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Yue Liu, Shi Qi Xie, Xia Yang, Jing Lan Chen, Jian Rong Zhou School of Nursing, Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Jian Rong Zhou; Shi Qi Xie, School of Nursing, Chongqing Medical University, 1 Medical College Road, Yu Zhong District, Chongqing, 400016, People’s Republic of China, Tel +86-135 0830 0955 ; +86-156 0833 2043, Fax +86-23-63555767, Email 202028@cqmu.edu.cn; xie47@cqmu.edu.cnPurpose: The clinical presentation of Obstructive Sleep Apnea (OSA) in children is insidious and harmful. Early identification of children with OSA, particularly those at a higher risk for severe symptoms, is essential for making informed clinical decisions and improving long-term outcomes. Therefore, we developed and validated a risk prediction model for severity in Chinese children with OSA to effectively identify children with moderate-to-severe OSA in a clinical setting.Patients and Methods: From June 2023 to September 2023, we retrospectively analyzed the medical records of 367 Children diagnosed with OSA through portable bedside polysomnography (PSG). Predictor variables were screened using the least absolute shrinkage and selection operator (LASSO) and logistic regression techniques to construct nomogram to predict the severity of OSA. Receiver operating characteristic curve (ROC), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) were used to determine the discrimination, calibration, and clinical usefulness of the nomogram.Results: A total of 367 children with a median age of 84 months were included in this study. Neck circumference, ANB, gender, learning problem, and level of obstruction were identified as independent risk factors for moderate-severe OSA. The consistency indices of the nomogram in the training and validation cohorts were 0.841 and 0.75, respectively. The nomogram demonstrated a strong concordance between the predicted probabilities and the observed probabilities for children diagnosed with moderate-severe OSA. With threshold probabilities ranging from 0.1 to 1.0, the predictive model demonstrated strong predictive efficacy and yielded improved net benefit for clinical decision-making. ROC analysis was employed to classify the children into high and low-risk groups, utilizing the Optimal Cutoff value of 0.39.Conclusion: A predictive model using LASSO regression was developed and validated for children with varying levels of OSA. This model identifies children at risk of developing OSA at an early stage.Keywords: obstructive sleep apnea, children, cephalometric, prediction nomogram, risk prediction model

Yuanyuan Jiang,1 Shan Jiang,1,2 Qing Long,1 Jundi Yang,1,3 Jyu-Lin Chen,4 Jia Guo1 1Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China; 2Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu, People’s Republic of China; 3School of Nursing, The University of Hong Kong, Hong Kong, People’s Republic of China; 4School of Nursing, University of California San Francisco, San Francisco, CA, USACorrespondence: Jia Guo, Tel +86 13875947418, Email guojia621@163.comBackground: Women in rural areas of China face the unique risk of developing diabetes, but data on the glycemic status among women without prior diabetes diagnosis in rural areas are lacking which may limit the decision-making for diabetes screening or prevention. This study was aimed to describe the glycemic status of women determined by hemoglobin A1c (HbA1c) and explore its associating factors.Methods: A cross-sectional survey was conducted among women without prior diabetes diagnosis from two counties of rural areas in Central South China from July to October 2018. On the basis of the life course framework, data on socio-demographic, environmental health, genetic, biological (blood pressure, weight and height, lipids), psychosocial, and healthy behavioral factors were collected on site either through questionnaires or field measurements. The questionnaires included social-demographic sheet, Perceived Stress Scale, Self-efficacy scales for health-related diet and exercise behaviors, and Chinese Diabetes Risk Questionnaire. Generalized linear model analysis was performed to determine the associating factors of glycemic status, which was measured by HbA1c level.Results: A total of 647 women were included in the study. The median age of women was 51.00 years (range 35– 65 years). The median HbA1c level was 5.1% (interquartile range 4.6%-5.5%, range 4– 13.6%), and 8.7% (n=56) of women were identified as elevated glycemic status (HbA1c> 6%). Environmental health factors (eg, living in less-developed county [β=0.206, p=0.027]), biological factors (eg, higher body mass index [β=0.201, p=0.036], higher total cholesterol [β=0.097, p=0.040], history of gestational diabetes mellitus [β=0.722, p< 0.001]), and psychosocial factors (eg, higher perceived stress [β=0.247, p=0.002]) were associated with higher HbA1c level.Conclusion: This study reported 8.7% of elevated glycemic status among women without prior diabetes diagnosis in rural Hunan Province, China. After a comprehensive investigation based on a theoretical framework, living in a less-developed county of rural areas, having larger body mass index, higher total cholesterol, higher perceived stress, and a gestational diabetes mellitus history were identified as associating factors of higher HbA1c level. Professional support regarding weight control, blood lipid control, stress management, and the prevention of gestational diabetes mellitus should be recommended among this population, especially for women from less-developed counties.Keywords: women, rural areas, glycemic status, hemoglobin A1c, associating factors, survey

Carl PC Chen,1 Chih-Chin Hsu,2 Chih-Hsiu Cheng,3 Shu-Chun Huang,1 Jean-Lon Chen,1 Shin-Yi Lin1 1Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan City, Taiwan; 2Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital at Keelung and College of Medicine, Chang Gung University, Taoyuan City, Taiwan; 3School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan City, TaiwanCorrespondence: Carl PC ChenDepartment of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, 5, Fu-Hsin Street, Guishan, Taoyuan 333, TaiwanTel +886-909396196Fax +886-3-3281320Email carlchendr@gmail.comBackground: To investigate whether body mass index (BMI) and changes in body positioning have any correlation with the distance from the pleura to the inferior trunk of the supraclavicular brachial plexus.Patients and Methods: Twenty stroke patients with upper limb spasticity and complex regional pain syndrome were recruited for this study. Distance from the pleura to the inferior trunk was measured in the supine position, body turned sideways at 45 °, and in the lateral decubitus position. Correlations between BMI and measured distances in these body positions were evaluated. A linear musculoskeletal ultrasound transducer was used to conduct these distance measurements.Results: The distance from the pleura to the inferior trunk in the supine position was calculated to have an average of 0.42 ± 0.06 cm (D1), 0.44 ± 0.05 (D2) when lying sideways at 45 °, and 0.87 ± 0.08 cm (D3) in the lateral decubitus position. The Kruskal–Wallis test revealed significant differences when comparing D3 with D1, and D3 with D2 (p < 0.001). Positive correlations were observed between BMI and D1 (Spearman’s rho = 0.62, p = 0.004, two-tailed), and between BMI and D2 (Spearman’s rho = 0.61, p = 0.005, two-tailed). The strongest positive correlation was observed between BMI and D3 (Spearman’s rho = 0.78, p < 0.001, two-tailed).Discussion: In the lateral decubitus body position, the distance from the pleura to the inferior trunk increased significantly by 2-fold and was positively correlated with BMI. The increased distance may improve the safety of the nerve block procedure. As a result, it is recommended that patients be placed in the lateral decubitus body position when performing ultrasound-guided supraclavicular brachial plexus nerve block of the inferior trunk.Keywords: body mass index, ultrasound-guided, brachial plexus, nerve block, inferior trunk, lateral decubitus, corner pocket, complex regional pain syndrome

Cai RD, Zhang CC, Xie LL, et al. Cancer Manag Res. 2020;12:12011–12020. The Editor and Publisher of Cancer Management and Research wish to retract the published article. Concerns were raised over the flow cytometry data presented in the article and over alleged image duplication in Figures 2F, 3F and 6C, specifically: Figure 2F panel KNS-81 si-NC appears to show duplication with regions from panel KALS-1 si-NC. Figure 2F panel KNS-81 SNHG1 appears to show duplication with regions from panel KALS-1 SNHG1. Figure 3C panel KALS-1 miR-NC appears to show duplication with regions from Figure 6C panel KNS-81 si-NC. The authors responded to our queries but were unable to provide a satisfactory reason for the alleged duplication and were unable to provide any original data for their study. The Editor advised for the paper to be retracted. Our decision-making was informed by our policy on publishing ethics and integrity and the COPE guidelines on retraction. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted”. This retraction relates to this paper

Si-jun Liu,1,* Cong Yang,2,* Yue Zhang,2,* Ru-yu Su,2 Jun-li Chen,2 Meng-meng Jiao,2 Hui-fang Chen,2 Na Zheng,2 Si Luo,2 Yun-bo Chen,2 Shi-jian Quan,1 Qi Wang21School of Chinese Materia Medica, 2Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China*These authors contributed equally to this workAim: β-asarone, an active component of Acori graminei rhizome, has been reported to have neuroprotective effects in Alzheimer’s disease. As the underlying mechanism is not known, we investigated the neuroprotective effects of β-asarone in an APP/PS1 double transgenic mouse model and in NG108 cells.Materials and methods: APPswe/PS1dE9 double transgenic male mice were randomly assigned to a model group, β-asarone treatment groups (21.2, 42.4, or 84.8 mg/kg/d), or donepezil treatment group (2 mg/kg/d). Donepezil treatment was a positive control, and background- and age-matched wild-type B6 mice were an external control group. β-asarone (95.6% purity) was dissolved in 0.8% Tween 80 and administered by gavage once daily for 2.5 months. Control and model animals received an equal volume of vehicle. After 2.5 months of treatment, behavior of all animals was evaluated in a Morris water maze. Expression of synaptophysin (SYP) and glutamatergic receptor 1 (G1uR1) in the hippocampus and cortex of the double transgenic mice was assayed by Western blotting. The antagonistic effects of β-asarone against amyloid-β peptide (Aβ) were investigated in vitro in the NG108-15 cell line. After 24 hours of incubation, cells were treated with 10 µm Aβ with or without β-asarone at different concentrations (6.25, 12.5, or 25 µM) for an additional 36 hours. The cytotoxicity of β-asarone was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay of cell viability, and cell morphology was evaluated by bright-field microscopy after 24 hours of treatment. The expression of SYP and GluR1 in cells was detected by Western blot assay in the hippocampus and brain cortex tissues of mice.Results: β-asarone at a high dose reduced escape latency and upregulated SYP and GluR1 expression at both medium and high doses. Cell morphology evaluation showed that β-asarone treatment did not result in obvious cell surface spots and cytoplasmic granularity. β-asarone had a dose-dependent effect on cell proliferation.Conclusion: β-asarone antagonized the Aβ neurotoxicity in vivo, improved the learning and memory ability of APP/PS1 mice, and increased the expression of SYP and GluR1 both in vivo and in vitro. Thus, β-asarone may be a potential drug for the treatment of Alzheimer’s disease.Keywords: neuroprotective effect, β-asarone, synaptic plasticity, synaptophysin, glutamatergic receptor 1

Chin-Pang Lee,1,2 Yu Chen,2–4 Kun-Hao Jiang,2,4,5 Chun-Lin Chu,1,2,4 Shih-Chieh Hsu,1,2,4 Jiun-Liang Chen,2,4,5 Ching-Yen Chen1,2,41Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; 2Men’s Health Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; 3Department of Urology, Chang Gung Memorial Hospital, Linkou, Taiwan; 4School of Medicine, Chang Gung University, Taoyuan; 5Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Linkou, TaiwanIntroduction: The Androgen Deficiency in the Aging Male (ADAM) questionnaire is widely used to screen for late-onset hypogonadism. The positive response to the ADAM questionnaire (positive ADAM) has been associated with depression and poorer quality of life in a number of studies. It is unclear whether there is any value of the ADAM questionnaire in psychiatric populations. In this study, we aimed to determine the utility of the ADAM questionnaire in a convenient sample of male psychiatric outpatients.Methods: One hundred and seventy-six men (mean age: 54.3 years; standard deviation: 10.7 years; range: 40–80 years) completed the ADAM questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Aging Males’ Symptoms (AMS) scale. Anxiety was defined as a HADS anxiety subscore ≥8; depression as a HADS depression subscore ≥8; and moderate/severe impairment of health-related quality of life (HQoL) as AMS ≥37. ADAM, anxiety, and depression was used to model the moderate/severe impairment of HQoL.Results: One hundred and sixty-four (93%) men had positive ADAM. Positive ADAM was associated with a lower body mass index (P0.05). Positive ADAM was associated with five symptoms of the AMS scale: “decline of one’s feeling of general well-being”, “depressive mood”, and three sexual symptoms. In regression analysis, positive ADAM was associated with increased risk of moderate/severe impairment of HQoL (unadjusted odds ratio 20.1, 95% confidence interval 3.77–372, P

Chun-Lin Chu,1–3 Yu Chen,1,3,4 Kun-Hao Jiang,1,3,5 Jiun-Liang Chen,1,3,5 Chin-Pang Lee,1–3 Yeuk-Lun Chau,1,2 Ching-Yen Chen1–3 1Men’s Health Center, 2Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, 3School of Medicine, Chang Gung University, 4Department of Urology, 5Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan Introduction: Symptoms of depression in males, such as aggression and irritability, are different from those in females. However, there are no adequate scales for detecting possible diagnoses in the Chinese population. The aim of this study was to assess whether the Chinese version of the Gotland Male Depression Scale (CV-GMDS) could identify male depression as effectively as the English version. Materials and methods: A total of 231 male outpatients were sampled from a men’s health polyclinic. We used questionnaires to evaluate the characteristics and mood status of participants, including the CV-GMDS, the Chinese version of the Beck Depressive Inventory II (CV-BDI-II), and the Chinese version of the Aging Males’ Symptoms (CV-AMS) scale. Cronbach’s α-coefficient and Levene’s test were used to investigate internal consistency and homogeneity, respectively. External validity was evaluated using Spearman’s correlation coefficient. A factor analysis was conducted to evaluate the conceptual structure of the CV-GMDS, and a regression analysis was used to determine the relationship of the CV-AMS scale with the CV-GMDS and CV-BDI-II. Results: The mean age of the 231 participants was 46.1 years (standard deviation 11.0). Of the participants, 36.8% (n=85) were found to have depression according to the CV-GMDS and 34.6% (n=80) according to the CV-BDI-II. The internal consistency of the CV-GMDS was demonstrated by a Cronbach’s α of 0.933, and the test of homogeneity revealed a P-value of 0.762. The external validity for the CV-GDMS and CV-BDI-II was demonstrated by an intercorrelation of 0.835. The third and fourth items of the GMDS differed from the others, and the CV-GMDS showed a better relationship (R2=0.616) with the CV-AMS scale than the CV-BDI-II did. Conclusion: The CV-GMDS is a satisfactory and suitable psychometric questionnaire for detecting depression among a Chinese-speaking middle-aged or older male population. The results of this study could be used as a basis for investigating specific male depression and aging symptoms. Keywords: male depression, validation, utilization, Gotland Male Depression Scale, Aging Males’ Symptoms scale

Jyu-Lin Chen,1 Mary Ellen Wilkosz2 1Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA, 2Nursing Department, Sonoma State University, Rohnert Park, CA, USA Abstract: About one third of adolescents in the USA are overweight and/or obese. Obesity during the adolescent years is associated with many adverse health consequences, including type 2 diabetes, hypertension, hyperlipidemia, and psychosocial problems. Because of substantial advances in technologies and wide acceptance by adolescents, it is now possible to use technology for healthy weight management and prevention of obesity. This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and aimed to evaluate the existing literature reported on the effectiveness of technology-based intervention (web-based, e-learning, and active video games) in preventing obesity in adolescents. The primary aim of this review was to explore if components of specific interventions were associated with a reduction in body mass index. Research articles obtained from CINAHL, Embase, PubMed, PsycInfo, and the Cochrane database from1990 to 2014 were reviewed. A total of 131 published articles were identified, and 14 met the inclusion criteria of a randomized or nonrandomized clinical study with body mass index as primary outcome and/or secondary outcomes of diet/physical activity and/or psychosocial function, tested lifestyle interventions to prevent obesity, used technology, and studied adolescents (aged 12–18 years). The results indicated that six of 14 studies found body mass index and/or body fat decreased at short-term (less than 12 months) follow-up. Six of eleven studies that examined physical activity or physical activity-related outcomes found an improved physical activity outcome (time playing active video games and increase in physical activity time), while five of seven studies which assessed dietary outcomes indicated improvement in dietary behaviors. Five of seven studies suggested an improvement in psychosocial function (reduced depression, improved self-esteem and efficacy, improvement on Behavior Assessment Scale) in adolescents involved in the technology-based intervention. All effective interventions utilized dietary and physical activity strategies as part of intervention components. Because of the variation in duration of intervention (range 10 weeks to 2 years), it is not clear what length of intervention is most effective. Future research should assess the long-term impact of technology-based interventions and evaluate mediators and moderators for weight change in adolescents. Keywords: technology intervention, obesity, adolescents, web-based, exer-gaming

Electrochemical conversion of small molecules such as carbon dioxide (CO2) and carbon monoxide (CO) to high-value multi-carbon products (C2+) offers a chemical upgrade approach for fuels and chemical feedstock production using renewable energy, in the possible absence of the petrochemical industry under the new energy system such as hydrogen economy. Identifying robust and efficient electrocatalysts to selectively produce C2+ products remains a challenge. Herein, we report a synthetic strategy of atomically dispersing copper atoms on nitrogen-rich porous carbon (Cu–N–C) through pyrolysis of a supramolecular assembly. Benefitting from the unsaturated coordination structure, in KOH electrolyte, the Cu–N–C with a Cu content of 6.9 wt% exhibits a maximum acetate Faradaic efficiency (FE) of 30% with an acetate partial current density as high as 48 mA cm−2 in electrochemical CO reduction. Different from the C–C coupling mechanism on metallic copper, we propose a CO insertion mechanism for the acetate production on the single site copper catalyst.

ObjectivesThe aim of the study was to examine self-rated health (SRH) of Middle Eastern immigrants in the US compared with US-born non-Hispanic whites and to examine factors associated with fair/poor SRH among Middle Eastern immigrants in the US.Study designWe used a cross-sectional design to analyze the National Health Interview Survey from 2001 to 2015.MethodsSecondary survey analysis procedures were conducted using the SAS program, with a total of 3,966 Middle Eastern and 731,285 US-born non-Hispanic whites. Descriptive statistics and regression analyses were used.ResultsMiddle Eastern immigrants had significantly higher rates of fair/poor SRH than US-born whites across the three survey waves. Reporting symptoms of serious psychological distress, older age (60+ years), current alcohol-drinking status, and having a family member with disability were the factors associated significantly with higher odds of reporting fair/poor SRH in Middle Eastern immigrants, whereas education was a protecting factor of fair/poor SRH.ConclusionsThis study indicates that Middle Eastern immigrants are one of the US immigrant populations that report poor health status, which reveals the need for health policy attention to reduce health disparities.

ObjectivesThe aim of the study was to examine self-rated health (SRH) of Middle Eastern immigrants in the US compared with US-born non-Hispanic whites and to examine factors associated with fair/poor SRH among Middle Eastern immigrants in the US.Study designWe used a cross-sectional design to analyze the National Health Interview Survey from 2001 to 2015.MethodsSecondary survey analysis procedures were conducted using the SAS program, with a total of 3,966 Middle Eastern and 731,285 US-born non-Hispanic whites. Descriptive statistics and regression analyses were used.ResultsMiddle Eastern immigrants had significantly higher rates of fair/poor SRH than US-born whites across the three survey waves. Reporting symptoms of serious psychological distress, older age (60+ years), current alcohol-drinking status, and having a family member with disability were the factors associated significantly with higher odds of reporting fair/poor SRH in Middle Eastern immigrants, whereas education was a protecting factor of fair/poor SRH.ConclusionsThis study indicates that Middle Eastern immigrants are one of the US immigrant populations that report poor health status, which reveals the need for health policy attention to reduce health disparities.

The precise measurement of the spectrum of protons, the most abundant component of the cosmic radiation, is necessary to understand the source and acceleration of cosmic rays in the Milky Way. This work reports the measurement of the cosmic ray proton fluxes with kinetic energies from 40 GeV to 100 TeV, with 2 1/2 years of data recorded by the DArk Matter Particle Explorer (DAMPE). This is the first time that an experiment directly measures the cosmic ray protons up to ~100 TeV with high statistics. The measured spectrum confirms the spectral hardening at ~300 GeV found by previous experiments and reveals a softening at ~13.6 TeV, with the spectral index changing from ~2.60 to ~2.85. Our result suggests the existence of a new spectral feature of cosmic rays at energies lower than the so-called knee and sheds new light on the origin of Galactic cosmic rays.

The precise measurement of the spectrum of protons, the most abundant component of the cosmic radiation, is necessary to understand the source and acceleration of cosmic rays in the Milky Way. This work reports the measurement of the cosmic ray proton fluxes with kinetic energies from 40 GeV to 100 TeV, with 2 1/2 years of data recorded by the DArk Matter Particle Explorer (DAMPE). This is the first time that an experiment directly measures the cosmic ray protons up to ~100 TeV with high statistics. The measured spectrum confirms the spectral hardening at ~300 GeV found by previous experiments and reveals a softening at ~13.6 TeV, with the spectral index changing from ~2.60 to ~2.85. Our result suggests the existence of a new spectral feature of cosmic rays at energies lower than the so-called knee and sheds new light on the origin of Galactic cosmic rays.

In order to effectively recover surface mass or geoid height changes from the gravity recovery and climate experiment (GRACE) time-variable gravity models, spatial smoothing is required to minimize errors from noise. Spatial smoothing, such as Gaussian smoothing, not only reduces the noise but also attenuates the real signals. Here we investigate possible amplitude attenuations and phase changes of seasonal water storage variations in four drainage basins (Amazon, Mississippi, Ganges and Zambezi) using an advanced global land data assimilation system. It appears that Gaussian smoothing significantly affects GRACE-estimated basin-scale seasonal water storage changes, e.g., in the case of 800 km smoothing, annual amplitudes are reduced by about 25-40%, while annual phases are shifted by up to 10°. With these effects restored, GRACE-estimated water storage changes are consistently larger than model estimates, indicating that the land surface model appears to underestimate terrestrial water storage change. Our analysis based on simulation suggests that normalized attenuation effects (from Gaussian smoothing) on seasonal water storage change are relatively insensitive to the magnitude of the true signal. This study provides a numerical approach that can be used to restore seasonal water storage change in the basins from spatially smoothed GRACE data. © Springer-Verlag 2006.

We estimate seasonal global mean sea level changes using different data resources, including sea level anomalies from satellite radar altimetry, ocean temperature and salinity from the World Ocean Atlas 2001, time-variable gravity observations from the Gravity Recovery and Climate Experiment (GRACE) mission, and terrestrial water storage and atmospheric water vapor changes from the NASA global land data assimilation system and National Centers for Environmental Prediction reanalysis atmospheric model. The results from all estimates are consistent in amplitude and phase at the annual period, in some cases with remarkably good agreement. The results provide a good measure of average annual variation of water stored within atmospheric, land, and ocean reservoirs. We examine how varied treatments of degree-2 and degree-1 spherical harmonics from GRACE, laser ranging, and Earth rotation variations affect GRACE mean sea level change estimates. We also show that correcting the standard equilibrium ocean pole tide correction for mass conservation is needed when using satellite altimeter data in global mean sea level studies. These encouraging results indicate that is reasonable to consider estimating longer-term time series of water storage in these reservoirs, as a way of tracking climate change. © Springer-Verlag 2005.