonistic associations only in boys (ARR = 0.44, 95 %CI = 0.07, 2.58). Long-term exposure to PAEs might increase the risk of early pubertal onset, and it appears to work in synergy with E 2 , while in antagonism with TT in boys' early pubertal onset. Reducing PAEs exposure might promote pubertal health. • Long-term phthalates exposure was related with girls' early pubertal onset. • Phthalates and estradiol had synergistic associations with early pubertal onset. • Phthalates worked in antagonism with testosterone in boys' early pubertal onset. • Determining exposure limits is critical for pubertal development. [ABSTRACT FROM AUTHOR]

Urban heat island (UHI) often cause negative impact and has been linked to heart stroke rate, morality, human comfort, energy consumption and air pollution. Fortunately, urban green spaces have been considered as an effective element to mitigate UHI through their cooling effect. However, further empirical research is necessary in order to efficiently guide the design and planning of urban green space. We observed the impacts of urban park's tree, grass and waterbody on microclimate inside the Olympic park of Beijing during summer days. The results indicated that, on average, the park was 0.48–1.12 °C cooler during the day, as well as increased air humidity 2.39–3.74% and reduced human comfort index 1.02–2.43 to generate more comfortable thermal environment. Urban park's cluster trees with short ground vegetation generated higher cooling effect than single trees, grass and waterbodies; proper irrigation regime enhanced the cooling effect of grasses, even the irrigated grass have similar cooling effect with small waterbody on sunny, windless summer days. Therefore, we advise to increase undergrowth coverage and grass irrigation management in order to take advantage of cooling effect of urban parks. [ABSTRACT FROM AUTHOR]

• Introduction: Fargesia qinlingensis is the primary food source for the endangered giant panda during the summer months in the Qinling Mountains, but little is known about its spatial distribution and plant community associations. • Methods and materials: We examined the composition and structure of the forest canopy and topographic patterns as correlates of F. qinlingensis population structure in Foping National Nature Reserve (FNNR), Qinling Mountains, China. • Discussion: F. qinlingensis is the dominant understory vegetation from 1,800-2,600 m in FNNR. Populations of F. qinlingensis were associated with several different tree communities, mainly with broad-leafed dominants at intermediate elevations and conifers at higher elevations. F. qinlingensis was associated with herb communities of intermediate species richness. F. qinlingensis densities were lowest at the highest elevations in herb-rich alpine meadows and at low elevations where the most species-rich tree communities had high cover. • Conclusion: The most species-rich tree and herb communities were not associated with F. qinlingensis populations, thus efforts to conserve both bamboo as a food resource for pandas and species diversity of other plants must prioritize the entire elevation range in these mountains. [ABSTRACT FROM AUTHOR]

Rising evidence of both experimental and epidemiological studies suggests that phthalate exposure may contribute to increased risks of metabolic disorders. But there is limited research on the childhood dyslipidemia. Our cohort study was conducted in Xiamen city, Fujian Province, China. A total of 829 children (mean age 8.5 years) were included with collection of urine, blood samples and demographic data in May 2018 and followed up once a year from 2018 to 2020. We performed adjusted log-binomial regressions to examine associations between sex-specific tertiles of seven phthalate metabolites and dyslipidemia in visit 1, as well as persistent dyslipidemia and occasional dyslipidemia. We also used generalized estimating equation models (GEE) to explore the relationships between log-transformed phthalate metabolites and lipid profiles. In adjusted models, the prevalence and RRs of dyslipidemia increased with tertile group of mono-n-butyl phthalate (MnBP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), and summed di-(2-ethylhexyl) phthalate (∑DEHP) metabolites with a dose-response relationship in visit 1, as well as persistent dyslipidemia. Higher MnBP, ∑LMWP, MEHHP, MEOHP, and ∑DEHP concentrations were also associated with higher levels of log-transformed triglycerides (TG). Boys were more vulnerable to phthalates exposure than girls. In conclusion, children in China were widely exposed to phthalates, and phthalates exposure during childhood might significantly increase the risk of dyslipidemia and a higher level of lipid profiles, particularly in boys. [Display omitted] • Children in China were widely exposed to phthalates. • Boys were exposed to higher levels of phthalates than girls. • Urine MnBP, MEHHP and MEOHP were associated with dyslipidemia of children. • Phthalates exposure may mainly affect the changes of triglycerides in child serum. • Boys were more vulnerable to phthalates exposure than girls. [ABSTRACT FROM AUTHOR]

[Display omitted] • Children in China were extensively exposed to phthalates. • The exposure to phthalates in children had higher risk of overweight and obesity. • A dose-response relationship of phthalates with overweight and obesity existed. There was growing interest in endocrine disrupting chemicals that might have effect on the obesity epidemic, but few studies on the association of phthalates (PAEs) with childhood overweight and obesity in China based on longitudinal cohort study were available, which was the purpose of the present study. A nested case-control study was conducted in a prospective cohort of 2298 children aged 7–13 years from October 2017 to October 2020 with five waves visits in Xiamen city, China. A total of 829 children remained in the first wave of follow up with collection of urine for measuring seven PAEs metabolites, including mono-methyl phthalate (MMP), mono-ethyl phthalate (MEP), mono-n-butyl phthalate (MBP), mono- iso -butyl phthalate (MiBP), mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP) and mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), utilizing ultra high performance liquid chromatography-triple quadrupole mass spectrometry. Overweight and obesity, defined by WHO classifications, were allocated to the cases group, and those of all normal weight and matched cases with normal weight in each wave of follow-up as two control groups. Logistic regression models after adjusting for confounders were utilized to analyze the effect of PAEs on overweight and obesity in children with divided four groups based on the quartile distribution of each and total PAEs concentration. The detection rates of children for each PAEs metabolite were 99.4% for MMP, 99.4% for MEP, 99.8% for MBP, 54.5% for MEHP, 84.4% for MEOHP, 99.9% for MEHHP, and 97.2% for MiBP. The geometric mean of concentrations of PAEs, MMP, MEP, MBP, MEHP, MEHHP, and MiBP were 310.085, 34.658, 9.127, 166.347, 7.043, 3.400, 18.571, and 24.093 (ng/ml), respectively. The total PAEs and seven metabolites concentrations were positively associated with childhood BMI Z-Scores with statistically significant slope rates and correlation coefficients, and were higher in the cases group than those in two controls groups in each wave of follow-up. The PAEs concentrations in the cases group was 5.90 (95 %CI: 5.79, 6.01) ng/ml in the first wave of survey, which was higher than those normal controls group (5.68 (95 %CI: 5.61, 5.75) ng/ml, P < 0.001) and matched controls group (5.72 (95 %CI: 5.61, 5.84) ng/ml, P = 0.018). The prevalence and ORs of overweight and obesity increased with quartile group of each and total PAEs concentrations accompanying a dose-response relationship. Compared with the quartile1 reference group with lowest total PAEs concentrations, the ORs of overweight and obesity in quartile2, quartile3 and quartile4 group increased gradually and reached at 1.20 (0.74–1.95), 1.49 (0.93–2.38) and 2.22 (1.41–3.48), respectively (P trend < 0.001). The strength of the associations between PAEs and overweight and obesity was sex-specific in children. Children in China were extensively exposed to PAEs, and the exposure to PAEs during childhood could significantly increase the risk of overweight and obesity with a dose-response relationship, particularly in girls. While limiting the exposure of PAEs products, the determination of exposure limit of plasticizer should be further strengthened. [ABSTRACT FROM AUTHOR]

• PAEs exposure and sex hormones homeostasis disruption increased childhood HBP risks. • Synergistic effect existed between PAEs exposures and testosterone on childhood HBP risks. • Antagonistic effect existed between PAEs exposures and estradiol on childhood HBP risks. • Limiting use and determining exposure limit for PAEs products should be strengthened. The structural similarity between sex hormones and exogenous phthalates (PAEs) enabled them as disrupters in regulating childhood blood pressure (BP). We aim to explore the association of sex hormones homeostasis and PAEs metabolites with childhood high BP (HBP). A cohort study was conducted with 1416 children aged 7–13 years at baseline and with 824, 819, and 801 children completing three waves' follow up. Serum testosterone (TT) and estradiol (E 2) in children during three consecutive waves of surveys were measured by radioimmunoassay, and then TT/E 2 ratio calculated as TT divided by E 2 were used to represent sex hormones homeostasis. Seven urinary PAEs metabolites were measured in children of first wave. The BP Z-Scores and HBP across waves were obtained by sex, age, and height specific percentiles. Log-binomial regression models with adjusted risk ratios (aRR) after adjusting for confounders were utilized. The prevalence of HBP at the baseline survey was 25.5%, and increased from 26.3% in the first wave of survey to 35.0% in the third wave of survey. PAEs were negatively correlated with E 2 , while positively correlated with TT and TT/E 2 ratio. A positive association of the serum TT levels, TT/E 2 ratio, and total PAEs was found with HBP prevalence (in wave 1, 2 and 3 with TT (aRR): 1.63, 1.37 and 1.45; with TT/E 2 : 1.63, 1.42 and 1.20; with PAEs: 1.40, 1.32 and 1.32), persistent HBP (with TT (aRR): 2.19; TT/E 2 : 2.16; PAEs: 2.57), occasional HBP (with TT (aRR): 1.94; TT/E 2 : 1.72; PAEs: 1.38), and new HBP incidence (with TT (aRR): 1.44; TT/E 2 : 1.57; PAEs: 1.67), but E 2 had a negative association with HBP phenotypes (HBP prevalence in wave 1, 2 and 3 (aRR): 0.77, 0.93, and 1.10; persistent HBP: 0.47; occasional HBP: 0.96; new HBP incidence: 0.81). The E 2 and PAEs had antagonistic effects on HBP risks in children, particularly in girls and those with high BMI group, but the TT levels, TT/E 2 ratio and PAEs had synergistic effects on HBP risks in children, particularly in boys and those with high BMI group. Exogenous PAEs exposure and endogenous sex hormones homeostasis disruption independently increase the risks of HBP. Moreover, the exogenous PAEs exposure could disrupt the endogenous sex hormones homeostasis in children, thereby combinedly increased risks of childhood HBP. [ABSTRACT FROM AUTHOR]

Feline parvovirus (FPV) or feline panleukopenia virus is a highly contagious, life-threatening infectious virus in cats. Although FPV vaccination is routinely practiced in China, clinical diseases continue to occur. The investigation of genotypes and viral evolution can contribute to the prevention, diagnosis, and treatment of FPV. Therefore, this study aimed to provide an up-to-date understanding of the epidemiological, genotypic, and phylogenetic characteristics of FPV. In total, 152 rectal swabs were collected from diseased cats. All swab samples were tested for FPV using molecular methods. Amplification of the complete viral protein 2 (VP2) gene was performed for further analysis and to infer the genotypic and evolutionary characteristics of FPV. Of the 152 samples, FPV DNA was detected in 17 (17/152, 11.18%). Cats with FPV showed variable clinical signs such as dehydration, anorexia, fever, vomiting, and blood-stained diarrhea. Furthermore, VP2 sequences were identified in 17 PCR-positive cats, confirming the presence of FPV. Phylogenetic and nucleotide pairwise identity analyses revealed high genetic similarity among FPV sequences (99.6-100%) and clustered them into the FPV-G1 group. Amino acid analysis indicated a novel mutation (Ala91Ser) in all VP2 gene sequences amplified in this study. Our study provides baseline epidemiological data for the better prevention of FPV with respect to vaccination strategies. Genotypic and phylogenetic analyses confirm that FPV-G1 was the predominant FPV group in infected cats in Kunshan. Therefore, a rigorous countrywide investigation of the genotypic and evolutionary characteristics of FPV is warranted.

Phthalates (PAEs) are synthetic compounds extensively employed in consumer products. Blood pressure (BP) in children can vary, the degree of visit-to-visit BP variability (VVV) is at least partially independent of BP. The interactions between PAEs exposure, pubertal-related genetic susceptibility and lifestyles on childhood VVV are not investigated. This study utilized data from a cohort collected from Oct 2017-2020 in Xiamen, China. Seven urine PAE metabolites were measured. The long-term VVV was characterized employing the standard deviation (SD) and average real variability. We constructed a genetic risk score (GRS) of pubertal-related genes and healthy lifestyle scores. Exposed to high levels of mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP) (OR=1.43, 95 %CI=1.07, 1.92) and mono-2-ethyl-5-oxohexyl phthalate (OR=1.36, 95 % CI=1.01, 1.83) was related to increased SBP-SD, and the OR for high SBP-SD related to high GRS was 1.38 (95 % CI=1.02, 1.85). Compared to participants who had low GRS and low MEHHP exposure, participants exhibiting high GRS and MEHHP levels were more likely to experience high SBP-SD (OR=2.00, P<0.05). Individuals exhibiting low GRS, low MEHHP levels, and adhering to healthy lifestyles were associated with the least probability of experiencing high SBP-SD (OR=0.31, P<0.05). Increased PAEs exposure could elevate childhood systolic VVV, and exacerbated the adverse impact of pubertal-related genetic susceptibility on the high VVV of SBP; however, healthy lifestyles might alleviate these adverse effects. Promoting healthy lifestyles and reducing PAEs exposure for preventing elevated BP variability among children is important, especially for individuals with greater genetic susceptibility to early pubertal onset. ENVIRONMENTAL IMPLICATION: Blood pressure (BP) in children can vary, as a noninvasive, inexpensive and applicable method, the extent of visit-to-visit variability (VVV) is at least partially independent of BP. The interactions between phthalates (PAEs) exposure, variants of puberty-related genes and lifestyles on VVV are not investigated. Increased childhood systolic VVV might be associated with PAEs exposure, with the associations more pronounced combined with pubertal genetic susceptibility. Yet, healthy habits could partly eliminate such adverse effects. Our study underscores the importance of advocating for healthy lifestyles and reducing exposure to PAEs, especially among individuals with high genetic susceptibility to early puberty onset., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Reading English academic articles is the cornerstone of innovative medical education and scientific research. However, limited by both language and professional knowledge, many nonnative English-speaking undergraduate medical students have a fear of reading English academic articles. The purpose of this study was to explore whether cognitive load theory can be a useful guiding strategy to promote English medical education article reading among Chinese undergraduates, while also evaluating students' attitudes toward the reading activities and cognitive load entailed in the last article they read. In the reading activities, students needed to read 19 English academic articles that are closely related to their courses. A questionnaire was administered after the students finished reading the 19th article to determine their attitudes toward reading English medical education articles and the cognitive load involved in reading the 19th article. The results showed that students' overall perceptions of reading English medical education articles were positive. Most students felt that their ability to read English academic articles and related skills had improved. The mean scores for students' intrinsic and germane cognitive loads in reading the 19th article were 6.44 ± 1.81 and 6.92 ± 2.05, respectively. The mean score for the extraneous cognitive load was 2.31 ± 2.63. In conclusion, the cognitive load theory can serve as the basis for an effective strategy to guide English medical education article reading activities among undergraduates in China. Meanwhile, students' attitudes toward the reading activities were favorable, and they read the latest article within an acceptable cognitive load. NEW & NOTEWORTHY Many nonnative English-speaking undergraduates have a fear of reading English academic articles. This study was performed to explore whether cognitive load theory can be a useful guiding strategy to promote English article reading among Chinese medical undergraduates. The results showed that cognitive load theory can serve as the basis for an effective strategy to guide English medical education article reading activities among undergraduates in China, and students' attitudes toward the reading activities were favorable.

Objective: This study aimed to examine the association between severity of menopausal symptoms and cardiovascular disease (CVD) risk among middle-aged Chinese women., Methods: A cross-sectional study recruited 9679 women aged 40-70 years from three socioeconomic regions of China in 2018. Menopausal symptoms were assessed by the modified Kupperman Menopausal Index (KMI). The severity of individual symptoms was classified as none (0 points), mild (1 points) and moderate-to-severe symptoms (2-3 points), and overall menopausal symptoms were classified as none (<15 points), mild (15-24 points) or moderate-to-severe (≥25 points) according to the sum score of the KMI. Logistic regression models were used to examine associations of the severity of menopausal symptoms with CVD risk., Results: A total of 5.6% of participants reported being diagnosed with CVD. Overall menopausal symptoms were more common in women aged 60-70 years than in women aged 40-59 years. After multiple adjustment, mild (odds ratio [OR] = 2.07, 95% confidence interval [CI]: 1.64-2.61) and moderate-to-severe (OR = 2.64, 95% CI: 1.92-3.63) overall menopausal symptoms were associated with increased risk of CVD compared with no symptoms. Significant positive associations between the severity of individual menopausal symptoms and CVD risk were observed for all 13 items., Conclusion: The severity of menopausal symptoms was positively associated with CVD risk in middle-aged Chinese women.

Objectives: To investigate the association of hypertension with depressive and anxiety disorders in middle-aged and older Chinese women, and to further assess whether the association was influenced by socioeconomic status (SES)., Design: Nationwide cross-sectional study., Setting: Six provinces of the eastern, central and western regions of China., Participants: Women aged 40-70 years were included by a multistage stratified random cluster sampling in 2018 (N=9900)., Primary Outcome Measures: Depressive and anxiety disorders were measured by the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, respectively. Logistic regression models were used to evaluate the OR and 95% CI for hypertension and the odds of depressive and anxiety disorders., Results: 18.5% of participants reported having hypertension; 20.9% and 15.3% of women experienced depressive and anxiety disorders, respectively. After adjusting for potential confounders, women diagnosed with hypertension were more likely to have depressive (OR=1.27, 95% CI 1.11 to 1.45) and anxiety disorders (OR=1.48, 95% CI 1.28 to 1.71) than those without hypertension. Stratified analyses demonstrated that hypertension was significantly associated with higher odds of depressive disorders in women living in rural areas (OR=1.34, 95% CI 1.13 to 1.59), with lower levels of education (OR=1.28, 95% CI 1.12 to 1.46) and with average monthly household income <¥3000 (OR=1.33, 95% CI 1.12 to 1.59), while hypertension was significantly correlated with increased odds of anxiety disorders in women living in urban (OR=1.41, 95% CI 1.12 to 1.79) and rural areas (OR=1.53, 95% CI 1.27 to 1.84), with lower levels of education (OR=1.47, 95% CI 1.27 to 1.70), and with average monthly household income <¥3000 (OR=1.45, 95% CI 1.20 to 1.75) and ≥¥3000 (OR=1.49, 95% CI 1.18 to 1.86)., Conclusions: Hypertension was associated with increased odds of depressive and anxiety disorders among middle-aged and older women, especially in those with low SES. Effective strategies and actions for identification and management of hypertension and depressive and anxiety disorders are needed., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Phthalate esters (PAEs) are known to have hormone-like properties, and there is a growing trend of children expressing a gender identity different from assigned sex. However, there has been limited research in the potential links between PAEs exposure and gender identity., Methods: A total of 571 children (278 boys) completed the follow-up from Oct 2017 to Oct 2020 in Childhood Blood Pressure and Environmental Factors (CBPEF) cohort in Xiamen, China. Urinary PAE metabolites were measured at three time of visits using ultraperformance liquid chromatography-tandem mass spectrometry. The Children's Sex Role Inventory scale was used to assess gender identity (masculinity, femininity, androgyny and undifferentiated), and Tanner definition was used to define puberty timing. Generalized linear models and log-binomial regression were used to assess the relationships between PAEs exposure, gender trait scores and gender identity., Results: Overall, the concentration of most PAEs in more than 90% of participants was above the limit of detection values. In visit 1, there were 10.1% boys with femininity and 11.3% girls with masculinity; while these figures increased to 10.8% and 12.3% during follow-up, respectively. Early puberty onset accounted for 24.8% and 25.6% among boys and girls. Long-term exposure to mono-2-ethylhexyl phthalate (MEHP) (β = 1.20, 95%CI = 0.13, 2.28), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP) (β = 1.25, 95%CI = 0.22, 2.28) and mono-2-ethyl-5-oxohexyl phthalate (MEOHP) (β = 1.40, 95%CI = 0.24, 2.56) was associated with the increased differences of femininity trait scores in boys who enter puberty earlier, prolonged exposure to di(2-ethylhexyl) phthalate (DEHP) might also have such a positive impact (β = 1.38, 95%CI = 0.36, 2.41). For gender identity, persistent exposure to low molecular weight phthalates (LMWP) was negatively associated with undifferentiated type among boys entering puberty earlier (RR = 0.18, 95%CI = 0.05, 0.75, P < 0.05), and most of the PAE metabolites exposures showed risk ratios > 1 for their femininity., Conclusion: Long-term exposure to PAEs increase the femininity trait scores in boys with early onset of puberty. Although the mechanisms remain to be determined, environmental pollution might have subtle, yet measurable effects on childhood gender identity. Reducing these chemicals exposure has important public implications on gender development., (© 2023. The Author(s).)

Objectives: With the rapid advancement of the "Internet +" era, network media have an increasingly greater influence on human production and lifestyle. However, the network security situation has become more serious, which has affected the trust of netizens in society. In this study, we explore the interaction between online media and universal trust, and further analyze the social psychological impact on Chinese netizens. Methods: We collected data from the "China General Social Survey" (CGSS) in 2017, using a 4-stage unequal probability sampling. We set 3 hypotheses and used a binary logistic regression model for data analysis. Results: We found that the universal trust of respondents who use online media as their main source of information is lower than that of traditional media, while social interaction and class status have a significant weakening effect on the negative impact of online media and its universal trust. Conclusions: These results contribute to further expansion of the theoretical and practical implications. The use of data ensures robust research conclusions; we propose factors that increase Chinese netizens' trust in online media.

Plant residues can affect C:N:P of soil, microbial biomass, and extracellular enzyme, but the effects are still unclear. We conducted a field experiment in an alpine meadow on the eastern part of the Qinghai-Tibetan Plateau to explore the effects of removing aboveground plant or roots and adding plant residues on the C:N:P of soil, microbial biomass, and extracellular enzyme. The results showed that removing aboveground plant biomass significantly decreased soil C:N (the change was -23.7%, the same below) and C:P (-14.7%), microbial biomass C:P and N:P, while significantly increased microbial biomass C:N, and enzyme C:N:P compared with meadow without human disturbance. Removing all plant biomass (aboveground and roots) significantly reduced soil C:N (-11.6%), C:P (-24.0%), N:P (-23.3%) and microbial biomass C:N in comparison to removing aboveground plant, while significantly improved microbial biomass N:P and enzyme N:P. Adding plant residues after removing aboveground plant significantly increased microbial biomass C:N and C:P, enzyme C:N compared with removing aboveground plant, while significantly decreased enzyme N:P. Compared with removing all the plant, adding plant residues after removing whole plant significantly reduced soil C:N (-16.4%), microbial biomass C:P, N:P and enzyme N:P, while significantly increased enzyme C:N. Our results suggest that removal of plants could have a strong effect on C:N:P of soil, microbial biomass, and extracellular enzyme, and C:N:P of microbial biomass and that extracellular enzyme woule be more sensitive to plant residues. Roots could play a key role in stabilizing C:N:P of soil, microbial biomass, and extracellular enzyme under plant residues addition. Adding plant residues could be a suitable solution for restoring alpine meadows under the circumstance of intact roots, which was conducive to soil C storage, but might not be suitable for alpine meadows with serious root damage, which would increase soil CO 2 emission.

Limited evidence exists on the influence of dietary behaviors on the association of overweight/obesity between parents and offspring. This study aimed to investigate the influence of dietary behaviors on the association of overweight/obesity between two generations, and puts forward strategies for preventing childhood obesity. Data were obtained from a cross-sectional survey conducted in China; a total of 40,197 parent-offspring pairs were included. Overweight/obesity was defined based on the body mass index and waist circumstance; the association of overweight/obesity between two generations was evaluated by multivariate and binary logistic regression and stratified analyses. Compared with the offspring who were free of parental overweight/obesity, the ORs of offspring with both parental overweight/obesity reached 2.66, 1.72 and 4.04 for general, simple abdominal and compound obesity. The offset effect of dietary behaviors was observed on the association between parental obesity and the offspring's general or simple abdominal obesity, with non-significant ORs when parents or/and offspring had healthy dietary behaviors. It was difficult for a healthy diet alone to offset the high heritability and intergenerational transmission of childhood obesity caused by parental obesity. Multifaceted improvement of lifestyle behaviors, and a combination of individual and family engagement, could be targeted measures to control childhood obesity.

Objective: To assess the effects of prepubertal BMI on pubertal growth patterns, and the influence of prepubertal BMI and pubertal growth patterns on long-term BMI among Chinese children and adolescents., Methods: A total of 9606 individuals aged between 7 and 18 years from longitudinal surveys in Zhongshan city of China from 2005 to 2016 were enrolled. Age at peak height velocity (APHV) and peak height velocity (PHV) were estimated using Super-Imposition by Translation and Rotation (SITAR) model. Associations between prepubertal BMI, APHV, PHV, and long-term overweight and obesity were assessed by linear regression and multinominal logistic regression. Scatter plots were elaborated to show the associations between prepubertal BMI and pubertal growth patterns according to prepubertal BMI categories., Results: Prepubertal BMI Z-Score was positively correlated with long-term BMI Z-Score, and negatively correlated with APHV in both sexes. In addition, there was a negative association between prepubertal BMI Z-Score and PHV in boys. With 1-year decrease in APHV, risk of long-term underweight decreased by 92%, while overweight increased by 33% in boys. Corresponding risk of long-term underweight and overweight for girls decreased by 42% and increased by 20%, respectively., Conclusion: High prepubertal BMI levels were associated with earlier APHV and lower PHV, and the early onset of pubertal development could increase the risks of long-term overweight and obesity at 17-18 years of age both in boys and girls. Such evidence emphasized the importance of reducing prepubertal obesity risks combined with appropriate pubertal development timing, including later APHV and higher PHV, so as to prevent the obesity and related cardiovascular diseases in adulthood., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

This study aimed to assess the association between the trend of urban-rural disparity in high blood pressure (HBP) in Chinese children and adolescents and socioeconomic development. Data on 1,054,602 students aged 7-18 years were obtained from five successive national surveys administered in 29 Chinese provinces in 1995, 2000, 2005, 2010, and 2014. HBP was defined as average measured systolic BP and/or diastolic BP equal to or more than 95th percentile. The socioeconomic indicators at the provincial-level included gross domestic product (GDP) per capita, the Engel coefficient, and urbanization rates. From 1995 to 2014, HBP prevalence in Chinese children and adolescents fluctuated between 6.9% and 9.2%. Rural areas had a higher prevalence of HBP than urban areas, with a diminishing trend in urban-rural disparity from 1995 to 2010 with a reduced OR from 1.45 (95% CI: 1.40-150) in 1995 to 1.09 (1.05-1.12) in 2010, whereas a widening gap in 2014 with OR of 1.23 (1.19-1.26)). A positive association existed between the improvement of socioeconomic indicators and the increase in HBP, which was demonstrated obviously by the Engel coefficient strata. The increases in the urbanization rates were accompanied by a greater increase of HBP in urban than in rural areas. The large urban-rural disparity suggests a priority of HBP control in rural children due to their current and future HBP and cardiovascular disease risks. Socioeconomic development could affect the urban-rural disparity in HBP risk, reflecting the importance of effective policy responses for preventing HBP by avoiding unhealthy lifestyles brought about by rapid economic development., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Metabolically healthy obesity (MHO) is a group of subjects with overweight/obesity who present a metabolically healthy profile; however, associated factors are complex and are far from completely understood. The aim of the current study was to estimate the prevalence of different metabolic body size phenotypes and investigate the associated factors in Chinese children and adolescents., Methods: A cross-sectional survey was conducted of 12,346 children and adolescents aged 7-18 years from seven provinces in China in 2013. Anthropometric, blood pressure, and biochemical measurements were obtained. A multi-component questionnaire covering demographic, neonatal, and lifestyle characteristics was administered. The classification of metabolic body size phenotype based on three definitions was compared. With metabolically healthy with normal weight (MHNW) as a reference group, logistic regression analyses were used to estimate the potential effects of associated risk factors, with adjustment for age, sex, single-child status, and residence area., Results: The prevalence of MHNW, MHO, metabolically unhealthy with normal weight (MUNW), and metabolically unhealthy overweight/obesity (MUO) phenotype was 68.6%, 2.0%, 26.4%, and 3.0%, respectively. There were 39.3% MHO and 60.7% MUO among obese participants and 72.2% MHNW and 27.8% MUNW among those with normal weight. Compared to cardiometabolic risk factor (CMRF) criteria and metabolic syndrome (MetS) component definition, the application of the 2018 consensus-based definition may identify more children with abnormal cardiovascular risks, independent of weight status. Compared to younger children, older-aged adolescents were positively associated with higher risks of MUNW (odds ratio (OR) = 1.38, 95% CI = 1.27-1.50) and MUO (OR = 1.29, 95% CI = 1.04-1.60), while factors positively associated with MHO were younger age, single-child status, urban residence, high birth weight, prolonged breastfeeding duration, parental overweight/obesity status, long screen time, and less physical activity., Conclusion: There were still a high proportion of children and adolescents at high cardiometabolic risk in China. Our findings reinforce the need for cardiometabolic risk prevention in children and adolescents irrespective of their weight statuses, such as parental educational programs and healthy lifestyle interventions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Liu, Ma, Chen, Ma, Li, Gao, Ma, Wang, Chen, Zhang, Dong, Song and Ma.)

Greenness could theoretically increase the impact of physical activity (PA) and reduce the adverse effects of air pollution on overweight/obesity. However, no evidence systematically compares these two pathways, especially in longitudinal studies of children and adolescent's cohort. Greenness, PA, and air pollution were assessed by Normalized Difference Vegetation Index (NDVI), International Physical Activity Short Form, and 7 pollutants (PM 1 , PM 2.5 , PM 10 , SO 2 , NO 2 , CO, and O 3 ). Each exposure was divided into low-/high-level groups based on the 50% quantile. Proportional hazards and logistic regression model were used to assess the associations of greenness, PA, pollutants with overweight/obesity. The incidence of overweight/obesity was 1.98% in the national survey, and the cumulative incidence and incidence density were 12.76% and 3.43 per 100 person-year in the dynamic cohort, separately. An increase of 0.1 units in NDVI was associated with a 12% lower risk of overweight/obesity, but no significant link between PA and incidence was observed. The HRs of the high-level of PM 1 , PM 2.5 , PM 10 , SO 2 , NO 2 , CO, and O 3 on the risk of overweight/obesity were 2.21, 2.63, 1.88, 2.38, 1.33, 2.43, and 1.33 in the low-level of greenness, which was higher than those in the high-level of greenness. The AFs of PM 1 , PM 2.5 , PM 10 , SO 2 , NO 2 , CO, and O 3 were 25.58%, 44.37%, 22.96%, 29.15%, 11.55%, 29.50%, and 10.92% in the low-level of greenness, which simultaneously was higher than those in the high-level of greenness. Moreover, the risk of overweight/obesity associated with high-level of greenness in the high-level of PM 10 , SO 2 , CO were 0.83, 0.81, and 0.83 respectively. Our findings confirmed that greenness has a moderating effect on the effects of air pollutants on childhood overweight/obesity especially in heavy-industry areas where PM 10 , SO 2 , and CO are the major pollutants, although it did not influence the association between PA and overweight/obesity risks., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

This study was aimed to investigate the associations between breastfeeding duration and blood pressure (BP) levels, BP Z scores and high BP (HBP) in children and adolescents. A total of 57,201 participants including 29,491 boys and 27,710 girls aged 7−18 years were recruited from seven provinces in China in 2012. HBP was defined as BP levels of ≥95th percentiles of the referent age-, sex-, and height-specific population. Breastfeeding duration was divided into non-breastfeeding, 0−5 months, 6−12 months, and >12 months. Information on demographic, parental or family factors and dietary behaviors was collected through a self-administered questionnaire. Multivariable linear regression and logistic regression models were applied to assess the relationships of breastfeeding duration with BP levels and BP Z scores and with HBP, respectively. Stratified analyses were performed to further investigate the potential subgroup-specific associations. The reported prolonged breastfeeding (>12 months) rate was 22.53% in the total population. After full adjustment, compared to the non-breastfeeding group, breastfeeding for 6−12 months was correlated with 0.43 (95% CI: −0.75, −0.11) and 0.36 (95% CI: −0.61, −0.12) mmHg lower levels of SBP and DBP, respectively. Similar decrease trends were found for BP Z scores. Prolonged breastfeeding (>12 months) was associated with 1.33 (95% CI: 1.12, 1.58) and 1.12 (95% CI: 0.94, 1.33) higher odds of HBP in boys and girls, respectively. Based on nationally representative data, there was no evidence that a longer duration of breastfeeding is protective against childhood HBP. Breastfeeding for 6−12 months may be beneficial to BP, while prolonged breastfeeding durations might increase the odds of HBP in children and adolescents.

Both ambient particulate matter (PM) and decrease of greenness have been suggested as risk factors for high blood pressure (HBP) in children and adolescents. But most evidence were from cross-sectional studies with limited data from prospective cohorts. In this cohort study, we included 588,004 children and adolescents aged 7 to 18 years without HBP from 2005 to 2018 in Beijing (240,081) and Zhongshan (347,923) city of China. The cumulative incidence of HBP was 32.04%, and incidence rate was 14.86 per 100 person-year. After adjustment for confounders, the ten-unit increase in PM 1 , PM 2.5 , and PM 10 exposure was significantly associated with 43%, 70%, and 43%- higher risks of HBP, respectively, but the 0.1-unit increase in NDVI exposure was significantly associated with a 25% lower risk of HBP. The HRs of PM 1 on the HBP risk were 1.486 and 1.150 in the low and the high-level of greenness, and they were 2.635 and 2.507 for PM 2.5 , and for PM 10 1.367 and 1.702 in the two groups. The attributable fraction (AFs) of PM 1 , PM 2.5 , and PM 10 on HBP incidents were 13.74%, 40.08%, and 15.47% in the low-level of greenness, which simultaneously was higher than those in the high-level of greenness (AF = 4.62%, 17.28%, and 9.96%). The exposure to higher ambient PM air pollution and lower greenness around schools were associated with a higher risk of HBP in children and adolescents, but higher greenness alleviated the adverse effects of ambient PM 1 and PM 2.5 on the HBP risks. Our findings highlighted a synergic strategy in preventing childhood HBP by decreasing air pollution reduction and improving greenness concurrently., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

To investigate associations between fruit consumption and lipid profiles, and to further explore a satisfactory level of frequency and daily fruit intake for children and adolescents. A national sample of 14,755 children and adolescents aged 5-19 years from seven provinces in China were recruited. Fasting blood samples were collected to test the lipid profile. Information regarding fruit consumption and other characteristics was collected by questionnaires. Logistic regression models adjusting for confounding covariates were applied to calculate the odds ratio (OR) and 95% confidence interval (95% CI). Participants who consumed fruits for 6-7 days per week had lower risks of high triglycerides (OR: 0.66, 95% CI: 0.58-0.75), dyslipidemia (OR: 0.77, 95% CI: 0.68-0.86), and hyperlipidemia (OR: 0.72, 95% CI: 0.63-0.81), compared to fruit consumption of 0-2 days per week. Risks of high triglycerides, dyslipidemia and hyperlipidemia of those who consumed fruits for 0.75-1.5 servings each day also decreased, compared to the insufficient fruit intake. The combined effects of high frequency and moderate daily intake of fruit on lipid disorders did not change essentially. The associations were more evident in girls, younger children and those whose families had higher educational levels. Moderate fruit consumption was associated with lower odds of lipid disorders, predominantly in girls, younger participants, and those came from higher-educated families. These findings supported the health effect of moderate fruit intake frequently to improve the childhood lipid profiles.

Aimed to investigate the associations between different growth patterns with high blood pressure, and further examine the mediation effect of BMI between growth patterns and high blood pressure among children and adolescents. A total of 31581 children and adolescents aged 7-18 years were selected based on the stratified cluster sampling method. Logistics regression models were used to calculate the odds rations (ORs) and 95% confidence interval (95%CI) of the association between different growth patterns and high blood pressure. Mediation effect analyses were applied to estimate the effect of BMI on the increase of blood pressure levels in different growth patterns. In different sex and ages, compared to reference group of normal growth, blood pressure levels and prevalence of high blood pressure of the catch-up growth were higher, but that of the catch-down growth were lower. The prevalence of high blood pressure was 11.69%, 16.06%, and 9.68% in normal growth, catch-up growth, and catch-down growth, respectively. In total, compared with the normal growth pattern, the ORs (95%CI) of high blood pressure, high systolic blood pressure and high diastolic blood pressure in the catch-up growth were 1.171(1.073,1.280), 1.110(1.001,1.230) and 1.141(1.025,1.270) (p < .05), respectively. Additionally, the mediation effect of current BMI existed in the association between blood pressure levels and different growth patterns, particularly in boys. Our findings suggested that different growth patterns after birth could modify blood pressure, and the potential risks of high blood pressure could be increased by catch-up growth at childhood and adolescence., (© 2021 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.)

To investigate the associations between body fat percentage (BF%) with childhood blood pressure (BP) levels and elevated BP (EBP) risks, and further examine the validity of bioelectrical impedance analysis (BIA), we conducted a cross-sectional study of 1426 children and adolescents aged 7-17 years in Beijing, 2020. EBP, including elevated systolic BP (ESBP) and elevated diastolic BP (EDBP), was defined based on the age- and sex-specific 90th BP reference values of children and adolescents in China. BF% was measured by dual-energy X-ray absorptiometry (DEXA) and BIA devices, and was divided into four quartiles. Log-binomial models were applied to calculate odds ratios (ORs) and 95% confidence intervals (95%CI). Girls tended to have higher BF% levels than boys ( p < 0.05). There was 41.0% of girls who developed EBP. High BF% was associated with increased BP levels with ORs of 0.364 (95%CI = 0.283-0.444) for SBP, 0.112 (95%CI = 0.059-0.165) for DBP, and 1.043 (95%CI = 1.027-1.059) for EBP, while the effects were more pronounced in girls and older-aged children. BIA devices agreed well with BF% assessment obtained by DEXA. High BF% might have negative effects on childhood BP. Convenient measurements of body fat might help to assess childhood obesity and potential risks of hypertension.

To investigate the relationship between breastfeeding duration and lipid profile among children and adolescents, a cross-sectional survey using random cluster sampling was performed, and a national sample of 12,110 Chinese children and adolescents aged 5-19 years were collected. Breastfeeding duration and sociodemographic factors were collected by questionnaires. Fasting blood samples were obtained to test the lipid profile. Linear regression and logistic regression models were employed to evaluate the association between breastfeeding duration and lipid profile. We found that prolonged breastfeeding was related with a low level of total cholesterol (TC), LDL-C, HDL-C, and TC/HDL-C in children and adolescents. With an increased duration of breastfeeding, the magnitude of the association between breastfeeding and lipid profile enlarged. The levels of TC, LDL-C, HDL-C, and TC/HDL-C in participants who were breastfed for more than 12 months decreased by 6.225 (95% CI: -8.390, -4.059), 1.956 (95% CI: -3.709, -0.204), 1.273 (95% CI: -2.106, -0.440) mg/dL, and 0.072 (95%CI: -0.129, -0.015), respectively, compared with those who were not breastfed. The corresponding risk of high TC declined by 43% (aOR: 0.570, 95% CI: 0.403, 0.808). The association was similar in both boys and girls, but only statistically significant in children and young adolescents aged 5-14 years. This suggested that prolonged breastfeeding duration was related with low lipid levels and decreased abnormal lipid risk, especially in children and young adolescents. These findings support the intervention of prompting a prolonged duration of breastfeeding to improve the childhood lipid profile.

Objective: Metabolic syndrome (MS) and its components are observed to emerge in childhood and may continue into adulthood. The study aimed to investigate the association between parental overweight and risk of childhood MS and its components in their offspring., Methods: Data were obtained from a cross-sectional survey conducted in Chinese children and adolescents; a total of 11 784 children aged 7-18 years were included in this study; child outcomes were obtained from objective measurements and parental data were obtained from questionnaires; MS was defined according to the modified criteria of Adult Treatment Panel Ⅲ; correlation between parental overweight and offspring MS was assessed via multivariate logistic regression models adjusted for potential covariates., Results: 3476 (29.5%) children were found to have overweight fathers, 1041 (8.8%) had overweight mothers and 852 (7.2%) had both overweight parents. The prevalence of MS was 7.1% in total, 8.2% in boys and 5.9% in girls; children with overweight parents had a higher prevalence of MS and its components (except for elevated glucose) compared with children with normal-weight parents. Children with overweight fathers, mothers and both parents had 2.17 times (95% CI: 1.65-2.85), 2.89 times (95% CI: 2.03-4.11) and 2.81 times (95% CI: 1.91-4.15) higher risk of MS, respectively. Children with overweight mothers were likely to have a higher risk of MS compared with children with overweight fathers. Parental overweight was positively correlated with higher risk of MS, abdominal obesity and low HDL-C both in boys and girls., Conclusion: Parental overweight was strongly associated with increased risk of MS in their offspring, the risk was highest in children with both parents to be overweight. Maternal overweight seems to have a stronger correlation with offspring MS than paternal overweight. Parental overweight is one of the factors for identifying metabolic dysfunction risk in their offspring and other factors need to be considered as well., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Abdominal obesity is becoming an increasingly serious public health challenge in children and adolescents, there remains controversial opinions on birth weight and risk of childhood abdominal obesity. This study aims to assess the association between birth weight and the risk of abdominal obesity in childhood, as well as to compare the associations among different sex and age groups., Methods: A total number of 30,486 (15,869 boys and 14,617 girls) participants aged 6-17 years old were included in this study. Participants were classified into five groups according to their birth weight. Waist-to-height ratio (WHtR) was used to define abdominal obesity. Fractional polynomial regression model was used to assess the association between birth weight and WHtR, and a multi-variable logistic regression model was applied to evaluate the risk of abdominal obesity in different birth weight groups., Results: A J-shaped association was observed between birth weight and WHtR. Compared with birth weight of 2500-2999 g, high birth weight was associated with increased risk of abdominal obesity [OR (95% CI) for 3000-3499 g: 1.12(1.00-1.24); 3500-3999 g: 1.19(1.07-1.34); ≥4000 g: 1.42(1.24-1.62)]. No significant correlation was observed in children with birth weight ≤ 2499 g. Similar patterns were observed across different age groups. Abdominal obesity risk for high birth weight was particularly pronounced in boys compared to girls., Conclusions: Birth weight ≥ 3000 g, especially for boys, was associated with an elevated risk of abdominal obesity in childhood and may benefit from intervention to mitigate this risk.

Purpose: This article explores differences between the current health status of adolescents and the targets set in Healthy China 2030 (HC2030)., Methods: Global and domestic policies and strategies relating to adolescent health were reviewed. Data from the Global Burden of Disease Study (1990-2016) and the Chinese National Survey on Students' Constitution and Health (1985-2014) were used to analyze time trends and geographical distributions of health indicators for adolescents aged 10-19 years in China., Results: The Chinese government has released many health policies over the past 3 decades. In this context, there has been a major decline in all-cause mortality and stunting. However, gaps between the current health status of adolescents and the targets set in HC2030 were numerous. The prevalence of obesity and poor vision increased rapidly, and few adolescents meet the physical activity and fitness targets set in HC2030. Urban/rural differences were marked for some indicators such as obesity, whereas for other indicators (e.g., stunting), there remained notable differences across provinces., Conclusions: Many long-standing health problems of adolescents have improved, but new problems related to noncommunicable disease risks have emerged and should be a prominent focus for policy action under HC2030., (Copyright © 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: To assess the association between comprehensive physical fitness and high blood pressure (HBP) among Chinese children and adolescents., Design: National cross-sectional surveys., Methods: 214,301 school students' data aged 7-18years was extracted in 2014. Six components of physical fitness (forced vital capacity, standing long jump, sit-and-reach, body muscle strength, 50m dash and endurance running) were measured, standardized and aggregated as a summary physical fitness indicator (PFI). HBP, systolic HBP (SHBP) and diastolic HBP (DHBP) were defined according to sex-, age- and height-specific references in China., Results: The prevalence of HBP, SHBP and DHBP was 8.6%, 4.7% and 5.7%, respectively, and PFI was -0.9 in Chinese children and adolescents. A significant negative association between the PFI and HBP was observed with adjusted prevalence of HBP (10.8% (95% CI: 10.4-11.2) to 7.6% (95% CI: 7.3-8.0), P trend <0.001), SHBP (5.7% (95% CI: 5.4-6.1) to 4.4% (95% CI: 4.1-4.6), P trend <0.001), and DHBP (7.6% (95% CI: 7.2-7.9) to 4.6% (95% CI: 4.3-4.9), P trend <0.001) and their ORs (HBP: 0.87(95% CI: 0.82-0.93) to 0.68(95% CI: 0.64-0.73), P trend <0.001; SHBP: 0.86(95% CI: 0.79-0.94) to 0.75(95% CI:0.69-0.82), P trend <0.001; DHBP: 0.85(95% CI: 0.79-0.92) to 0.59(95% CI: 0.54-0.64), P trend <0.001) declined with the increase in PFI. Stratified nutritional status exhibited a similar negative association between PFI and HBP, SHBP and DHBP in children with normal weight, overnutrition, and undernutrition. Stand long jump, body muscle strength, 50m dash, and endurance running, had a negative association with HBP, SHBP and DHBP, but forced vital capacity had a positive such association. Sit-and-reach and HBP are not significantly associated., Conclusions: Physical fitness was negatively correlated to the increased HBP in children and adolescents. Comprehensive policies and measures to enhance children and adolescents' physical fitness are urgently needed through the promotion of physical activity, healthy dietary patterns, and strategies of educational guidelines to reduce schoolwork, which will in turn reduce the cardiovascular burdens in the future., (Copyright © 2020 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objective: To investigate the relationship between low birthweight (LBW) and blood pressure and to assess whether LBW leads to a higher risk of high blood pressure (HBP) by gender in Chinese students aged 6-18 years. Also, to investigate whether the association was affected by childhood obesity., Methods: Data was obtained from a baseline dataset of a national school-based program. Anthropometric parameters, including height, weight, and blood pressure, were measured, while birthweight and other characteristics were obtained from questionnaires. Stratified chi-squared tests were used to compare the prevalence of HBP between LBW and normal birthweight (NBW) groups in each age and sex category. Multivariable logistic regressions were conducted to estimate the HBP risks in each birthweight group., Results: Both systolic and diastolic blood pressure showed a U-shaped relationship with increased birthweight. Compared to NBW groups, LBW girls showed a higher HBP risk, with an odds ratio of 1.29 (95% confidence interval (CI): 1.02, 1.64, p = 0.033), regardless of their current body mass index status, while no significant association in boys was found. Conclusions : Low birthweight is associated with higher HBP risk in adolescent girls, regardless of their childhood BMI status.

Objective: To investigate the association of long-term PM 2.5 exposure with blood pressure (BP) outcomes in children aged 6-18 years, and to examine the population attributable risk (PAR) of PM 2.5 exposure., Methods: A total of 53,289 participants aged 6-18 years with full record of age, sex, BP, height, and local PM 2.5 exposure from a cross-sectional survey conducted in 6 cities of China in 2013 were involved in the present study. PM 2.5 data from 18 January 2013 to 31 December 2013 were obtained from the nearest environmental monitoring station for each selected school. Two-level linear and logistic regression models were used to evaluate the influence of PM 2.5 on children's BP, and PAR was calculated in each sex and age group., Results: Participants had a mean age of 10.8 (standard deviation: 3.4) years at enrollment, 51.7% of them were boys. U-shaped trends along with increased PM 2.5 concentration were found for both systolic blood pressure (SBP) and diastolic blood pressure (DBP), with the thresholds of 57.8 and 65.0 μg/m 3 , respectively. Both increased annual mean of PM 2.5 concentration and ratio of polluted days were associated with increased BP levels and high blood pressure (HBP), with effect estimates for BP ranging from 2.80 (95% CI: -0.51, 6.11) mmHg to 5.78 (95% CI: 2.32, 9.25) mmHg for SBP and from 0.77 (95% CI: -1.98, 3.52) mmHg to 2.66 (-0.35, 5.66) mmHg for DBP, and the odds ratios for HBP from 1.21 (0.43, 3.38) to 1.92 (0.65, 5.67) in the highest vs. the lowest quartiles. Overall, 1.16% of HBP in our participants could be attributed to increased annual mean of PM 2.5 concentration, while 2.82% could be attributed to increased ratio of polluted days. These proportions increased with age., Conclusions: The association between long-term PM 2.5 exposure and BP values appeared to be U-shaped in Chinese children aged 6-18 years, and increased PM 2.5 exposure was associated with higher risk of HBP.