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With the intensification of global economic competition, innovation has become one of the core elements of vigorous development in various regions. Improving the innovation ability of cross-regional central cities is the main factor influencing whether a region can achieve economic and social development. In this paper, an innovation primacy index system is designed according to the links of the innovation value chain, and the innovation advantages and empirical effects are comprehensively analyzed by using the point-to-point method, entropy weight method, gravity model and two-way fixed effect model. Based on the data of 8 cities in the core area of the Huaihai Economic Zone from 2010 to 2020 in China, Xuzhou's innovation primacy ranks first in the core area of the Huaihai Economic Zone, which accords with its status as the central city of the region. Its index has been rising, and its development trend is also good. However, the overall innovation ability of the core area of the Huaihai Economic Zone is unbalanced; the overall economic foundation is not solid enough. In terms of knowledge innovation, R&D innovation and industrial innovation, the industrialization level, around the activation of Xuzhou city vitality, enhances the Xuzhou innovation radiation drive, leading to a decrease in the Huaihai Economic Zone. Finally, some corresponding suggestions on innovation primacy have been proposed for the city of the Huaihai Economic Zone. [ABSTRACT FROM AUTHOR]

The aims of the study were to assess the contribution of resilience, coping style, and COVID-19 stress on the quality of life (QOL) in frontline health care workers (HCWs). The study was a cross-sectional surveyperformed among 309 HCWs in a tertiaryhospital during the outbreak of COVID-19 in China. Data were collected through an anonymous, self-rated questionnaire, including demographic data, a 10-item COVID-19 stress questionnaire, Generic QOL Inventory-74, Connor-Davidson Resilience Scale, and the Simplified Coping Style Questionnaire. Hierarchical regression was used to analyse the relationship between the study variables and the QOL. Among the 309 participants, resilience and active coping were positively correlated with the QOL (P<0.001), whereas, working in confirmed case wards, COVID-19 stress, and passive coping were negatively correlated with the QOL (P<0.001). Resilience and the active coping were negatively correlated with COVID-19 stress (P<0.001). Resilience, coping style,and COVID-19 stressaccounted for 32%, 13%, and 8% of the variance in predicting the Global QOL, respectively. In conclusion, working in confirmed COVID-19 case wards and COVID-19 stress impaired the QOL in HCWs. Psychological intervention to improve the resilience and coping style, and reduce COVID-19 stress are important in improving the QOL and mental health of HCWs. [ABSTRACT FROM AUTHOR]

Objectives: It is unclear whether and to what extent depression subcases and cases in older age were associated with all‐cause mortality. Little is known about gender differences in the associations. We assess these in older Chinese. Methods: We examined a random sample of 6124 participants aged ≥60 years across five provinces in China. They were interviewed using a standard method of the GMS‐AGECAT to diagnose depression subcase and case and record sociodemographic and disease risk factors at baseline, and to follow up their vital status. We employed Cox regression models to determine all‐cause mortality in relation to depression subcases and cases, with adjustment for important variables, including social support and co‐morbidities. Results: Over the 10‐year follow‐up, 928 deaths occurred. Compared to those without depression at baseline, participants with depression subcase (n = 196) and case (n = 264) had increased risk of mortality; adjusted hazard ratios (HRs) were 1.46 (95% CI 1.07–2.00) and 1.45 (1.10–1.91). The adjusted HRs in men were 1.15 (0.72–1.81) and 1.85 (1.22–2.81), and in women 1.87 (1.22–2.87) and 1.22 (0.83–1.77) respectively. In participants aged ≥65 years, the adjusted HRs were 1.12 (0.68–1.84) and 1.99 (1.28–3.10) in men, and 2.06 (1.32–2.24) and 1.41 (0.94–2.10) in women. Increased HR in depression subcases was higher in women than man (ratio of HRs was 1.84, p = 0.034). Conclusions: Older people with depression subcase could have increased all‐cause mortality to a similar extent to those with depression case. More attention should be paid to subcases of depression in women to tackle gender inequalities and improve survival. Key points: This study is the first to report that there were significant impacts of depression subcase and case on all‐cause mortality in older people in China, and their impacts were stronger than those from other countries averaged levels.Older Chinese with depression subcase had a similar increase in all‐cause mortality to those with depression case.This study is the first to examine gender differences in the impact of depression subcase in older age on all‐cause mortality in low and middle‐income countries.Older women in China had a higher impact of depression subcase on all‐cause mortality than their male counterparts, which needs to be addressed for intervention. [ABSTRACT FROM AUTHOR]

Background: The pandemic of coronavirus disease (Covid-19) seriously impacts the health and well-being of all of us. Aims: We aim to assess the psychological impact of Covid-19 on frontline health care workers (HCWs), including anxiety, depression and stress of threat of the disease. Method: The study was a cross-sectional survey among the frontline HCWs in a hospital at Jinan, China. Data were collected through an anonymous, self-rated questionnaire, including basic demographic data, a 10-item Covid-19 stress questionnaire, the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). The risk and rate of anxiety, depression and stress of Covid-19 were estimated. Results: Among the 309 participants, there were 88 (28.5%) with anxiety and 172 (56.0%) with depression. Multivariate logistic regression analyses showed that age ⩽ 30 years, age > 30 to 45 years, working in confirmed case isolation wards, and worrying about disinfection measures being not sufficient were independently associated with anxiety with an odds ratio (95% confidence interval, CI) of 4.4 (1.6–12.2), 3.1 (1.1–8.8), 2.3 (1.4–4.0) and 2.5 (1.5–4.3), respectively; age ⩽ 30 years, age > 30 to 45 years, nurse and worrying about disinfection measure being not sufficient were independently associated with depression with an odds ratio (95% CI) of 3.8 (1.8–7.8), 2.7 (1.3–5.7), 2.5 (1.1–5.6) and 2.1 (1.3–3.5), respectively. Conclusions: A high prevalence of anxiety and depression was found among frontline HCWs during the COVID-19 outbreak. More psychological care should be given to young staffs and nurses. Measures to prevent professional exposure is important for HCWs' physical and mental health. [ABSTRACT FROM AUTHOR]

Background: HSCT is the only proven curative therapy for JMML. Matching donor and recipient HLA alleles is considered optimal to reduce the risk of GVHD after HSCT but is not always possible. Only a limited number of studies have compared the influence of HLA disparities on HSCT outcomes for patients with JMML. Methods: We conducted a retrospective study among 47 children with JMML who received related or unrelated unmanipulated HSCT (March 2010‐October 2018). Among our participants, 27 (57.4%) donor‐recipient pairs had 0‐1 HLA disparities (Group 1: HLA‐matched or ≤1 allele/antigen mismatch donor) and 20 (42.6%) had ≥2 HLA disparities (Group 2: 2‐3 mismatched/haploidentical donors). Results: The median follow‐up period was 26.0 months (range: 1‐105 months), and the 5‐year probabilities of DFS and RI for the whole cohort were 54.6 ± 7.7% and 34.8 ± 15.0%, respectively. Compared to Group 1, Group 2 patients had a significantly lower RI (5.3 ± 10.5% vs 55.5 ± 20.9%, P ˂.001), though similar rates of grade II–IV acute GVHD (60.0 ± 22.4% vs 33.3 ± 18.2%, P =.08), grade III–IV acute GVHD (25.0 ± 19.5% vs 7.4 ± 10.1%, P =.08), chronic GVHD (30.0 ± 20.9% vs 34.9 ± 18.8%, P =.85), NRM (20.0 ± 18.0% vs 3.9 ± 7.7%, P =.07), and DFS (74.4 ± 9.9% vs 41.3 ± 10.0%, P =.08). Conclusions: Disease relapse remains the major cause of treatment failure in JMML patients, especially in patients receiving HLA‐matched and limited HLA‐mismatched HSCT. Our findings suggest that donor‐recipient HLA disparities may improve the outcome of HSCT in children with JMML. [ABSTRACT FROM AUTHOR]

There is a lack of data on drug-related problems (DRPs) among elderly patients from surgical departments. The current study is aimed at identifying and categorizing types of DRPs and assessing the severities of the DRPs. Medication orders for hospitalized patients aged ≥65 years from six surgery departments were reviewed to determine DRPs over 6 months in a tertiary teaching hospital of Chongqing, China. DRPs were classified based on the Pharmaceutical Care Network Europe classification V8.02. The severity ratings of the DRPs were assessed using the National Coordinating Council for Medication Error Reporting and Prevention classification. A total of 53,231 medication orders from 1,707 elderly patients were reviewed, and 1,061 DRPs were identified. Treatment safety (44.9%) was the most common DRP type. Drug selection (43.1%) and dose selection (43.1%) were the major causes of DRPs. A total of 75.1% of the DRPs were classified into severity categories B to D (causing no or potential harm), and 24.9% were classified as categories E to H (causing actual harm). DRPs are common in hospitalized elderly surgical patients. Pharmacists should provide medication order reviews in this vulnerable patient population. [ABSTRACT FROM AUTHOR]

Background: We aimed to examine the association between social capital and loneliness in Anhui Province, China.Methods: Data were collected from a cross-sectional study using a multi-stage stratified cluster sampling strategy. Data on demographic characteristics, socioeconomic factors, social capital, and loneliness in 1810 older adults (aged 60 years and older) were used for analysis. Binary logistic regression models and a classification and regression tree model were performed to assess the association of social capital and loneliness.Results: Our results indicated that social capital in terms of lower level of social participation (AOR = 1.38; 95% CI: 1.10-1.74), social connection (AOR = 1.51; 95% CI: 1.18-1.93), and reciprocity (AOR = 1.47; 95% CI: 1.13-1.90) were associated with higher odds of developing loneliness. We noted the interactive effect of different social capital dimensions on loneliness, suggesting that the risk for suffering loneliness was greatest in older people limited in functional ability, with less trust, less social connection, and less social participation.Conclusions: Our findings show that social capital is associated with loneliness in older adults. This implies that social capital, especially in terms of trust, social connection, and social participation may be significant for alleviating loneliness in later life. [ABSTRACT FROM AUTHOR]

Objective: To measure the prevalence of insomnia and identify the socio‐economic correlates of insomnia among older people of Anhui Province of China. Methods: A cross‐sectional study was conducted among 3045 randomly selected consenting residents aged 60 and older from Anhui Province during 2013. Insomnia was assessed using the Athens Insomnia Scale (AIS). Data collected included: (i) demographics; (ii) socio‐economic status; (iii) social support; (iv) social contact; and (v) social capital. Results: Overall, 24% were found to have insomnia and 9% were found to have suspected insomnia according to the AIS score. After adjusting for potential confounders, participants having no fixed income, less social contact, less social capital and living alone were more likely to suffer from insomnia. Conclusions: A high prevalence of insomnia was found among older people in Anhui Province of China. Socio‐economic determinants should be addressed in devising policies aimed at improving sleep quality for older people in this region. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore the relationship between non-disclosure of sexual orientation to parents and sexual risk behaviors among gay and bisexual men who have sex with men (MSM) in China. A total of 295 eligible participants (gay n = 179, bisexual n = 116) were recruited from MSM venues and MSM organizations in Anhui Province, China. Overall, 16.6 % of participants chose to disclose their sexual orientation to parents. Fewer bisexual participants chose to disclose their sexual orientation than gay participants (9.5 vs. 21.2 %, p < 0.01). A multivariate logistic regression analysis indicated that non-disclosers were more likely than disclosers to report having one or more female sex partners among gay and bisexual MSM (AOR = 2.91), non-disclosure of sexual orientation to parents was positively associated with the number of female sex partners (AOR = 3.40) and with engagement in unprotected anal intercourse with men (AOR = 2.49) among gay MSM, in the past 6 months. Our findings indicated that HIV/AIDS intervention programs should promote the disclosure of sexual orientation and should design interventions specific to gay and bisexual MSM separately. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the association between social support and AIDS high-risk behaviors in commercial sex workers (CSWs) in China. Methods: A cross-sectional study was performed based on a convenience sample. Data were collected through questionnaire interviews including information about social demographic characteristics, the Social Support Rating Scale (SSRS) and AIDS knowledge. Multiple logistic regression was performed to evaluate the association between social support and AIDS high-risk behaviors, specifically condom use during commercial sex. Results: A total of 581 commercial sex workers from 4 counties in East China participated in the study. The majority of the participants were 15 to 30 years old (79.7%). Sources of individual and family support were mainly provided by their parents (50.3%), relatives and friends (46.3%), spouses (18.4%), respectively. Univariate analysis revealed that marital status, hobbies, smoking habit, individual monthly income and family monthly income were all significantly correlated with current levels of social support being received (P = 0.04, P = 0.00, P = 0.01, P = 0.01, P = 0.01, respectively). Furthermore, Multiple logistic regression analysis indicated that after adjusting for confounding factors, high levels of social support were significantly correlated with increased condom use at the last sexual encounter (P = 0.02, OR = 1.86, 95%CI: 1.10–3.16); and consistently in the past month with clients (P = 0.03, OR = 2.10, 95%CI: 1.09–4.04). Conclusion: CSWs with high levels of social support are more likely to use condoms during commercial sex. This suggests that increasing social support can potentially reduce AIDS-related high-risk behaviors and accordingly play an important role in AIDS prevention. [ABSTRACT FROM AUTHOR]

Fertilizing based on soil test and crop nitrogen (N) demand is the key to optimize yields and minimize fertilizer cost. In 2008, a field experiment with different N rates was conducted with early rice near Yingtan City, Jiangxi Province, in southern China. Canopy normalized difference vegetation index (NDVI) with an active sensor and plant N uptake (PNU) were collected at key fertilization stages; and the sufficiency index (SI) was calculated as the ratio of under-fertilized and well-fertilized NDVI. Rice PNU and yield were positively correlated with NDVI and SI at the tillering and panicle initiation stages. Canopy SI improved the PNU and yield estimations when the relationship was validated with a different dataset. A spectrally-determined N topdressing model (SDNT) was established and used in combination with a target yield strategy and split-fertilization scheme. An allocation coefficient for plant N requirement to accommodate the potential for high yield and soil N supply was introduced. Optimum nitrogen use efficiency (NUE) at different growth stages was incorporated into the model. The model was validated with data from a 2009 plot experiment and three production fields in 2010. The difference of recommended N rate and yield between SDNT and the current yield curve recommendation method was 2.1 and −0.7 % at high planting density and −2.4 and −4.8 % at low planting density, respectively. Compared with farmers' N management, the SDNT strategy resulted in similar or higher yield with reduced N rates, higher NUE and higher net profit in both 2009 and 2010. Because canopy NDVI can be obtained while sidedressing N fertilizer in a single field pass, the potential of SDNT to accommodate within-field spatial and temporal variability in N availability should improve N management in rice. [ABSTRACT FROM AUTHOR]

Background: Non-Hodgkin's lymphoma (NHL) has been reported to be associated with autoimmune and pro-inflammatory response, and genetic polymorphisms of candidate genes involved in autoimmune and pro-inflammatory response may influence the susceptibility to NHL. To evaluate the role of such genetic variations in risk of NHL, we conducted a casecontrol study of 514 NHL patients and 557 cancer-free controls in a Chinese population. Method: We used the Taqman assay to genotype six potentially functional single nucleotide polymorphisms (SNPs) in six previously reported inflammation and immune-related genes (TNF rs1799964T>C, LTA rs1800683G>A, IL-10 rs1800872T>G, LEP rs2167270G>A, LEPR rs1327118C>G, TNFAIP8 rs1045241C>T). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI). Results: We observed a significantly increased risk of NHL associated with the TNFAIP8 rs1045241C>T polymorphism (adjusted OR = 3.03; 95% CI = 1.68-5.45 for TT vs. CC and adjusted OR = 2.03; 95% CI = 1.53-2.69 for CT/TT vs. CC). The risk associated with the T allele was more evident in subgroups of 40-60 year-old, non-smokers or light-smokers (less than 25 pack-years), and subjects with normal weight or overweight. Risk for both B and T cell non-Hodgkin's lymphoma was elevated for CT/TT genotypes (adjusted OR = 1.95, 95% CI = 1.41-2.70 for B cell NHL and adjusted OR = 2.22, 95% CI = 1.49- 3.30 for T cell NHL), particularly for DLBCL (adjusted OR = 2.01, 95%CI = 1.41-2.85) and FL (adjusted OR = 2.53, 95% CI = 1.17- 5.45). These risks were not observed for variant genotypes of other five SNPs compared with their common homozygous genotypes. Conclusions: The polymorphism of TNFAIP8 rs1045241C.T may contribute to NHL susceptibility in a Chinese population. Further large-scale and well-designed studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

In order to supply new information on the antioxidant function of selected beverages for nutritionists and the general public, total phenolic contents of 51 kinds of herbal and tea infusions made in China were measured by the Folin-Ciocalteu method, and their antioxidant capacities were evaluated using ferric reducing antioxidant power (FRAP) and Trolox equivalent antioxidant capacity (TEAC) assays. A significant correlation between FRAP and TEAC values suggested that antioxidant components in these beverages were capable of reducing oxidants and scavenging free radicals. The high correlation between antioxidant capacities and total phenolic contents indicated that phenolic compounds could be one of the main components responsible for antioxidant activities of these beverages. Generally, these beverages had high antioxidant capacities and total phenolic contents, and could be important dietary sources of antioxidant phenolics for prevention of diseases caused by oxidative stress. [ABSTRACT FROM AUTHOR]

Background: Depression and dementia often exist concurrently. The associations of depressive syndromes and severity of depression with incident dementia have been little studied.Aims: To determine the effects of depressive syndromes and cases of depression on the risk of incident dementia.Method: Participants in China and the UK aged > or =65 years without dementia were interviewed using the Geriatric Mental State interview and re-interviewed 1 year later in 1254 Chinese, and 2 and 4 years later in 3341 and 2157 British participants respectively (Ageing in Liverpool Project Health Aspects: part of the Medical Research Council - Cognitive Function and Ageing study).Results: Incident dementia was associated with only the most severe depressive syndromes in both Chinese and British participants. The risk of dementia increased, not in the less severe cases of depression but in the most severe cases. The multiple adjusted hazard ratio (HR)=5.44 (95% CI 1.67-17.8) for Chinese participants at 1-year follow-up, and HR=2.47 (95% CI 1.25-4.89) and HR=2.62 (95% CI 1.18-5.80) for British participants at 2- and 4-year follow-up respectively. The effect was greater in younger participants.Conclusions: Only the most severe syndromes and cases of depression are a risk factor for dementia. [ABSTRACT FROM AUTHOR]

To verify the pre-earthquake ionospheric anomaly (PEIA), statistical analyses are implemented on the relationship between the total electron content (TEC) of global ionosphere map (GIM) and 62 M ≥ 6.0 earthquakes in China during 1998 - 2015. A median-based method together with z test is employed to determine the criteria and/or characteristics of TEC anomalies related to earthquakes. It is found that the GIM TEC significantly decreases at 18:00 - 22:00 UT (universal time, post-midnight to pre-dawn) 4 - 5 days before 37 6.0 ≤ M < 6.5 earthquakes, at 01:00 - 04:00 UT (morning) 3 - 6 days before 18 6.5 ≤ M < 7.0 earthquakes, and 04:00 - 10:00 UT (pre-noon to afternoon) 3 - 5 days; but increases 08:00 - 12:00 UT (late afternoon to early evening), 18 - 20 days before 7 M ≥ 7.0 earthquakes. The receiver operating characteristic (ROC) curve is used to compare the TEC anomaly-based method with some competitive alternatives for predicting the earthquakes under study. We found, based on possible TEC anomalies, that the observed PEIAs are significantly earthquake-related. Moreover, the results of regression analyses show that the PEIA strength is associated with the magnitude of earthquakes. [ABSTRACT FROM AUTHOR]

Abstract: A number of field studies have reported very high rice yields in Taoyuan, Yunnan province, China, and the physiological and ecological factors associated with high yield have been explored. However, little attention has been paid to differences in plant type. The main objective of this study was to reveal the plant type characteristics associated with the high rice yield through the comparison of two sites: Taoyuan, Yunnan province and Nanjing, Jiangsu province, China. The physiological and environmental factors were also discussed. Field experiments were conducted at two sites in 2006 and 2007. Three Indica F1 hybrid varieties, Eryou 107, Xieyou 107 and Eryouhang 1 in 2006, Eryou 107 and Xieyou 107 in 2007 were grown at two sites under optimum crop management to achieve maximum attainable yields. Leaf area, leaf length, leaf width, leaf angles, specific leaf weight (SLW) and specific leaf nitrogen (SLN) at heading, yield and yield components at maturity were determined. Daily radiation, air temperature and relative humidity (RH) were monitored. The highest yield of 18.5tha−1 was achieved by Eryou 107 at Taoyuan in 2006, and average yield of all varieties at Taoyuan was 96% and 85% higher than Nanjing in 2006 and 2007, respectively. The higher yield at Taoyuan was attributed primarily to the larger sink size, which was mainly caused by the greater number of panicles per m2. Biomass production was greater at Taoyuan than at Nanjing in 2006 and 2007, while differences in harvest index were very small. Compared with Nanjing, the rice planted in Taoyuan has greater leaf area index about 10 with smaller area per stem, shorter, wider and thicker leaves and smaller leaf angles. These results indicate that in addition to the higher biomass accumulation (main physiological factor) and the intense solar radiation with the large diurnal temperature range (main environmental factor), the greater leaf area index (LAI) with smaller area per stem, may be an important morphological factor contributing to the high yield in Taoyuan. [Copyright &y& Elsevier]

Purpose: To determine the impact of PM 2.5 exposure in old age and its interactive effect with smoking on incident diabetes., Methods: A total of 2766 participants aged ≥60 years in China were interviewed at baseline for disease risk factors in 2001-03 and were then followed up for 10 years to document incident diabetes. They were assessed for daily PM 2.5 exposure in 2005. Multivariate Cox regression models were used to examine the association of PM 2.5 exposure with incident diabetes and interactive effect between PM 2.5 and smoking on incident diabetes., Results: During the cohort follow-up, 176 participants developed diabetes. The incidence of diabetes increased with PM 2.5 exposure; the multiple-adjusted hazard ratio (HR) of diabetes was 2.27 (95 % CI 1.36-3.77) in participants with PM 2.5 at ≥62.0 μg/m 3 compared to those at <62.0 μg/m 3 . There was a significant interaction effect of PM 2.5 with smoking on increased risk of diabetes. The adjusted HR for participants exposed to PM 2.5 levels ≥62.0 μg/m 3 who smoked was 4.39 (95 % CI 1.72-11.21), while for non-smokers it was 1.65 (95 % CI 0.88-3.09), compared to those at <62.0 μg/m 3 ., Conclusions: Exposure to PM 2.5 in old age was associated with an increased incidence of diabetes and smoking enhanced the impact of PM 2.5 on diabetic risk. These findings underscore the urgent need for air quality improvement measures and smoking cessation programs to mitigate the risk of diabetes in aging populations., 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 B.V. All rights reserved.)

The strategic position of the core area of the Huaihai Economic Zone is very important. The evaluation and analysis of the listed companies' innovation ability in this core area effectively reflect the level of innovation ability of regional enterprises and uncover the differences and influencing factors of the enterprise innovation ability level across different cities and industries; this would provide a reference for further improving the enterprise innovation ability level in the Huaihai Economic Zone. Given this context, data are collected from the CSMAR database on 37 listed companies in eight cities in the Huaihai Economic Zone core area from 2017 to 2021, and an innovation ability evaluation index is constructed from the innovation input and innovation output dimensions of listed companies. The results show that the innovation ability of listed companies in the region is weak; the main reason for the lack of innovation ability of listed companies is the lack of capital investment and talent investment; the innovation primacy of Xuzhou listed enterprises is not high. Finally, in view of the improvement of the innovation ability of listed enterprises in the core field, corresponding suggestions are put forward from the aspects of increasing innovation investment, optimizing the innovation environment and improving the innovation leading force in Xuzhou., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Qin-Xia Liu. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Obesity classifications vary globally and the impact of older age adiposity on incident diabetes has not been well-studied., Methods: We examined a random sample of 2,809 participants aged ≥60 years in China, who were free of diabetes at baseline and were followed up for up to 10 years to document diabetes (n=178). The incidence of diabetes was assessed in relation to different cut-off points of body mass index (BMI) and waist circumference (WC) in multiple adjusted Cox regression models., Results: The diabetic risk in the cohort increased linearly with the continuous and quartile variables of BMI and WC. The BMI-World Health Organization (WHO) and BMI-China criteria analysis did not show such a linear relationship, however, the BMI-Asian/Hong Kong criteria did; adjusted hazards ratio (HR) was 0.42 (95% confidence interval [CI], 0.20 to 0.90) in BMI <20 kg/m2, 1.46 (95% CI, 0.99 to 2.14) in 23-≤26 kg/m2, and 1.63 (95% CI, 1.09 to 2.45) in ≥26 kg/m2. The WC-China criteria revealed a slightly better prediction of diabetes (adjusted HRs were 1.79 [95% CI, 1.21 to 2.66] and 1.87 [95% CI, 1.22 to 2.88] in central obese action levels 1 and 2) than the WC-WHO. The combination of the BMI-Asian/Hong Kong with WC-China demonstrated the strongest prediction. There were no gender differences in the impact of adiposity on diabetes., Conclusion: In older Chinese, BMI-Asian/Hong Kong criteria is a better predictor of diabetes than other BMI criterion. Its combination with WC-China improved the prediction of adiposity to diabetes, which would help manage bodyweight in older age to reduce the risk of diabetes.

Background: To examine the relationship between social capital and depression among community-dwelling older adults in Anhui Province, China., Methods: A cross-sectional study was conducted among older people selected from three cities of Anhui Province, China using a multi-stage stratified cluster random sampling method. Data were collected through questionnaire interviews and information on demographic characteristics, social capital, and depression was collected. The generalized linear model and classification and regression tree model were employed to assess the association between social capital and depression., Results: Totally, 1810 older people aged ≥60 years were included in the final analysis. Overall, all of the social capital dimensions were positively associated with depression: social participation (coefficient: 0.35, 95% CI: 0.22-0.48), social support (coefficient:0.18, 95% CI:0.07-0.28), social connection (coefficient: 0.76, 95% CI:0.53-1.00), trust (coefficient:0.62, 95% CI:0.33-0.92), cohesion (coefficient:0.31, 95% CI:0.17-0.44) and reciprocity (coefficient:0.30, 95% CI:0.11-0.48), which suggested that older people with higher social capital had a smaller chance to develop depression. A complex joint effect of certain social capital dimensions on depression was also observed. The association with depression and the combinative effect of social capital varied among older adults across the cities., Conclusions: Our study suggests that improving social capital could aid in the prevention of depression among older adults.

In China, Voluntary HIV Counseling and Testing (VCT) services are mostly provided by Civil Society Organizations (CSOs). This cross-sectional study investigated the association between CSOs' social capital and VCT service availability in eight Chinese provinces during July-December 2015. Data on CSOs' characteristics were collected through questionnaire-based interviews. Social capital was measured using a purpose-developed questionnaire. Logistic regression models tested the association between social capital and the scale of VCT services. A total of 103 CSOs that provided VCT to MSM (MSM-focused CSOs), and 109 CSOs that provided such service to non-MSM population (other CSOs) were included. Overall, 144 (67.9%) CSOs were not registered with local governments, while 106 (50%) received RMB 50,000 ($7,670) funding in 2014. Multivariate logistic regression analysis indicated that the CSOs with a higher level of shared vision were more likely to provide a large-scale of VCT service than those with a lower level of shared vision (AOR = 1.95). Moreover, intra-networks were positively associated with the VCT service (AOR = 2.87) among other CSOs, while the level of shared vision was positively associated with the VCT service (AOR = 3.08) among other-MSM-focused CSOs. There was no significant association between social capital and total service scale. Our findings suggest that increasing social capital can potentially enhance VCT service and play an important role in AIDS prevention.

This study aimed to explore the relationship between individual social capital and functional ability, with a focus on whether there is an interactive relationship that exists among social capital related to functional ability among older people in Anhui province, China. We conducted a cross-sectional study with a multi-stage stratified cluster random sampling method from July to September 2017. Data were collected through questionnaire including demographic characteristics, individual social capital status, and functional capability status. Binary logistic regression analysis model and classification and regression tree model (CART) were utilized. Overall, this study included 1810 elderly people, 43% of whom had functional disability. After the adjustment, subjects with lower social participation (AOR = 1.60; 95% CI: 1.26-2.03) and lower social connection (AOR = 1.74; 95% CI: 1.34-2.25) had an increased risk of functional disability. However, social support (AOR = 0.73; 95% CI: 0.57-0.94) was inversely related to functional ability. We also observed interactive relationship of social capital associated with functional ability, which indicated that special attention and efforts should be paid to older adults with less educational attainment, with multimorbidity, with advanced age, and with lower level of social participation, cohesion for the purpose of maintaining sound functional ability. Our findings may be of salient relevance for devising more targeted and effective interventions to prevent the onset of functional limitations among community-dwelling older adults., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Rationale: Acute necrotizing encephalopathy (ANE) is a rapidly progressing disease associated with frequent neurologic sequelae and has poor prognosis. Currently, the diagnosis and treatment of ANE rely on neuroradiologic findings and offering supportive care. Here, we report the successful treatment of a teenager diagnosed with ANE using combination of high-dose methylprednisolone and oseltamivir., Patient Concerns: The patient, a 15-year-old female, presented with impaired consciousness and seizures secondary to acute upper respiratory tract infection. A series of brain magnetic resonance images (MRIs) were obtained toward establishing a possible diagnosis., Diagnosis: Based on the history of presenting illness and subsequent brain MRI scans, the patient was diagnosed to be suffering from ANE., Interventions: Following the diagnosis, the patient was placed on therapy comprising of high-dose methylprednisolone and oseltamivir., Outcomes: After treatment with methylprednisolone and oseltamivir for 15 days, the patient recovered nearly completely from ANE as confirmed by subsequent brain MRI scans. No complications or other emerging clinical symptoms were noted for the duration of follow-up that lasted 6 months., Lessons: Contrary to common reports, ANE can occur beyond pediatric populations and its treatment should not be restricted to supportive care. Our case suggests that the use of high-dose corticosteroids and oseltamivir leads to promising prognosis.

Background: There is a growing recognition of the need to provide HIV/AIDS prevention and care to migrant workers. Social involvement, a type of social capital, is considered a 'critical enabler' of effective HIV/AIDS prevention. Designated participation in formal community groups by the government (e.g., political parties) and informal, voluntary local networks by NGOs (e.g., alumni association, cultural & sports club) play different roles in HIV prevention. The objective of this study is to assess the impact of different types of social organizations on HIV/AIDS prevention knowledge among migrant workers., Methods: A cross-sectional study of 758 migrants was conducted in Hefei, Anhui Province, China. Data were collected through a self-reported questionnaire. Logistic regression was used to assess associations between different social organizations and HIV/AIDS prevention., Results: Migrants who participated in social organizations had a higher awareness of HIV/AIDS knowledge than migrants who do not participate in social organizations. Higher levels of HIV/AIDS knowledge is associated with positive HIV/AIDS behaviors for people who attended political parties (odds ratio [OR] = 3.49, 95% CI: 1.22-9.99). This effect is not significant for alumni association. For both political parties and alumni association members (OR = 0.19, 95% CI: 0.06-0.66, OR = 0.20, 95% CI: 0.08-0.61, respectively), people who exhibited higher levels of HIV/AIDS knowledge had more negative attitudes than those with less knowledge., Conclusion: Social organizations play an important role in improving HIV/AIDS knowledge and behavior in migrants, providing a great opportunity for HIV/AIDS prevention.

Objectives: Environmental tobacco smoke (ETS) has a range of adverse health effects, but its association with dementia remains unclear and with dementia syndromes unknown. We examined the dose-response relationship between ETS exposure and dementia syndromes., Methods: Using a standard method of GMS, we interviewed 5921 people aged ≥60 years in five provinces in China in 2007-2009 and characterised their ETS exposure. Five levels of dementia syndrome were diagnosed using the Automated Geriatric Examination for Computer Assisted Taxonomy instrument. The relative risk (RR) of moderate (levels 1-2) and severe (levels 3-5) dementia syndromes among participants exposed to ETS was calculated in multivariate adjusted regression models., Results: 626 participants (10.6%) had severe dementia syndromes and 869 (14.7%) moderate syndromes. Participants exposed to ETS had a significantly increased risk of severe syndromes (adjusted RR 1.29, 95% CI 1.05 to 1.59). This was dose-dependently related to exposure level and duration. The cumulative exposure dose data showed an adjusted RR of 0.99 (95% CI 0.76 to 1.28) for >0-24 level years of exposure, 1.15 (95% CI 0.93 to 1.42) for 25-49 level years, 1.18 (95% CI 0.87 to 1.59) for 59-74 level years, 1.39 (95% CI 1.03 to 1.84) for 75-99 level years and 1.95 (95% CI 1.34 to 2.83) for ≥100 level years. Significant associations with severe syndromes were found in never smokers and in former/current smokers. There were no positive associations between ETS and moderate dementia syndromes., Conclusions: ETS should be considered an important risk factor for severe dementia syndromes. Avoidance of ETS may reduce the rates of severe dementia syndromes worldwide.

Objective: To investigate the prevalence and determinants of depressive symptoms among 'empty-nest' and 'non-empty-nest' elderly in four cities/provinces., Methods: 4265 elderly aged 60 and over, were recruited with cluster sampling method in Shanghai, Heilongjiang, Guangdong and Shanxi province and interviewed, using the Geriatric Mental State Schedule and self-developed related questionnaire., Results: (1) The prevalence of depressive symptoms for 'empty-nest' elderly was (8.18%), significantly higher than that for 'non-empty-nest' elderly (P=0.019); (2) the 'empty-nest' elderly had a significantly higher proportion of the following factors: being male, married, with higher income (≥15,000 Yuan/year), living in city, with high education background, under employment etc. than the 'non-empty-nest' elderly (P<0.0001); (3) the 'empty-nest' elderly had significantly higher proportions on good self-rated health status and life (P=0.0001, P<0.0001) as well as heavier health problems and economic difficulties (P=0.001, P=0.002); (4) there were significantly negative associations between depressive symptoms and the following 10 factors: being female, single, having bad self-rated health and life status, having somatic disease≥3, with big health problems in the last two years and loss of dearest persons, community engagement and involvement of religious activities., Conclusion: The 'empty-nest' elderly showed higher prevalence of having depressive symptoms than the 'non-empty-nest' elderly. The 'empty-nest' elderly had characteristics as being single, female, having adverse event etc. and should be under greater attention for care.

Background: With growing recognition of the social determinants of health, social capital is an increasingly important construct in international health. However, the application of social capital discourse in response to HIV infection remains preliminary. The aim of this study was to assess the impact of social capital on quality of life (QoL) among adult patients with acquired immune deficiency syndrome (AIDS)., Methods: A convenient sample of 283 patients receiving antiretroviral treatment (ART) was investigated in Anhui province, China. QoL data were collected using the Medical Outcomes Study HIV Survey (MOS-HIV) questionnaire. Social capital was measured using a self-developed questionnaire. Logistic regression models were used to explore associations between social capital and QoL., Results: The study sample had a mean physical health summary (PHS) score of 50.13 ± 9.90 and a mean mental health summary (MHS) score of 41.64 ± 11.68. Cronbach's α coefficients of the five multi-item scales of social capital ranged from 0.44 to 0.79. When other variables were controlled for, lower individual levels of reciprocity and trust were associated with a greater likelihood of having a poor PHS score (odds ratio [OR] =2.02) or PHS score (OR=6.90). Additionally, the factors of social support and social networks and ties were associated positively with MHS score (OR=2.30, OR=4.17, respectively)., Conclusions: This is the first report to explore the effects of social capital on QoL of AIDS patients in China. The results indicate that social capital is a promising avenue for developing strategies to improve the QoL of AIDS patients in China, suggesting that the contribution of social capital should be fully exploited, especially with enhancement of QoL through social participation. Social capital development policy may be worthy of consideration.

China is facing a major crisis because of the increasing epidemic of HIV/AIDS, especially in the western areas. The purpose of this paper is to enhance understanding of the crisis by analysing the published literature on the epidemiology, demographic features, routes of infection, and risk factors of HIV/AIDS infection in the 12 provinces in the west of China. HIV/AIDS has increased rapidly in recent years. The situation is urgent and requires comprehensive action. China's health care system is decentralized and under-funded, and access to treatment by the poor is seriously limited. There is a lack of knowledge about HIV/AIDS in the general public and health care workers. The HIV/AIDS epidemic emerged initially in western areas of the country by means of intravenous drug use, but sexual risk behaviour and mother-to-child transmissions in the west of China are becoming important for HIV transmission.

Background: In Western countries depression is the most common psychiatric condition in older persons and related to low socioeconomic status and low social supports. Along with social deprivation, the rural communities in China retain many Chinese traditions that involve high levels of social supports. Studying such a population might offer insights into the cause and prevention of depression that may be applicable in developing and developed countries., Methods: Using a cross-sectional, household-based, community survey in rural China, we aimed to determine the prevalence of and risk factors for depression among older people who had a low income (mean annual per capita income of about 280 US dollars) and high social support in 16 villages in Anhui Province. Participants included 754 men and 846 women aged 60 years or older. Depression was diagnosed using the Geriatric Mental State and the Automated Geriatric Examination for Computer Assisted Taxonomy. Risk factors, collected from the standard questionnaire and physical measurements, were examined in a stepwise multiple logistic regression model., Results: The prevalence of depression (world age standardized) was 6.0% (95% confidence interval [CI], 4.8%-7.3%). Of all persons, 1374 older persons (85.9%) living with family members. Depression was significantly and independently associated with female gender, low family income, lack of social support, relationship problems, poor health status, and adverse life events in the past 2 years. The risk of depression increased in those eating meat less than once a week (multiple-adjusted odds ratio, 2.20; 95% CI, 1.20-4.03), not watching television (odds ratio, 1.76; 95% confidence interval, 1.03-3.00), and having undetected hypertension (odds ratio, 1.78; 95% CI, 1.05-3.01)., Conclusions: Older people in rural China have a lower risk of depression than those in Western countries. Low socioeconomic status showed a "dose-response" relationship with depression, and social supports were much more common, which were protective for depression. Further exploration of Chinese culture and tradition may yield universal insights into preventive factors for depression in older people.

Objective: Previously published studies of prevalence of depression in older people in China showed much variation in the results, while the pooled prevalence is low. In this study we used a standardised method, the Geriatric Mental State (GMS) to investigate the prevalence of depression in older people in China, validate the GMS-AGECAT depression cases and examine the relationship between depression and socio-economic deprivation., Methods: 1736 subjects aged > or =65 were recruited from Hefei city, China. They were interviewed at home by a survey team from Anhui Medical Universtiy using the GMS and other interviews. Their mental disorders were diagnosed by the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT). Chinese psychiatrists re-examined depression cases and their controls., Results: 39 depressed cases were diagnosed by the GMS-AGECAT. Age-standardised prevalence was 2.2% (95% CI 1.5-2.9), which was about five-times lower than that of older people in Liverpool, UK. Agreement on depression diagnoses between the GMS-AGECAT and local Chinese psychiatrists was 83.6%, with a Kappa of 0.67 (p<0.001). Depression was significantly related to socio-economic deprivation., Conclusions: This community-based study suggested a low prevalence of depression in older people in urban China. Approved training in the use of the GMS-AGECAT in mainland China should make it possible to carry out a large scale epidemiological study on depression in the Chinese elderly population to investigate its geographic variation and risk factors. The dose-response relation between socio-economic deprivation and depression indicates that strategies for tackling inequality in depression in elderly are urgently needed in China., (Copyright 2004 John Wiley & Sons, Ltd.)